title: Reliability and validity of a new physical activity questionnaire for India.
abstract: BACKGROUND
  Measurement of physical activity in epidemiological studies requires tools which are reliable, valid and culturally relevant. We attempted to develop a physical activity questionnaire (PAQ) that would measure physical activity in various domains over a year and which would be valid for use in adults of different age groups with varying levels of activity in urban and rural settings in low and middle income countries like India. The present paper aims to assess the reliability and validity of this new PAQ- termed the Madras Diabetes Research Foundation- Physical Activity Questionnaire (MPAQ).
  
  
  METHODS
  The MPAQ was administered by trained interviewers to 543 individuals of either gender aged 20 years and above from urban and rural areas in 10 states of India from May to August 2011, followed by a repeat administration within a month for assessing reliability. Relative validity was performed against the Global Physical Activity Questionnaire (GPAQ). Construct validity was tested by plotting time spent in sitting and moderate and vigorous physical activity (MVPA) against body-mass index (BMI) and waist circumference. Criterion validity was assessed using the triaxial accelerometer, in a separate subset of 103 individuals. Bland and Altman plots were used to assess the agreement between MPAQ and accelerometer.
  
  
  RESULTS
  The interclass correlation coefficients (ICC) for total energy expenditure and physical activity levels were 0.82 and 0.73 respectively, between baseline and 1st month. The ICC between GPAQ and the MPAQ was 0.40 overall. The construct validity of the MPAQ showed linear association between sitting and MVPA, and BMI and waist circumference independent of age and gender. The Spearman's correlation coefficients for sedentary activity, MVPA and overall PA for MPAQ against the accelerometer were 0.48 (95%CI-0.32-0.62), 0.44 (0.27-0.59) and 0.46 (0.29-0.60) respectively. Bland and Altman plots showed good agreement between MPAQ and accelerometer for sedentary behavior and fair agreement for MVPA.
  
  
  CONCLUSIONS
  The MPAQ is an acceptable, reproducible and valid instrument, which captures data from multiple activity domains over the period of a year from adults of both genders and varying ages in various walks of life residing in urban and rural India.
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 6B, Conran Smith Road, Gopalapuram, 600086, Chennai, India. dranjana@drmohans.com.
authors.forename: Ranjit Mohan
authors.initials: RM
authors.lastname: Anjana
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 6B, Conran Smith Road, Gopalapuram, 600086, Chennai, India. s2r_7@mdrf.in.
authors.forename: Vasudevan
authors.initials: V
authors.lastname: Sudha
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 6B, Conran Smith Road, Gopalapuram, 600086, Chennai, India. lakshmipriya@mdrf.in.
authors.forename: Nagarajan
authors.initials: N
authors.lastname: Lakshmipriya
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 6B, Conran Smith Road, Gopalapuram, 600086, Chennai, India. subhashini.mdrf@gmail.com.
authors.forename: Sivasankaran
authors.initials: S
authors.lastname: Subhashini
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 6B, Conran Smith Road, Gopalapuram, 600086, Chennai, India. guhapradeepa@gmail.com.
authors.forename: Rajendra
authors.initials: R
authors.lastname: Pradeepa
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 6B, Conran Smith Road, Gopalapuram, 600086, Chennai, India. drgeetha73@gmail.com.
authors.forename: Loganathan
authors.initials: L
authors.lastname: Geetha
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 6B, Conran Smith Road, Gopalapuram, 600086, Chennai, India. ramya@mdrf.in.
authors.forename: Mookambika Ramya
authors.initials: MR
authors.lastname: Bai
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 6B, Conran Smith Road, Gopalapuram, 600086, Chennai, India. gayathri@mdrf.in.
authors.forename: Rajagopal
authors.initials: R
authors.lastname: Gayathri
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 6B, Conran Smith Road, Gopalapuram, 600086, Chennai, India. deepa.mohan1@gmail.com.
authors.forename: Mohan
authors.initials: M
authors.lastname: Deepa
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 6B, Conran Smith Road, Gopalapuram, 600086, Chennai, India. drranjit@drmohans.com.
authors.forename: Ranjit
authors.initials: R
authors.lastname: Unnikrishnan
authors.affiliation: Department of Statistics, Manipal University, Manipal, 576104, Karnataka, India. binu.vs@manipal.edu.
authors.forename: Valsalakumari Sreekumaran Nair
authors.initials: VS
authors.lastname: Binu
authors.affiliation: Department of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, 560 034, Karnataka, India. a.kurpad@sjri.res.in.
authors.forename: Anura V
authors.initials: AV
authors.lastname: Kurpad
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 6B, Conran Smith Road, Gopalapuram, 600086, Chennai, India. drmohans@diabetes.ind.in.
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Mohan
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015444:Exercise; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D057185:Sedentary Behavior; D011795:Surveys and Questionnaires / Q000592:standards*; D013995:Time; D055105:Waist Circumference