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Published on: March 7, 2019
Comparing Accelerometer-Measured and Self-Reported Physical Activity Among Adults in Semi-Urban Nepal: Findings From
Rajan Shrestha1,2, Susan Paudel3,4, Anupa Rijal5
1Research Unit for Global Health, Aarhus University, Aarhus, Denmark.
Background:
Accurate physical activity data are essential for public health planning. In low- and middle-income countries, self-reported questionnaires often overestimate activity. This study compared physical activity estimates from a self-reported questionnaire with wrist-worn accelerometer data among adults in Nepal.
Methods:
A cross-sectional study of 423 adults (aged 18-69 y) in Pokhara, Nepal, was conducted. Participants completed the Global Physical Activity Questionnaire (GPAQ) and wore an Axivity AX3 accelerometer on the nondominant wrist for 7 days. Accelerometer outcomes included moderate to vigorous physical activity (MVPA) minutes, light-intensity activity, and sedentary time. Accumulated self-reported MVPA was calculated by summing domain-specific physical activity minutes during work, transport, and leisure time. To compare accelerometer and GPAQ-derived estimates, we used the sign test that assesses paired median differences.
Results:
Median daily MVPA was 15.3 (Q1-Q3: 4.1-37.5) minutes per day measured by accelerometer and 43.3 (Q1-Q3: 24.8-109.3) minutes per day by GPAQ. GPAQ reported a higher estimate, with a median paired difference of 25.7 (Q1-Q3: 3.8-87.4) minutes per day (P < .001). Only 41.7% of participants met World Health Organization's physical activity recommendations based on accelerometer-measured MVPA, compared with 81.9% by GPAQ.
Conclusions:
GPAQ reported substantially higher estimates of bouted MVPA compared with accelerometry in this semi-urban adult population. This study supports the value of complementing GPAQ-based surveillance with device-based measurement in representative subsamples and locally calibrated interpretation. Cost-effectively integrating accelerometers and locally validating self-report tools can improve physical activity surveillance. Financial and technical support are critical in low-resource settings to ensure fair tracking toward global targets.
