Küresel fiziksel aktivite anketinin (GPAQ) Türkçeye uyarlanması, güvenilirlik ve geçerliliğinin Bornova Belediyesi çalışanlarında değerlendirilmesi
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Dosyalar
Tarih
2017
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve Amaç: Fiziksel aktivite dünyada halk sağlığının ilgi alanındadır. Derlemelere göre düşük düzeyde fiziksel aktivite, mortaliteyi artırmaktadır. Fiziksel aktivite sürveyansı standart yöntemle yapılmalıdır. Fiziksel aktiviteyi değerlendirmede anket, adımsayar, akselerometre vb. kullanılmaktadır. Epidemiyolojik araştırmalarda anketler kullanılmaktadır. Adımsayar ve akselerometrenin dezavantajı farklı alanlardaki aktiviteleri ayıramamalarıdır. Daha önce sık kullanılan Uluslararası Fiziksel Aktivite Anketi'nin (IPAQ) kısa ve uzun formlarının Türkçe güvenilirlik-geçerliliği yapılmıştır. Ancak kısa formda iş, ulaşım ve boş zaman etkinlikleri gibi alanlar sorulmamaktadır. Uzun formsa toplum taramalarında uygun değildir. IPAQ'te sadece son hafta değerlendirildiğinden mevsimsellik vb.den etkilenebilmektedir. Fiziksel aktiviteyi değerlendirmede kullanılan diğer anket GPAQ'tir. Birçok dile uyarlanmıştır. GPAQ'in DSÖ tarafından dünyada risk taramasında kullanılması ülkeler arasında karşılaştırmada avantajdır. Anket 16 sorudan oluşmaktadır. İş, ulaşım ve boş zaman etkinliklerinde fiziksel aktiviteyi sorgulayan üç bölüm; sedanter süre için ayrı bir soru bulunmaktadır. Her bölümde evet/hayır şeklinde bir soru, ardından haftada kaç gün; bir günde ne kadar süre yapıldığı ölçüm tipi olarak açık uçlu sorulmaktadır. MET (metabolik eşdeğer), bir kişinin çalıştığı durumdaki metabolik hızının dinlenmiş durumdaki hıza oranıdır. GPAQ'te haftalık toplam MET-dk, (Haftalık orta şiddetli aktivite dakikası x 4 MET) + (haftalık yüksek şiddetli aktivite dakikası x 8 MET) şeklinde hesaplanmaktadır. Dünya Sağlık Örgütüne (DSÖ) göre haftada 600 MET-dk'nın altı fiziksel inaktif kabul edilmektedir. GPAQ'in birçok ülkede güvenilirlik-geçerliliği yapılmıştır, ancak Türkçe güvenilirlik-geçerliliği yoktur. Amaç GPAQ'in Türkçe güvenilirlik-geçerliliğini Bornova Belediyesi çalışanlarında değerlendirmektir. İkincil amaç Bornova Belediyesi çalışanlarının fiziksel aktivite düzeyini, ilişkili faktörleri değerlendirmektir. Gereç ve Yöntem: Çalışmanın geçerlilik-güvenilirlik kısmı metodolojik; belediye çalışanlarında fiziksel aktivite sıklığı ve ilişkili faktörlere yönelik kısım kesitseldir. Etik kurul, belediye ve DSÖ'den onay alınmıştır. İki bağımsız uzman anketi İngilizceden Türkçeye çevirmiştir. Çeviri panellerinden sonra oluşturulan ortak Türkçe metni iki bağımsız çevirmen (birinin anadili İngilizce) İngilizceye geri çevirmiştir. Çevrilenle orijinal metin karşılaştırılıp değişiklikler yapılmıştır. Uzman paneli (4 kişi), uzman görüşü (10 kişi) ve pilot çalışmadan sonra ankete son hali verilmiştir. Araştırmanın verileri Bornova Belediyesinde Ağustos-Kasım 2016 tarihlerinde toplanmıştır. Güvenilirlikte test-tekrar test, eş zamanlı geçerlilikte IPAQ ve kriter geçerliliğinde adımsayar kullanılmıştır. Korelasyon katsayıları 0–0,20 zayıf, 0,21–0,40 "kabul edilebilir", 0,41–0,60 "orta", 0,61–0,80 "güçlü", 0,81–1,00 "çok güçlü" olarak değerlendirilmiştir. MET-dk'da uç değerler olduğundan iki grupta Mann-Whitney U ve ikiden fazla grupta normal dağılıma uymadığından Kruskal Wallis testi yapılmıştır. Toplam 2137 çalışandan örnek büyüklüğü; %33 prevalans (Türkiye Beslenme-Sağlık Araştırması, 2010), %5 hata payı, %95 güven aralığı, %20 cevaplanmama payı alındığında 352 çalışan olarak belirlenmiş; sistematik örneklemle seçilmiştir. Çalışmaya katılım oranı %81,53'tür. GPAQ'in uluslararası güvenilirlik-geçerlilik çalışmasında adımsayarla saptanan korelasyon katsayısı 0,31, %95 güç, %5 hata payı, %20 cevaplanmama payı alındığında örnek büyüklüğü 129 hesaplanmıştır. İlk kabul eden 112 çalışana (%86,82) bir hafta sonra tekrar test uygulanmış, haftalık adım sayıları alınmıştır. Bulgular: Grubun %36,2'si kadındır. Yaş ortalaması 38,91±8,49'dur. Ortanca MET-dk'sı 1360'tır (en düşük:0, en yüksek:19680). Çalışanların %80,5'i fiziksel aktiftir. Güvenilirlik katsayıları güçlü, çok güçlü ilişki düzeyindedir (Kappa 0,74–0,87 [p<0,0005]; Spearman rho 0,77–0,91 [p<0,0005]). IPAQ'le GPAQ arasında güçlü, çok güçlü ilişki saptanmıştır (r=0,79–0,94 aralığında [p<0,0005]). Adımsayarla kriter geçerliliği sonucu kabul edilebilir ilişki düzeyindedir (r=0,32 [p=0,001]). Ayırıcı geçerlilikte eğitim düzeyi, belediyede çalışma süresi, kişi başına düşen gelir, fiziksel aktif iş durumu istatistiksel anlamlı şekilde ayrılabilmiştir. Diğer değişkenleri istatistiksel anlamlı şekilde ayıramasa bile grupların ortancaları arasında farklar vardır. Sonuç: GPAQ'in Türkçe versiyonu güvenilir-geçerlidir. Ayırıcı geçerlilikte fiziksel aktivite düzeyi yüksekten düşüğe sırasıyla "ortaokul ve altı", "üniversite ve üzeri", "lise" şeklindedir. Eğitim düzeyi "ortaokul ve altı" olanlar fiziksel aktif işlerde çalışıyor olabilirler. Çalışma yılı arttıkça fiziksel aktivite düzeyi artmaktadır. Bu durum yeni işe girenlerin eğitim düzeyinin yüksek olmasıyla ilişkili olabilir. Yoksulluk sınırı ve altındaki çalışanların ortanca MET-dk'sı yoksulluk sınırı üstündekilerden daha yüksektir. Fiziksel aktif işlerde sosyoekonomik düzeyi daha düşük çalışanlar görevli olabilir. Adımsayarla yapılan kriter geçerliliği sonuçları diğer araştırmalarla benzer şekilde kabul edilebilir düzeydedir. Çalışmanın sınırlılığı, katılımcıların tamamının aktif çalışan olmasıdır. Öneri olarak ev hanımları, öğrenciler, işsizlerde güvenilirlik-geçerliliğe bakılabilir. DSÖ'nün önerdiği anket Türkiye'de güvenilir-geçerli biçimde sahada kullanılabilecektir.
Introduction and Aim: Physical activity is the concern of public health in the world. According to reviews, low levels of physical activity increase mortality. Surveillance of physical activity should be done by a standard method. Questionnaire, pedometer, accelerometer, etc. are used to evaluate physical activity. Questionnaires are used in epidemiological surveys. A disadvantage of pedometers and accelerometers is their inability to discriminate activities in different areas. The Turkish reliability and validity of the short and long forms of International Physical Activity Questionnaire (IPAQ) had already been conducted. However activity areas such as work, transportation and leisure activities are not asked in the short form. Its long form is not suitable for public screenings. Since IPAQ only evaluates the last week, it can be affected by seasonality etc. Another questionnaire used to evaluate physical activity is GPAQ. It has been adapted to many languages. The use of GPAQ by World Health Organization (WHO) in risk screening in the world is enables comparison with other countries. There are 16 questions in GPAQ. Physical activity is questioned in three areas as work, transportation and leisure activities and there is another question for sedentary behavior. There are three questions in each section: a yes/no question, then a question on how many days a week and an open-ended question asking the duration of physical activity on a typical day. MET (metabolic equivalent) is the ratio of the metabolic rate of a person in the working state to the rate in the resting state. Weekly total MET-min is calculated as (weekly moderate intensity activity duration in minutes x 4 MET) + (weekly high intensity activity duration in minutes x 8 MET). According to WHO, less than 600 MET-min per week is considered physically inactive. GPAQ has been validated in many countries, however there is no reliability and validity in Turkish. The aim of this study is to evaluate the Turkish reliability and validity of GPAQ in Bornova Municipality employees. The secondary aim is to assess the level of physical activity among Bornova Municipality employees and related factors. Material and Methods: The validity-reliability part of the study is methodological; the part on physical activity level and related factors among municipal workers is cross-sectional. Permission was obtained from the ethics committee, municipality and WHO. Two independent experts have translated the questionnaire from English to Turkish. The common Turkish text created after the translation panels was translated back to English by two independent translators (one a native speaker). The original text has been compared with the translated text and relevant changes were made. The final version of the questionnaire was formed after an expert panel (4 people), expert opinions (10 people) and the pilot study. The data of the study were collected in Bornova Municipality between August and November 2016. Test-retest was used for reliability, IPAQ was used for concurrent validity and pedometer was used for criterion validity. Correlation coefficients were classified as 0-0.20 poor, 0.21-0.40 fair, 0.41-0.60 moderate, 0.61-0.80 substantial, 0.81-1.00 near perfect. Mann-Whitney U test was performed in two groups because of extreme values in MET-min and Kruskal Wallis test was performed because the distribution was not normal in more than two groups. Among a total of 2137 workers, a sample size of 352 employees was determined using 33% prevalence (Turkish Nutrition and Health Research, 2010), 5% error margin, 95% confidence interval and 20% non-response rate. They were selected systematically randomly. The participation rate in study was 81.53%. A sample size of 129 participants as a subgroup was calculated using the correlation coefficient determined by pedometer as 0.31 in the international reliability-validity study of GPAQ, 95% power, 5% error margin and 20% non-response rate. The first accepting 112 employees were tested again after one week and weekly step counts were obtained. Results: Among the participants, 36.2% were women. The average age was 38.91±8.49. Median MET-min was 1360 (lowest: 0, highest: 19680) and 80.5% of employees were physically active. Reliability coefficients were substantial, near perfect (Kappa 0.74-0.87, p<0.0005; Spearman Rho 0.77-0.91, p<0.0005). A substantial, near perfect relationship was found between IPAQ and GPAQ (r = 0.79-0.94, p<0.0005). The result of criterion validity was fair relationship (r = 0.32, p=0.001). Education level, municipal working time, per capita income, physical active work status could be distinguished statistically significant as differential validity. Even if the other variables could not be distinguished statistically significant, there are differences between medians of the groups. Conclusion: The Turkish version of GPAQ is reliable and valid. Levels of physical activity are highest among "middle school and lower", lower among "university and above" and lowest among "high school" graduates. "Middle school and lower" graduates may be working in physically more active jobs. As the duration of employment increases, the level of physical activity increases. The higher level of education of new recruits may be a reason of this. The median MET-min of "poverty line and below" workers is higher than "the poverty line above". Employees with lower socioeconomic status may be employed in physical active jobs. The results of criterion validity with pedometer are similar (fair level) to other studies. The limitation of the study is that all of the participants are working. As a recommendation reliability and validity of GPAQ among housewives, students and unemployed can be studied. This WHO recommended questionnaire can be used reliably and validly in field studies in Turkey.
Introduction and Aim: Physical activity is the concern of public health in the world. According to reviews, low levels of physical activity increase mortality. Surveillance of physical activity should be done by a standard method. Questionnaire, pedometer, accelerometer, etc. are used to evaluate physical activity. Questionnaires are used in epidemiological surveys. A disadvantage of pedometers and accelerometers is their inability to discriminate activities in different areas. The Turkish reliability and validity of the short and long forms of International Physical Activity Questionnaire (IPAQ) had already been conducted. However activity areas such as work, transportation and leisure activities are not asked in the short form. Its long form is not suitable for public screenings. Since IPAQ only evaluates the last week, it can be affected by seasonality etc. Another questionnaire used to evaluate physical activity is GPAQ. It has been adapted to many languages. The use of GPAQ by World Health Organization (WHO) in risk screening in the world is enables comparison with other countries. There are 16 questions in GPAQ. Physical activity is questioned in three areas as work, transportation and leisure activities and there is another question for sedentary behavior. There are three questions in each section: a yes/no question, then a question on how many days a week and an open-ended question asking the duration of physical activity on a typical day. MET (metabolic equivalent) is the ratio of the metabolic rate of a person in the working state to the rate in the resting state. Weekly total MET-min is calculated as (weekly moderate intensity activity duration in minutes x 4 MET) + (weekly high intensity activity duration in minutes x 8 MET). According to WHO, less than 600 MET-min per week is considered physically inactive. GPAQ has been validated in many countries, however there is no reliability and validity in Turkish. The aim of this study is to evaluate the Turkish reliability and validity of GPAQ in Bornova Municipality employees. The secondary aim is to assess the level of physical activity among Bornova Municipality employees and related factors. Material and Methods: The validity-reliability part of the study is methodological; the part on physical activity level and related factors among municipal workers is cross-sectional. Permission was obtained from the ethics committee, municipality and WHO. Two independent experts have translated the questionnaire from English to Turkish. The common Turkish text created after the translation panels was translated back to English by two independent translators (one a native speaker). The original text has been compared with the translated text and relevant changes were made. The final version of the questionnaire was formed after an expert panel (4 people), expert opinions (10 people) and the pilot study. The data of the study were collected in Bornova Municipality between August and November 2016. Test-retest was used for reliability, IPAQ was used for concurrent validity and pedometer was used for criterion validity. Correlation coefficients were classified as 0-0.20 poor, 0.21-0.40 fair, 0.41-0.60 moderate, 0.61-0.80 substantial, 0.81-1.00 near perfect. Mann-Whitney U test was performed in two groups because of extreme values in MET-min and Kruskal Wallis test was performed because the distribution was not normal in more than two groups. Among a total of 2137 workers, a sample size of 352 employees was determined using 33% prevalence (Turkish Nutrition and Health Research, 2010), 5% error margin, 95% confidence interval and 20% non-response rate. They were selected systematically randomly. The participation rate in study was 81.53%. A sample size of 129 participants as a subgroup was calculated using the correlation coefficient determined by pedometer as 0.31 in the international reliability-validity study of GPAQ, 95% power, 5% error margin and 20% non-response rate. The first accepting 112 employees were tested again after one week and weekly step counts were obtained. Results: Among the participants, 36.2% were women. The average age was 38.91±8.49. Median MET-min was 1360 (lowest: 0, highest: 19680) and 80.5% of employees were physically active. Reliability coefficients were substantial, near perfect (Kappa 0.74-0.87, p<0.0005; Spearman Rho 0.77-0.91, p<0.0005). A substantial, near perfect relationship was found between IPAQ and GPAQ (r = 0.79-0.94, p<0.0005). The result of criterion validity was fair relationship (r = 0.32, p=0.001). Education level, municipal working time, per capita income, physical active work status could be distinguished statistically significant as differential validity. Even if the other variables could not be distinguished statistically significant, there are differences between medians of the groups. Conclusion: The Turkish version of GPAQ is reliable and valid. Levels of physical activity are highest among "middle school and lower", lower among "university and above" and lowest among "high school" graduates. "Middle school and lower" graduates may be working in physically more active jobs. As the duration of employment increases, the level of physical activity increases. The higher level of education of new recruits may be a reason of this. The median MET-min of "poverty line and below" workers is higher than "the poverty line above". Employees with lower socioeconomic status may be employed in physical active jobs. The results of criterion validity with pedometer are similar (fair level) to other studies. The limitation of the study is that all of the participants are working. As a recommendation reliability and validity of GPAQ among housewives, students and unemployed can be studied. This WHO recommended questionnaire can be used reliably and validly in field studies in Turkey.
Açıklama
Anahtar Kelimeler
Küresel Fiziksel Aktivite Anketi, Global Physical Activity Questionnaire, GPAQ, Güvenilirlik, Geçerlilik, Belediye Çalışanlarının Fiziksel Aktivite Düzeyi, Turkish Global Physical Activity Questionnaire, Turkish GPAQ, Reliability, Validity, Physical Activity Levels Of Municipal Employees
