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Surveillance of physical activity in the UK is flawed: validation of the Health Survey for England Physical Activity Questionnaire
  1. L Basterfield1,
  2. A J Adamson1,
  3. K N Parkinson1,
  4. U Maute2,
  5. P X Li2,
  6. J J Reilly2,
  7. the Gateshead Millennium Study Core Team
  1. 1
    Human Nutrition Research Centre, School of Clinical Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
  2. 2
    University of Glasgow Division of Developmental Medicine, Yorkhill Hospitals, Glasgow, UK
  1. Professor John J Reilly, University of Glasgow Division of Developmental Medicine, 1st Floor, Tower Block QMH, Yorkhill Hospitals, Dalnair Street, Glasgow G3 8SJ, Scotland, UK; jjr2y{at}


Objective: Public health surveillance of physical activity in children in the UK depends on a parent-reported physical activity questionnaire which has not been validated. We aimed to validate this questionnaire against measurement of physical activity using accelerometry in 6–7-year-old children.

Methods: In 130 children aged 6–7 years (64 boys, 66 girls) we estimated habitual moderate–vigorous intensity physical activity (MVPA) using the Health Survey for England parent-report questionnaire for physical activity. For the same time period and the same children, we measured MVPA objectively using 7-day accelerometry with the Actigraph accelerometer.

Results: The questionnaire over-estimated MVPA significantly (paired t test, p<0.01). Mean error (bias) when using the questionnaire was 122 min/day (95% CI 124 to 169). Mean time spent in MVPA was 146 min/day (95% CI 124 to 169) using the questionnaire and 24 min/day (95% CI 22 to 26) using the accelerometer. Rank order correlations between MVPA measured by accelerometer and estimated by the questionnaire were not statistically significant.

Conclusions: Public health surveillance of physical activity should not rely on this questionnaire. Levels of habitual physical activity in children are likely to be substantially lower than those reported in UK health surveys.

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  • Funding: The Gateshead Millennium Study is supported by a grant from the National Prevention Research Initiative (incorporating funding from the British Heart Foundation, Cancer Research UK, Diabetes UK, Department of Health, Economic and Social Research Council, Food Standards Agency, Medical Research Council, Research and Development Office for the Northern Ireland Health and Social Services, Chief Scientist Office of the Scottish Government Health Directorate, Welsh Assembly Government and World Cancer Research Fund). The cohort was first set up with funding from the Henry Smith Charity and Sport Aiding Medical Research for Kids (SPARKS). The funding body had no influence on the decision to publish, the content of this publication, or in interpretation of the data.

  • Competing interests: None.

  • Ethics approval: Ethics approval for the study was obtained from the Gateshead Primary Care Trust Local Research Ethics Committee.

  • Patient consent: Parents provided informed consent to participation and children assented to participation.

  • Contributors: JJR was responsible for the original concept. JJR, AJA, KNP and LB designed the study. All authors contributed to study methodology, analysis, interpretation and report writing. LB, P-XL and UM collected data. All authors saw and approved the final version of the manuscript.

    All authors declare that they participated in the present study as described above. The study guarantor has full access to study data and final responsibility over the decision to submit for publication.