title: Validity of electronically administered Recent Physical Activity Questionnaire (RPAQ) in ten European countries.
abstract: OBJECTIVE
  To examine the validity of the Recent Physical Activity Questionnaire (RPAQ) which assesses physical activity (PA) in 4 domains (leisure, work, commuting, home) during past month.
  
  
  METHODS
  580 men and 1343 women from 10 European countries attended 2 visits at which PA energy expenditure (PAEE), time at moderate-to-vigorous PA (MVPA) and sedentary time were measured using individually-calibrated combined heart-rate and movement sensing. At the second visit, RPAQ was administered electronically. Validity was assessed using agreement analysis.
  
  
  RESULTS
  RPAQ significantly underestimated PAEE in women [median(IQR): 34.9 (22.3, 52.8) vs. 40.6 (32.4, 50.9) kJ/kg/day, 95%LoA: -44.4, 66.1 kJ/kg/day) and overestimated PAEE in men [45.9 (30.6, 71.1) vs. 45.5 (34.1, 57.6) kJ/kg/day, 95%LoA: -44.8, 102.6 kJ/kg/day]. Using individualised definition of 1MET, RPAQ significantly underestimated MVPA in women [median(IQR): 63.7 (30.5, 126.9) vs. 73.6 (47.8, 107.2) min/day, 95%LoA: -127.4, 311.9 min/day] and overestimated MVPA in men [90.0 (42.3, 188.6) vs. 83.3 (55.1, 125.0) min/day, 95%LoA: -134.8, 427.3 min/day]. Correlations (95%CI) between subjective and objective estimates were statistically significant [PAEE: women, rho = 0.20 (0.15-0.26); men, rho = 0.37 (0.30-0.44); MVPA: women, rho = 0.18 (0.13-0.24); men, rho = 0.31 (0.24-0.38)]. When using non-individualised definition of 1MET (3.5 mlO2/kg/min), MVPA was substantially overestimated (16 min/day, and 32 min/day in women and men, respectively). Revisiting occupational intensity assumptions in questionnaire estimation algorithms with occupational group-level empirical distributions reduced median PAEE-bias in manual (38.8 kJ/kg/day vs. 6.8 kJ/kg/day, p<0.001) and heavy manual workers (63.6 vs. -2.8 kJ/kg/day, p<0.001) in an independent hold-out sample [corrected].
  
  
  CONCLUSIONS
  Relative validity of RPAQ-derived PAEE and MVPA is comparable to previous studies but underestimation of PAEE is smaller. Electronic RPAQ may be used in large-scale epidemiological studies including surveys, providing information on all domains of PA.
authors.affiliation: MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Rajna
authors.initials: R
authors.lastname: Golubic
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Anne M
authors.initials: AM
authors.lastname: May
authors.affiliation: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.
authors.forename: Kristin
authors.initials: K
authors.lastname: Benjaminsen Borch
authors.affiliation: Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark and Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.affiliation: Inserm, Centre for research in Epidemiology and Population Health, U1018, Lifelong epidemiology of obesity, diabètes and chronic renal disease Team, F-94807, Villejuif, France; Univ Paris-Sud, UMRS 1018, F-94807, Villejuif, France.
authors.forename: Marie-Aline
authors.initials: MA
authors.lastname: Charles
authors.affiliation: Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department Sociosanitary Sciences, Murcia School of Medicine, Murcia, Spain.
authors.forename: Maria Jose Tormo
authors.initials: MJ
authors.lastname: Diaz
authors.affiliation: Subdirección de Salud Pública de Gipuzkoa, Gobierno Vasco, San Sebastian, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Amiano
authors.affiliation: Molecular and Nutritional Epidemiology Unit, ISPO, Cancer Prevention and Research Institute, Florence, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.affiliation: Hellenic Health Foundation (HHF), Athens, Greece.
authors.forename: Elisavet
authors.initials: E
authors.lastname: Valanou
authors.affiliation: Department of Epidemiology, Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke, Nuthetal, Germany.
authors.forename: Matthaeus
authors.initials: M
authors.lastname: Vigl
authors.affiliation: Department of Clinical Sciences, Genetic & Molecular Epidemiology Unit, Skåne University Hospital, Lund University, Malmö, Sweden; Genetic Epidemiology & Clinical Research Group, Department of Public Health & Clinical Medicine, Section for Medicine, Umeå University, Umeå, Sweden.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Franks
authors.affiliation: MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Wareham
authors.affiliation: MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Ulf
authors.initials: U
authors.lastname: Ekelund
authors.affiliation: MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Soren
authors.initials: S
authors.lastname: Brage
mesh_terms: D000328:Adult; D004734:Energy Metabolism; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011795:Surveys and Questionnaires