Ahmad Shaleen, Harris Tess, Limb Elizabeth, Kerry Sally, Victor Christina, Ekelund Ulf, Iliffe Steve, Whincup Peter, Beighton Carole, Ussher Michael, Cook Derek G
Population Health Research Institute, St George's University of London, Cranmer Terrace, SW17 0RE, UK.
Pragmatic Clinical Trials Unit, QMUL, London, UK.
BMC Fam Pract. 2015 Sep 2;16:113. doi: 10.1186/s12875-015-0324-8.
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.
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.
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).
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.
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.
全科医疗身体活动问卷（GPPAQ）是一种在初级医疗中广泛使用的自我评估身体活动问卷。目前缺乏老年人中的可靠性和有效性数据。本研究的目的是：评估GPPAQ在PACE-Lift（计步器加速度计咨询评估-提升）身体活动试验中60至74岁人群中的可靠性和有效性；以及评估在评估是否达到身体活动指南时，将快走纳入GPPAQ评分是否能提高其有效性。
在基线、三个月和十二个月时，通过加速度计和自我报告的GPPAQ对来自英国三家参与PACE-Lift的全科医疗诊所的60至74岁参与者进行为期一周的身体活动客观评估。可靠性：比较对照组（n = 148）在基线、3个月和12个月时GPPAQ评分的重复性。
在所有基线受试者（n = 298）中，我们将GPPAQ的“活跃”评级（那些不需要身体活动建议的人）与通过加速度计达到身体活动指南的人进行比较。以加速度计作为客观比较器，计算GPPAQ的敏感性和特异性，并在将快走纳入GPPAQ评分（GPPAQ-WALK）后重复计算。
对于可靠性，GPPAQ显示分别有56%（70/126）和67%（87/129）的对照组在3个月和12个月时的得分与基线时相同。在基线时，根据加速度计有24%（69/289）的人达到身体活动指南，而16%（47/289）被归类为GPPAQ“活跃”。GPPAQ的敏感性为19%（13/69），特异性为85%（186/220）。GPPAQ-WALK的敏感性为39%（27/69），特异性为70%（155/220）。
GPPAQ具有合理的可靠性，但本研究中测量老年人有效性的结果表明，在准确识别身体活动水平方面，与客观加速度计的一致性较差。将快走纳入GPPAQ增加了敏感性，但降低了特异性，且未改善整体筛查性能。因此，与加速度计比较的这项有效性研究不支持在该年龄组的初级医疗中，将GPPAQ用于国民健康服务健康检查。
