Chronic diseases and health promotion

Global Physical Activity Surveillance

Introduction

Physical inactivity is a major independent modifiable risk factor for noncommunicable diseases (NCDs) such as cardiovascular disease, ischaemic stroke, type 2 diabetes, colon cancer, and breast cancer. It is also associated with other important health outcomes including mental health, injuries, falls, and obesity.

Surveillance of population levels of physical activity using a standardized protocol is an important and necessary part of a public health response to current concerns regarding lack of physical activity in many populations. Surveillance of physical activity in populations is most often undertaken using questionnaires, as these are relatively inexpensive and easy to administer compared to objective measurement techniques.

About a decade ago, given the increased global interest in the role of physical activity to prevent NCDs and the lack of data to inform within-country public health efforts, the WHO developed the Global Physical Activity Questionnaire (GPAQ) for physical activity surveillance. Since then, the GPAQ has undergone a research program which shows that it is valid and reliable, but also adaptable to incorporate cultural and other differences. It has been used in more than 100 countries globally, mainly through the WHO STEPwise approach to NCD risk factor surveillance (STEPS).

The GPAQ covers several components of physical activity, such as intensity, duration, and frequency, and it assesses three domains in which physical activity is performed (occupational physical activity, transport-related physical activity, and physical activity during discretionary or leisure time).

Questionnaire

To access the Global Physical Activity Questionnaire, please click on the links below. The GPAQ is available in Arabic, Chinese, English, French, German, Italian, Russian, and Spanish. To access it as part of the WHO STEPS Instrument, click on "The STEPS Instrument and Support Materials".

Show cards

It is advised that show cards be used when the GPAQ is administered. Show cards should be developed for each of the activity types covered by the GPAQ: vigorous and moderate activity at work, transport activity, vigorous and moderate activity during leisure time, as well as sitting. Show cards will help the respondents to know what activities are meant by each question. They should be showing typical physical activities for the setting that the GPAQ is used in. Examples of generic show cards that will need to be adapted to the local context can be accessed below.

GPAQ Analysis Guide

Guidelines on how to clean and analyse data derived from the GPAQ are accessible in English by clicking on the link below.

GPAQ data analysis allows to produce, amongst other indicators, the percentage of a population that meets or does not meet the WHO Global Recommendations on Physical activity for Health. Click on the link below for more information on the WHO Global Recommendations on Physical activity for Health.

GPAQ Analysis Programs

Programs for the analysis of data derived from the GPAQ are available in EpiInfo and SPSS as part of the STEPS Analysis Programs. The GPAQ Analysis Programs are those starting with 'CleanRecode' and those starting with 'P'. Please click on the link below to access the programs. GPAQ Analysis Programs are also available in STATA and SAS upon request.

The Global Strategy on Diet, Physical Activity and Health

In order to use information derived from the GPAQ as well as other information on population levels of physical activity and diet to inform policy and set up interventions, WHO has developed, under a May 2002 mandate from Member States, a Global Strategy on Diet, Physical Activity and Health, which was endorsed by the May 2004 World Health Assembly. More information on this Strategy is accessible by clicking on the link below.

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