Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Sep 2:16:113.
doi: 10.1186/s12875-015-0324-8.

Evaluation of reliability and validity of the General Practice Physical Activity Questionnaire (GPPAQ) in 60-74 year old primary care patients

Shaleen Ahmad  1 , Tess Harris  2 , Elizabeth Limb  3 , Sally Kerry  4 , Christina Victor  5 , Ulf Ekelund  6   7 , Steve Iliffe  8 , Peter Whincup  9 , Carole Beighton  10 , Michael Ussher  11 , Derek G Cook  12
Affiliations

Evaluation of reliability and validity of the General Practice Physical Activity Questionnaire (GPPAQ) in 60-74 year old primary care patients

Shaleen Ahmad et al. BMC Fam Pract. .

Abstract

Background: GPPAQ (General Practice Physical Activity Questionnaire) is a self-assessment physical activity questionnaire widely used in primary care. Reliability and validity data in older people are lacking. The study aims were: to assess GPPAQ's reliability and validity in 60-74 year olds from the PACE-Lift (Pedometer Accelerometer Consultation Evaluation-Lift) physical activity trial; and to assess whether adding brisk walking to the GPPAQ score improves its validity when assessing if physical activity guidelines are being met.

Method: Physical activity was assessed objectively by accelerometry and by self-report GPPAQ over one week periods at baseline, and three and twelve months later, in 60-74 year old participants from three United Kingdom general practices enrolled in PACE-Lift. Reliability: GPPAQ scores in controls (n = 148) were compared for repeatability at baseline, 3 and 12 months.

Validity: we compared the GPPAQ "active" rating (those not requiring physical activity advice) with those achieving physical activity guidelines using accelerometry, in all baseline subjects (n = 298). Using accelerometry as an objective comparator, GPPAQ sensitivity and specificity were calculated and repeated after adding brisk walking into the GPPAQ score (GPPAQ-WALK).

Results: For reliability, GPPAQ showed 56 % (70/126) and 67 % (87/129) of controls scored the same at 3 and 12 months respectively, as they scored at baseline. At baseline 24 % (69/289) achieved physical activity guidelines according to accelerometry, whilst 16 % (47/289) were classified as GPPAQ "active". GPPAQ had 19 % (13/69) sensitivity and 85 % (186/220) specificity. GPPAQ-WALK had 39 % (27/69) sensitivity and 70 % (155/220) specificity.

Conclusions: GPPAQ has reasonable reliability but results from this study measuring validity in older adults indicates poor agreement with objective accelerometry for accurately identifying physical activity levels. Including brisk walking in GPPAQ increased sensitivity, but reduced specificity and did not improve overall screening performance. GPPAQ's use in National Health Service health checks in primary care in this age group cannot therefore be supported by this validity study comparing to accelerometry.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Modified from PACE-Lift Protocol [14]. All participants wore an accelerometer for 7 days and completed the GPPAQ questionnaire at each time point (baseline, 3 months and 12 months)
Fig. 2
Fig. 2
Summary of the GPPAQ Physical Activity Index Scoring [5]
See this image and copyright information in PMC

References

    1. Department of Health: Start Active, Stay Active . A report on physical activity from the four home countries’ Chief Medical Officers. 2011.
    1. Scarborough P, Bhatnagar P, Wickramasinghe KK, Allender S, Foster C, Rayner M. The economic burden of ill health due to diet, physical inactivity, smoking, alcohol and obesity in the UK: an update to 2006–07 NHS costs. J Public Health. 2011;33:527–535. doi: 10.1093/pubmed/fdr033. - DOI - PubMed
    1. Anokye NK, Lord J, Fox-Rushby J. Is brief advice in primary care a cost-effective way to promote physical activity? Br J Sports Med. 2014;48:202–206. doi: 10.1136/bjsports-2013-092897. - DOI - PMC - PubMed
    1. Physical activity: brief advice for adults in primary care [http://www.nice.org.uk/guidance/PH44]
    1. Department of Health. The General Practice Physical Activity Questionnaire: A Screening tool to assess adult physical activity levels, within primary care. 2009 [https://www.gov.uk/government/uploads/system/uploads/attachment_data/fil...]

Publication types

LinkOut - more resources