Public Health Nutrition

Assessment and methodology

A frequency questionnaire to estimate free-living physical activity among Tunisian preadolescent and adolescent children

Houda Ben Gharbiaa1, Agnès Gartnera2, Pierre Traissaca2, Francis Delpeucha2, Bernard Mairea2 and Jalila El Atia1 c1

a1 Department of Studies and Planning, National Institute of Nutrition and Food Technology (INNTA), 11 rue Jebel Lakhdar, Bab Saadoun, 1007 Tunis, Tunisia

a2 Institut de Recherche pour le Développement (IRD), UMR 204 NUTRIPASS, IRD-UM2-UM1, Montpellier, France


Objective To develop a child- and adolescent-appropriate physical activity frequency questionnaire (PAFQ) in Tunisia, North Africa.

Design A PAFQ was developed from a physical activity (PA) inventory that comprised major activity components (at home, preparing meals, school time, transport, non-sport leisure, sports, prayer and sleeping time). Then, type and duration of each activity undertaken during the past week were estimated. Total energy expenditure (TEE) estimated by the PAFQ was compared with data derived from two criterion methods: heart-rate monitoring (HRM) and a 24 h PA recall (24h-R), both collected during a 3 d period including one weekday and two weekend days.

Setting Two elementary schools and two high schools of the most developed and urbanized area, Greater Tunis.

Subjects One hundred and forty-two volunteer children and adolescents aged 10–19 years.

Results The PAFQ strongly was correlated with both HRM (r = 0·70; 95 % CI 0·62, 0·76) and 24h-R (r = 0·81; 95 % CI 0·77, 0·84). It featured acceptable agreement with both criterion measures, slightly underestimating TEE compared with 24h-R (−2·8 %, mean of individual differences −272·7 kJ/d; 95 % CI −490·6, −57·4 kJ/d) and moderately overestimating it compared with HRM (+11·3 %, mean of individual differences +1106·2 kJ/d; 95 % CI 845·8, 1366·6 kJ/d). Reliability ranged from moderate to good (weighted kappa coefficients from 0·47 to 0·78 and intra-class correlation coefficients between 0·79 and 0·86 for energy expenditure by PA categories), indicating strong agreement between the two assessments.

Conclusions This PAFQ could be useful in the description and surveillance of PA patterns or for the evaluation of population-based interventions directed at promoting PA in Tunisian children and adolescents.

(Received December 21 2012)

(Revised August 31 2013)

(Accepted September 04 2013)

(Online publication October 14 2013)


  • Physical activity frequency questionnaire;
  • Heart-rate monitoring;
  • Validity;
  • Preadolescent;
  • Adolescent


c1 Corresponding author: Email