Physical activity surveillance in the European Union: reliability and validity of the European Health Interview Survey-Physical Activity Questionnaire (EHIS-PAQ)

Current lifestyles are marked by sedentary behaviour; thus, it is of great importance for policymaking to have valid and reliable tools to measure sedentary behaviour in order to combat it. Therefore, the aim of this review and meta-analysis is to critically review, assess, and compile the reliability, criterion validity, and construct validity of the single-item sedentary behaviour questions within national language versions of most commonly used international physical activity questionnaires for adults in the European Union: The International Physical Activity Questionnaire-Short Form and the Global Physical Activity Questionnaire. A total of 1749 records were screened, 287 full-text papers were read, and 14 studies were included in the meta-analysis. The results and quality of studies were evaluated by the Quality Assessment of Physical Activity Questionnaires checklist. Meta-analysis indicated moderate to high reliability (rw = 0.59) and concurrent validity (rw = 0.55) of national language versions of single-item sedentary behaviour questions. Criterion validity was rather low (rw = 0.23) but in concordance with previous studies. The risk of bias analysis highlighted the poor reporting of methods and results, with a total bias score of 0.42. Thus, we recommend using multi-item SB questionnaires and smart trackers for providing information on SB rather than single-item sedentary behaviour questions in physical activity questionnaires.

Download Full-text

Health-Enhancing Physical Activity in Europe—Combined Aerobic Physical Activity and Muscle-Strengthening Exercise Guideline Adherence Among 280,605 Adults From 28 European Countries

Journal of Physical Activity and Health ◽

10.1123/jpah.2021-0349 ◽

2021 ◽

pp. 1-7

Author(s):

Jason A. Bennie ◽

Glen H. Wiesner

Keyword(s):

Physical Activity ◽

Guideline Adherence ◽

European Countries ◽

Muscle Strengthening ◽

Health Interview Survey ◽

Health Interview ◽

Strengthening Exercise ◽

Interview Survey ◽

European Health ◽

European Health Interview Survey

Background: Compared with engaging in aerobic physical activity (aerobic PA; eg, walking, running, cycling) or muscle-strengthening exercise (MSE; eg, weight/resistance training) alone, epidemiological evidence suggests that combining both is linked to better health. However, the assessment of both PA modes is rare in health surveillance. This article provides the first multicountry study on the descriptive epidemiology of combined moderate to vigorous PA–MSE guideline adherence. Methods: Data were drawn from the European Health Interview Survey wave 2 (2013–2014), comprising samples from 28 European countries (n = 280,605). Self-reported aerobic PA and MSE were assessed using the validated European Health Interview Survey Physical Activity Questionnaire. The authors calculated the weighted proportions meeting the health-enhancing PA guideline (aerobic PA ≥ 150 min/wk and MSE ≥ 2 sessions/wk). Poisson regression assessed the prevalence ratios for meeting the combined guideline across sociodemographic factors and by country. Results: A total of 15.0% met the health-enhancing PA guideline. The lowest prevalence was from respondents from Southern and Central European countries (Romania, Poland, and Croatia, range: 0.5%–5.7%). Poorer self-rated health, older age, lower income, being female, and being obese had a lower likelihood of meeting the combined guideline. Conclusions: Most European adults do not meet the health-enhancing PA guideline that includes both aerobic PA and MSE.

Download Full-text

Reliability and Validity of Slovenian Versions of IPAQ-SF, GPAQ and EHIS-PAQ for Assessing Physical Activity and Sedentarism of Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19010430 ◽

2021 ◽

Vol 19 (1) ◽

pp. 430

Author(s):

Kaja Meh ◽

Vedrana Sember ◽

Saša Đurić ◽

Henri Vähä-Ypyä ◽

Paulo Rocha ◽

...

Keyword(s):

Physical Activity ◽

Sedentary Behavior ◽

Short Form ◽

High Reliability ◽

Reliability And Validity ◽

Qualitative Assessment ◽

Health Related ◽

Interview Survey ◽

European Health ◽

European Health Interview Survey

Health policies rely on physical activity (PA) and sedentary behavior data collected through PA questionnaires (PAQs). Validity of international PAQs varies among countries. Therefore, it is important to know the validity of the national versions of the PAQs to properly evaluate the results. We conducted a validation study of the Slovenian versions of the International PAQ Short Form (IPAQ-SF), the Global PAQ (GPAQ), and the PAQ used in the European Health Interview Survey (EHIS-PAQ) on 306 healthy adults. The most valid and reliable constructs in all tested were sedentary behavior and vigorous PA (VPA), however the criterion validity of these constructs was low (Spearman’s ρ 0.38–0.45 for sedentary behavior and 0.34–0.42 for VPA). Moderate to vigorous PA (MVPA) had low validity (0.26–0.29) despite being used as a standard measure of PA behavior. Participants over-reported MVPA for 17 to 156 min and underreported the sedentary behavior for more than two hours. The test-retest study found high reliability for sedentary behavior (0.69–0.81) and low to moderate reliability for PA behavior (0.42–0.76). The Slovenian versions of the observed PAQs are a useful tool for national PA surveillance, but for qualitative assessment of individual health-related PA behavior they should be combined with accelerometer-based devices.

Download Full-text

The epidemiology of muscle-strengthening exercise in Europe: A 28-country comparison including 280,605 adults

PLoS ONE ◽

10.1371/journal.pone.0242220 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0242220

Author(s):

Jason A. Bennie ◽

Katrien De Cocker ◽

Jordan J. Smith ◽

Glen H. Wiesner

Keyword(s):

Physical Activity ◽

European Countries ◽

Muscle Strengthening ◽

Health Interview Survey ◽

Self Rated Health ◽

Health Interview ◽

Strengthening Exercise ◽

Interview Survey ◽

European Health ◽

European Health Interview Survey

Objective Muscle-strengthening exercise (use of weight machines, free weights, push-ups, sit-ups), has multiple independent health benefits, and is a component of the Global physical activity guidelines. However, there is currently a lack of multi-country muscle-strengthening exercise prevalence studies. This study describes the prevalence and correlates of muscle-strengthening exercise across multiple European countries. Methods Data were drawn from the European Health Interview Survey Wave 2 (2013–14), which included nationally representative samples (n = 3,774–24,016) from 28 European countries. Muscle-strengthening exercise was assessed using the European Health Interview Survey Physical Activity Questionnaire. Population-weighted proportions were calculated for (1) “insufficient” (0–1 days/week) or (2) “sufficient” muscle-strengthening exercise (≥2 days/week). Prevalence ratios were calculated using multivariate Poisson regression for those reporting sufficient muscle-strengthening by country and by sociodemographic/lifestyle characteristics (sex, age, education, income, self-rated health etc.). Results Data were available for 280,605 European adults aged ≥18 years. Overall, 17.3% (95% CI = 17.1%-17.5%) reported sufficient muscle-strengthening exercise (≥2 days/week). Muscle-strengthening exercise was geographically patterned with the lowest prevalence reported in South-eastern European countries (Romania, Malta and Cyprus: range: 0.7%-7.4%), and the highest prevalence in the Nordic countries (Iceland, Sweden, and Denmark: range: 34.1%-51.6%). Older age, insufficient aerobic activity, poorer self-rated health, lower income/education, being female, and being overweight/obese were significantly associated with lower likelihood of reporting sufficient muscle-strengthening exercise, independently of other characteristics. Conclusions Most European adults do not report sufficient muscle-strengthening exercise, and prevalence estimates varied considerably across countries. Low participation in muscle-strengthening exercise is widespread across Europe, and warrants public health attention.

Download Full-text

Diabetes Mellitus and Associated Factors in Slovakia: Results from the European Health Interview Survey 2009, 2014, and 2019

Nutrients ◽

10.3390/nu13072156 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2156

Author(s):

Nour Mahrouseh ◽

Carlos Alexandre Soares Andrade ◽

Nóra Kovács ◽

Diana Wangeshi Njuguna ◽

Orsolya Varga

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Communicable Disease ◽

Bivariate Analysis ◽

Inverse Association ◽

Health Interview Survey ◽

Health Interview ◽

Interview Survey ◽

European Health ◽

European Health Interview Survey

Diabetes mellitus (DM) is a high-risk non-communicable disease with an emerging burden for the European Union (EU) member states in the past decades. The unfavorable trend of the burden is striking compared to the declining disease burden due to cardiovascular diseases or stagnation of neoplasms. The goal of this study is to describe the temporal changes of diabetes in the adult population of Slovakia through the three European Health Interview Survey (EHIS) waves and to assess the association between DM and socioeconomic and/or lifestyle characteristics. These cross-sectional studies were carried out using microdata derived from Slovakia’s EHISs conducted in the years 2009 (n = 4972), 2014 (n = 5490), and 2019 (n = 5527). The DM variable was compared to the independent variables such as sociodemographic and lifestyle characteristics including dietary patterns and physical activity. DM prevalence for the EHIS in 2009, 2014, and 2019 were 6.1%, 8.2%, and 9.8%, respectively. In bivariate analysis, the relationship between DM and age, education level, job status, BMI, walking for at least 10 min, and physical activity was significant in the three EHISs. In 2014 and 2019, there was an inverse association between the risk of DM and walking regularly. There was no association between the frequency of eating fruits or vegetables and DM, with the exception of 2009, where a negative association between eating vegetables one to six times a week and DM was observed. Present health policies and activities in Slovakia were unable to reverse the increasing DM burden, indicating that a more systematic approach is needed. Complex policy strategies and legislative measures must be developed and implemented at both the national and EU levels.

Download Full-text