title: Understanding and interpreting the concept of physical activity -- a focus group study among Swedish women.
abstract: OBJECTIVE
  Strong epidemiological evidence indicates that physical activity is highly beneficial for health. To follow physical activity trends and correctly target interventions, feasible, reliable and valid assessment methods are needed. This paper examines Swedish women's understanding and interpretations of the concepts of physical activity and exercise, as well as different intensity modifiers used in the International Physical Activity Questionnaire (IPAQ).
  
  
  METHODS
  Four focus group discussions were conducted with 27 women in total aged 35 to 69 (median = 52). Responses and accompanying discussion were analysed according to the principles for qualitative content analysis including both manifest and latent content in the text.
  
  
  RESULTS
  Understanding of physical activity and exercise depends on differences in people's experiences. The women felt physical activity and exercise were different concepts, but ultimately agreed that physical activity and exercise were terms along a continuum of movement experiences, from informal to formal settings. The interpretations of the intensity modifiers ;;moderate'' and ;;vigorous'' were close to the formal definitions in IPAQ. However the Swedish terms ;;mattligt anstraöngande'' (moderate intensity) and ''mycket anstraöngande'' (vigorous intensity) are the best possible terms and should be used in IPAQ.
  
  
  CONCLUSIONS
  There are different interpretations of the meaning of the key concepts in IPAQ that must be considered. The use of a qualitative approach when developing physical activity questionnaires can lead to more feasible, reliable and valid assessment methods as well as a clearer message for health-enhancing physical activity recommendations.
authors.affiliation: Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden. isabel.johnson@ki.se
authors.forename: Isabel
authors.initials: I
authors.lastname: Johnson
authors.forename: Per
authors.initials: P
authors.lastname: Tillgren
authors.forename: Maria
authors.initials: M
authors.lastname: Hagströmer
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D015444:Exercise / Q000502:physiology / Q000523:psychology; D005260:Female; D017144:Focus Groups; D006293:Health Promotion; D006801:Humans; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D011795:Surveys and Questionnaires; D013548:Sweden; D016387:Women's Health