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Comparability of the Netherlands Physical Activity Questionnaire with accelerometer-measured physical activity in Samoan children: a retrospective analysis of Ola Tuputupua’e data

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posted on 2021-10-07, 15:21 authored by Clara R Warmath, Courtney C Choy, Elizabeth A Frame, Lauren SherarLauren Sherar, Rachel L Duckham, Christina Soti-Ulberg, Take Naseri, Muagututia S Reupena, Nicola L Hawley
Accurate measurement of physical activity is critical to understand its role in cardiometabolic health and obesity development in children and to monitor trends in behavior and evaluate interventions. An ongoing mixed-longitudinal study of child growth and development in Samoa is collecting physical activity data with both accelerometers and the Netherlands Physical Activity Questionnaire (NPAQ). The aims of our analyses were to (1) describe the response frequency and correlations of individual questions in the NPAQ, (2) develop modified NPAQ scores with selected questions and (3) examine the concordance of modified NPAQ scores with accelerometer outcomes among children aged 2–4 years. We developed two modified NPAQ scores with combinations of questions and assessed concordance of the modified scores with accelerometer data using estimated marginal means adjusted for monitor wear time. Although the evenly distributed tertiles of the modified 15-point NPAQ score showed promising trends of increasing minutes of accelerometer-assessed high-intensity physical activity with increasing tertile, the estimated marginal means were imprecise with high variance, demonstrating that NPAQ score could not accurately assess physical activity levels of preschool-aged children in Samoa. Considering that questionnaires are often considered more cost-effective tools for physical activity measurement than accelerometry, further research is necessary to develop a culturally and age-appropriate physical activity questionnaire in this population.


The Ola Tuputupua’e study received financial support from the following sources: Yale School of Public Health (Faculty Funding, David Dull Internship Fund, Jan A.J. Stolwijk Fellowship Fund, Yale Downs International Health Student Travel Fellowship, Thomas C. Barry Travel Fellowship), US National Institutes of Health (NIH) Minority and Health Disparities International Research Training Program (NIMHD T37MD008655), U.S. Fulbright Graduate Student Research Fellowship, Brown University School of Public Health (International Health Institute, Nora Kahn Award, and Framework in Global Health Program) and Brown University Population Studies and Training Center, which receives funding from the NIH for training (T32 HD007338) and general support (P2C HD041020). While writing this publication, C.R.W. was supported by a Brown University Undergraduate Teaching and Research Award. C.C.C. was supported by the Brown-Yale IvyPlus Exchange Scholar Program, NIH National Lung, Health, Blood Institute (NIH 1F31HL147414), and the Fogarty Global Health Equity Scholars Program (FIC D43TW010540). N.L.H. was supported by NIH R01HL140570.



  • Sport, Exercise and Health Sciences

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International Journal of Environmental Research and Public Health








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This is an Open Access Article. It is published by MDPI under the Creative Commons Attribution 4.0 International Licence (CC BY 4.0). Full details of this licence are available at: https://creativecommons.org/licenses/by/4.0/

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Prof Lauren Sherar. Deposit date: 7 October 2021

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