Development, validation and reliabilty of a questionnaire to evaluate the changes on the level of physical exercises and in daily life habits due to COVID-19 pandemic social distancing

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Danúbia da Cunha de Sá-Caputo
Anelise Sonza
José Alexandre Bachur
Mario Bernardo-Filho


COVID-19 pandemic, survey, physical exercise, psychological impact, social distancing, psychometric properties


Background and Aim: Physical inactivity is expected to happen during the COVID-19 pandemic through home quarantine measures. The aim of this study was to develop, validate and perform the reliability of the questionnaire “Physical exercise (PE) level before and during social isolation (PEF-COVID19)” to evaluate the level of PE during the social distancing due to the COVID-19 pandemic and to try to identify changes in the daily life of the individuals. Methods: This transversal study was developed to measure psychometric properties of the questionnaire PEF-COVID19. The survey was divided into 4 sections including subjects’ characterization, social isolation update and physical exercise performed, pain, anxiety and stress before and during COVID-19 pandemic. After the survey construction in Portuguese language (Brazil), the survey was transferred to an online digital platform (Google® forms). The Construct, Clarity and Relevance Validation strategy was judged by a panel of experts and the validity index (VI) were calculated. The reliability was evaluated through the test-retest interrater reliability and measured through the intraclass correlation coefficient (ICC) and Kappa coefficient (KC). Results: Twenty-five experts participated of the survey validity and 34 respondents from the target population participated of the test-retest reliability. The general average measures for VI were all above 0.84 and test-retest ICC and KC were 0.89 and 0.88, respectively. Conclusions: This survey was considered valid and reliable to be applied to the general population over 18 years-old to investigate the PE practice and psychological aspects during the social distancing due to the COVID-19 pandemic, a public health problem.


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1. Artino AR, La Rochelle JS, Dezee KJ, Gehlbach H. Developing questionnaires for educational research: AMEE Guide No. 87. Med Teach. 2014;36(6):463-474. doi:10.3109/0142159X.2014.889814
2. Tsang S, Royse CF, Terkawi AS. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J Anaesth. 2017;11(1):S80-S89.
3. Souza JB De, Grossmann E, Perissinotti DiMN, Oliveira Junior JO De, Fonseca PRB Da, Posso IDP. Prevalence of Chronic Pain, Treatments, Perception, and Interference on Life Activities: Brazilian Population-Based Survey. Pain Res Manag. 2017;2017. doi:10.1155/2017/4643830
4. WHO; World Health Organization. Statement on the second meeting of the international health regulations (2005) emergency committee regarding the outbreak of novel coronavirus (2019-nCoV). January 30th [Internet]. Published 2020. Accessed May 3, 2020.
5. Lau H, et al. The positive impact of lockdown in Wuhan on containing the COVID-19 outbreak in China. J Travel Med. 2020;1:1-14.
6. Oliveira WK, Duarte E, França GVA de, Garcia LP. How Brazil can hold back COVID-19. Epidemiol e Serviços Saúde. 2020;29(2):1-8. doi:10.5123/s1679-49742020000200023
7. Holmes EA, et al. Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. The Lancet Psychiatry. April 2020. doi:10.1016/S2215-0366(20)30168-1
8. Rossman H, et al. A framework for identifying regional outbreak and spread of COVID-19 from one-minute population-wide surveys. Nat Med. April 2020. doi:10.1038/s41591-020-0857-9
9. Singhal T. A Review of Coronavirus Disease-2019 (COVID-19). 2020;87(April):281-286.
10. WHO. Coronavirus. [internet]. Published 2020. Accessed April 15, 2020.
11. Kelly P, et al. Systematic review and meta-analysis of reduction in all-cause mortality from walking and cycling and shape of dose response relationship. 2014. doi:10.1186/s12966-014-0132-x
12. Löllgen H, Böckenhoff A, Knapp G. Physical Activity and All-cause Mortality: An Updated Meta-analysis with Different Intensity Categories. Int J Sport Med. 2009;30(3):213-224. doi:10.1055/s-0028-1128150
13. Je Y, Jeon JY, Giovannucci EL, Meyerhardt JA. Association between physical activity and mortality in colorectal cancer : A meta-analysis of prospective cohort studies. 2013. doi:10.1002/ijc.28208
14. Fong DYT, et al. Physical activity for cancer survivors : meta-analysis of randomised controlled trials. 2011:1-14. doi:10.1136/bmj.e70
15. Steffens D, Maher CG, Pereira, Leani S. M. Stevens, Matthew L Oliveira, Vinicius C. Chapple M, Teixeira-Salmela, Luci F. Hancock MJ. Prevention of Low Back Pain A Systematic Review and Meta-analysis. JAMA Intern Med. 2016;176(2):199-208.
16. Rayhan RU, Zheng Y, Uddin E, Timbol C, Adewuyi O, Baraniuk JN. Administer and collect medical questionnaires with Google documents: a simple, safe, and free system. Appl Med informatics. 2013;33(3):12-21.
17. Beck CT, Gable RK. Ensuring content validity: an illustration of the process. J Nurs Meas. 2001;9(2):201-215.
18. Kimberlin CL, Winterstein AG. Validity and reliability of measurement instruments used in research. Am J Heal Pharm. 2008;65(23):2276-2284. doi:10.2146/ajhp070364
19. Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL. Best Practices for Developing and Validating Scales for Health, Social, and Behavioral Research: A Primer. Front Public Heal. 2018;6. doi:10.3389/fpubh.2018.00149
20. Souza AC de, Alexandre NMC, Guirardello E de B, Souza AC de, Alexandre NMC, Guirardello E de B. Propriedades psicométricas na avaliação de instrumentos: avaliação da confiabilidade e da validade. Epidemiol e Serviços Saúde. 2017;26(3):649-659. doi:10.5123/S1679-49742017000300022
21. Halek M, Holle D, Bartholomeyczik S. Development and evaluation of the content validity, practicability and feasibility of the Innovative dementia-oriented Assessment system for challenging behaviour in residents with dementia. BMC Health Serv Res. 2017;17(1):554. doi:10.1186/s12913-017-2469-8
22. Zamanzadeh V, Ghahramanian A, Rassouli M, Abbaszadeh A, Alavi-Majd H, Nikanfar A-R. Design and Implementation Content Validity Study: Development of an instrument for measuring Patient-Centered Communication. J Caring Sci. 2015;4(2):165-178. doi:10.15171/jcs.2015.017
23. Lynn MR. Determination and quantification of content validity. Nurs Res. 1986;35(6):382-385.
24. Tsang S, Royse C, Terkawi A. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J Anaesth. 2017;11(5):80. doi:10.4103/sja.SJA_203_17
25. Kottner J, Audigé L, Brorson S, et al. Guidelines for reporting reliability and agreement studies (GRRAS) were proposed. J Clin Epidemiol. 2011;64(1):96-106. doi:10.1016/j.jclinepi.2010.03.002
26. Portney LG, Watkins MP. Foundations of Clinical Research: Applications to Practice. 3 ed. Philadelphia: F. A. Davies Company; 2015.
27. Brenner H, Kliebsch U. Dependence of Weighted Kappa Coefficients on the Number of Categories. Epidemiology. 1996;7(2):199-202.
28. Streiner DL, Norman GR. Health Measurement Scales: A Practical Guide to Their Development and Use. 3rd ed. Oxford: Oxford University Press; 2003.
29. Cicchetti D V. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol Assess. 1994;6(4):284-290. doi:10.1037/1040-3590.6.4.284
30. Brennan P, Silman A. Statistical methods for assessing observer variability in clinical measures. BMJ. 1992;304(6840):1491-1494. doi:10.1136/bmj.304.6840.1491
31. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159-174.
32. Saadat S, Rawtani D, Hussain CM. Environmental perspective of COVID-19. Sci Total Environ. 2020;728:138870. doi:10.1016/j.scitotenv.2020.138870
33. Nicola M, et al. The Socio-Economic Implications of the Coronavirus and COVID-19 Pandemic: A Review. Int J Surg. April 2020. doi:10.1016/j.ijsu.2020.04.018
34. Hall G, Laddu DR, Phillips SA, J LC, R A. A tale of two pandemics : How will COVID-19 and global trends in physical inactivity and sedentary behavior affect one another ? Prog Cardiovasc Dis. 2020;20(xxxx):4-6. doi:10.1016/j.pcad.2020.04.005
35. de Oliveira Neto L, de Oliveira Tavares VD, Schuch FB, Lima KC. Coronavirus Pandemic (SARS-COV-2): Pre-Exercise Screening Questionnaire (PESQ) for Telepresential Exercise. Front Public Heal. 2020;8. doi:10.3389/fpubh.2020.00146
36. Micelli E, et al. Desire for parenthood at the time of COVID-19 pandemic: an insight into the Italian situation. J Psychosom Obstet Gynecol. May 2020:1-8. doi:10.1080/0167482X.2020.1759545
37. Abdessater M, et al. COVID19 pandemic impacts on anxiety of French urologist in training: Outcomes from a national survey. Progrès en Urol. April 2020. doi:10.1016/j.purol.2020.04.015
38. Roy D, Tripathy S, Kar SK, Sharma N, Verma SK, Kaushal V. Study of knowledge, attitude, anxiety & perceived mental healthcare need in Indian population during COVID-19 pandemic. Asian J Psychiatr. 2020;51:102083. doi:10.1016/j.ajp.2020.102083
39. Wang S, Xie L, Xu Y, Yu S, Yao B, Xiang D. Sleep disturbances among medical workers during the outbreak of COVID-2019. Occup Med (Chic Ill). May 2020. doi:10.1093/occmed/kqaa074
40. Chew NWS, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun. April 2020. doi:10.1016/j.bbi.2020.04.049
41. Perez-Alba E, Nuzzolo-Shihadeh L, Espinosa-Mora JE, Camacho-Ortiz A. Use of self-administered surveys through QR code and same center telemedicine in a walk-in clinic in the era of COVID-19. J Am Med Informatics Assoc. May 2020. doi:10.1093/jamia/ocaa054
42. Nelson LM, et al. US Public Concerns About the COVID-19 Pandemic From Results of a Survey Given via Social Media. JAMA Intern Med. April 2020. doi:10.1001/jamainternmed.2020.1369
43. Delgado D, et al. Personal Safety during the COVID-19 Pandemic: Realities and Perspectives of Healthcare Workers in Latin America. Int J Environ Res Public Health. 2020;17(8):2798. doi:10.3390/ijerph17082798
44. Pedreira RBS, Rocha SV, Santos CA dos, Vasconcelos LRC, Reis MC. Content validity of the Geriatric Health Assessment Instrument. Einstein (São Paulo). 2016;14(2):158-177. doi:10.1590/S1679-45082016AO3455
45. Morgado FFR, Meireles JFF, Neves CM, Amaral ACS, Ferreira MEC. Scale development: ten main limitations and recommendations to improve future research practices. Psicol Reflexão e Crítica. 2018;30(1):3. doi:10.1186/s41155-016-0057-1
46. Goni MD, et al. Development and validation of knowledge, attitude and practice questionnaire for prevention of respiratory tract infections among Malaysian Hajj pilgrims. BMC Public Health. 2020;20(1):189. doi:10.1186/s12889-020-8269-9
47. Patterson PD, et al. Reliability and Validity of Survey Instruments to Measure Work-Related Fatigue in the Emergency Medical Services Setting: A Systematic Review. Prehospital Emerg Care. 2018;22(sup1):17-27. doi:10.1080/10903127.2017.1376134