ORIGINAL ARTICLE https://doi.org/10.1590/1806-9282.

20211374

The Baecke Habitual Physical Activity Questionnaire (BHPAQ):

a valid internal structure of the instrument to assess healthy
Brazilian adults
Daniel Santos Rocha1 , Almir Vieira Dibai-Filho2 , Jocassia Silva Pinheiro2 ,
Lisiane Fernanda Simeão de Azevedo3 , Angela Falcai3 , Rudys Rodolfo de Jesus Tavarez4 ,
Adriana Sousa Rego5 , Gabriela Nascimento de Santana6 , Cid André Fidelis de Paula Gomes6 ,
Daniela Bassi-Dibai3,4,5*

SUMMARY
OBJECTIVE: This study aimed to validate the internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire.
METHODS: A cross-sectional study was conducted with individuals over 18 years old of both sexes, with Brazilian Portuguese as their native language.
The structure of the Baecke Habitual Physical Activity Questionnaire was tested by confirmatory factor analysis. The model fit was evaluated by the
following indices: root mean square error of approximation, comparative fit index, Tucker-Lewis index, standardized root mean square residual, and
χ²/degrees of freedom. We used the Akaike information criterion and Bayesian information criterion to compare different structures of the Baecke
Habitual Physical Activity Questionnaire.
RESULTS: A total of 241 individuals participated in this study. The original structure of the Baecke Habitual Physical Activity Questionnaire with
16 items and 3 domains was compared to a structure with 14 items and 3 domains. The internal structure of the Baecke Habitual Physical Activity
Questionnaire with 14 items showed better fit indices and lower Akaike information criterion and Bayesian information criterion values.
CONCLUSION: The best internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire in adults presents 3
domains and 14 items.
KEYWORDS: Physical activity. Factor analysis. Reproducibility of results.

sports (items 13–16). For each domain, the score ranges from
INTRODUCTION 1–5, with higher scores indicating higher physical activity1.
The Baecke Habitual Physical Activity Questionnaire (BHPAQ) This instrument has been translated, adapted, and vali-
is a self-administered and self-evaluating instrument capable dated for several countries, such as Belgium2, Portugal3, and
of measuring the physical activity of the past 12 months, cre- Iran4. In Brazil, several validation studies have been conducted.
ated in the Netherlands in 1982. The original study initially The process of translation and cross-cultural adaptation of the
involved the measurement of construct and content valid- BHPAQ was carried out by Sardinha et al.5 and Florindo et al.6,
ity, in addition to test-retest reliability. Initially, the BHPAQ who also determined the internal consistency of the question-
had 29 items, reduced to 16 items after principal component naire to be good when applied to men aged 50 years or older.
analysis (PCA). It included three domains: physical activity Florindo and Latorre7 validated and investigated the test-retest
in occupation (items 1–8), physical activity in sports in free reliability of the BHPAQ in adult men and concluded that the
time (items 9–12), and leisure-time physical activity other than tool is a good choice for evaluating habitual physical activity in

1
Universidade Ceuma, Department of Physical Therapy – São Luís (MA), Brazil.
2
Universidade Federal do Maranhão, Department of Physical Education – São Luís (MA), Brazil.
3
Universidade Ceuma, Postgraduate Program in Environment – São Luís (MA), Brazil.
4
Universidade Ceuma, Postgraduate Program in Dentistry – São Luís (MA), Brazil.
5
Universidade Ceuma, Postgraduate Program in Programs Management and Health Services – São Luís (MA), Brazil.
6
Universidade Nove de Julho, Postgraduate Program in Rehabilitation Sciences – São Paulo (SP), Brazil.
*Corresponding author: [email protected]
Conflicts of interest: the authors declare there is no conflicts of interest. Funding: This work as partially supported by Conselho Nacional de
Desenvolvimento Científico e Tecnológico (PIBIC/CNPq), Fundação de Amparo à Pesquisa e ao Desenvolvimento Científico e Tecnológico do Maranhão
(PIBIC/FAPEMA), and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, finance code 001).
Received on March 31, 2022. Accepted on April 06, 2022.

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 Rocha, D. S. et al.

Brazilian men. In another study, Guedes et al.8 verified the validity of 16 items, divided into 3 domains: physical activity in occu-
and reliability of the BHPAQ in adolescents, obtaining satisfac- pation (items 1–8), physical activity in sports in free time
tory results regarding its measurement properties. Garcia et al.9 (items 9–12), and physical activity during leisure other than
verified the construct validity of the BHPAQ using the acceler- sport (items 13–16). There are five Likert scale (1–5) response
ometer as a reference and found acceptable values. In contrast, possibilities1,6.
Carvalho et al.10 concluded that the construct validity was inad- The score of the occupational domain is calculated by sum-
equate when applied to patients with chronic lower back pain. ming the answers indicated and dividing by 8 (for item 2, the
Despite these scientific initiatives, there are no studies defining value indicated should be subtracted by 6). The score of the
the internal structure of the BHPAQ in Brazil considering the sports domain is calculated by summing the values indicated
three domains defined in the original version, despite the ques- and dividing by 4. To calculate the leisure domain score, all
tionnaire being used commonly in the country. Structural valid- of the checked answers must be summed and the value must
ity is useful to measure whether the result obtained reflects the be divided by 4 (for item 13, the indicated value must be sub-
dimensionality of the instrument to be evaluated11. Given the tracted by 6). For each domain, the final score ranges from 1 to
importance of this instrument for research and practical appli- 5; the higher the score, the higher the level of physical activity 6.
cations in healthcare, the objective of this study was to evaluate
the internal structure of the Brazilian version of the BHPAQ. Statistical analysis
Descriptive statistical analysis was performed, with the presen-
tation of the values as mean and standard deviation for quanti-
METHODS tative variables and using absolute number and percentage for
qualitative variables. Descriptive analysis was performed using
Study design the SPSS software version 17.0 (Chicago, IL, USA).
This was a cross-sectional, quantitative study. Data were col- The validity of the BHPAQ structure was tested by con-
lected online using the Google Forms platform (Mountain firmatory factor analysis (CFA), using the R Studio software
View, CA, USA). After reading the informed consent form, all (Boston, MA, USA) with the lavaan and semPlot packages.
participants included in the study confirmed their participa- CFA was performed with the implementation of a poly-
tion ticking the option “I agree to participate” on the first page choric matrix and the robust extraction method diagonally
of the online form. This study was approved by the Research weighted least squares (RDWLS), as recommended by spe-
Ethics Committee of the Universidade Ceuma (under num- cialized literature12. The model fit was evaluated using the
ber 3.115.347). following indices: root mean square error of approximation
(RMSEA) with confidence interval (CI) at 90%, compara-
Participants tive fit index (CFI), Tucker-Lewis index (TLI), standardized
The sample size followed the recommendations of the COnsensus- root mean square residual (SRMR), and chi-square/degrees
based Standards for the selection of health Measurement of freedom (DF)13,14.
INstruments (COSMIN): seven times the number of items In this study, values >0.90 were considered adequate for
of the questionnaire. Therefore, a minimum of 112 individ- CFI and TLI, and values <0.08 were considered adequate for
uals was recommended based on the inclusion of 16 items11. RMSEA and SRMR. Values <3.00 were considered adequate
The inclusion criteria adopted in this study were as follows: in the interpretation of chi-square/DF13,15,16. In CFA, factor
healthy individuals of both sexes, practicing physical activity loadings ≥0.40 were considered adequate for the domain.
or not, with Brazilian Portuguese as their native language, and The RMSEA and SRMR indices evaluate the model residuals;
aged 18 years or over. The exclusion criteria for this study were in the best of conditions, the residual should be equal to 0.
as follows: participants without a fixed profession or unem- In another perspective, CFI and TLI calculate the relative fit of
ployed, presence of a medical diagnosis of cognitive alteration, the observed model and compare it with a base model; under
and inability to read or write. the best of conditions, the value should equal 1.
For comparison between the BHPAQ models, i.e., the orig-
Baecke Habitual Physical Activity inal version of the questionnaire with 16 items versus 14 items,
Questionnaire the Akaike information criterion (AIC) and Bayesian infor-
The BHPAQ is a self-applicable, self-report instrument that mation criterion (BIC) indices were used. The structure with
assesses physical activity over the past 12 months. It consists the lowest AIC and BIC values was considered to be the most

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Structural validity of the BHPAQ

parsimonious model, as recommended in the specialized liter- original structure of the BHPAQ with 16 items and 3 domains
ature17. Parsimonious models are simple models that explain versus the structure with 14 items and 3 domains (excluding
the data with a minimum number of parameters. items 6 and 13), as given in Table 2. The internal structure
Criterion validity was assessed by correlating the score of with 14 items presented the best fit indices and lowest values
the BHPAQ domains with 14 and 16 items, considering a of AIC and BIC. In addition, Figure 1 also presents the factor
correlation magnitude >0.70 as adequate11. Therefore, nor- loadings of the BHPAQ with 14 items and 3 domains, and
mality was verified using the Kolmogorov-Smirnov test and all items have a factorial load >0.40. The Brazilian version of
correlations were performed using Spearman’s correlation the BHPAQ with 14 items is available on the website: https://
coefficient (rho). questionariosbrasil.blogspot.com
Regarding criterion validity, we observed a satisfactory cor-
relation between the occupational domain with 8 and 7 items
RESULTS (rho=0.985, p<0.001) and between the leisure domain with 4
A total of 241 individuals participated in this study. As can be and 3 items (rho=0.907, p<0.001). As the sport domain did
seen in Table 1, most participants were women, young adults, not change in the number of items, the correlation was not
and single adults, with secondary education and who were performed.
mildly overweight. Regarding the BHPAQ score, all domains
scored slightly higher than 2.50.
The internal structure of the BHPAQ was evaluated by means
of CFA. However, as can be seen in Figure 1, items 6 and 13 A
had a factor loading below 0.40. Therefore, we compared the

Table 1. Personal characteristics of study participants (n=241).

Mean (standard deviation)
or number (%)
Age (years) 27.73 (9.58)
Gender (female) 130 (53.9)
Marital status
Single 184 (76.3)
Married 51 (21.2)
Divorced 2 (0.8)
Widower 4 (1.7)
B
Schooling
Primary 13 (5.4)
Secondary 150 (62.2)
Superior 78 (32.4)
Mass (kg) 70.57 (16.32)
Height (m) 1.68 (0.10)
Body mass index (kg/m )2
25.11 (6.64)
BHPAQ (score, 1–5)
Occupational domain (8 items) 2.71 (0.66)
Occupational domain (7 items) 2.66 (0.71)
Sport domain (4 items) 2.52 (0.81)
Leisure domain (4 items) 2.58 (0.68) D1: Occupational domain; D2: Sports domain; D3: Leisure domain.
Leisure domain (3 items) 2.51 (0.77)
Figure 1. Path diagram of the Baecke Habitual Physical Activity
BHPAQ: Baecke Habitual Physical Activity Questionnaire. Questionnaire (BHPAQ) with 16 items (A) and 14 items (B).

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 Rocha, D. S. et al.

Table 2. Comparison between the internal structures of the Baecke Habitual Physical Activity Questionnaire (BHPAQ).
RMSEA
Structure χ² DF χ² /DF CFI TLI SRMR AIC BIC
(90%CI)
0.073
16 items 230.498 101 2.28 0.935 0.923 0.077 10576.960 10698.928
(0.061–0.086)
0.057
14 items 131.437 74 1.77 0.971 0.964 0.061 9192.560 9300.589
(0.041–0.073)
DF: degrees of freedom; CFI: comparative fit index; TLI: Tucker-Lewis index; RMSEA: root mean square error of approximation; CI: confidence interval; SRMR:
standardized root mean square residual; AIC: Akaike information criterion; BIC: Bayesian information criterion.

DISCUSSION modern devices such as mobile phones, it may be that other

This study identifies the most appropriate structure for the sedentary habits during leisure time are more important than
Brazilian version of the BHPAQ with 3 domains, according watching television today.
to the original article, however, with 14 items: 7 items in the Our study was carried out in Brazilians and the conclusions
physical activity domain in occupation (items 1–5, 7, 8), 4 in must be restricted to this population. However, considering
the physical activity domain in sports (items 9–12), and 3 items that the BHPAQ was created in 19821, it is important that
in the physical activity domain in leisure without sport (items the original version of the questionnaire should be revised in
14–16). Thus, items 6 (occupation domain) and 13 (leisure all languages, as society has undergone consistent changes in
domain) were excluded. Item 6 refers to how physically tired recent years and physical activity has been considerably affected
the individual becomes after work, and item 13 refers to watch- by these changes. We suggest that consistent factor analyses
ing television during leisure time. be considered to suit the ordinal characteristics of the possible
To the best of our knowledge, only two studies in the literature responses to the BHPAQ.
have verified the internal structure of the BHPAQ. The original
version of the questionnaire was carried out by Baecke et al.1
and used PCA to identify the number of retained factors, find- CONCLUSION
ing a structure with 3 dimensions and 16 items. Almeida and The structure of the Brazilian version of the BHPAQ with
Ribeiro3 evaluated the structure of two of the three domains 3 domains and 14 items is the most appropriate based on fac-
of the BHPAQ, excluding the occupation domain for meth- tor analysis and should be used to investigate physical activity
odological reasons. A valid internal structure with two dimen- related to occupation, sport, and leisure.
sions and eight items was found.
Both studies above did not use the most appropriate anal-
ysis method to verify the internal structure of the BHPAQ11. AUTHORS’ CONTRIBUTIONS
According to Tabachnick and Fidell16, PCA has less adequacy DSR: Conceptualization, Data curation, Formal Analysis,
when compared to factor analysis because it considers all vari- Methodology, Writing – original draft. JCS: Conceptualization,
ance and is, therefore, contaminated by the variability of error, Data curation, Formal Analysis, Methodology, Writing
so it is not recommended to evaluate the internal structure of – original draft. LFSA: Conceptualization, Data cura-
a questionnaire. tion, Formal Analysis, Methodology, Writing – original
After analysis of the BHPAQ, in this study, items 6 (occu- draft. GNS: Conceptualization, Data curation, Formal
pation domain) and 13 (leisure domain) were excluded fol- Analysis, Methodology, Writing – original draft. AVDF:
lowing the suggestion of the literature regarding items with Conceptualization, Formal Analysis, Methodology, Writing
non-significant factor loading, in this case, <0.40. The low – review & editing. AF: Conceptualization, Formal
factor load may be due to the following aspects: item 6 asks Analysis, Methodology, Writing – review & editing. RRJT:
the respondent to describe physical fatigue after work; how- Conceptualization, Formal Analysis, Methodology, Writing
ever, it may be difficult to differentiate between physical – review & editing. ASR: Conceptualization, Formal
fatigue and mental fatigue. The individual may be mentally Analysis, Methodology, Writing – review & editing. CAFPG:
tired, but this does not represent their usual physical activ- Conceptualization, Formal Analysis, Methodology, Writing –
ity. Item 13 is related to watching television at leisure; how- review & editing. DBD: Conceptualization, Formal Analysis,
ever, due to technological changes and the increasing use of Methodology, Writing – review & editing.

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Structural validity of the BHPAQ

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