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Scand J Public Health. 2014 May;42(3):255-62. doi: 10.1177/1403494813514143. Epub 2013 Dec 5.

Cross-cultural validation of a simple self-report instrument of physical activity in immigrants from the Middle East and native Swedes.

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1Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.



To investigate cross-cultural validity of a simple self-report instrument of physical activity intended to be used in Swedish health care.


A validation study performed in 599 Iraqis (58% men) and 553 Swedes (53% men) aged 30-75 years living in the city of Malmö, Sweden. The self-report instrument by the Swedish National Board of Health and Welfare was compared to corresponding measures assessed from accelerometry as reference.


The agreement between the methods in assessing the participants as sufficiently/insufficiently physically active (cut-point 150 min/week) was 65% in the Iraqis and 52% in the Swedes (p<0.001). The proportion disagreement where the self-reported physical activity was sufficient but insufficient according to the accelerometry was 26% and 45% in Iraqis and Swedes, respectively. Physical activity time (min/week) was overestimated by self-report compared to accelerometry by 71% in the Iraqis and 115% in the Swedes (p<0.001). The smallest and largest overestimation was seen in Iraqi (57%) and Swedish (139%) women, respectively. The deviation of the self-report instrument compared to accelerometry was related to the physical activity level, as the overestimation mainly occurred at lower physical activity.


The self-report instrument proposed by the Swedish National Board of Health and Welfare may overestimate the proportion sufficiently physically active, but to an extent depending on cultural background and gender.


Accelerometer; GT1M; accuracy; agreement; ethnicity; gender; migration

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