Validity, reliability, and calibration of the physical activity unit 7 item screener (PAU7S) at population scale

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2021Author
Schröder, Helmut
Subirana Cachinero, Isaac
Wärnberg, Julia
Medrano, María
González-Gross, Marcela
Gusi, Narcis
Aznar, Susana
Alcaraz, Pedro E.
González-Valeiro, Miguel A.
Serra-Majem, Lluis
Terrados, Nicolás
Tur, Josep A.
Segú, Marta
Homs, Clara
Garcia-Álvarez, Alicia
Benavente-Marín, Juan C.
Barón-López, F. Javier
Labayen, Idoia
Zapico, Augusto G.
Sánchez-Gómez, Jesús
Jiménez-Zazo, Fabio
Marín-Cascales, Elena
Sevilla-Sanchez, Marta
Herrera-Ramos, Estefanía
Pulgar, Susana
Bibiloni, María del Mar
Sistac-Sorigué, Clara
Suggested citation
Schröder, Helmut;
Subirana Cachinero, Isaac;
Wärnberg, Julia;
Medrano, María;
González-Gross, Marcela;
Gusi, Narcis;
...
Gómez Santos, Santiago Felipe.
(2021)
.
Validity, reliability, and calibration of the physical activity unit 7 item screener (PAU7S) at population scale.
International Journal of Behavioral Nutrition and Physical Activity, 2021, vol. 18, article 98.
https://doi.org/10.1186/s12966-021-01169-w.
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Show full item recordAbstract
Background
Validation of self-reported tools, such as physical activity (PA) questionnaires, is crucial. The aim of this study was to determine test-retest reliability, internal consistency, and the concurrent, construct, and predictive validity of the short semi-quantitative Physical Activity Unit 7 item Screener (PAU-7S), using accelerometry as the reference measurement. The effect of linear calibration on PAU-7S validity was tested.
Methods
A randomized sample of 321 healthy children aged 8–16 years (149 boys, 172 girls) from the nationwide representative PASOS study completed the PAU-7S before and after wearing an accelerometer for at least 7 consecutive days. Weight, height, and waist circumference were measured. Cronbach alpha was calculated for internal consistency. Test-retest reliability was determined by intra-class correlation (ICC). Concurrent validity was assessed by ICC and Spearman correlation coefficient between moderate to vigorous PA (MVPA) derived by the PAU-7S and by accelerometer. Concordance between both methods was analyzed by absolute agreement, weighted kappa, and Bland-Altman statistics. Multiple linear regression models were fitted for construct validity and predictive validity was determined by leave-one-out cross-validation.
Results
The PAU-7S overestimated MVPA by 18%, compared to accelerometers (106.5 ± 77.0 vs 95.2 ± 33.2 min/day, respectively). A Cronbach alpha of 0.76 showed an acceptable internal consistency of the PAU-7S. Test-retest reliability was good (ICC 0.71 p < 0.001). Spearman correlation and ICC coefficients of MVPA derived by the PAU-7S and accelerometers increased from 0.31 to 0.62 and 0.20 to 0.62, respectively, after calibration of the PAU-7S. Between-methods concordance improved from a weighted kappa of 0.24 to 0.50 after calibration. A slight reduction in ICC, from 0.62 to 0.60, yielded good predictive validity. Multiple linear regression models showed an inverse association of MVPA with standardized body mass index (β − 0.162; p < 0.077) and waist to height ratio (β − 0.010; p < 0.014). All validity dimensions were somewhat stronger in boys compared to girls.
Conclusion
The PAU-7S shows a good test-retest reliability and acceptable internal consistency. All dimensions of validity increased from poor/fair to moderate/good after calibration. The PAU-7S is a valid instrument for measuring MVPA in children and adolescents.
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International Journal of Behavioral Nutrition and Physical Activity, 2021, vol. 18, article 98European research projects
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