Rajan Shrestha, Susan Paudel, Anupa Rijal, Philippe Jean-Luc Gradidge, Bijay Khatri, Dinesh Neupane, Sebastian Dyrup Skejø, Abhinav Vaidya, Taren Sanders, Chris Lonsdale, Tara Ballav Adhikari, Per Kallestrup, Rasmus Østergaard Nielsen
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.
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.