SEDENTARY AND PHYSICAL ACTIVITY TIME DIFFERS BETWEEN SELF-REPORTED ATLS-2 QUESTIONNAIRE AND ACCELEROMETER MEASUREMENTS IN CHILDREN AND YOUNG ADULTS OF THE UAE

A. Arumugam^1,2,3, S.A. Mohammedzadeh¹, Z.A. Zabin¹, T.M. Emad¹, H.I. Ahmed¹, F.S. Jauhari¹, H.Y. Alkalih¹, T.M. Shousha^1,2, I.M. Moustafa^1,2, C. Häger^4,2

¹University of Sharjah, Department of Physiotherapy, College of Health Sciences, Sharjah, United Arab Emirates, ²Neuromusculoskeletal Rehabilitation Research Group, RIMHS–Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates, ³Sustainable Engineering Asset Management Research Group, RISE-Research Institute of Sciences and Engineering, University of Sharjah, Sharjah, United Arab Emirates, ⁴Umeå University, Department of Community Medicine and Rehabilitation - Physiotherapy Section, Umeå, Sweden

Background: Most children and young adults of the United Arab Emirates do not meet the established internationally recommended physical activity levels per day. The Arab Teen Lifestyle Study (ATLS) physical activity questionnaire has been recommended for measuring self-reported physical activity of Arab children and young adults (aged 14 years to mid-twenties). The first version of the ATLS has been validated with accelerometers and pedometers (r ≤ 0.30). The revised version of the questionnaire (ATLS-2, 2021) needs further validation.

Purpose: The aim of this study was to validate the self-reported sedentary and physical activity time of the ATLS-2 physical activity questionnaire with that of Fibion accelerometer-measured data in children and young adults of the UAE.

Methods: One hundred and thirty-one healthy children and young adults (aged 20.47 ± 2.16 [mean ± SD] years (range 14-26 years), body mass index 23.09 ± 4.45 kg/m²) completed the ATLS-2 and wore the Fibion accelerometer for 7 days. Participants (n = 131) with valid ATLS-2 data without missing scores and Fibion data of minimum 10 hours/day for at least 3 weekdays and 1 weekend day were analyzed. Concurrent validity between the two methods was assessed by Spearman rho correlation (for skewed data) and the Bland-Altman plots.

Results: The questionnaire underestimated sedentary and physical activity time compared to the accelerometer data. Only negligible to weak correlations (r ≤ 0.12; p > 0.05) and a low agreement between self-reported ATLS-2 and Fibion accelerometer-measured sitting, walking, cycling, moderate intensity activity and total activity time were found. In addition, a proportional/systematic bias was evident in the plots for all but one (moderate intensity activity time) of the outcome measures of interest.

Conclusions: Overall, self-reported ALTS-2 sedentary and physical activity time had low correlation and agreement with objective Fibion accelerometer measurements in children and young adults of the UAE.

Implications: Sedentary and physical activity assessment in children and young adults should not be limited to self-reported measures. The ALTS-2 physical activity questionnaire may be used while collecting self-reported data on a large Arab (teen/young adult) population and in those settings where accelerometers are unavailable; however, the chances for underestimation of sedentary and physical activity time with the self-reported physical activity questionnaires must be noted. We recommend including accelerometers or similar devices whenever possible to provide objective physical activity estimates.

Funding acknowledgements: VC for Research and Graduate Studies Office, University of Sharjah

Keywords:
Accelerometry
Physical activity questionnaire
Young adults

Topics:
Health promotion & wellbeing/healthy ageing/physical activity
Musculoskeletal
Paediatrics

Did this work require ethics approval? Yes

Institution: University of Sharjah

Committee: The Research Ethics Committee

Ethics number: REC-22-02-23-01-S