Health Promotion Journal of Australia, 2013, 24, 126–131

Physical Activity and Diet

http://dx.doi.org/10.1071/HE13012

Reliability and validity of the International Physical

Activity Questionnaire–Short Form for older adults
in Vietnam
Dinh V. Tran A, Andy H. Lee B,E, Thuy B. Au C, Chung T. Nguyen D and Dong V. Hoang D
A
Department of Community Health and Preventive Medicine Network Coordination, National Institute of Hygiene
and Epidemiology, 1 Yersin Street, Hanoi, 10000, Vietnam.
B
School of Public Health, Curtin University, GPO Box U 1987, Perth, WA 6845, Australia.
C
Royal Hobart Hospital, 48 Liverpool Street, Hobart, Tas. 7000, Australia.
D
Department of Epidemiology, National Institute of Hygiene and Epidemiology, 1 Yersin Street, Hanoi, 10000, Vietnam.
E
Corresponding author. Email: Andy.Lee@curtin.edu.au

Abstract
Issues addressed: The International Physical Activity Questionnaire (IPAQ) was developed as a global standard questionnaire to
monitor physical activity across diverse populations. In Vietnam, the IPAQ–Short Form (SF) has only been tested for reliability and
validity among adolescents. The present study determined test–retest reliability and criterion validity of the IPAQ-SF for older
Vietnamese adults aged 60–75 years.
Methods: In all, 197 participants were recruited from the community. Subjects were requested to wear a pedometer, record
daily steps and list all physical activities in a log-book for 7 consecutive days. Those who completed the requirements were
interviewed using the IPAQ-SF (IPAQ1). A repeated interview was arranged 3 days later (IPAQ2).
Results: The final sample consisted of 150 participants (75 men, 75 women) with mean ( s.d.) age of 66.8  5.1 years. The intraclass
correlation coefficients between IPAQ1 and IPAQ2 exceeded 0.80 for all physical activity domains and sitting, indicating good
reliability. However, fair to weak validity was evident between IPAQ1 measures and activity log and pedometer readings, with
Spearman correlations of 0.46 and 0.20, respectively.
Conclusions: The Vietnamese translated version of IPAQ-SF appears to be a reliable and reasonably valid instrument to assess
and monitor habitual physical activity for older adults in Vietnam.

So what? The IPAQ-SF could provide useful physical activity data to evaluate the effectiveness of health promotion intervention
programs and for international comparison purposes.

Key words: pedometer, test–retest, validation, Vietnamese.

Received 4 February 2013, accepted 21 June 2013, published online 25 July 2013

Introduction Although the validity and reliability of the IPAQ has been examined
The International Physical Activity Questionnaire (IPAQ) was in 12 countries, it needs to be tested in other settings with different
developed as a standardised instrument to monitor physical activity target groups.1 A recent systematic review reported that 23 IPAQ-SF
(PA) among 15–65-year-old individuals across countries and cultural validation studies have been conducted globally.2 These studies
contexts.1 There are four versions of the IPAQ consisting of a long varied greatly in methodology, sample size, age group and the
form (IPAQ-LF) and a short form (IPAQ-SF) that can be either self- study population. Most studies were conducted on participants
administered or administered over the telephone. The IPAQ-SF <40 years of age.1,3–6 Only five studies focused on older adults:
collects PA information for the previous 7 days regarding vigorous in Australia (65–89 years),7 in the US (50–87 years),8 in Japan
and moderate acitivity, walking and sedentary behaviours. The IPAQ- (65–89 years),9 in China (51–82 years)10 and in South Africa (60–70
LF and IPAQ-SF are recommended for use in research requiring + years).11 Nevertheless, the IPAQ-SF is still widely used to monitor the
detailed assessment and PA surveillance, respectively.1 PA of older adults.12,13

Journal compilation  Australian Health Promotion Association 2013 CSIRO Publishing www.publish.csiro.au/journals/hpja
Reliability and validity of Vietnamese IPAQ-SF Health Promotion Journal of Australia 127

In Vietnam, there have been five reports on the validation of PA were collected on three occasions: Days 1, 9 and 12. On Day 1, the
instruments,14–18 but the IPAQ-SF has only been validated for investigator sought informed consent from the participants
Vietnamese adolescents.17 Therefore, it is important to determine before obtaining their demographic information. Participants were
whether the IPAQ-SF is suitable to monitor the PA of older adults instructed to wear the pedometer for 7 consecutive days, except
in the Vietnamese context. The present study investigated the when sleeping and during any water-based activity, and to make
test–retest reliability and criterion validity of the Vietnamese log-book entries every day. In addition, participants were requested
translated version of the IPAQ-SF for older adults aged 60–75 years to reset the pedometer each morning and to write down the
in Vietnam. We focused on older adults aged 60–75 years because number of steps in the log-book at the end of each day. On Day 9,
of the aging of the population and the known health benefits of the investigator administered the IPAQ-SF (IPAQ1) and collected
PA for this age group. the pedometer and log-book. On Day 12, the investigator met the
participant and administered the IPAQ-SF again (IPAQ2) using the
Methods same reference time frame.20 The scheduling of the initial interview
was arranged to suit the participants. The entire data collection
Recruitment of participants was stacked over a period of 8 weeks. Each IPAQ-SF interview
In all, 197 older adults residing in Hung Yen Province, Vietnam, were took approximately 10 min to complete.
invited to participate in the study. This convenience sample of
subjects was recruited from the community using a snowball Statistical analysis
strategy, whereby volunteers introduced others to the study Data on self-reported PA were coded and scored according to IPAQ
through word of mouth. Subjects were screened for suitability guidelines.21 The metabolic equivalent task (MET-minutes per week)
based on self-report on the following selection criteria: (1) age of each domain was calculated by multiplying the reported weekly
between 60 and 75 years; (2) generally healthy without any mobility- minutes spent by the corresponding MET score (8 for vigorous
related problems; and (3) no difficulty recalling recent events. To activities, 4 for moderate activities and 3.3 for walking). Energy
assess memory recall, potential participants were asked the expenditure for each individual was obtained by summing these
question, ‘Do you remember what you did yesterday? Please list three activity domains.
these activities’. The interviewer then made a decision on eligibility Each activity reported in the PA log was assigned the MET score of
based on the logic of the response obtained. No inducement was the most similar activity listed in the Compendium of Physical
given for participation in the study. Activities.22 The MET-minutes of each reported activity were
calculated by multiplying the activity duration by its MET score.
Instruments The daily total minutes of activity were aggregated by intensity
A questionnaire incorporating the IPAQ-SF was used to collect PA
level into the following categories: sitting (1.5 MET), moderate
and demographic information. The items were translated into
(3–5.99 MET) and vigorous ( 6 MET). The total duration spent for
Vietnamese and back-translated by independent translators. The
the whole week was generated from the completed daily logs.23
original meaning of the words was kept and adapted culturally. The
Average steps per week recorded by the pedometers were calculated
questionnaire was tested for face and content validity involving 10
from the log-book entries.
older adults during the pilot phase of the study. The translated
version was then revised and modified accordingly. The test–retest reliability of the questionnaire was examined using
intraclass correlation coefficient (ICC) with respect to intensity
A log-book for recording daily PA and their duration was developed
levels (vigorous, moderate, walking and sitting) and total reported
by the research team. The log-book consisted of seven pages (one
activities obtained from the second interview (IPAQ1) and the third
page per day), with each page having four columns: activity number,
interview (IPAQ2). Spearman correlation coefficients (r) were
type of activity (with a brief description), intensity of the activity and
obtained to assess the criterion validity. These correlations were
the duration over which the activity was performed (from start to
used to determine the association between each activity domain
end time). The daily reading (number of steps) from a pedometer was
reported from IPAQ1 and data from the PA log and the pedometer
recorded on the bottom of the page. A separate two-page guide,
readings. The magnitude of the correlations may be interpreted as
explaining how to record activities, together with examples, was
low (<0.40), moderate (0.40–0.59), substantial (0.60–0.79) and high
provided to each participant.
(>0.80) associations.24 All statistical analyses were performed using
The Yamax SW-200 pedometer (Yamax, Kumamoto, Japan) was used SPSS version 20 (SPSS Inc., Chicago, IL, USA).
to count the daily steps for each participant. This objective measure
of PA has been reported to be accurate and reliable.19 Results
Measurements The final sample consisted of 150 participants (75 men, 75 women)
The study protocol was approved by the Human Research Ethics who had successfully completed the PA log and recorded steps
Committee of Curtin University (Approval no. SPH-26-2012). Data for 7 days, giving a final response rate of 76%. Table 1 presents
128 Health Promotion Journal of Australia D. V. Tran et al.

sample characteristics. The mean ( s.d.) age of the cohort was (69.3%), and one-third (34%) had already retired from the
66.8  5.1 years. Most participants were married and living with workforce. Only a few participants were considered to be in the low
their partners (88.7%), few of them were divorced or widowed or PA range.
living alone. Most had secondary school or lower education
Measurements of PA
Table 2 compares PA measures and sitting times between IPAQ1
Table 1. Demographic characteristics and physical activity levels of and IPAQ2. As expected, the older Vietnamese adults engaged in
the study participants relatively little vigorous activity, whereas moderate-intensity activity
Data show the number of individuals in each group, with percentages in
was the most popular PA domain reported. There were no significant
parentheses. IPAQ1, results from the first International Physical Activity
Questionnaire; PA, physical activity differences in PA minutes between IPAQ1 and IPAQ2 for men,
women and both genders (P 0.05) according to Wilcoxon signed-
Men Women Both
(n = 75) (n = 75) (n = 150)
rank tests.

Age (years) Table 3 summarises the 7-day pedometer readings and the PA log
60–65 29 (38.7%) 43 (57.3%) 72 (48.0%) outcomes. On average men reported a similar number of steps
66–70 19 (25.3%) 16 (21.3%) 35 (23.3%) per week to women (P = 0.76) based on a signed-rank test.
71–75 27 (36.0%) 16 (21.3%) 43 (28.7%) Moderate-intensity activities again accounted for the largest
Marital status proportion of total PA in the recorded week of diary data, followed
Married 68 (90.6%) 65 (86.7%) 133 (88.7%) by walking. Popular moderate activities for the older Vietnamese
Divorced/widowed/single 7 (9.4%) 10 (13.3%) 17 (11.3%)
adults included cycling and household work, such as preparing
Education level meals and washing clothes by hand, whereas swimming was
No education 2 (2.7%) 12 (16.0%) 14 (9.3%)
Primary school 12 (16.0%) 17 (22.7%) 29 (19.3%) seldom undertaken. It is also evident that the older adults spent
Secondary school 30 (40.0%) 31 (41.3%) 61 (40.7%) much time sitting (while watching television and having meals)
High school 15 (20.0%) 6 (8.0%) 21 (14.0%) during the week.
College or university 16 (21.3%) 9 (12.0%) 25 (16.7%)
Retirement status Test–retest reliability
Farmer or employed 36 (48.0%) 63 (84.0%) 99 (66.0%) Table 4 presents results of the test–retest. The IPAQ-SF showed good
Retired 39 (52.0%) 12 (16.0%) 51 (34.0%) reliability with all ICC >0.80 (P < 0.05), except for men’s sitting. The
PA levelA highest ICC was the vigorous domain (0.96), whereas the lowest
IPAQ1 ICC corresponded to sitting (0.81) on both weekdays and weekends.
Low 2 (2.7%) 0 (0%) 2 (1.3%) Only slight differences in ICC were found between older Vietnamese
Moderate 17 (22.7%) 14 (18.7%) 31 (20.7%)
High 56 (74.7%) 61 (81.3%) 117 (78.0%) men and women, with generally higher ICC recorded among men
in all three PA domains. However, the IPAQ-SF appeared to be more
PA log
Low 4 (5.3%) 1 (1.3%) 5 (3.3%) reliable for women in terms of sitting.
Moderate 30 (40.0%) 23 (30.7%) 53 (35.3%)
High 41 (54.7%) 51 (68.0%) 92 (61.3%) Criterion validity
A
Table 5 shows the Spearman correlation coefficients between
Activity levels were classified on the basis of metabolic equivalent task
IPAQ1 measures and the PA log outcomes and pedometer
(MET-minutes per week) as follows: low, <600 MET-minutes per week;
moderate, 600–3000 MET-minutes per week; high, >3000 MET-minutes readings. The associations were consistently higher among men
per week.21 than women in all domains, except moderate activity. Overall,

Table 2. Physical activity measures and sitting time as determined from the first and second International Physical Activity Questionnaires
(IPAQ1 and IPAQ2) administered at 3-day intervals
Data show the median, with the interquartile range (i.e. difference between upper and lower quartiles) in parentheses. MET, metabolic equivalent task

Men (n = 75) Women (n = 75) Both (n = 150)

IPAQ1 IPAQ2 IPAQ1 IPAQ2 IPAQ1 IPAQ2
MET-minutes per week
Vigorous 0 (480) 0 (480) 0 (480) 0 (720) 0 (480) 0 (540)
Moderate 3360 (3640) 3360 (3360) 4320 (4800) 5040 (4800) 3360 (5040) 4200 (5040)
Walking 924 (1188) 693 (1040) 1039 (1848) 1040 (1779) 924 (1848) 924 (1040)
Total activities 4746 (4293) 4746 (4200) 6279 (4760) 6279 (5027) 5351 (4589) 5415 (4406)
Sitting per day (min)
Weekdays 360 (180) 330 (120) 300 (120) 300 (120) 300 (120) 300 (98)
Weekend 360 (180) 330 (120) 300 (120) 300 (120) 300 (150) 315 (98)
Reliability and validity of Vietnamese IPAQ-SF Health Promotion Journal of Australia 129

reasonable validity was achieved, with r = 0.46 for total PA between Discussion
IPAQ1 and PA log. However, for sitting the correlations were low for
both genders. The correlations between IPAQ1 measures and Test–retest reliability of the IPAQ-SF
pedometer steps were generally low and varied substantially in The Vietnamese version of IPAQ-SF appears to have good test–retest
magnitude and sign for both genders. Therefore, the IPAQ-SF does reliability, with all ICC exceeding 0.80 except for men’s sitting. The
not have adequate validity if pedometer readings are relied upon as results are consistent with previous IPAQ validation studies, which
the objective criterion. reported ICC >0.65.1,25,26 Some IPAQ validation studies on older
adults also reported a moderate to good test–retest reliability, in
particular ICC >0.57 among Japanese elderly9 and ICC >0.80 among
Table 3. Pedometer readings and physical activity log outcomes Chinese older adults.10 The observed high ICC may be due to the
Data show the median, with the interquartile range (i.e. difference between short interval (3 days) between repeated administrations. Previous
upper and lower quartiles) in parentheses. MET, metabolic equivalent task studies have suggested that reliability could be affected by the
Men (n = 75) Women (n = 75) Both (n = 150) interval between the two interviews. The ICC were generally higher
in IPAQ validation studies adopting a shorter interval (8 days)1,10
Pedometer
Steps per week 48 249 (32 546) 52 244 (38 872) 48 971 (34 746) than those using a longer interval (2–3 weeks).9,15,27 It has been
suggested that 3 or 4 days is best and 7 days is the maximum gap
Physical activity log (MET-minutes per week)
Vigorous 0 (270) 0 (540) 0 (360) to assess the test–retest reliability of the IPAQ.20 Moreover, the
Moderate 1998 (2438) 3300 (3036) 2550 (3059) reliability of the IPAQ-SF could be influenced by memory
Walking 840 (1200) 580 (855) 660 (1086) deterioration and increasing cognitive problems due to aging.28 In
Total activities 3293 (3345) 4650 (3035) 3977 (3260) the present study, those older adults who reported difficulty in
Sitting 3191 (1599) 2578 (1477) 2913 (1572)
recalling recent events were excluded during the initial eligibility
assessment.
The ICC for vigorous activity was very high (0.96) because older adults
Table 4. Test–retest reliability of the International Physical Activity typically undertake vigorous-intensity activities less frequently.29
Questionnaire–Short Form for older Vietnamese adults Indeed, only one-third of participants reported participating in
The intraclass coefficient (ICC) was calculated from responses on the first and
vigorous activities in the past week, such as jogging, playing
second International Physical Activity Questionnaire–Short Form (IPAQ1 and
IPAQ2, respectively), administered 3 days apart. MET, metabolic equivalent basketball, farming and preparing firewood. In addition, many
task, CI, confidence interval participants admitted to having stable daily habitual activities for
ICC (95% CI)
some years, which may explain the similarity in answers between
Men (n = 75) Women (n = 75) Both (n = 150) the two interviews.
MET-minutes per week
Vigorous 0.97 (0.96–0.98) 0.94 (0.94–0.96) 0.96 (0.94–0.97) Validity of the IPAQ-SF
Moderate 0.93 (0.89–0.95) 0.91 (0.86–0.94) 0.92 (0.89–0.94) Few studies used both direct and indirect methods to examine the
Walking 0.88 (0.82–0.93) 0.87 (0.79–0.91) 0.88 (0.83–0.91) validity of the IPAQ-SF. In the present study, activities reported in the
Total activities 0.90 (0.84–0.93) 0.91 (0.86–0.94) 0.91 (0.87–0.93) questionnaire were compared with two reference methods, a PA
Sitting log and the steps per day measured by a pedometer. The Spearman
Weekdays 0.78 (0.66–086) 0.83 (0.73–0.89) 0.81 (0.74–0.86) correlations were higher than those among Vietnamese women in
Weekend 0.77 (0.65–0.86) 0.83 (0.74–0.89) 0.81 (0.74–0.86)
a previous IPAQ-LF validation study using the same criteria, in

Table 5. Criterion validity of International Physical Activity Questionnaire–Short Form for older Vietnamese
adults
IPAQ1, first International Physical Activity Questionnaire administered; MET, metabolic equivalent task; PA, physical activity

Spearman correlation coefficient

PA log Pedometer (steps per week)
Men Women Both Men Women Both
(n = 75) (n = 75) (n = 150) (n = 75) (n = 75) (n = 150)
IPAQ1 (MET-minutes per week)
Vigorous 0.62 0.37 0.50 0.11 0.03 0.07
Moderate 0.41 0.43 0.45 0.11 0.27 0.19
Walking 0.73 0.55 0.64 0.24 –0.28 –0.04
Total activities 0.48 0.40 0.46 0.23 0.18 0.20
Sitting 0.34 0.15 0.32 –0.22 –0.28 –0.23
130 Health Promotion Journal of Australia D. V. Tran et al.

which the correlation between IPAQ and activity log for total PA type and duration of activities based on 24-h recall.38 Thus, it was
was r = 0.14.15 The results were also comparable with another log- easy to assign MET scores for each activity to obtain the
book validation of the Chinese version of the IPAQ-SF,23 in which corresponding energy expenditure estimates. In addition, a
the same 7-day reference period was used. pedometer was worn by each participant for 7 consecutive days.
Several sources of information errors can potentially arise in PA None of the four IPAQ-SF validation studies for older adults used
logs. First, a memory recall problem is likely if the PA log is not concurrent measures of direct and indirect PA for comparison
updated on an on-going basis.30 Second, similar activities could purposes.8–11 Second, the Vietnamese version of the IPAQ-SF has
have been performed at different levels of intensity,30,31 such as been carefully pilot tested to ensure its face and content validity
gardening or taking care of children. To minimise such errors, our before application. All participants were interviewed and assessed
participants were requested to provide the intensity level and by a single investigator (DVT) to eliminate inter-rater bias.
brief description of the activities they performed, which facilitated Intrarater bias was also minimised by adopting the same
the subsequent assignment and conversion to MET scores. They consistent procedure throughout the data-collection period.
were also encouraged to record their activities into the PA log- Several limitations should be considered when interpreting the
book as soon as possible, and enter their daily activities for 7 findings. The present study adopted a convenience snowball
consecutive days. sampling strategy for the recruitment of community-dwelling
When compared with objective pedometer data, the IPAQ-SF older adults. Although the participants were selected from the
exhibited fair but relatively weak validity. Nevertheless, the underlying population, the recruitment process introduced
magnitude of the correlation for total PA was comparable with a selection bias because all subjects were voluntary participants.
previous IPAQ-SF validation study for adults aged >50 years in Another limitation concerned the PA log, from which it was unable
China.10 These low correlations may be attributable to either the to determine whether participants completed their activities in
lack of sensitivity of the questionnaire to detect PA intensities32 or multiples of 10-min bouts or performed the activities during one
the nature of the pedometer.10 It has been well documented that continuous period, despite the fact that they were requested to
overestimation is a common issue for the IPAQ-SF.2,33 Meanwhile, enter the start and end times for each activity. Moreover, subjects
the pedometer is designed to detect vertical accelerations at the may report combined activities with durations <10 min for the
hip; it cannot measure walking at slow speeds, upper body IPAQ-SF, which could explain the overreporting in some validation
movement and activities such as swimming, cycling and washing studies.33 Finally, alternative methods exist to measure daily PA
clothes by hand. Pedometers are also unable to record the intensity instead of the pedometer, but they were not used in the present
of different activities.34,35 study due to cost and logistic constraints.

It should be noted that the associations between the IPAQ-SF and

the two reference methods were stronger in men than in women, Conclusion
except for moderate PA. Similar results using an accelerometer as The present study represents the first validation of an international
the criterion objective measure to validate the IPAQ-SF among older standardised PA questionnaire for elderly Vietnamese people. The
adults have been reported.8,11 Research focusing on the responses IPAQ-SF appears to have good test–retest reliability and satisfactory
of different genders and PA would warrant further consideration. criterion validity. It was found to be a suitable instrument for
The MET values assigned to the intensity of PA were developed monitoring habitual PA in older Vietnamese adults, and could
for adults aged 18–64 years and may not be applicable to older provide useful PA data for international comparison purposes.
adults.36,37 Another issue is that the standard MET scores from the
IPAQ guidelines21 are different from those assigned to specific
activities in the diary log based on the Compendium of Physical
Acknowledgement
Activities.22 To further assess the sensitivity of our findings, the The authors are indebted to all the participants who volunteered
analyses were repeated using activity duration (minutes). The their time for the study.
resulting correlations (omitted for brevity) were very similar to
those reported in Table 5, confirming the findings that adjusted for
PA intensity.
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