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Table 6 Criterion/construct validity of physical activity, sedentary behavior and/or sleep questionnaires, sorted by quality of evidence, level of evidence, result rating and methodological quality

From: A systematic review of proxy-report questionnaires assessing physical activity, sedentary behavior and/or sleep in young children (aged 0–5 years)

Questionnaire

Study population b

Comparison measure

Methodological quality c

Results

Rating d , level of evidence e & evidence grading f

Early Years Physical Activity Questionnaire (EY-PAQ) [57]

n = 196

Age = 3.2 ± 0.8 years

Sex = 49.5% girls

Accelerometer (Actigraph, GT3X+, right hip, 5 s (Costa)/15 s (Pate) epoch, Costa (SB) / Pate (PA) cut-points [68, 69])

Doubtful (PA) / Adequate (SB)

MVPA: MD = 7.1 min/day (LoA = 85.9 ± 200.1); r = 0.03 (no boundaries); r = 0 .30 (boundaries applied)

ST: MD = 87.5 min/day (LoA = 376.6 ± 192.7); r = 0.02 (no boundaries); r = 0.19 (boundaries applied)

PA: – (Level 1) Low

SB: – (Level 2) Moderate

Sleep diary by phone (nn) [42]

n = 90

Age: = 3.61 months (range 2.67–5.17 months)

Sex = 43% girls

- Videosomnography (four infrared, high-definition, color Hikvision cameras with internal microphones)

- Accelerometer (Actiwatch-2, left ankle, 15 s epoch, default wake threshold value = .888 * average activity count)

Adequate (Vid) / Doubtful (Acc)

Videosomnography correlations:

Sleep onset time (r = 0.84), rise time (r = 0.74), sleep period (r = 0.81), night awakenings (r = 0.37);

Videosomnography MD (min):

Sleep onset time = − 0:23:51, rise time = 0:13:19, sleep period = 31.99, night awakenings = − 1.38;

Accelerometer correlations:

Sleep onset time (r = 0.91), rise time (r = 0.84), sleep period (r = 0.90), night awakenings (r = 0.51)

Accelerometer MD (min):

Sleep onset time = 0:06:17, rise time = 0:15:08, sleep period = 8.41, night awakenings = −.26;

Vid: + (Level 1) Low

Acc: + (Level 2) Very low

Preschool-aged Children’s Physical Activity Questionnaire (Pre-PAQ) [58]a

n = 67

Age = 3–5 years

Sex = 38% girls

Accelerometer (Actigraph, uni-axial MTI 7164, right hip, 15 s epoch, Sirard/Reilly cut-points [70, 71])

Adequateg (both PA and SB)

Level 1–2 Pre-PAQ vs Stationary: MD = 7.6, LoA = [− 141.3, 156.4], r = 0.25;

Level 1–2 Pre-PAQ vs Sedentary (Reilly): MD = − 208.6, LoA = [− 349.8, − 67.5], r = 0.28;

Level 1–2 Pre-PAQ vs Sedentary (Sirard): MD = − 235.4, LoA = [− 383.1, − 87.7], r = 0.19;

Level 3 Pre-PAQ vs LPA (Sirard): MD = − 4.8, LoA = [− 105.4, 96.0], r = − 0.07;

Level 4 Pre-PAQ vs MPA (Sirard): MD = 48.2, LoA = [− 24.9, 121.3], r = 0.13;

Level 5 Pre PAQ vs VPA (Sirard): MD = 1.9, LoA = [− 37.5, 41.3], r = 0.17;

Level 4–5 Pre-PAQ vs MVPA (Sirard): MD = 50.1, LoA = [− 42.9, 143.1], r = 0.17;

Level 3–5 Pre-PAQ vs LMVPA (Sirard): MD = 45.2, LoA = [− 103.6, 194.1], r = 0.05;

Level 3–5 Pre-PAQ vs Non-sedentary (Reilly): MD = 20.9, LoA = [− 121.9, 163.7], r = 0.16

PA: – (Level 1) Low

SB: – (Level 2) Low

Modified Burdette proxy report [55]a

n = 107

Age = 3.4 ± 1.2 years

Sex = unknown

Accelerometer (Actigraph, GTM1, right hip, 15 s epoch, Pate cut-points [72])

Doubtful

PA: vs. total PA min/day: r = 0.30; vs. MVPA min/day: r = 0.34

– (Level 1) Low

Modified Harro proxy report [55]a

n = 131

Age = 3.8 ± 1.3 years

Sex = unknown

Accelerometer (Actigraph, GTM1, right hip, 15 s epoch, Pate cut-points [72])

Doubtful

MVPA: vs. MVPA min/day: r = 0.10; vs. total PA min/day: r = 0.09

– (Level 1) Low

Electronic-diary (nn) [43]

n = 90

Age = 5.0 ± 2.0 months (range 1–9)

Sex = 50% girls

Accelerometer (MicroMini Motionlogger Actigraph, ankle, 60s epoch, Sadeh algorithm [73])

Adequate

Sleep percentage over 24 h (r = 0.41), sleep percentage during the day (r = 0.65), sleep percentage at night (r = 0.64)

+ (Level 2) Low

Paper-diary (nn) [43]

n = 95

Age = 5.0 ± 2.0 months (range 1–9)

Sex = 47% girls

Accelerometer (MicroMini Motionlogger Actigraph, ankle, 60s epoch, Sadeh algorithm [73])

Adequate

Sleep percentage over 24 h (r = 0.57), Sleep percentage during the day (r = 0.47), Sleep percentage at night (r = 0.70)

+ (Level 2) Low

Sleep diary (nn) [44]

n = 314

Age = 6.4 ± 0.6 months

Sex = 51% girls

- Accelerometer (Philips Actiwatch 2, left ankle, 30s epoch, wake threshold value = 80 [74])

- Questionnaire (Sleep survey)

Doubtful (both methods)

Accelerometer ICC:

Total night sleep duration = 0.51, longest night sleep = 0.40, total day sleep duration = 0.53;

Accelerometer MD (95% CI):

Total night sleep duration = − 42.9 (− 50.6 – − 35.2), longest night sleep = 58.2 (43.4–73.0), total day sleep duration = − 30.8 (− 35.9 – − 25.6);

Questionnaire ICC:

Total night sleep duration = 0.44, longest night sleep = 0.55, total day sleep duration = 0.33, sleep onset time = 0.31, sleep offset time = 0.10;

Questionnaire MD (95% CI):

Total night sleep duration = 22.9 (14.0–31.7), longest night sleep = 1.8 (− 17.2–13.6), total day sleep duration = − 1.0 (− 10.3–8.3), sleep onset time = 0.2 (0.0, 0.5), sleep offset time = − 0.4 (− 0.6 – − 0.1)

Acc: + (Level 2) Low

QA: – (Level 3) Low

Sleep diary (nn) [38]

Data were collected at 3 (n = 226, girls = 49.5%), 6 (n = 191), 12 (n = 172), and 18 months (n = 150) postpartum.

- Accelerometer (micromotion logger sleep watch, 60s epoch, Sadeh algorithm [75])

- Questionnaire (BISQ)

Doubtful (both methods)

Accelerometer correlations at 3, 6, 12 and 18 months:

Night awakenings: 0.58, 0.56, 0.40, 0.27;

WASO = 0.72, 0.69, 0.63, 0.61;

Sleep duration = 0.87, 0.94, 0.61, 0.78;

Sleep onset = 0.88, 0.89, 0.89, 0.84;

BISQ correlations at 3, 6, 12 and 18 months:

Night awakenings: 0.70, 0.76, 0.68, 0.59;

WASO = 0.33, 0.34, 0.54, 0.69;

Sleep latency = 0.40, 0.43, 0.59, 0.63;

Sleep onset = 0.82, 0.82, 0.81, 0.78

Acc: + (Level 2) Low

QA: – (Level 3) Low

Brief Infant Sleep Questionnaire (BISQ) [38]

Data were collected at 3 (n = 226, girls = 49.5%), 6 (n = 191), 12 (n = 172), and 18 months (n = 150) postpartum.

- Accelerometer (micromotion logger sleep watch, 60s epoch, Sadeh algorithm [75])

- Sleep diary

Doubtful (both methods)

Accelerometer correlations at 3, 6, 12 and 18 months:

Night awakenings: 0.53, 0.48, 0.27, 0.06;

WASO = 0.22, 0.15, 0.31, 0.39;

Sleep onset = 0.74, 0.75, 0.78, 0.72

Diary correlations at 3, 6, 12 and 18 months:

Night awakenings: 0.70, 0.76, 0.68, 0.59;

WASO = 0.33, 0.34, 0.54, 0.69;

Sleep latency = 0.40, 0.43, 0.59, 0.63;

Sleep onset = 0.82, 0.82, 0.81, 0.78

Acc: ± (Level 2) Low

Diary: – (Level 3) Low

Sleep survey (including items from the BISQ and CSHQ) [44]

n = 314

Age = 6.4 ± 0.6 months

Sex = 51% girls

- Accelerometer (Philips Actiwatch 2, left ankle, 30s epoch, wake threshold value = 80 [74])

- Sleep diary

Doubtful (both methods)

Accelerometer ICC:

Total night sleep duration = 0.34, longest night sleep = 0.17, total day sleep duration = 0.25, sleep onset time = 0.23, sleep offset time = 0.08;

Accelerometer MD (95% CI):

Total night sleep duration = − 67.1 (− 76.3 – − 57.9); longest night sleep = 58.2 (39.9–76.4), total day sleep duration = − 28.9 (− 38.1 – − 19.7), sleep onset time = − 0.3 (− 0.6 – − 0.1), sleep offset time = 0.4 (0.1–0.6);

Sleep diary ICC:

Total night sleep duration = 0.44, longest night sleep = 0.55, total day sleep duration = 0.33, sleep onset time = 0.31, sleep offset time = 0.10;

Sleep diary MD (95% CI):

Total night sleep duration = 22.9 (14.0–31.7), longest night sleep = 1.8 (− 17.2–13.6), total day sleep duration = − 1.0 (− 10.3–8.3), sleep onset time = 0.2 (0.0–0.5), sleep offset time = − 0.4 (− 0.6 – − 0.1)

Acc: – (Level 2) Low

Diary: – (Level 3) Low

Parental report – outdoor time checklist [54]a

n = 250

Age: 44 months (29–52 months)

Sex: 43% girls

- Accelerometer (RT3 tri-axial research tracker, waist worn, 60s epoch)

- Questionnaire (Outdoor time recall questionnaire)

Doubtful (both methods)

Accelerometer: r = 0.33;

Recall questionnaire: r = 0.57

Acc: – (Level 2) Low

QA: – (Level 3) Low

Parental report – outdoor time recall questionnaire [54]a

n = 250

Age: 44 months (29–52 months)

Sex: 43% girls

- Accelerometer (RT3 tri-axial research tracker, waist worn, 60s epoch)

- Questionnaire (Outdoor time checklist)

Doubtful (both methods)

Accelerometer: r = 0.20;

Checklist questionnaire: r = 0.57

Acc: – (Level 2) Low

QA: – (Level 3) Low

Healthy Kids [61]

n = 176

Age = 3.3 ± 1.6 years

Sex = 42% girls

Parent reported physical, screen, and sleep activity using 3 days of 36-h activity logs

Doubtful

Television: r = − 0.53; Computer games: r = − 0.50; Play: r = 0.21, Bedtime: r = 0.22

– (Level 3) Low

Children’s Sleep Habits Questionnaire - Infant version (CSHQ-I) [39]

n = 299

Age = 2–12 months

Sex = 46.8% girls

Sleep diary (Infant Sleep Chronogram)

Doubtful

Sleep hours (r = − 0.36), awake hours (r = 0.26), night-time awakenings (r = 0.04), latency to sleep (r = 0.14), longest sleep period (r = − 0.36)

– (Level 3) Low

Children’s Physical Activity Questionnaire (CPAQ) [59]a

n = 27

Age: 4.9 ± 0.7 years (range 4–5)

Sex: 38% girls

- Doubly labeled water (DLW)

- Accelerometer (Actigraph, model 7165, hip left/right randomized, 60s epoch, Treuth/Freedson cut-points [76, 77])

Very good (DLW) / Doubtfulg (Acc)

DLW: PAEE: r = 0.22;

Accelerometer (both cut-points): MVPA: r = 0.42

DLW: – (Level 1) Low

Acc: – (Level 1) Very low

Physical activity questionnaire for parents of preschoolers in Mexico [62]a

n = 35

Age = 4.4 ± 0.7 years

Sex = 51% girls

Accelerometer (Actigraph, GT1M, right hip, 15 s epoch, Sirard/Pate cut-points [70, 72])

Adequateg (both PA and SB)

Sirard cut-points:

SB vs. % of time in SB: 0.35;

MPA vs. % of time in MPA: r = −  0.23;

VPA vs. % of time in VPA: r = 0.53;

MVPA vs. % of time in MVPA: 0.49

Pate cut-points:

SB vs. % of time in SB: 0.34;

MPA vs. % of time in MPA: r = − 0.07;

VPA vs. % of time in VPA: r = 0.41;

MVPA vs. % of time in MVPA: r = 0.34

PA: – (Level 1) Very low

SB: – (Level 2) Very low

Children’s ChronoType Questionnaire (CCTQ) - Japanese version [50]

n = 72

Age = 4.8 ± 0.8 years

Sex = 51% girls

- Accelerometer (Actiwatch-2, non-dominant wrist, 60s epoch, threshold automatic sensitivity)

- Sleep diary

Doubtful (both methods)

Accelerometer correlations (week/weekend):

Sleep onset (r = 0.78/0.61), wake-up time (r = 0.82/0.71), midsleep point (r = 0.84/0.79), sleep period (r = 0.74/0.49), sleep latency (r = 0.51/0.38)

Diary correlations (week/weekend):

Bedtime (r = 0.77/0.64), get-up time (r = 0.83/0.71,) time in bed (r = 0.74/0.56)

Acc: + (Level 2) Very low

Diary: + (Level 3) Very low

Physical activity and sedentary behavior questionnaire (based on Canadian Health Measures Survey) [64]a

n = 87

Age = 4–70 months

Sex = 54% girls

Accelerometer (Actical, right hip, Wong/Adolph cut-points [78, 79])

Doubtfulg (both PA and SB)

Total PA vs. total PA min/day: MD = 131 min/day*, LoA = [− 80, 290], r = 0.39 (95% CI 0.19–0.56)

Outdoor unstructured free play aside from school daycare setting vs. total PA min/day: r = 0.30 (95% CI 0.09–0.49)

Unstructured play in school/daycare setting vs. total PA min/day: r = 0.42 (95% CI 0.23–0.58)

Structured PA vs. total PA min/day: r = 0.26 (95% CI 0.05–0.46)

Total SB: MD = 306 min/day*, LoA = [125, 460], r = 0.10 (95% CI − 0.12–0.33)

Screen time: r = − 0.05 (95% CI − 0.27–0.18)

Stroller time: r = 0.31 (95% CI 0.09–0.50)

Motor vehicle time: r = − 0.09 (95% CI − 0.30–0.13)

PA: – (Level 1) Very low

SB: – (Level 2) Very low

Sleep diary (nn) [46]

n = 52

Age = 13.7 ± 6.7 months (<  1 year old = 28, >  1 year old = 21)

Sex = 56% girls

Accelerometer (Actigraph, Micro-mini RC, ankle, 60s epoch, Sadeh algorithm [80])

Doubtful

Sleep onset time (r = 0.89), sleep offset time (r = 0.91), nocturnal sleep duration (r = 0.75), the number of night awakenings (r = 0.46), WASO (r = 0.34)

+ (Level 2) Very low

Children’s Sleep Habits Questionnaire (CSHQ) [41]

n = 46

Age = 58 ± 10.25 months (range = 3–6 years)

Sex = 50% girls

Accelerometer (Actiwatch 2, non-dominant wrist, 60s epoch, wake threshold value = 40)

Doubtful

Bedtime (week/weekend): r = 0.75/0.57, wake-up (week/weekend): r = 0.86/0.64, total sleep: r = − 0.08;

Interval in hours/min (LoA): Bedtime (week/weekend) = ± 0:52 [− 1:31, 0:12]/± 1:20 [− 1:37, 1:02], wake-up (week/weekend) = ± 0:38 [− 0:45, 0:31]/± 0:32 [− 1:04, 2:00], total sleep = ± 2:39 [− 0:06, 5:12], WASO = ± 1:02 [− 2:17, − 0:14]

+ (Level 2) Very low

Own questionnaire (nn) [48]

n = 21

Age = 3.81 ± 0.28 years

Sex = 43% girls

Accelerometer (Actiwatch, non-dominant ankle, 60s epochs, threshold automatic sensitivity)

Doubtful

Reported vs assumed sleeping hours (r = 0.90); Reported vs actual sleeping hours (r = 0.90); assumed vs actual sleeping hours (r = 0.99)

+ (Level 2) Very low

Sleep diary (nn) [47]

n = 80

Age = 25.34 ± 1.04 months

Sex = 40% girls

Accelerometer (Mini-Mitter Actiwatch Actigraph, wrist/ankle, 60s epoch, high sensitivity automatic scoring algorithm/Sitnick “smooting” algorithm to detect night awakenings [81])

Doubtful

Sleep duration: r = 0.30, sleep efficiency: r = 0.02.

Based on the a priori agreement criteria in this study, agreement was satisfactory for 70.0% of children with respect to sleep duration (≤90 min) and for 71.3% of children with respect to sleep efficiency (≤15%)

– (Level 2) Very low

Parent log (nn) [49]

n = 59

Age = 4.34 ± 0.75 years

Sex = 53% girls

Accelerometer (Minimitter Motionlogger Actiwatch, non-dominant wrist, 60s epoch, Sadeh algorithm [80])

Doubtful

Weekday naps (t = 0.19), weekend naps (t = − 1.48), total napping (t = 0.004), weekday night sleep (t = − 5.33*), weekend night sleep (t = − 2.96*), total nights (t = − 5.01*), total sleep (t = − 5.07*)

– (Level 2) Very low

BISQ Spanisch version (BISQ-E) [35]

n = 27

Age = 3–30 months

Sex = unknown

Sleep diary

Doubtful

Bedtime during weekdays (Mon-day through Friday) (r = 0.73), hours of night-time sleep (between 8 pm and 7 am) (r = 0.73), hours of daytime sleep (between 7 am and 8 pm) (r = 0.87) and number of night-time awakenings (r = 0.89), bedtime on weekend days (r = 0.69)

+ (Level 3) Very low

Sleep and Settle Questionnaire (SSQ) [45]

n = 34–36 mothers of infants

Age = unknown

Sex = unknown

Mothers attending a community class on sleep and settling difficulties with infants

Doubtful

Discriminant validity (mothers who report their babies sleep well vs. mothers attending a sleep and settle class):

Time the infant sleeps (min): mornings (η2 = 0.03*), afternoons (NS), during night (η2 = 0.12*);

How long to settle the baby to sleep (min): daytime (η2 = 0.17*), evening (η2 = 0.18*), night-time (η2 = 0.07*);

Number of daytime sleeps (NS), number night awakenings (η2 = 0.17*).

+ (Level 3) Very low

  1. Abbreviations: Acc accelerometer, BISQ Brief Infant Sleep Questionnaire, CI confidence interval, COSMIN COnsensus-based Standards for the selection of health Measurement Instruments, CSHQ Children’s Sleep Habits Questionnaire, DLW doubly labeled water, h hour, ICC intraclass correlation, LoA limits of agreement, MD mean difference, min minute, MPA moderate physical activity, MVPA moderate-to-vigorous physical activity, nn no name, NS not significant, PA physical activity, PAEE physical activity energy expenditure, QA Questionnaire, r correlation coefficient (Pearson or Spearman), s second, SB sedentary behavior, ST sedentary time, VPA vigorous physical activity, Vid videosomnography, WASO wake after sleep onset, * significant
  2. a Questionnaire included from previous review
  3. b Age presented as mean age ± SD (range)
  4. c Methodological quality based on the COSMIN risk of bias checklist
  5. d Result rating based on Table 1: + indicates ≥75% in accordance with hypotheses; ± indicates ≥50 to < 75% in accordance with hypotheses; − indicates < 50% accordance with hypotheses
  6. e Level of evidence based on criteria listed in Table 1
  7. f Quality of evidence grading based on the COSMIN guidelines
  8. g When multiple methods (e.g., cut-points) were used to analyze accelerometer data, the methodological quality rating was based on the method with the highest quality