Cross-cultural validation of a simple self-report instrument of physical activity in immigrants from
the Middle East and native Swedes
Sammanfattning
Aim: To investigate cross-cultural validity of a simple self-report instrument of physical activity
intended to be used in Swedish health care. Methods: 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. Results: 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. Conclusions: 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.