Abstract
Physical inactivity among children and adolescents is a growing public health concern in low- and middle-income countries (LMICs) in Africa, where culturally appropriate physical activity (PA) surveillance tools remain scarce. The Global Adolescent and Child Physical Activity Questionnaire (GAC-PAQ) was developed to assess PA across multiple domains in diverse settings. This study evaluated the GAC-PAQ's cultural relevance, feasibility, and inter-rater reliability among children and caregivers in Nigeria. In Phase 1, we conducted cognitive interviews with 10 child–caregiver pairs from urban (n= 5) and rural (n= 5) settings, using think-aloud techniques and targeted probing to assess comprehension of the GAC-PAQ and its cultural appropriateness. Findings informed linguistic and contextual revisions prior to pilot testing. In Phase 2, the revised GAC-PAQ was pilot-tested with 45 youth–caregiver pairs (youth aged 8–17 years) from primary and secondary schools in Osogbo and Ede, Osun State, Nigeria. Inter-rater reliability between child and caregiver reports was assessed using Cohen's kappa (κ), and we examined associations between PA duration, age, sex, and residence using proportional-odds regression models. Cognitive interviews identified key cultural adaptations and post-revision app satisfaction was high (caregivers: 100%; youth: 95%). Inter-rater reliability ranged from fair to almost perfect across domains, with the strongest agreement for transportation mode (κ= 0.81) and the weakest for recess duration (κ = 0.26). Age, sex, and residence were each significantly associated with PA duration across selected domains. These findings provide preliminary evidence supporting the cultural appropriateness, content validity, and inter-rater reliability of the GAC-PAQ among children and adolescents in Nigeria.
References
Ackah, M., Owiredu, D., Salifu, M. G., & Yeboah, C. O. (2022). Estimated prevalence and gender disparity of physical activity among 64,127 in-school adolescents (aged 12–17 years): A multi-country analysis of Global School-based Health Surveys from 23 African countries. PLOS Global Public Health, 2(10), e0001016. https://doi.org/10.1371/journal.pgph.0001016
Adeniyi, A. F., Odukoya, O. O., Oyeyemi, A. L., Adedoyin, R. A., Ojo, O. S., Metseagharun, E., & Akinroye, K. K. (2016). Results from Nigeria's 2016 report card on physical activity for children and youth. Journal of Physical Activity and Health, 13(Suppl. 2), S231–S236. https://doi.org/10.1123/jpah.2016-0305
Akwaboah, P. K., Pierson, A., Obrutu, K., Rostami Haji Abadi, M., Oyeyemi, A. L., & Larouche, R. (2026). Testing the physical activity transition model among children and adolescents in low- and middle-income countries: A systematic review and meta-analysis. Journal of Physical Activity and Health, 23(7), 923–935. https://doi.org/10.1123/jpah.2025-0372
Aubert, S., Barnes, J. D., Demchenko, I., Hawthorne, M., Abdeta, C., Abi Nader, P., Adsuar Sala, J. C., Aguilar-Farias, N., Aznar, S., Bakalár, P., Bhawra, J., Brazo-Sayavera, J., Bringas, M., Cagas, J. Y., Carlin, A., Chang, C.-K., Chen, B., Christiansen, L. B., Christie, C. J.-A., . . . Tremblay, M. S. (2022). Global Matrix 4.0 physical activity report card grades for children and adolescents: Results and analyses from 57 countries. Journal of Physical Activity and Health, 19(11), 700–728. https://doi.org/10.1123/jpah.2022-0456
Aubert, S., Brazo-Sayavera, J., González, S. A., Janssen, I., Manyanga, T., Oyeyemi, A. L., Picard, P., Sherar, L. B., Turner, E., & Tremblay, M. S. (2021). Global prevalence of physical activity for children and adolescents; inconsistencies, research gaps, and recommendations: A narrative review. International Journal of Behavioral Nutrition and Physical Activity, 18, 81. https://doi.org/10.1186/s12966-021-01155-2
Bervoets, L., Van Noten, C., Van Roosbroeck, S., Hansen, D., Van Hoorenbeeck, K., Verheyen, E., Van Hal, G., & Vankerckhoven, V. (2014). Reliability and validity of the Dutch Physical Activity Questionnaires for Children (PAQ-C) and Adolescents (PAQ-A). Archives of Public Health, 72, 47. https://doi.org/10.1186/2049-3258-72-47
Bigna, J. J., & Noubiap, J. J. (2019). The rising burden of non-communicable diseases in sub-Saharan Africa. The Lancet Global Health, 7(10), e1295–e1296. https://doi.org/10.1016/S2214-109X(19)30370-5
Chinapaw, M. J. M., Mokkink, L. B., van Poppel, M. N. M., van Mechelen, W., & Terwee, C. B. (2010). Physical activity questionnaires for youth: A systematic review of measurement properties. Sports Medicine, 40(7), 539–563. https://doi.org/10.2165/11530770-000000000-00000
City Population (2022). Osun State Nigerai. Population Statistics, Chart and Map. https://www.citypopulation.de/en/nigeria/admin/NGA030__osun/
Cohen, J. (1968). Weighted kappa: Nominal scale agreement with provision for scaled disagreement or partial credit. Psychological Bulletin, 70, 213–220. https://doi.org/10.1037/h0026256
de Raadt, A., Warrens, M. J., Bosker, R. J., & Kiers, H. A. L. (2021). A comparison of reliability coefficients for ordinal rating scales. Journal of Classification, 38(3), 519–543. https://doi.org/10.1007/s00357-021-09386-5
Encyclopedia Britannica. (2024). Osogbo. https://www.britannica.com/place/Osogbo
Guthold, R., Stevens, G. A., Riley, L. M., & Bull, F. C. (2020). Global trends in insufficient physical activity among adolescents: A pooled analysis of 298 population-based surveys with 1.6 million participants. The Lancet Child & Adolescent Health, 4(1), 23–35. https://doi.org/10.1016/S2352-4642(19)30323-2
Koning, M., de Jong, A., de Jong, E., Visscher, T. L. S., Seidell, J. C., & Renders, C. M. (2018). Agreement between parent and child report of physical activity, sedentary and dietary behaviours in 9–12-year-old children and associations with children's weight status. BMC Psychology, 6, 14. https://doi.org/10.1186/s40359-018-0227-2
Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33(1), 159–174. https://doi.org/10.2307/2529310
Larouche, R., Rostami Haji Abadi, M., Aubert, S., Bhawra, J., Brazo-Sayavera, J., Carson, V., Colley, R. C., Delisle Nyström, C., Esliger, D. W., Harper-Brown, R., Gonzalez Cifuentes, S. A., Jáuregui, A., Katewongsa, P., Khadilkar, A., Kira, G., Kuzik, N., Liu, Y., Lof, M., Loney, T., . . . Tremblay, M. S. (2024). Development and validation of the Global Adolescent and Child Physical Activity Questionnaire (GAC-PAQ) in 14 countries: Study protocol. BMJ Open, 14, e082275. https://doi.org/10.1136/bmjopen-2023-082275
Larouche, R., Neves de Oliveira, S., Rostami Haji Abadi, M., Benavides-Castro, J. K., Sarmiento, O. L., Angulo Garay, G., Argumedo, G., Ashaolu, J. O., Baghestani, A., Bhawra, J., Brazo-Sayavera, J., Choonak, N., Nyström, C. D., Evance, S., Hamrik, Z., Jáuregui, A., Kaewpikul, P., Katewongsa, P., Khadilkar, A., Kira, G., … Tremblay, M. S. (2025). Content validation of the Global Adolescent and Child Physical Activity Questionnaire (GAC-PAQ) in low-, middle-, and high-income countries across 6 continents. Journal of sport and health science, 15, 101074. Advance online publication. https://doi.org/10.1016/j.jshs.2025.101074
Nasruddin, N. I. N., Murphy, J., & Armstrong, M. E. G. (2023). Physical activity surveillance in children and adolescents using smartphone technology: Systematic review. JMIR Pediatrics and Parenting, 6, e42461. https://doi.org/10.2196/42461
National Bureau of Statistics. (2017). Annual abstract of statistics 2016 (Vol. 1). Federal Republic of Nigeria. https://www.nigerianstat.gov.ng/pdfuploads/ANNUAL%20ABSTRACT%20STATISTICS%20VOLUME-1.pdf
Onwuakagba, I. U., Obiekwe, S. J., Okoye, E. C., Kanu, F. C., Amaechi, I. A., & Akosile, C. O. (2024). The Igbo version of the Global Physical Activity Questionnaire (GPAQ): A cross-cultural adaptation study. Journal of Activity, Sedentary and Sleep Behaviors, 3, 20. https://doi.org/10.1186/s44167-024-00061-9
Onywera, V. O., Larouche, R., Oyeyemi, A. L., Prista, A., Akinroye, K. K., Heyker, S., Owino, G. E., & Tremblay, M. S. (2018). Development and convergent validity of new self-administered questionnaires of active transportation in three African countries: Kenya, Mozambique and Nigeria. BMC Public Health, 18, 1018. https://doi.org/10.1186/s12889-018-5954-z
Oyeyemi, A. L., Moss, S. J., Monyeki, M. A., & Kruger, H. S. (2016). Measurement of physical activity in urban and rural South African adults: A comparison of two self-report methods. BMC Public Health, 16, 1004. https://doi.org/10.1186/s12889-016-3693-6
Oyeyemi, A. L., Kasoma, S. S., Onywera, V. O., Assah, F., Adedoyin, R. A., Conway, T. L., Moss, S. J., Ocansey, R., Kolbe-Alexander, T. L., Akinroye, K. K., Prista, A., Larouche, R., Gavand, K. A., Cain, K. L., Lambert, E. V., Aryeetey, R., Bartels, C., Tremblay, M. S., & Sallis, J. F. (2016B). NEWS for Africa: Adaptation and reliability of a built environment questionnaire for physical activity in seven African countries. International Journal of Behavioral Nutrition and Physical Activity, 13, 33. https://doi.org/10.1186/s12966-016-0357-5
Oyeyemi, A. L., & Larouche, R. (2018). Prevalence and correlates of active transportation in developing countries. In R. Larouche (Ed.), Children's active transportation (pp. 173–191). Elsevier. https://doi.org/10.1016/B978-0-12-811931-0.00012-0
Oyeyemi, A. L., Ogunleye, A. B., Okafor, A. C., Kollipara, N., ChinAPaw, M. J. M., & Omotoso, D. R. (2026). Social and physical environmental correlates of movement behaviors, body weight status, and well-being among adolescents in Nigeria: A youth-centered participatory action project narrative review. International Journal of Behavioral Nutrition and Physical Activity, 23, 42. https://doi.org/10.1186/s12966-026-01904-1
Oyeyemi, A. L., Oyeyemi, A. Y., Adegoke, B. O., Oyetoke, F. O., Aliyu, H. N., Aliyu, S. U., & Rufai, A. A. (2011). The short International Physical Activity Questionnaire: Cross-cultural adaptation, validation and reliability of the Hausa language version in Nigeria. BMC Medical Research Methodology, 11, 156. https://doi.org/10.1186/1471-2288-11-156
Oyeyemi, A. L., Umar, M., Oguche, F., Aliyu, S. U., & Oyeyemi, A. Y. (2014). Accelerometer-determined physical activity and its comparison with the International Physical Activity Questionnaire in a sample of Nigerian adults. PLOS ONE, 9(1), e87233. https://doi.org/10.1371/journal.pone.0087233
Poulain, T., Vogel, M., Meigen, C., Spielau, U., Hiemisch, A., & Kiess, W. (2020). Parent-child agreement in different domains of child behavior and health. PLOS ONE, 15(4), e0231462. https://doi.org/10.1371/journal.pone.0231462
Ritchie, J., & Spencer, L. (1994). Qualitative data analysis for applied policy research. In A. Bryman & R. G. Burgess (Eds.), Analyzing qualitative data (pp. 173–194). Routledge, London, 173-194. https://doi.org/10.4324/9780203413081_chapter_9.
Rostami Haji Abadi, M., Kwaghbo, N., Onyeso, O. K., Sadia, F., Benavides Castro, J. K., Santos Silva, D. A., Yan, Y., Shen, Y., Hamrik, Z., Sarmiento, O. L., Liu, Y., Tremblay, M. S., & Larouche, R. (2025). Psychometric properties of physical activity questionnaires for children and adolescents: An updated systematic review. Sports Medicine, 55(9), 2225–2301. https://doi.org/10.1007/s40279-025-02270-x
Sallis, J. F., Bull, F., Guthold, R., Heath, G. W., Inoue, S., Kelly, P., Oyeyemi, A. L., Perez, L. G., Richards, J., Hallal, P. C., & Lancet Physical Activity Series 2 Executive Committee. (2016). Progress in physical activity over the Olympic quadrennium. The Lancet, 388(10051), 1325–1336. https://doi.org/10.1016/S0140-6736(16)30581-5
Scott, K., Ummer, O., & LeFevre, A. E. (2021). The devil is in the detail: Reflections on the value and application of cognitive interviewing to strengthen quantitative surveys in global health. Health Policy and Planning, 36(6), 982–995. https://doi.org/10.1093/heapol/czab048
Šuc, A., Einfalt, L., Šarabon, N., & Kastelic, K. (2024). Validity and reliability of self-reported methods for assessment of 24-h movement behaviours: A systematic review. International Journal of Behavioral Nutrition and Physical Activity, 21, 83. https://doi.org/10.1186/s12966-024-01632-4
Todorovic, N., Ranisavljev, M., Korovljev, D., Mauti, J., Neumann, C., Mboya, I., Ferrero, E., Ourohiré, M., Somé, S., Liu, S., Shinde, S., Noor, R. A., Bärnighausen, T., & Ostojic, S. M. (2025). Promoting adolescent and youth health through physical activity initiatives and interventions in Sub-Saharan Africa: The ARISE-NUTRINT and DASH initiatives. International Journal of Public Health, 70, 1608609. https://doi.org/10.3389/ijph.2025.1608609
Wachira, L.-J., Hayker, S. O., Larouche, R., Oyeyemi, A. L., Prista, A., Owino, G. E., Tremblay, M. S., & Onywera, V. O. (2022). Physical activity and active transportation behaviour among rural, peri-urban and urban children in Kenya, Mozambique and Nigeria: The PAAT Study. PLOS ONE, 17(1), e0262768. https://doi.org/10.1371/journal.pone.0262768
Willis, G. B. (2005). Cognitive interviewing: A tool for improving questionnaire design. SAGE Publications. https://doi.org/10.4135/9781412983655
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2026 Godsway Otchere, Olufunke Bamigboye, Sonia Lopez, Umar Hassan, Misha Capuno, Rufus Adedoyin, Adewale Oyeyemi