The validity and reliability of a home environment preschool-age physical activity questionnaire (Pre-PAQ)

Int J Behav Nutr Phys Act. 2011 Aug 4;8:86. doi: 10.1186/1479-5868-8-86.


Background: There is a need for valid population level measures of physical activity in young children. The aim of this paper is to report the development, and the reliability and validity, of the Preschool-age Children's Physical Activity Questionnaire (Pre-PAQ) which was designed to measure activity of preschool-age children in the home environment in population studies.

Methods: Pre-PAQ was completed by 103 families, and validated against accelerometry for 67 children (mean age 3.8 years, SD 0.74; males 53%). Pre-PAQ categorizes activity into five progressive levels (stationary no movement, stationary with limb or trunk movement, slow, medium, or fast-paced activity). Pre-PAQ Levels 1-2 (stationary activities) were combined for analyses. Accelerometer data were categorized for stationary, sedentary (SED), non-sedentary (non-SED), light (LPA), moderate (MPA) and vigorous (VPA) physical activity using manufacturer's advice (stationary) or the cut-points described by Sirard et al and Reilly et al. Bland-Altman methods were used to assess agreement between the questionnaire and the accelerometer measures for corresponding activity levels. Reliability of the Pre-PAQ over one week was determined using intraclass correlations (ICC) or kappa (κ) values and percentage of agreement of responses between the two questionnaire administrations.

Results: Pre-PAQ had good agreement with LPA (mean difference 1.9⁻¹) and VPA (mean difference -4.8⁻¹), was adequate for stationary activity (mean difference 7.6⁻¹) and poor for sedentary activity, whether defined using the cut-points of Sirard et al (mean difference -235.4⁻¹) or Reilly et al (mean difference -208.6⁻¹) cut-points. Mean difference between the measures for total activity (i.e. Reilly's non-sedentary or Sirard's LMVPA) was 20.9⁻¹ and 45.2⁻¹. The limits of agreement were wide for all categories. The reliability of Pre-PAQ question responses ranged from 0.31-1.00 (ICC (2, 1)) for continuous measures and 0.60-0.97 (κ) for categorical measures.

Conclusions: Pre-PAQ has acceptable validity and reliability and appears promising as a population measure of activity behavior but it requires further testing on a more broadly representative population to affirm this. Pre-PAQ fills an important niche for researchers to measure activity in preschool-age children and concurrently to measure parental, family and neighborhood factors that influence these behaviors.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Child, Preschool
  • Female
  • Humans
  • Male
  • Motor Activity*
  • Reproducibility of Results
  • Sedentary Behavior
  • Self Report
  • Social Environment
  • Socioeconomic Factors
  • Surveys and Questionnaires*