TRANSLATION, CROSS-CULTURAL ADAPTATION AND TEST-RETEST RELIABILITY OF THE GREEK VERSION OF BAGE QUESTIONNAIRE

V. Stefanouli¹, K. Chandolias¹, E.A. Tsounia¹, T. Dimopoulos¹, G. Tsatsakos¹, N. Strimpakos^1,2

¹University of Thessaly, Department of Physiotherapy, Lamia, Greece, ²University of Manchester, Division of Musculoskeletal & Dermatological Sciences, Manchester, United Kingdom

Background: Green exercise (GE) is defined as physical activity (PA) that takes place in the presence of nature. Many studies have shown that GE provides significant improvements in mental and physical health. Despite the promising benefits of GE, little is known about how people’s thoughts and feelings about GE affect their participation and subsequent outcomes. Previous studies have already shown that individuals’ beliefs and attitudes play a key role in the determination of exercise behavior. Following this, PA interventions have focused on beliefs and attitudes, with beneficial results seen in exercise behavior and, ultimately, physical and mental health. As there was a need for an exploration of GE beliefs to better understand how to augment engagement with GE behaviors, Flowers et al., (2017) developed the BAGE questionnaire. The BAGE was developed to evaluate how individuals feel about being physically active in nature at least once per week. It consists of 17 items that scored from 1 to 7. The total score is divided into 4 subscales: intention (5 items), attitude (6 items), subjective norm (3 items), and perceived behavioral control (PBC) (3 items).

Purpose: The purposes of the current study were to translate, adapt, and evaluate the test-retest reliability of the BAGE questionnaire in the Greek language and culture.

Methods: The cross-cultural adaptation of the BAGE was performed according to internationally accepted guidelines by Beaton et al., (2000). To assess test-retest reliability, 262 participants (112 males and 150 females) were requested to complete the BAGE questionnaire on two occasions, 1 week apart. The data were checked for normality with Kolmogorov–Smirnov test, internal consistency was computed with Cronbach’s alpha, and test-retest reliability with Intraclass Correlation Coefficient (ICC).

Results: There were no significant discrepancies between the original and translated versions, except for one item that was resolved by the four translators.TheBAGE-GR for subscales intention, attitude and subjective norm had good to excellent test-retest reliability (intention ICC (2,1) = 0.82, 95% CI = 0.77–0.85; attitude ICC (2,1) = 0.73, 95% CI = 0.67–0.78; subjective norm ICC (2,1) = 0.66, 95% CI = 0.58–0.73), whereas PBC had fair reliability (ICC (2,1)=0.47, 95% CI 0.37-0.56). The results also showed acceptable internal consistency for subscales intention (Cronbach's alpha = 0.87) and attitude (Cronbach's alpha = 0.77). For subjective norm (Cronbach's alpha = 0.53), and PBC (Cronbach's alpha = 0.18) internal consistency was poor and not acceptable respectively.

Conclusions: Greek researchers and health professionals have a reliable tool for assessing intention and attitudes on GE behaviors. Results indicated challenges in reliability in subjective norm and PBC subscale. Further research is needed to assess other types of reliability, and validity.

Funding acknowledgements: Framework "Smart Tourist". Co-financed by Greece and EU (European Regional Development Fund) NSRF 2014-2020, MIS 5047243

Keywords:
green exercise
reliability
questionnaire

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

Did this work require ethics approval? Yes

Institution: University of Thessaly

Committee: Research Ethics Committee (EHDE)

Ethics number: 41 / 09.12.2020