Construct validity and test-retest reliability of the International Fitness Scale (IFIS) in Colombian children and adolescents aged 9-17.9 years: the FUPRECOL study

The International Fitness Scale (IFIS): A valid tool to assess physical fitness in French children

BACKGROUND

The need for monitoring regularly physical fitness in youth is well established for public health issues. The aim of this study was to assess the validity and reliability of the International Fitness Scale questionnaire (IFIS) to assess physical fitness in French children in the school context.

METHODS

A sample of 2 060 children (1054 boys), aged 10.6 ± 0.9 years, participated in the validation study while an independent sample of 366 children (175 boys), aged 9 to 11 years, participated in the assessment of reliability. Physical fitness was measured by a self-report of 5 questions with a 5-point Likert-scale (from very poor to very good) (IFIS), and also measured objectively by 4 field tests: cardiorespiratory fitness, muscular strength, speed/agility and flexibility. For the test-retest reliability assessment, children were instructed to complete the questionnaire twice, 1 week apart.

RESULTS

For all physical fitness components studied, children reporting a good or a very good physical fitness in the IFIS had better results in objective measurements of physical fitness tests compared to children reporting a very poor to an average physical fitness (p<0.001) without or with adjustments for sex, age and weight status. The reliability coefficients were acceptable for all components of physical fitness (0.59-0.72).

CONCLUSIONS

These results suggest that IFIS appears to be a useful instrument for teachers to estimate physical fitness levels of French children, possibly on a large scale.

Adaptation of the International Fitness Scale and Self-Perceived Health-Related Physical Fitness Questionnaire into Turkish

This study aims to investigate the Turkish validity and reliability of the International Fitness Scale (IFIS) and the Self-Perceived Health-Related Physical Fitness Questionnaire for Children (SPHQ-C) aged 10-17. The measurement tools were translated into Turkish by two independent researchers and back-translated. Then, the content validity was established with a group of 13 individuals (Sample 1) who presented to the sports medicine clinic. The pilot application phase was initiated. A sample of 372 individuals (Sample 2) studying in the provincial center was selected for piloting the measurement tools with the ALPHA-FIT Test Battery. The test-retest application of the measurement tools with a 15-day interval was carried out with 207 individuals (Sample 3) not included in Sample 2. The authors calculated that the content validity ratio values for the items in the IFIS ranged from 0.85 to 1.00, with a content validity index of 0.94 for the scale. In the SPHQ-C, these values were found to be between 0.92 and 1.00, with a content validity index of 0.99. According to the Z-score difference analysis for both measurement tools, the construct validity of all items was achieved (p < 0.05). In the Bland-Altman plot test conducted for the IFIS-TR, the mean difference was calculated as 0.11, the standard deviation of the differences was 1.57, and the p-value was determined as 0.31. For the SPHQ-C-TR, the mean difference was -0.15, the standard deviation of the differences was 1.95, and the p-value was determined as 0.26. The Kappa coefficients for the items of the IFIS-TR ranged from 0.45 to 0.52, while for the SPHQ-C-TR, the Kappa coefficients ranged from 0.47 to 0.75. Confirmatory factor analysis conducted on Sample 2 confirmed model fit indices with covariance among some items of the measurement tools (IFIS-TR: e1-e3; SPHQ-C-TR: e1-e2, e1-e3, e2-e3, e3-e4, e6-e7, e8-e9). The IFIS and SPHQ-C measurement tools have been adapted into Turkish, and their validity and reliability have been established.

Physical Fitness, Screen Time and Sleep Habits According to Obesity Levels in Schoolchildren: Findings from the Health Survey of the Extreme South of Chile

Obesity is a worry because it is associated with a greater burden of disease, and it has been shown to be related to the health habits and physical condition of children and adolescents.

OBJECTIVE

To associate physical fitness, screen time, and sleep habits with the different categories of obesity in schoolchildren from the extreme south of Chile.

METHODS

583 schoolchildren were included in this cross-sectional analysis. The screen time and sleep habits were measured with the Sleep Self-Report questionnaire, while the physical fitness was assessed with the Alpha Fitness test battery. The Body Mass Index/age (BMI/age) and the Waist-to-Height ratio (WtHr) were used to define adiposity using the following categories: healthy weight/low-risk waist-to-height ratio (H/LR), healthy weight/high-risk waist-to-height ratio (H/HR), overweight/low-risk waist to height ratio (O/LR), and overweight/high-risk waist to height ratio (O/HR).

RESULTS

A considerable number of schoolchildren (23.2%) presented sleep problems, while the mean screen time was 9.3 (95% CI: 8.4; 10.1) hours/day. Schoolchildren classified as H/HR showed better physical fitness than the O/HR group but worse physical fitness than the H/LR group.

CONCLUSIONS

Significant differences were evidenced in the physical fitness between the adiposity categories, which could open future lines of research concerning the characterization of the healthy weight-obese adiposity categories in children.

Reliability of International Fitness Scale (IFIS) in Chinese Children and Adolescents

Background and Objectives: It has previously been shown that the International Fitness Scale (IFIS) is a reliable and valid instrument when used in numerous regions and subgroups, but it remains to be determined whether the IFIS is a reliable instrument for use with Chinese children and adolescents. If the reliability of the IFIS can be verified, populational surveillance and monitoring of physical fitness (PF) can easily be conducted. This study aimed to test the reliability of the IFIS when used with Chinese children and adolescents. Methods: The convenience sampling method was used to recruit study participants. In total, 974 school-aged children and adolescents between 11 and 17 years of age were recruited from three cities in Southeast China: Shanghai, Nanjing and Wuxi. The study participants self-reported demographic data, including age (in years) and sex (boy or girl). The participants completed the questionnaire twice within a two-week interval. Results: A response rate of 95.9% resulted in a sample of 934 participants (13.7 ± 1.5 years, 47.4% girls) with valid data. On average, the participants were 13.7 ± 1.5 years of age. The test–retest weighted kappa coefficients for overall fitness, cardiorespiratory fitness, muscle fitness, speed and agility and flexibility were 0.52 (Std. errs. = 0.02), 0.51 (Std. errs. = 0.02), 0.60 (Std. errs. = 0.02), 0.55 (Std. errs. = 0.02) and 0.55 (Std. errs. = 0.02), respectively. Conclusions: The International Fitness Scale was found to have moderate reliability in the assessment of (self-reported) physical fitness in Chinese children and adolescents. In the future, the validity of the IFIS should be urgently tested in Chinese subgroup populations.

Validity and Reliability of the International FItness Scale (IFIS) in preschool children

OBJECTIVES

Examine the validity and reliability of parent-reported International FItness Scale (IFIS) in preschool-age children.

METHOD

A cross-sectional study of 3051 Spanish preschoolers (3-5 years). Fitness was measured by PREFIT fitness test battery and reported by parents using an adapted version of the IFIS. Waist circumference was evaluated, and the waist-to-height ratio (WHtR) was calculated. Seventy-six parents of randomly selected schoolchildren completed the IFIS twice (two weeks apart) for a reliability assessment.

RESULTS

ANCOVA, adjusted for sex, age and WHtR, showed that preschoolers who were scored by their parents as having average-to-very good fitness had better levels of measured physical fitness than those preschoolers who were classified as having "very poor/poor" fitness levels (18.1laps to 22.1laps vs 15.6laps for cardiorespiratory fitness; 6.6 kg to 7.5 kg vs 5.3 kg for muscular fitness-handgrip-; 71.7 cm to 76.4 cm vs 62.0 cm for muscular fitness-standing long jump-; 17.2s to 16.2s vs 18.2s for speed/agility; and 11.2s to 15.6s vs 8.7s for balance; p < 0.001). The weighted kappa for concordance between parent-reported fitness levels and objective assessment was poor (κ ≤0.18 for all fitness measures). Overall, the mean values of the abdominal adiposity indicators were significantly lower in high-level fitness categories reported by parents than in low-level fitness categories (p < 0.05). The test-retest reliability of IFIS items ranged from 0.46 to 0.62.

CONCLUSIONS

The reliability of the parent-reported IFIS are acceptable, but the concordance between parents reported and objectively measures fitness levels is poor, suggesting that parents' responses may not be able to correctly classify preschoolers according to their fitness level.

Reliability and validity of the Healthy Fitness Measurement Scale Version 1.0 (HFMS V1.0) in Chinese people

OBJECTIVE

To investigate the reliability and validity of Healthy Fitness Measurement Scale Version 1.0 (HFMS V1.0) for different population cohorts in the city of Guangzhou, Guangdong, China and to provide evidence and tools for further evaluation of healthy fitness of Chinese population and related factors.

DESIGN

Cross-sectional study.

SETTING

Urban neighbourhood and Medical University.

PARTICIPANTS

Elderly people (n=393; mean age 68.27±6.38 years; 53.18% male), university students (n=390; mean age 19.29±1.29 years; 38.21% male) and urban residents (n=393; mean age 32.23±9.41 years; 44.78% male).

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcomes were evaluated the reliability and validity of HFMS V1.0 by internal consistency evaluation, split-half reliability, test-retest reliability, convergent and discriminant construct validity, and factor analysis.

RESULTS

The Cronbach's α coefficients for HFMS V1.0 were all greater than 0.85 for overall scale of total samples and three individual groups, and the split-half reliability and intragroup correlation coefficients were both greater than 0.70 (p<0.01). The correlation of each item, dimension and subscales ranged from 0.52 to 0.91 (p < 0.01). A total of 10 factors were screened by exploratory factor analysis with the cumulative contribution rate of 61.40%, basically consistent with the theoretical structure of scale. The confirmatory factor analysis indicated good fit: CMIN/DF=3.45, root mean square error of approximation=0.05, GFI=0.91, AGFI=0.90, IFI=0.90, comparative fit index=0.90.

CONCLUSION

HFMS V1.0 showed acceptable reliability and validity in the test of healthy fitness of general population in Guangzhou. This scale could be a reliable measurement tool for evaluation of healthy fitness and potential risk factors.

Self-reported (IFIS) versus measured physical fitness, and their associations to cardiometabolic risk factors in early pregnancy

Physical fitness is a strong marker of health, but objective fitness measurements are not always feasible. The International FItness Scale (IFIS) for self-reported fitness is a simple-to-use tool with demonstrated validity and reliability; however, validation in pregnancy needs to be confirmed. Also, its association with cardiometabolic health in pregnant women is unknown. Hence, we examined (1) the validity of the IFIS with objectively measured fitness, and (2) the associations of self-reported versus objectively measured cardiorespiratory fitness (CRF) and muscular strength with cardiometabolic risk factors in early pregnancy. Women (n = 303) from the HealthyMoms trial were measured at gestational week 14 for: CRF (6-min walk test); upper-body muscular strength (handgrip strength test); self-reported fitness (IFIS), body composition (air-displacement plethysmography); blood pressure and metabolic parameters (lipids, glucose, insulin). Higher self-reported fitness was associated with better measured fitness (ANOVA overall p < 0.01 for all fitness types), indicating the usefulness of the IFIS in pregnancy. Furthermore, higher self-reported overall fitness and CRF were associated with lower cardiometabolic risk scores (ANOVA p < 0.001), with similar results shown for measured CRF (ANOVA p < 0.001). The findings suggest that IFIS could be useful to stratify pregnant women in appropriate fitness levels on a population-based level where objective measurement is not possible.

Fear-related barriers to physical activity among adults with overweight and obesity: A narrative synthesis scoping review

Physical activity is a health behavior contributing to successful weight management. Adults with overweight and obesity find it challenging to meet recommended activity guidelines because of a range of barriers, some of which are not yet fully understood. A barrier receiving limited consideration, compared with other literature within this field, is that of fear. The purpose of this scoping review was to establish the extent of literature on fear-related barriers to physical activity in adults with overweight or obesity and to identify gaps in this literature. The review followed the scoping review framework outlined by Arksey and O'Malley and adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. The findings of the identified papers were charted thematically using a framework of fears and age group. In total, 34 studies were included that identified nine different fears related to barriers to activity in this population. However, only a small number of studies (n = 5) had explicitly intended to explore fear-related barriers. There were notable knowledge gaps including activity-related fear of pain and movement in adults under 45 years of age. There is a strong rationale to further explore these fears because they may restrict health promoting behavior.

Reliability of questionnaire The International Fitness Scale: a systematic review and meta-analysis

Objective

To perform a systematic literature review and meta-analysis to investigate the reliability of The International Fitness Scale questionnaire for assessing overall physical fitness and related components.

Methods

PubMed^®, BIREME, SciELO, EMBASE, SPORTDiscus, LILACS and Cochrane databases were searched using the following search terms: “The International Fitness Scale”, “International Fitness Scale” and “IFIS”. Article selection and data extraction were performed according to the following eligibility criteria: reliability and/or validity study of the measure tools of The International Fitness Scale; adoption of the The International Fitness Scale as a reference criterion (gold standard) and being an original article. Quality of the study was considered based on Assessment of Reliability Studies. Data analysis used Kappa coefficient of agreement, Cochran and the Higgins I² test. Sensitivity analysis was conducted using the withdrawal model.

Results

A total of seven articles were included in the analysis. Test-retest reliability coefficients ranged from 0.40 to 0.99, with most studies achieving values ≥0.60, indicative of moderate to substantial reliability.

Conclusion

In spite of appropriate test-retest scores attributed to most reliability indicators, heterogeneity among the studies remained high. Therefore, further studies with low risk of bias are needed to support the reliability of the self-reported The International Fitness Scale.

Doctor, ask your perimenopausal patient about her physical fitness; association of self-reported physical fitness with cardiometabolic and mental health in perimenopausal women: the FLAMENCO project

OBJECTIVE

The aim of this study was to explore the association of self-reported physical fitness (PF) and its components with cardiometabolic and mental health in perimenopausal women.

METHODS

These cross-sectional analyses included 191 participants (53 ± 4 y old) from the FLAMENCO project. Self-reported PF was assessed with the International Fitness Scale (IFIS). Body mass index (BMI), fat mass (FM), waist circumference (WC), systolic and diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL-C), triglycerides, C-reactive protein (CRP), and glucose were measured. The Beck's Depression Inventory, State-Trait Anxiety Inventory, Pittsburgh Sleep Quality Index, Life Orientation Test Revised, and Positive and Negative Affect Schedule were used to assess mental health.

RESULTS

After adjusting for potential confounders, greater overall PF was associated with lower BMI, FM, WC (P < 0.001), DBP and CRP, and higher HDL-C (P < 0.05). Cardiorespiratory fitness (CRF), speed-agility, and flexibility were associated with lower BMI, WC, and FM (P < 0.001), and muscle strength (MS) with lower WC and FM (P < 0.05). In addition, CRF, MS, and speed-agility were associated with lower CRP (P < 0.01), and flexibility with enhanced triglycerides and HDL-C (P < 0.05). Overall PF and all its components were associated with lower depression, anxiety, and negative affect (P≤0.01), and greater positive affect (P≤0.05). Overall PF and MS were associated with better sleep quality (P < 0.05), and CRF, MS, and speed-agility with greater optimism (P≤0.05). Finally, overall PF showed evidence of significant association with less pharmaceutical expenditure (B = -7.2, β=-0.145, P = 0.08).

CONCLUSIONS

Self-reported PF was associated with better cardiometabolic and mental health in perimenopausal women. The IFIS might be proposed as an inexpensive, quick, and easy tool in clinical settings.

Cardiorespiratory Fitness in Youth: An Important Marker of Health: A Scientific Statement From the American Heart Association

Cardiorespiratory fitness (CRF) refers to the capacity of the circulatory and respiratory systems to supply oxygen to skeletal muscle mitochondria for energy production needed during physical activity. CRF is an important marker of physical and mental health and academic achievement in youth. However, only 40% of US youth are currently believed to have healthy CRF. In this statement, we review the physiological principles that determine CRF, the tools that are available to assess CRF, the modifiable and nonmodifiable factors influencing CRF, the association of CRF with markers of health in otherwise healthy youth, and the temporal trends in CRF both in the United States and internationally. Development of a cost-effective CRF measurement process that could readily be incorporated into office visits and in field settings to screen all youth periodically could help identify those at increased risk.

Reliability and Validity of a Questionnaire for Assessing Self-Perceived Health-Related Fitness in Spanish Children

There is a need for developing tools aimed at assessing fitness in children, due to its relationship with health. This study is aimed at testing the reliability and the validity of a questionnaire designed for assessing self-perceived health-related fitness in Spanish children. The questionnaire was created based on the model of physical self-concept developed by Fox and Corbin (1989) who conceived four sub-domains: Sport competence, attractive body, strength and physical condition. A total of 283 children (mean age: 10.80 ± 0.69 years; 45.6% girls) answered the questionnaire twice, in order to determine its test-retest reliability. The results obtained in the International Fitness Scale (IFIS) and on a fitness battery were used to determine its validity evidence based on relations to other variables. Exploratory and factorial analyses were performed to check its validity evidence based on internal structure. The obtained results indicated that the questionnaire showed an accurate validity evidence based on internal structure and a very good test-retest reliability, Intraclass correlation coefficient: .88; 95% CI [.84, .90]. The questionnaire established moderate correlations with the IFIS questionnaire (ρ = -.51 to -.68) and the fitness level showed by the children (ρ = -.53). These findings indicate that the questionnaire can be a useful research tool for assessing self-perceived health-related fitness in children.

Development and Evaluation of the High-Intensity Interval Training Self-Efficacy Questionnaire

This study involved the design and evaluation of the High-Intensity Interval Training Self-Efficacy Questionnaire (HIIT-SQ). Phase 1: Questionnaire items were developed. Phase 2: Australian adolescents (N = 389, 16.0 ± 0.4 years, 41.10% female) completed the HIIT-SQ, and factorial validity of the measurement model was explored. Phase 3: Adolescents (N = 100, age 12-14 years, 44% female) completed the HIIT-SQ twice (1 week apart) to evaluate test-retest reliability. Confirmatory factor analysis of the final six items (mean = 3.43-6.73, SD = 0.99-25.30) revealed adequate fit, χ2(21) = 21, p = .01, comparative fit index = .99, Tucker-Lewis index = .99, root mean square of approximation = .07, 90% confidence interval [.04, .11]. Factor loading estimates showed that all items were highly related to the factor (estimates range: 0.81-0.90). Intraclass coefficients and typical error values were .99 (95% confidence interval [.99, 1.00]) and .22, respectively. This study provides preliminary evidence for the validity and reliability of scores derived from the HIIT-SQ in adolescents.

International Fitness Scale-IFIS: Validity and association with health-related quality of life in pregnant women

This study aimed (a) to examine the construct validity of the International Fitness Scale (IFIS) to discriminate between different objectively measured physical fitness levels in pregnant women and (b) to assess the extent to which IFIS is able to discriminate between pregnant women with different levels of health-related quality of life (HRQoL). A total of 159 pregnant women were involved in the GESTAtion and FITness project: 106 pregnant women (mean age 32.7, SD 4.4 years) were included. Self-reported physical fitness-that is, cardiorespiratory fitness, muscular strength, flexibility, and overall fitness-was assessed with the IFIS. Physical fitness was objectively measured using the Bruce test, the handgrip strength test and the back-scratch test. The HRQoL was assessed with the 36-item Short Form Health Survey (SF-36). Higher self-reported physical fitness measured with IFIS was associated with higher objectively measured physical fitness (P < .05). There was a linear association so that higher self-reported physical fitness (ie, IFIS; regardless of the fitness component) was related to greater General Health dimension scores (P < .05). Moreover, higher self-reported physical fitness (all components except muscular strength) was associated with better Physical Functioning, lower Bodily Pain and higher Vitality scores (ie, SF-36 components). This linear trend was not seen for objectively measured physical fitness. The results of this study suggest that IFIS might be a useful tool for identifying pregnant women with low or very low physical fitness and with low quality of life health-related. Further research should elucidate whether IFIS can identify women with pregnancy complications before it can be implemented in clinical practice.

Is Self-Reported Physical Fitness Useful for Estimating Fitness Levels in Children and Adolescents? A Reliability and Validity Study

Background and objective: The assessment of physical fitness has become a necessary issue in epidemiological studies, since a reduction in fitness is directly associated with early mortality. Therefore, the development of simple, accurate, and inexpensive methods is necessary to measure physical fitness. This study aimed to determine the reliability and validity of the criteria and constructs of the International Fitness Scale (IFIS), Portuguese version, in Brazilian pediatric populations. Methods: A total of 190 children aged 3-10 years and 110 adolescents aged 11-17 years were enrolled in an observational study of reliability and validity. For reliability, the participants completed a questionnaire twice (with an interval of 15 days). To test the criterion validity, we analyzed the agreement between the questionnaire and physical tests (20-m shuttle run test, handgrip strength, standing long jump tests, 4 × 10-m shuttle run test, and back-saver sit and reach test), and the construct validity was estimated by agreement between the questionnaire and high blood pressure. The reliability was analyzed by kappa coefficients. The agreement between the testing and retesting of the questionnaire was evaluated by kappa coefficients. We applied a 2 × 2 table to estimate the specificity, sensitivity, and accuracy of the questionnaire. Results: The mean age of the children was 6.7 years (n = 190), and for the adolescents it was 14.6 years (n = 110). The questionnaire reliability showed an almost perfect score (κ ≥ 0.93 in children and κ ≥ 0.88 in adolescents). The questionnaire showed moderate criterion validity (κ ≥ 0.40 in children and adolescents) as well as moderate construct validity (κ ≥ 0.40) in the components of general conditioning, cardiorespiratory capacity, muscular strength, and speed/agility in children and in the components of cardiorespiratory capacity, muscle strength, and speed/agility in adolescents. The questionnaire was a sensitive method for measuring physical fitness. Conclusions: The Portuguese version of the IFIS is a reliable and valid method for measuring physical fitness in pediatric populations.

Transcultural adaptation and new proposal for the nursing outcome, Physical condition (2004)

Objectives:

cross-culturally adapt to the Spanish context and make a new proposal for the nursing outcome, Physical Condition (2004), of the Nursing Outcomes Classification (NOC) for its precise use in clinical practice.

Method:

a cross-cultural adaptation study and a proposal for the nursing outcome, Physical Condition, was conducted and supported by the opinion of 26 experts. The data was obtained through an electronic form, and a quantitative analysis was conducted, using the SPSS software.

Results:

the version adapted to the Spanish context was obtained and the proposal of the outcome, Physical Condition, received agreement from 26 experts, with a mean score greater than 7.6 for adequacy of the outcome definition and its indicators, and 8.5 for the relevance of the indicators.

Conclusions:

the version adapted to the Spanish context and a new proposal for Physical Condition were obtained. The results obtained indicate a high level of adequacy and relevance, an instrument of great utility in the clinic, and research was obtained to evaluate the interventions directed to the improvement of the physical condition.