This study aims to assess the acceptance and effectiveness of an exercise board game in improving knowledge of physical activity among overweight and obese children. A quasi-experimental research design was carried out. This study was conducted among 68 overweight and obese children aged 7-11 years old from four primary schools in Kuala Lumpur. Children in the intervention group (n=34) played the exercise board game, while those in the control group (n=34) were given explanations using the Ministry of Heath Malaysia’s physical activity pyramid. Both groups were tested on their knowledge of physical activity using a pre-tested questionnaire before and after the study. The results showed a significant increase in the knowledge of physical activity among both the intervention and control groups. In the intervention group, the total scores before and after intervention were respectively: median (25th – 75th percentile), 8 .0 (6.0 - 9.0) and 8.0 (8.0 – 10.0), p=0.005. In the control group, the total scores before and after intervention were respectively: median (25th – 75th percentile), 9.0 (7.0 – 10.0) and 10.0 (8.8 – 10.0), p=0.005. Overall, the acceptance score of children on the exercise board game was high [7.0 (6.0 – 8.0)] from total score of 8.0. In conclusion, both groups improved their knowledge of physical activity after the intervention sessions. This study confirms the acceptance of the exercise board game among overweight and obese children in primary schools. Further research is needed to evaluate the attitudes and practices of children towards physical activity after playing the exercise board game.
BACKGROUND: The aim of this cross-sectional study was to examine the ability of a children's physical activity questionnaire (cPAQ) to assess physical activity levels and bone health status of school children.
METHODS: Subjects consisted of 90 pre-pubertal and early pubertal children aged 9-10 years. Components of physical activity were assessed using metabolic intensity (METPA) scores and mechanical bone strain (MECHPA) scores. An Actical accelerometer was used to validate METPA scores among a sub-sample of 57 children. Reliability was assessed by test-retesting all children after a 7 day interval. Whole body bone mineral content (BMC) was measured using dual-energy X-ray absorptiometry.
RESULTS: The reliability of cPAQ for assessment of various categories of physical activity was moderate to high (r ranged from 0.55 to 0.68, P < 0.001). Agreement was fair for repeated use of the cPAQ (Cohen's kappa = 0.32, P < 0.001). Bland-Altman plots show cPAQ had fair agreement only for moderate activity (mean difference 35.4 min/week; 95% limits of agreement -434.0 to +504.9 min/week). Approximately 69.6% of children were correctly classified (into the same or adjacent quartiles) according to the quartiles of BMC for METPA score, and 58.7% were correctly classified according to MECHPA score. Only 10.9% and 12.0% of children were grossly misclassified as compared to METPA and MECHPA scores, respectively.
CONCLUSIONS: The cPAQ has reasonable validity in assessing moderate physical activity, and it demonstrates good ability to accurately classify children according to BMC. It fails, however, to assess other activity levels, suggesting that objective measurement is still a better method of assessment of physical activity among primary school children.