Related Experiment Video
Updated: Oct 3, 2025
Physical Activity Measurement in Children Accepting Table Tennis Training
Published on: July 27, 2022
A systematic review of proxy-report questionnaires assessing physical activity, sedentary behavior and/or sleep in
Jelle Arts1, Jessica S Gubbels2, Arnoud P Verhoeff3,4
1Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands. j.arts@amsterdamumc.nl.
Insights
Valid questionnaires for monitoring 24-hour movement behaviors in young children are scarce. High-quality research is needed to develop and validate these crucial tools for children aged 0-5 years.
Area of Science:
- Pediatric Health Research
- Behavioral Science
- Measurement Science
Background:
- Accurate monitoring of 24-hour movement behaviors (physical activity, sedentary behavior, sleep) in young children (0-5 years) is essential.
- Existing proxy-report questionnaires require adaptation to developmental stages, especially for large-scale and low-resource studies.
Purpose of the Study:
- To systematically review and summarize studies evaluating the measurement properties of proxy-report questionnaires for assessing physical activity, sedentary behavior, and/or sleep in children aged 0-5 years.
Main Methods:
- Systematic literature searches were conducted in PubMed, Embase, and SPORTDiscus up to January 2021.
- Studies were included if they evaluated measurement properties (e.g., validity, reliability) of proxy-report questionnaires for 0-5 year olds.
- The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline was used for quality assessment.
Main Results:
- Thirty-three studies examined 37 questionnaires across different age groups (infants, toddlers, preschoolers) and movement behaviors.
- Construct validity was assessed for 26 questionnaires, and test-retest reliability for 16.
- Critically, no questionnaires were found to be sufficiently valid and/or reliable for assessing movement behaviors in this age group, with mostly low or very low evidence quality.
Conclusions:
- There is a significant lack of valid and reliable proxy-report questionnaires for assessing 24-hour movement behaviors in children aged 0-5 years.
- High-quality studies are urgently needed to develop new questionnaires and rigorously evaluate their measurement properties.
Background:
Accurate proxy-report questionnaires, adapted to the child's developmental stage, are required to monitor 24-h movement behaviors in young children, especially for large samples and low-resource settings.
Objectives:
This review aimed to summarize available studies evaluating measurement properties of proxy-report questionnaires assessing physical activity, sedentary behavior and/or sleep in children aged 0-5 years.
Methods:
Systematic literature searches were carried out in the PubMed, Embase and SPORTDiscus databases, up to January 2021. For physical activity and sedentary behavior questionnaires this is a review update, whereas for sleep questionnaires we included all relevant studies published up to now. Studies had to evaluate at least one of the measurement properties of a proxy-report questionnaire assessing at least duration and/or frequency of physical activity, sedentary behavior and/or sleep in 0- to 5-year-old children. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline was used to evaluate the quality of evidence.
Results:
Thirty-three studies were included, examining a total of 37 questionnaires. Ten questionnaires were designed for infants, two for toddlers, 11 for preschoolers, and 14 for a broader age range targeting multiple of these age groups. Twenty questionnaires assessed constructs of sleep, four assessed constructs of physical activity, two assessed screen behavior, five assessed constructs of both physical activity and sedentary behavior, and six assessed constructs of all 24-h movement behaviors. Content validity was evaluated for six questionnaires, structural validity for two, internal consistency for three, test-retest reliability for 16, measurement error for one, criterion validity for one, and construct validity for 26 questionnaires. None of the questionnaires were considered sufficiently valid and/or reliable for assessing one or more movement behaviors in 0- to 5-year-old children, and the quality of evidence was mostly low or very low.
Conclusions:
Valid and/or reliable questionnaires assessing 24-h movement behaviors in 0- to 5-year-olds are lacking. High-quality studies are therefore required, to develop proxy-report questionnaires and evaluate their measurement properties.
Prospero Registration Number:
CRD42020169268.
