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Background  Accurate measurement of physical activity (PA) is critical to establish dose-response relationships with various health outcomes. We compared the self-administered PA questionnaire from the Norwegian Women and Cancer Study (NOWAC) with a criterion method in middle-aged Norwegian women.    Methods  A sample of 177 randomly recruited healthy women attended two clinical visits approximately 4-6 months apart. At each visit, the women completed the NOWAC PA questionnaire (NOPAQ), rating their overall PA level on a 10-category scale (1 being a  "very low"  and 10 being a  "very high"  PA level) and performed an 8-minute step-test to estimate aerobic fitness (VO 2 max). After each visit, the women wore a combined heart rate and movement sensor for 4 consecutive days of free-living. Measures of PA obtained from the combined heart rate and movement sensor, which were used as criterion, included individually calibrated PA energy expenditure (PAEE), acceleration, and hours/day of moderate-to-vigorous intensity PA (MVPA). These were averaged between visits and compared to NOPAQ scores at visit 2.    Results  Intra-class correlation coefficients for objective measures from both free-living periods were in the range of 0.65-0.87 ( P  < 0.001), compared to 0.62 ( P  < 0.001) for NOPAQ. There was a moderate but significant ( P  < 0.001) Spearman's rank correlation coefficient in the range of 0.36-0.46 between NOPAQ and objective measures of PA. Linear trends for the association between the NOPAQ rating scale with PAEE, hours/day of MVPA and VO 2 max  (P  < 0.001) were also demonstrated.    Conclusions  Self-reported PA level measured on a 10-category scale appears valid to rank PA in a female Norwegian population.

Criterion validity of a 10-category scale for ranking physical activity in Norwegian women