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Evaluation of a short retrospective questionnaire for physical activity in women

European Journal of Epidemiology volume 21, pages 575–585 (2006)Cite this article

Abstract

Physical activity (PA) is discussed as a preventive factor for many chronic diseases. Thus, in epidemiological studies it often is an important covariate. Due to frequently long latency periods, long-term PA in the past is of greater interest than current PA. However, there is a lack of retrospective questionnaires that are validated for long-term PA, including occupational, household, and leisure activities. We therefore evaluated a short questionnaire for the comprehensive assessment of usual PA in distant age periods, administered with cognitive interviewing techniques. From an ongoing study on postmenopausal breast cancer 110 cases and 101 controls, age 50–74 years, were randomly selected. Our questionnaire was administered in a telephone interview more than two months after the main study interview, which included a detailed questionnaire on PA performed in the age periods 30–49 years and 50+ years. Total PA scores were derived from both interviews as MET-hours per week. Degree of agreement was assessed using Bland–Altman analyses. Further, potential sources of systematic and random error were investigated. The mean difference between both questionnaires was 3 MET hours/week, and 53.6% of absolute differences were below 35 MET hours/week, i.e. showing good agreement. Further 28.9% of differences could be considered acceptable agreement. Measurement errors seem to be non-differential with respect to cancer status. The median interviewing time was 10 min. Overall, this short questionnaire appears to be a useful and valid tool to distinguish between high and low levels of women’s physical activity in the distant past.

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Abbreviations

MET:

metabolic equivalent

PA:

physical activity

Q25:

0.25-quantile

Q75:

0.75-quantile

SD:

standard deviation

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Acknowledgements

The case–control study from which we derived the participants and the reference values was funded by the Deutsche Krebshilfe e.V. (Project number 70–2892).

Author information

Affiliations

  1. Unit of Environmental Epidemiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany

    Martina E. Schmidt, Jürgen Wahrendorf & Karen Steindorf

  2. Division of Clinical Epidemiology, German Cancer Research Center, Heidelberg, Germany

    Tracy Slanger & Jenny Chang-Claude

  3. Unit of Environmental Epidemiology, German Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg, 69120, Germany

    Karen Steindorf

Authors
  1. Martina E. Schmidt
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  2. Tracy Slanger
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  3. Jenny Chang-Claude
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  4. Jürgen Wahrendorf
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  5. Karen Steindorf
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Corresponding author

Correspondence to Karen Steindorf.

Appendices

Appendix 1: Basic 24 hours-questionnaire (English translation)

Starting with the following standardized questions, the interviews were performed as dialogues, where respondents could describe their activities and interviewers used follow-up questions to clarify intensities or to gain more information about other activities (probing). Presented here is the English translation of the original German questionnaire, which was used in the validation study.

Interviewer instruction → Please write down the time! ___:___o’clock
READ: At the beginning of the interview I would like to ask you to recall the time when you were 30–49 years old:
(GIVE MEMORY AIDS: this is a period of about 20 years, from 19xx to 19xx; have you been employed during that time; did you have small children; did you live in a house or an apartment; did you have a garden?)
READ: I would now like to ask you how much time you spent on the average during the day – that is 24 hours – on sleeping, sitting, light, moderate, or vigorous physical activities. At first I will ask you about your activities during a weekday :
(Interviewer instruction: Please round the time data to half hours.)
● How many hours on the average did you spend on a weekday with sleeping or reclining? (Probing: during the night or having a nap): ____,__ h
z.cirf; How many hours on the average did you spend on a weekday with predominantly sedentary activities, e.g. sitting in the office, during meals, drinking coffee, watching television, reading, doing needlework, going by car or by train? ____,__ h
● How many hours on the average did you spend on a weekday with physically vigorous activities: e.g.␣lifting or carrying heavy objects (Probing: small children, bags?), heavy gardening, climbing stairs, cycling uphill, jogging, circuit training, fast swimming? ____,__ h
● How many hours on the average did you spend on a weekday with physically moderate activities, e.g.␣fast walking, cycling without going uphill, cleaning windows, mopping, vacuum-cleaning, moderate gardening, light gym, leisurely swimming? ____,__ h
● xx,x hours are left for physically light activities, e.g. cooking, washing the dishes, ironing, dusting, promenading, doing personal hygiene, or other light, predominantly standing or walking activities. ____,__ h
READ: Does the relationship of the activities reflect the reality of that time? I will repeat the numbers:
(Read out: x hrs. sleeping or reclining, x hrs. sitting activities, x hrs. vigorous physical activities, x hrs. moderate physical activities and x hrs. light physical activities → if necessary adjust)
If more then 24 hours:
READ: All these together are more than 24 hours, x hours are too much. In which categories could the number of the hours be shortened? I will read the numbers out:
(Read out. x hours sleeping or reclining, x hrs sitting activity, x hrs. vigorous physical activity, x hrs moderate and x hrs light physical activities.) → correct hours.
Then questions repeated for weekend days, and for the 2nd age period age 50 +  years.

Sample data sheet

During the interview reported hours were entered directly into this excel sheet, which calculated the sum and the remaining hours immediately.

  30–49 years: Weekdays 30–49 years: Weekend days 50 +  years: Weekdays 50 +  years: Weekend days
Sleeping/reclining 8,5 8,5 9 9
Sitting 3 3,5 5 4,5
Vigorous activities 1 0,5 0 0
Moderate activities 2 6 4 4
Light activities 9,5 5,5 6 6,5
Sum 24 24 24 24
Remaining hours 0 0 0 0

Appendix 2: Reference questionnaire (English translation)

I would now like to ask you about physical activities at your job, during your leisure time, and at home, during different periods of your life.

First, please consider the time period when you were 30–49 years old.

  30–49 years 50 +  years
A. Please specify how many years you work/have worked at your job or education. |__|__| years |__|__| years
B. On the average, how many hours per week did you work? |__|__|.|__| |__|__|.|__|
hours hours
C. Was/is the work:   
predominantly physically light (that is, sedentary activities such as clerical employee, precision mechanic, car driver, etc. ) □ □
predominantly physically moderate (that is, walking or standing activities such as sales clerk, hairdresser, domestic worker with larger manual tasks, mechanic, house painter) □ □
predominantly physically strenuous (such as masseuse, nurse, farmer, mason, steel worker) □ □
  30–49 years 50 +  years
How many hours during this time period did/do you spend typically on household chores, such as child care, window cleaning, dusting, gardening? I would like to know in more detail:
D. How many hours (minutes) total did/do you spend on household chores on weekdays? |__|__|:|__|__| |__|__|:|__|__|
hours min. hours min.
E. How many hours (minutes) total did/do you spend on household chores on weekends? |__|__|:|__|__| |__|__|:|__|__|
hours min. hours min.
How often during this time period did/do you typically walk (only outside the house and not at work)? I would like to know in more detail:
F. How many hours (minutes) total did/do you walk on weekdays? |__|__|:|__|__| |__|__|:|__|__|
hours min. hours min.
G. How many hours (minutes) total did/do you walk on weekends? |__|__|:|__|__| |__|__|:|__|__|
hours min. hours min.
How often during this time period did/do you typically ride a bicycle (ordinary cycling for transportation, not for exercise)? I would like to know in more detail:
H. How many hours (minutes) total did/do you bicycle on weekdays? |__|__|:|__|__| |__|__|:|__|__|
hours min. hours min.
I. How many hours (minutes) total did/do you bicycle on weekends? |__|__|:|__|__| |__|__|:|__|__|
hours min. hours min.
How many hours during this time period did/do you spend being predominantly sedentary, e.g., watching television, sitting at the computer, in the car, at the office?
J. How many hours (minutes) total did/do you spend sedentary on weekdays? |__|__|:|__|__| |__|__|:|__|__|
hours min. hours min.
K. How many hours (minutes) total did/do you spend sedentary on weekends? |__|__|:|__|__| |__|__|:|__|__|
hours min. hours min.
L. Have you done any particular type of sport during the given period? e.g. calisthenics, gymnastics, jogging etc..
yes □ □
no □ → next period □ → end of PA questionnaire
not Specified/don’t know □ → next period □ → end of PA questionnaire
M. Which were/are the most frequent types of sport that you did/do? 1. 1.
2. 2.
3. 3.
Regarding the first type of sport, I would like to know in more detail:
N. How many total years during that time period did/do you do that sport? |__|__| |__|__|
years years
O. How many months per year did/do you do that sport? |__|__| |__|__|
months months
P. How many days per week did/do you do that sport/or |__|__| |__|__|
days per week days per week
Q. How many days per month did/do you do that sport? |__|__| |__|__|
days per month days per month
R. How many hours/minutes per day did/do you do that sport? |__|__|:|__|__| |__|__|:|__|__|
Hours minutes hours minutes
similar for the 2nd and 3rd type of sport Then: Period 50 + years  

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Schmidt, M.E., Slanger, T., Chang-Claude, J. et al. Evaluation of a short retrospective questionnaire for physical activity in women. Eur J Epidemiol 21, 575–585 (2006). https://doi.org/10.1007/s10654-006-9042-9

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Keywords

  • Evaluation
  • Exercise
  • Physical activity
  • Questionnaire
  • Relative validity
  • Retrospective assessment