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

Richard Larouche, Mahdi Rostami Haji Abadi,Salomé Aubert, Jasmin Bhawra,Javier Brazo-Sayavera,Valerie Carson, Rachel C Colley,Christine Delisle Nyström, Dale W Esliger, Ryan Harper-Brown, Silvia Alejandra Gonzalez Cifuentes,Alejandra Jáuregui,Piyawat Katewongsa, Anuradha Khadilkar,Geoff Kira,Nicholas Kuzik,Yang Liu, Marie Lof,Tom Loney, Taru Manyanga,Tawonga W Mwase-Vuma,Adewale L Oyeyemi,John J Reilly, Justin Richards, Karen Roberts,Olga Lucia Sarmiento,Diego Augusto Santos Silva,Melody Smith, Narayan Subedi,Leigh M Vanderloo, Dyah Anantalia Widyastari,Oliver W A Wilson, S H Wong,Mark S Tremblay

BMJ open(2024)

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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.
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