GPAQ Analysis Guide - WHO
Global Physical ActivityQuestionnaire(GPAQ)Analysis GuideSurveillance and Population-Based PreventionPrevention of Noncommunicable Diseases DepartmentWorld Health Organization20 Avenue Appia, 1211 Geneva 27, SwitzerlandFor further information: www.who.int/chp/steps
Global Physical Activity Questionnaire(GPAQ)Analysis GuideTable of contents123456Overview . 2The questionnaire . 4GPAQ Question by Question Guide. 6Cleaning GPAQ data . 9Cleaning GPAQ data with EpiInfo . 11Analysis Guidelines and Calculations . 14GPAQ Analysis Guide1
1OverviewIntroductionThe Global Physical Activity Questionnaire was developed by WHO forphysical activity surveillance in countries. It collects information on physicalactivity participation in three settings (or domains) as well as sedentarybehaviour, comprising 16 questions (P1-P16). The domains are: Activity at work Travel to and from places Recreational activitiesUsing GPAQPrior to using GPAQ, you should review the question by question section.This section, which follows the actual questions, will guide the interviewer inasking the questions and recording responses.When using GPAQ, all the questions must be asked. Skips of questions doONLY apply to the corresponding day and time variables if P1, P4, P7, P10,or P13 have been answered negatively. Skipping any other questions orremoving any of the domains will restrict the results that you will be able tocalculate.Administrationof the GPAQThe GPAQ has been developed for face-to-face interviews conducted bytrained interviewers. It had been tested in large scale population-basedsurveys with the general adult population.Show cardsIt is advised that show cards be used when the GPAQ is administered. Showcards should be developed for each of the activity types covered by theGPAQ: vigorous and moderate activity at work, transport activity, vigorousand moderate activity during leisure time, as well as sitting. Show cards willhelp the respondents to know what activities are meant by each question.They should be showing typical physical activities for the setting that theGPAQ is used in. Examples of generic show cards that will need to beadapted to the local context can be found on the GPAQ .htmlGPAQversion 1 and 2This document provides information on version 2 of GPAQ. It is advisedthat you use version 2 of GPAQ.If you have already used GPAQ version 1 and need advise on analysing thisinformation, please contact the STEPS team at steps@who.int.Calculating andcleaningphysicalactivity dataThis document includes information on how to clean and analyse GPAQ datain general as well as specifically with the statistical package EpiInfo.The coding column of GPAQ is used as a reference for all the calculations.If you insert this questionnaire into another questionnaire, you should notchange the coding column.Continued on next pageGPAQ Analysis Guide2
1Overview, ContinuedMetabolicEquivalent(MET)METs (Metabolic Equivalents) are commonly used to express the intensity ofphysical activities, and are also used for the analysis of GPAQ data.MET is the ratio of a person's working metabolic rate relative to the restingmetabolic rate. One MET is defined as the energy cost of sitting quietly, andis equivalent to a caloric consumption of 1 kcal/kg/hour. For the analysis ofGPAQ data, existing guidelines have been adopted: It is estimated that,compared to sitting quietly, a person's caloric consumption is four times ashigh when being moderately active, and eight times as high when beingvigorously active.Therefore, when calculating a person's overall energy expenditure usingGPAQ data, 4 METs get assigned to the time spent in moderate activities,and 8 METs to the time spent in vigorous activities.GPAQ Analysis Guide3
2The questionnairePhysical ActivityNext I am going to ask you about the time you spend doing different types of physical activity in a typical week. Please answer these questionseven if you do not consider yourself to be a physically active person.Think first about the time you spend doing work. Think of work as the things that you have to do such as paid or unpaid work, study/training,household chores, harvesting food/crops, fishing or hunting for food, seeking employment. [Insert other examples if needed]. In answering thefollowing questions 'vigorous-intensity activities' are activities that require hard physical effort and cause large increases in breathing or heartrate, 'moderate-intensity activities' are activities that require moderate physical effort and cause small increases in breathing or heart rate.QuestionResponseCodeWorkDoes your work involve vigorous-intensity activity that causeslarge increases in breathing or heart rate like [carrying or liftingheavy loads, digging or construction work] for at least 10minutes continuously?[INSERT EXAMPLES] (USE SHOWCARD)YesP1NoIn a typical week, on how many days do you do vigorousintensity activities as part of your work?Number of daysHow much time do you spend doing vigorous-intensity activitiesat work on a typical day?Hours : minutesDoes your work involve moderate-intensity activity, that causessmall increases in breathing or heart rate such as brisk walking[or carrying light loads] for at least 10 minutes continuously?[INSERT EXAMPLES] (USE SHOWCARD)12If No, go to P 4 : hrsYesP2 minsP3(a-b)1P4NoIn a typical week, on how many days do you do moderateintensity activities as part of your work?Number of daysHow much time do you spend doing moderate-intensity activitiesat work on a typical day?Hours : minutes2If No, go to P 7P5 : hrsminsP6(a-b)Travel to and from placesThe next questions exclude the physical activities at work that you have already mentioned.Now I would like to ask you about the usual way you travel to and from places. For example to work, for shopping, to market, to place ofworship. [Insert other examples if needed]Do you walk or use a bicycle (pedal cycle) for at least 10minutes continuously to get to and from places?Yes1No2In a typical week, on how many days do you walk or bicycle forat least 10 minutes continuously to get to and from places?Number of daysHow much time do you spend walking or bicycling for travel on atypical day?Hours : minutesP7If No, go to P 10P8 : hrsminsP9(a-b)Continued on next pageGPAQ Analysis Guide4
2The questionnaire, ContinuedPhysical Activity, ContinuedQuestionResponseCodeRecreational activitiesThe next questions exclude the work and transport activities that you have already mentioned.Now I would like to ask you about sports, fitness and recreational activities (leisure), [Insert relevant terms].Do you do any vigorous-intensity sports, fitness or recreational(leisure) activities that cause large increases in breathing orheart rate like [running or football] for at least 10 minutescontinuously?[INSERT EXAMPLES] (USE SHOWCARD)YesP10NoIn a typical week, on how many days do you do vigorousintensity sports, fitness or recreational (leisure) activities?Number of daysHow much time do you spend doing vigorous-intensity sports,fitness or recreational activities on a typical day?Hours : minutesDo you do any moderate-intensity sports, fitness or recreational(leisure) activities that cause a small increase in breathing orheart rate such as brisk walking, [cycling, swimming, volleyball]for at least 10 minutes continuously?12If No, go to P 13P11 : hrsYes1No2minsP12(a-b)P13[INSERT EXAMPLES] (USE SHOWCARD)In a typical week, on how many days do you do moderateintensity sports, fitness or recreational (leisure) activities?Number of daysHow much time do you spend doing moderate-intensity sports,fitness or recreational (leisure) activities on a typical day?Hours : minutesIf No, go to P16P14 : hrsminsP15(a-b)Sedentary behaviourThe following question is about sitting or reclining at work, at home, getting to and from places, or with friends including time spent sitting at adesk, sitting with friends, traveling in car, bus, train, reading, playing cards or watching television, but do not include time spent sleeping.[INSERT EXAMPLES] (USE SHOWCARD)How much time do you usually spend sitting or reclining on atypical day?Hours : minutes : hrsGPAQ Analysis GuideP16(a-b)mins5
3GPAQ Question by Question GuidePhysical ActivityNext I am going to ask you about the time you spend doing different types of physical activity in a typical week. Please answer these questionseven if you do not consider yourself to be a physically active person.Think first about the time you spend doing work. Think of work as the things that you have to do such as paid or unpaid work, study/training,household chores, harvesting food/crops, fishing or hunting for food, seeking employment. [Insert other examples if needed]. In answering thefollowing questions 'vigorous-intensity activities' are activities that require hard physical effort and cause large increases in breathing or heartrate, 'moderate-intensity activities' are activities that require moderate physical effort and cause small increases in breathing or heart rate.Read this opening statement out loud. It should not be omitted. The respondent will have to think first about the time he/she spends doing work (paid orunpaid work, household chores, harvesting food, fishing or hunting for food, seeking employment [Insert other examples if needed]), then about the timehe/she travels from place to place, and finally about the time spent in vigorous as well as moderate physical activity during leisure time.Remind the respondent when he/she answers the following questions that 'vigorous-intensity activities' are activities that require hard physical effort and causelarge increases in breathing or heart rate, 'moderate-intensity activities' are activities that require moderate physical effort and cause small increases inbreathing or heart rate. Don't forget to use the showcard which will help the respondent when answering to the questions.QuestionResponseCodeWorkDoes your work involve vigorous-intensity activity that causes largeincreases in breathing or heart rate like [carrying or lifting heavy loads,digging or construction work] for at least 10 minutes continuously?[INSERT EXAMPLES] (USE SHOWCARD)Ask the participant to think about vigorous-intensity activities at work only.Activities are regarded as vigorous intensity if they cause large increases inbreathing and/or heart rate.YesP1NoIn a typical week, on how many days do you do vigorous-intensity activitiesas part of your work?“Typical week” means a week when the participant is engaged in his/herusual activities. Valid responses range from 1-7.Number of daysHow much time do you spend doing vigorous-intensity activities at work ona typical day?Ask the participant to think of a typical day he/she can recall easily in whichhe/she engaged in vigorous-intensity activities at work. The participantshould only consider those activities undertaken continuously for 10minutes or more. Probe very high responses (over 4 hrs) to verify.Hours : minutesDoes your work involve moderate-intensity activity, that causes smallincreases in breathing or heart rate such as brisk walking [or carrying lightloads] for at least 10 minutes continuously?[INSERT EXAMPLES] (USE SHOWCARD)Ask the participant to think about moderate-intensity activities at work only.Activities are regarded as moderate intensity if they cause small increasesin breathing and/or heart rate.12If No, go to P 4P2 : hrsYes1No2P3(a-b)minsP4In a typical week, on how many days do you do moderate-intensityactivities as part of your work?“Typical week” means a week when the participant is engaged in his/herusual activities. Valid responses range from 1-7.Number of daysHow much time do you spend doing moderate-intensity activities at work ona typical day?Ask the participant to think of a typical day he/she can recall easily in whichhe/she engaged in moderate-intensity activities at work. The participantshould only consider those activities undertaken continuously for 10minutes or more. Probe very high responses (over 4 hrs) to verify.Hours : minutesIf No, go to P 7P5 : hrsP6(a-b)minsContinued on next pageGPAQ Analysis Guide6
3GPAQ Question by Question Guide, ContinuedPhysical Activity, ContinuedQuestionResponseCodeTravel to and from placesThe next questions exclude the physical activities at work that you have already mentioned.Now I would like to ask you about the usual way you travel to and from places. For example to work, for shopping, to market, to place ofworship. [Insert other examples if needed]The introductory statement to the following questions on transport-related physical activity is very important. It asks and helps the participant to now thinkabout how they travel around getting from place-to-place. This statement should not be omitted.Do you walk or use a bicycle (pedal cycle) for at least 10 minutescontinuously to get to and from places?Select the appropriate response.How much time do you spend walking or bicycling for travel on a typicalday?Ask the participant to think of a typical day he/she can recall easily in whichhe/she engaged in transport-related activities. The participant should onlyconsider those activities undertaken continuously for 10 minutes or more.Probe very high responses (over 4 hrs) to verify.Yes1No2P7If No, go to P 10Hours : minutes : hrsP9(a-b)minsRecreational activitiesThe next questions exclude the work and transport activities that you have already mentioned.Now I would like to ask you about sports, fitness and recreational activities (leisure) [Insert relevant terms].This introductory statement directs the participant to think about recreational activities. This can also be called discretionary or leisure time. It includes sportsand exercise but is not limited to participation in competitions. Activities reported should be done regularly and not just occasionally. It is important to focus ononly recreational activities and not to include any activities already mentioned. This statement should not be omitted.Do you do any vigorous-intensity sports, fitness or recreational (leisure)activities that cause large increases in breathing or heart rate like [runningor football] for at least 10 minutes continuously?[INSERT EXAMPLES] (USE SHOWCARD)Ask the participant to think about recreational vigorous-intensity activitiesonly. Activities are regarded as vigorous intensity if they cause largeincreases in breathing and/or heart rate.Yes1No2P10In a typical week, on how many days do you do vigorous-intensity sports,fitness or recreational (leisure) activities?“Typical week” means a week when the participant is engaged in his/herusual activities. Valid responses range from 1-7.Number of daysHow much time do you spend doing vigorous-intensity sports, fitness orrecreational activities on a typical day?Ask the participant to think of a typical day he/she can recall easily in whichhe/she engaged in recreational vigorous-intensity activities. The participantshould only consider those activities undertaken continuously for 10minutes or more. Probe very high responses (over 4 hrs) to verify.Hours : minutesDo you do any moderate-intensity sports, fitness or recreational (leisure)activities that cause a small increase in breathing or heart rate such asbrisk walking, [cycling, swimming, volleyball] for at least 10 minutescontinuously?[INSERT EXAMPLES] (USE SHOWCARD)Ask the participant to think about recreational moderate-intensity activitiesonly. Activities are regarded as moderate intensity if they cause smallincreases in breathing and/or heart rate.In a typical week, on how many days do you do moderate-intensity sports,fitness or recreational (leisure) activities?“Typical week” means a week when the participant is engaged in his/herusual activities. Valid responses range from 1-7.If No, go to P 13P11 : hrsYesP12(a-b)mins1P13No2If No, go to P16P14Number of days Continued on next pageGPAQ Analysis Guide7
3GPAQ Question by Question Guide, ContinuedPhysical Activity, ContinuedQuestionHow much time do you spend doing moderate-intensity sports, fitness orrecreational (leisure) activities on a typical day?Ask the participant to think of a typical day he/she can recall easily in whichhe/she engaged in recreational moderate-intensity activities. The participantshould only consider those activities undertaken continuously for 10minutes or more. Probe very high responses (over 4 hrs) to verify.ResponseHours : minutesCode : hrsP15(a-b)minsSedentary behaviourThe following question is about sitting or reclining at work, at home, getting to and from places, or with friends including time spent sitting at adesk, sitting with friends, traveling in car, bus, train, reading, playing cards or watching television, but do not include time spent sleeping.[INSERT EXAMPLES] (USE SHOWCARD)How much time do you usually spend sitting or reclining on a typicalday?Ask the participant to consider total time spent sitting at work, in anoffice, reading, watching television, using a computer, doing hand craftlike knitting, resting etc. The participant should not include time spentsleeping.GPAQ Analysis GuideHours : minutes : hrsP16(a-b)mins8
4Cleaning GPAQ dataIntroductionIt is important to standardize the way in which the data collected are cleanedand analysed. Please use the guidelines below when cleaning and analysingyour data.The cleaning and analysis guidelines use the coding column in thequestionnaire as an identifier.CleaningYou should clean all domains as a combined set. While some of thecalculations of results use all the domains and others use only one of thedomains, it is necessary that each respondent has an overall "clean" responseto all physical activity questions. To be included in the analyses, eachparticipant must have a valid response for at least one domain and have noinvalid responses for any domains.Check for the following for all the domains.If Values in the hours column are 15,30, 45, or 60Maximum values: If for at least one"sub-domain" (vigorous work,moderate work, transport, vigorousrecreation, or moderate recreationactivity) the value of hours minutes 16 hoursIf a respondent reports implausiblevalues (eg., 7 days in any dayscolumn)If a respondent has inconsistentanswers (eg., 0 days, but values 0in the corresponding time variables)If one whole "sub-domain"(vigorous work, moderate work,transport, vigorous recreation,or moderate recreation activity)has missing values, but the other"sub-domains" are validNotesThen move them into the correspondingminutes variable, if thecorresponding minutes variable isempty or zero (most likely a datarecording error).remove the case from all analyses.remove the case from all analyses.remove the case from all analyses.include the case in the analysis,assuming no activity (0 days, 0 time)for this "sub-domain". That meansthat, as long as at least one "subdomain" has valid answers, and allothers are missing, this person willbe included in analyses.Overall, this cleaning method should result in the same denominator acrossall domains and all analyses.For information on how to create P3, P6, P9, P12, and P15 see the CleaningGPAQ with EpiInfo section at the end of this document (p. 12).Continued on next pageGPAQ Analysis Guide9
4Cleaning GPAQ data,
GPAQ Analysis Guide 3 1 Overview, Continued Metabolic Equivalent (MET) METs (Metabolic Equivalents) are commonly used to express the intensity of physical activities, and are also used for the analysis of GPAQ data. MET is the ratio of a person's working metabolic rate relative to the resting metabolic rate.
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