學齡前幼兒24小時活動問卷之信度及效度

Reliability and validity of the 24-hour movement questionnaire for preschool children

目標：本研究旨在發展具信度與效度之學齡前幼兒24小時活動問卷。方法：225位（女孩=107位）3至7歲幼兒配戴三軸加速規連續7天，家長於第1天（前測）及第7天（後測）填寫問卷。再測信度以組內相關係數（Intraclass correlation coefficient, ICC）及斯皮爾曼等級相關檢驗前後測問卷之相關程度，同時效度則透過斯皮爾曼等級相關評估問卷後測與三軸加速規測量24小時活動之相關性。結果：問卷的一週再測信度顯示身體活動及靜態行為均呈現中等至良好相關程度，包括：每日平均中高強度活動（ICC=0.84；ρ=0.84）、輕度活動（ICC=0.85；ρ=0.79）；靜態行為之螢幕時間（ICC=0.83；ρ=0.88）、活動受限（ICC=0.84；ρ=0.84）及非螢幕時間（ICC=0.77；ρ=0.75）；夜晚睡眠時間（ICC=0.44；ρ=0.75）、午睡（ICC=0.56；ρ=0.81）及睡眠中斷（ICC=0.68~0.82）。同時效度部分，問卷與客觀測量在不同行為呈現低至中度相關（ρ=0.13~0.49），但不同行為相關程度略有差異，其中以夜間睡眠相關程度最高，中高強度身體活動最低。結論：本研究發展的問卷較過往其他分別測量幼兒活動行為問卷具備較良好的一週再測信度與三軸加速規測量比較的同時效度，有助於大規模的針對學齡前幼兒24小時活動行為進行監測與例行性測量，作為未來發展幼兒24小時活動指引及健康政策擬定之參考基礎。

Objectives: To develop and validate a reliable and valid 24-hour movement questionnaire for use in preschool children. Methods: A total of 225 preschool children (107 girls), aged 3 to 7 years, wore a triaxial accelerometer on their waist for 7 consecutive days. Their parents completed the 24-hour movement questionnaire on Day 1 (test) and Day 7 (retest). The test–retest reliability of the questionnaire was assessed by calculating intraclass correlation coefficients (ICCs) and Spearman’s rank correlation coefficients. The questionnaire’s concurrent validity was evaluated by examining the associations between the retest questionnaire scores and accelerometer-derived measures of the participants’24-hour movement behaviors. Results: Regarding 1-week test–retest reliability, moderate to good agreement was noted in the test and retest scores for most physical activity (PA) and sedentary behavior measures, including daily average moderate to vigorous PA (ICC = 0.84;ρ= 0.84) and light PA (ICC = 0.85;ρ= 0.79). Regarding sedentary behavior, moderate to good reliability was observed in the test–retest scores for screen time (ICC = 0.83;ρ= 0.88), restrained activity (ICC = 0.84;ρ= 0.84), and nonscreen sedentary time (ICC = 0.77;ρ= 0.75). Furthermore, the questionnaire exhibited fair to good reliability for sleep-related measures such as nighttime sleep duration (ICC = 0.44;ρ= 0.75), daytime napping (ICC = 0.56;ρ= 0.81), and sleep interruptions (ICC = 0.68-0.82). Regarding the questionnaire’s concurrent validity, the correlations between the questionnaire scores and accelerometer-derived measures for various health behaviors were weak to moderate (ρ= 0.13–0.49), with the strongest and weakest correlations noted for nighttime sleep duration and moderate to vigorous PA, respectively. Conclusions: Our questionnaire exhibits higher 1-week test–retest reliability and concurrent validity with accelerometer-derived measures than do instruments that separately assess preschool children’s 24-hour activity behaviors. The questionnaire can facilitate large-scale surveillance and routine assessment of preschool children’s 24-hour movement behaviors and may inform future 24-hour movement guidelines for this population and related health policy formulation.