Development and validation of the Global Adolescent and Child Physical Activity Questionnaire (GAC- PAQ) in 14 countries: study protocol

Abstract

Abstract Introduction: Global surveillance of physical activity (PA) of children and adolescents with questionnaires is limited by the use of instruments developed in high- income countries (HICs) lacking sociocultural adaptation, especially in low- and middle- income countries (LMICs); under- representation of some PA domains; and omission of active play, an important source of PA. Addressing these limitations would help improve international comparisons, and facilitate the cross- fertilisation of ideas to promote PA. We aim to develop and assess the reliability and validity of the app- based Global Adolescent and Child Physical Activity Questionnaire (GAC- PAQ) among 8–17 years old in 14 LMICs and HICs representing all continents; and generate the ‘first available data’ on active play in most participating countries.

Methods and analysis: Our study involves eight stages: (1) systematic review of psychometric properties of existing PA questionnaires for children and adolescents; (2) development of the GAC- PAQ (first version); (3) content validity assessment with global experts; (4) cognitive interviews with children/adolescents and parents in all 14 countries; (5) development of a revised GAC- PAQ; (6) development and adaptation of the questionnaire app (application); (7) pilot- test of the app- based GAC- PAQ; and, (8) main study with a stratified, sex- balanced and urban/ rural- balanced sample of 500 children/adolescents and one of their parents/guardians per country. Participants will complete the GAC- PAQ twice to assess 1- week test–retest reliability and wear an ActiGraph wGT3X- BT accelerometer for 9 days to test concurrent validity. To assess convergent validity, subsamples (50 adolescents/country) will simultaneously complete the PA module from existing international surveys.

Ethics and dissemination: Approvals from research ethics boards and relevant organisations will be obtained in all participating countries. We anticipate that the GAC- PAQ will facilitate global surveillance of PA in children/ adolescents. Our project includes a robust knowledge translation strategy sensitive to social determinants of health to inform inclusive surveillance and PA interventions globally.