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Medicine & Science in Sports & Exercise:
BASIC SCIENCES: Epidemiology

International Physical Activity Questionnaire: 12-Country Reliability and Validity

CRAIG, CORA L.1; MARSHALL, ALISON L.2; SJÖSTRÖM, MICHAEL3; BAUMAN, ADRIAN E.4; BOOTH, MICHAEL L.5; AINSWORTH, BARBARA E.6; PRATT, MICHAEL7; EKELUND, ULF3; YNGVE, AGNETA3; SALLIS, JAMES F.8; OJA, PEKKA9

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Abstract

CRAIG, C. L., A. L. MARSHALL, M. SJÖSTRÖM, A. E. BAUMAN, M. L. BOOTH, B. E. AINSWORTH, M. PRATT, U. EKELUND, A. YNGVE, J. F. SALLIS, and P. OJA. International Physical Activity Questionnaire: 12-Country Reliability and Validity. Med. Sci. Sports Exerc., Vol. 35, No. 8, pp. 1381–1395, 2003.

Background: Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity.

Methods: Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the “last 7 d” or a “usual week” of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman’s correlation coefficients are reported, based on the total reported physical activity.

Results: Overall, the IPAQ questionnaires produced repeatable data (Spearman’s ρ clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median ρ of about 0.30, which was comparable to most other self-report validation studies. The “usual week” and “last 7 d” reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode.

Conclusions: The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form “last 7 d recall” is recommended for national monitoring and the long form for research requiring more detailed assessment.

Physical inactivity is now considered a global health concern, but no standardized approaches to measurement exist, and international comparisons and global surveillance are difficult (3,10,11). In 1996, one of the authors (MLB) initiated an international effort to develop comparable measures, and this was followed by the development of an International Consensus Group, which met in Geneva in 1998. The objective was to develop a self-reported measure of physical activity suitable for assessing population levels of physical activity across countries.

Initial pilot testing occurred during 1998–1999, and eight versions of the International Physical Activity Questionnaire (IPAQ) were developed, with four short and four long versions of the questionnaire. These could be administered by telephone interview or self-administration. There were two different reference periods under investigation, either the “last 7 d” or a “usual week” (see Appendix A, Table 1). To determine the measurement properties of these questionnaires, a reliability and validity study was carried out in 14 centers in 12 countries during 2000 (see Appendix A, Table 2 for country codes). This paper reports on the international reliability and validity study of the IPAQ instruments, in an effort to determine the suitability of different forms of the IPAQ instrument for international physical activity surveillance.

Table 1
Table 1
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Table 2
Table 2
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©2003The American College of Sports Medicine

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