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Examining the Construct Validity of the Childrens Assessment of

Participation and Enjoyment (CAPE)


by
Jeremy J. Lynn

A Directed Study Submitted in Partial Fulfillment


of the Requirements for the Degree of

BACHELORS OF KINESIOLOGY
in the School of Exercise Science, Physical and Health Education

Jeremy J. Lynn, 2016


University of Victoria

All rights reserved. This thesis may not be reproduced in whole or in part, by photocopy or other
means, without the permission of the author.
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Table of Contents

Introduction.................................................................................................................. 2
Method......................................................................................................................... 3
Participants................................................................................................................ 3
Measures................................................................................................................... 3
Procedure.................................................................................................................. 4
Data Treatment............................................................................................................ 4
Data Analysis.............................................................................................................. 7
Results......................................................................................................................... 7
Discussion..................................................................................................................... 9
Appendix A................................................................................................................. 14
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Introduction
A growing body of evidence is showing that the physical activity levels of children in
Canada is low and has been declining in recent decades (Colley et al., 2011; Colley et al., 2013).
According to physical activity report cards from Active Healthy Kids Canada (2015), physical
activity levels of Canadian children have been very poor, with scores remaining low for overall
physical activity since 2005. The Canadian Physical Activity Guidelines suggest 60 minutes of
moderate to vigorous physical activity (MVPA) daily, and an estimated 4% and 9% of Canadian
girls and boys, respectively, achieve 60 minutes of MVPA at least six days a week (Colley et al.,
2011; Tremblay et al., 2011). This lack of physical activity in Canadian children is concerning
due to the positive relationship found between physical inactivity and obesity (Tremblay &
Willms, 2000), with obesity in children leading to cardiovascular disease risk factors, as well as
social and psychological challenges (Ogden, Carroll, & Flegal, 2003). Additionally, the disease
prevention of health benefits of physical activity in children are numerous (Warburton, Nicol, &
Bredin, 2006). Physical activity in the form of sport participation is also known to provide
psychological and social health benefits (Dimech & Seiler, 2011; Eime, Young, Harvey, Charity,
& Payne, 2013).

Given the general inactivity of children, monitoring of activity levels is important for
heath promotion planning and the development of policy and legislation (Tremblay & Willms,
2000). In order to better understand changes to activity levels, a quantitative tool is required to
measure the physical activity participation of children. Physical activity and sedentary behavior
in young children can be measured using direct (e.g., pedometers and accelerometers) and
indirect (e.g., parent-report and observation) methods. However, it has been shown that indirect
measures can limit the accuracy of physical activity reporting (Cain, Sallis, Conway, Van Dyck,
& Calhoon, 2013). One existing method for indirectly measuring activity in children is the
Childrens Assessment of Participation and Enjoyment (CAPE). As there are few established
indirect measures of activity in children, validation processes for new measures is ongoing (King
et al., 2006). This study will examine the suggestions made by King et al. (2004) that the CAPE
is a valid measure of activity patterns in children by comparing the CAPE survey results with a
direct measure of physical activity levels through accelerometry.
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Method
Participants
Participants were initially recruited in Kindergarten, during the 2010-2011 and 2011-2012
school years. Two cohorts totalling 428 grade 3 children participated in this study (73% of
sampling frame) from eight elementary schools in a single school district in Victoria, British
Columbia. The data of the present study was collected during the months of November April of
the 2013-2014 and 2014-2015 school years.

Children were included in the study if: they had complete CAPE data collected in grade
3, and accelerometry wear time criteria were met. For the purpose of this study, accelerometry
inclusion criteria were met if the participant had a wear time of at least 10 hours for three
weekdays and one weekend day (Barreira et al., 2015; Troiano et al., 2007).

Measures
The CAPE is a survey designed to measure the participation of children ages 6-21 years
in various activities within the prior four months (King et al., 2004) and is considered to have a
high construct validity and testretest reliability (King et al., 2004; King et al., 2006). To
examine the CAPE test-retest reliability, a sample of 427 children were administered the CAPE
twice, with a period of three weeks between tests (King et al., 2004). Sufficient test-retest
reliability for overall participation and the formal and informal domains was shown (King et al.,
2004). Construct validity of the CAPE was examined in terms of content and typology of
activities and was established by conducting an intensive review of literature on participation,
pilot work, and expert review (King et al., 2004).
The CAPE includes 55 activities grouped into the following categories: Recreational
activities, Social activities, Self-improvement activities, Active Physical activities, and Skill-
based activities (Appendix A). As well, the CAPE items can be classified further into categories
including but not limited to: organized sports and quiet recreation. Measures of diversity
(number of activities done), intensity (how often), with whom, where, and enjoyment level are
also taken.
ActiGraph GT1M accelerometers were used to measure physical activity and sedentary
behaviour in a uniaxial mode. Accelerometers were placed on participants hips with an elastic
belt for seven days to best estimate physical activity (Barreira et al., 2015; Trost, McIver, & Pate,
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2005). To determine the amount of time spent in different activity intensities, accelerometers
recorded movement in 15 second epochs (Ojiambo et al., 2011; Trost et al., 2005). The use of
ActiGraph accelerometers in recording the activity habits of children has been shown to be valid
and reliable in application (John, Tyo, & Bassett, 2010; Puyau et al., 2002). ActiLife software
(Actigraph LLC) was used to enter participant codes on the accelerometers, set the epoch and
number of axis, and set initialization times and dates. Accelerometry data was examined using
Kinesoft (version 2.0.94, Kinesoft Software, New Brunswick, Canada), an accelerometer
analyzing software.

Procedure
Consent forms were sent out to the parents/guardians of the recruited children through the
school teachers. Additional information was collected including date of birth, gender, and
disability status.

During school hours, each participant completed the CAPE survey. The survey was
administered through interview by members of the research team. Images, such as those
demonstrating the activity in question, were used to aid in response to the survey questions.
Researchers initially asked participants if he/she had done the activity within the prior four
months. If the response was no, then the researcher proceeded to the next question. If the
participant responded yes, they were asked subsequent questions of how often have you done
this activity in the past four months (intensity), with whom do you do this activity most often,
where do you do this activity most often, and how much do you enjoy doing this activity
were asked. This process continued until all 55 items had been completed.

After the survey, participants were outfitted with accelerometers. Belt size was
manipulated on-site if issues of comfort or secureness of the device arose. Information sheets
were given to children at the time of outfitting, which detailed usage requirements, return dates,
and study information. Accelerometers were collected a minimum of seven full days after initial
outfitting.

Data Treatment
To examine the extent to which activities of the CAPE could be classified as more or less
active, we created activity type categories independently from those recommended by the CAPE
manual score sheets. CAPE items were grouped into the following activity types: physically
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active, sedentary activities, moderate-to-vigorous physical activity (MVPA), organized sport, and
physical activities (CAPE) (outlined in Table 1). Items placed in the physically active, sedentary
activities, and MVPA categories were identified as such based on work by Ridley, Ainsworth,
and Olds (2008). Items were included in the organized sport category if the item description
included only activities that exist within organized sport. Items for each category were
independently selected by two researchers and any discrepancies in item selection were removed
from the categories. The existing CAPE manual activity type category of physical activities was
also included in analysis (King et al., 2004). From the CAPE, only the diversity and intensity
scores were considered in this study.
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Table 1
Activity type categories, number of items per category, and the items included in each category
Activity Type Number of Items Items

Physically Active 14 Martial arts (16), swimming (17), gymnastics


(18), track and field (20), team sports (21),
learning to dance (24), dancing (31),
walk/hike (32), bicycling, in-line skating, or
skateboarding (33), snow sports (35), playing
games (37), gardening (38), individual
physical activities (40), non-team sports (41)

Sedentary Activities 19 Puzzles (1), board/card games (2),


crafts/drawing/coloring (3), collecting (4),
video games (5), talking on the phone (6),
hanging out (8), visiting (9), writing letters
(10), writing a story (13), learning to sing
(22), being tutored (25), religious activities
(29), going to the movies (42), going to the
library (43), watching TV/movies (44),
reading (47), listening to music (48),
homework (53)

MVPA 11 Martial arts (16), swimming (17), gymnastics


(18), track and field (20), team sports (21),
learning to dance (24), dancing (31),
bicycling, in-line skating, or skateboarding
(33), snow sports (35), playing games (37),
individual physical activities (40)

Organized Sport 7 Martial arts (16), swimming (17), gymnastics


(18), track and field (20), team sports (21),
learning to dance (24), non-team sports (41)

Physical Activities (CAPE) 13 Martial arts (16), track and field (20), team
sports (21), participating in school clubs (30),
bicycling, in-line skating, or skateboarding
(33), water sports (34), snow sports (35),
playing games (37), gardening (38), fishing
(39), individual physical activities (40), non-
team sports (41), paid job (51)
7

Kinesoft was used to analyze accelerometry data, which output the minutes spent at
sedentary, light, moderate, or vigorous activity levels. In this study, total physical activity,
sedentary activity, and MVPA were analyzed. Total physical activity was a combination of light
activity and MVPA.

Data Analysis
The data from the CAPE survey was grouped into the mentioned categories by item
number. Diversity scores were taken dichotomously, either a 0 for no participation or a 1 for
participation. The diversity scores were summed for the items in each category, resulting in the
overall diversity score for that category. Intensity scores were taken on a scale from 1 (one time
in the past four months) to 7 (one time a day or more) as per the set scoring in the CAPE manual
(King et al., 2004). The intensity scores were summed per category and divided by the total
number of items in that category, giving the overall intensity score.

Epoch, axis number, and cut-points for sedentary, light, moderate, and vigorous activity
levels were entered in Kinesoft. The following cut-off points for levels of physical activity were
used during analysis: <1.5 metabolic equivalent of task (METs) for sedentary behaviors, 1.5 to
<4 METs for light activity, 4 to <6 METs for moderate activity, and 6 METs was classified as
vigorous activity (Puyau et al., 2002). The wear time inclusion criteria were included in the
Kinesoft analysis. Data which met these criteria was output as minutes of activity per intensity
category.

IBM SPSS (Version 23.0) for Windows (IBM Corp, 2015) was used to generate
descriptive statistics for the diversity and intensity scores of the CAPE categories examined, as
well as for the sedentary, MVPA, and total activity levels from accelerometry. A Pearson-product
moment correlation was used to compare the diversity and intensity scores of each activity
category to the accelerometry measures of activity.

Results
A total of 137 participants met the inclusion criteria of this study (65 males, 72 females;
mean age =104.3 months, SD = 3.79 months). Results from a descriptive analysis of the five
CAPE categories and three accelerometry measures are shown in Table 2. According to
accelerometry, physical activity levels were generally high with mean MVPA minutes per day
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exceeding the Canadian Physical Activity Guidelines recommendation (Tremblay et al., 2011).
However, most minutes of the day were still spent in sedentary pursuits.

Table 2
Participant numbers, mean values, and standard deviation from the direct and indirect measures
of activity
N Mean SD

Accelerometry

Sedentary Minutes per Day 137 412.41 94.63

MVPA Minutes per Day 137 92.81 24.54

Total PA Minutes per Day 137 270.25 44.87

CAPE

Physically Active Diversity 137 6.39 2.29

Physically Active Intensity 137 2.12 .85

Sedentary Activities Diversity 137 11.66 2.55

Sedentary Activities Intensity 137 2.91 .70

MVPA Diversity 137 4.97 1.89

MVPA Intensity 137 2.18 .91

Organized Sport Diversity 137 2.57 1.20

Organized Sport Intensity 137 1.74 .88

Physical Activities (CAPE) 137 4.63 2.10


Diversity

Physical Activities (CAPE) 137 1.69 .81


Intensity

Results from the Pearson-product moment correlation analysis are shown in Table 3.
Similar negative correlations were observed for the direct MVPA values and the indirect CAPE
measures of sedentary activity diversity, as well as for the direct MVPA and the CAPE sedentary
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activity intensity. A positive relationship was also seen between direct MVPA and the existing
CAPE measure of physical activity intensity. No other correlation coefficients were significant.

Table 3
Results from a correlation analysis of the five CAPE activity categories and the direct measures
of physical activity
Sedentary Minutes MVPA Minutes Total PA Minutes
per Day per Day per Day

Physically Active Diversity -.024 .072 .102

Physically Active Intensity -.017 .119 .110

Sedentary Activities Diversity .007 -.236** -.108

Sedentary Activities Intensity .036 -.213* -.126

MVPA Diversity .024 .086 .102

MVPA Intensity .025 .109 .099

Organized Sport Diversity .035 .065 -.023

Organized Sport Intensity .051 .082 -.021

Physical Activities (CAPE) -.065 .144 .119


Diversity

Physical Activities (CAPE) -.076 .202* .144


Intensity

Discussion
This study examined the validity of the CAPE as a measure of activity patterns in
children. Results show a relationship between indirect measures of sedentary activities through
the CAPE and direct measures of MVPA through accelerometry. As well, a relationship between
the direct measures of MVPA and CAPE physical activity intensity. No relationships were seen
between the researcher created category of sedentary activities and directly measured sedentary
activity. There was also no relationship seen between directly measured MVPA and total physical
activity to either the researcher created categories of MVPA or physically active activities.
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Limitations of this study include the different time frames used by the CAPE and
accelerometers. The CAPE indirectly assessed participation over a four-month retrospective
period, while the accelerometers directly assessed physical activity over a period of seven days.
This different in testing time frame may confound the amount of activity recorded by the CAPE
compared to the accelerometers.

The findings of this study do not align with the suggestions made by King et al. (2004)
that the CAPE is a valid measure of activity patterns in children. Our results bring into question
the construct validity of the measures taken by the CAPE survey. Future research in the
validation of the CAPE measures should be done in order to expand the area of valid
participation surveys.

References
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Barreira, T. V., Schuna, J. M., Tudor-Locke, C., Chaput, J. P., Church, T. S., Fogelholm, M.,
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Cain, K. L., Sallis, J. F., Conway, T. L., Van Dyck, D., & Calhoon, L. (2013). Using
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Colley, R. C., Garriguet, D., Janssen, I., Craig, C. L.,Clarke, J., & Tremblay, M. S. (2011).
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Appendix A

CAPE item descriptions and activity type


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Item Expanded Description Activity Type


1 Doing puzzles Includes jigsaw, wooden, crossword, 3-d, and geometric Recreational
puzzles.
2 Playing board or card Includes games played on a board and/or games using a Recreational
games deck of playing cards. Video games are not included in this
item.
3 Doing crafts, drawing or Included activities that involve paper, glue, paints, glitter, Recreational
coloring crayons, markers, foam shapes, felt, etc. Activities done in
an art class outside of school should be recorded under the
item labeled taking art lessons.
4 Collecting things Includes collections such as dolls, cards, stamps, coins, Recreational
insects, buttons, stickers, and action figures. It also
includes picking or gathering of things such as apples,
flowers, berries, leaves.
5 Playing computer or video Includes games played on hand-help systems, larger Recreational
games systems, and also games played on a computer that are
installed or played from the Internet.
6 Talking on the phone Includes talking to others on a home-based phone, cell Social
phone, or payphone.
7 Going to a party Includes birthday parties, reunions, weddings, graduations, Social
and other celebrations.
8 Hanging out Includes spending time with other with no specific activity Social
planned. If an activity is done while hanging out, the
specific activity should be recorded under the most
appropriate item.
9 Visiting Includes going over to someones house for a meal or Social
sleepover.
10 Writing letters Includes correspondence on paper, email, or audiotape. Self-Improvement
11 Entertaining others Includes hosting others for a meal, party, or gathering. Social
12 Playing with pets Includes walking, throwing toys, and general play. Does Recreational
not include grooming or feeding.
13 Writing a story Includes writing a true or imaginary story or writing in a Self-Improvement
journal or diary.
14 Doing pretend or Includes creating plays; making houses, cars, or tents out Recreational
imaginary play of boxes and blankets; and acting out stories or role-
playing.
15 Playing with things or toys Recreational
16 Doing martial arts Includes Judo, Karate, Tai Kwon Do, and Jujitsu done in Active Physical
the context of a formal class or club.
17 Swimming Includes swimming in a club or within lessons at a pool or Skill-Based
body of water.
18 Doing gymnastics Includes tumbling, vaulting, balancing, jumping, and Skill-Based
swinging using equipment. If this activity is done as part
of a team, it should be recorded in the team sports item.
19 Horseback riding Includes trail riding and/or jumping and riding in a fenced Skill-Based
area.
20 Racing or track and field Includes all racing such as running, wheeling, and/or Active Physical
cycling. Also includes relay races, hurdle jumping, high
jump, long jump, and shot put.
21 Doing team sports Includes being a member of a sports team in any position Active Physical
on the team.
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22 Learning to sing (choir or Includes individual singing lessons or in a choir. Skill-Based


individual lessons)
23 Taking art lessons Includes classes or individual lessons using clay, paint, Skill-Based
paper, metals, glass, plastic, and/or wood.
24 Learning to dance Includes all types of dance with an instructor. Skill-Based
25 Getting extra help for Working with a tutor outside of classroom time. Self-Improvement
schoolwork from a tutor
26 Playing a musical Includes playing any instrument outside of lessons. Skill-Based
instrument
27 Taking music lessons Includes playing a musical instrument with an instructor. Skill-Based
28 Participating in community Includes groups such as Brownies or Cub Scouts. If an Skill-Based
organizations activity is done outside of the formal meeting time, the
activity should be recorded under the most appropriate
item.
29 Doing a religious activity Includes praying, meditating, attending a place of worship Self-Improvement
and/or religious classes outside of the school curriculum.
30 Participating in school Includes extra-curricular clubs such as chess, science, Active Physical
clubs book, yearbook, social, and/or athletic.
31 Dancing Includes dancing at home or at school gatherings, with no Skill-Based
instructor present.
32 Going for a walk or hike Includes walking or mobilizing on a trail, sidewalk, or Recreational
roadway. The walk is the main activity, not a means of
transportation.
33 Bicycling, in-line skating, Active Physical
or skateboarding
34 Doing water sports Includes slashing or casual swimming, water skiing, Active Physical
tubing, and/or boating.
35 Doing snow sports Includes skiing, skating, sledding, snowshoeing, and/or Active Physical
snowboarding.
36 Playing on equipment Includes climbing on abrs, ropes, and rock walls. It also Recreational
includes using slides, swings, carousels, and/or playing
with sand in a box.
37 Playing games Includes casual street hockey, soccer, basketball, skipping Active Physical
rope, or catching a ball.
38 Gardening Includes planting, watering, weeding, and harvesting Active Physical
outdoors.
39 Fishing Active Physical
40 Doing individual physical Includes jogging, working out, yoga, and rock climbing. Active Physical
activities
41 Playing non-team sports Includes tennis, badminton, archery, bowling, golf darts, Active Physical
and pool.
42 Going to the movies Social
43 Going to the public library Self-Improvement
44 Watching TV or a rented Recreational
movie
45 Going to a live event Includes attending a play show, concert, or sporting event Social
that is live.
46 Going on a full-day outing Includes day trips to amusement park, zoo, park or Social
conservation area, beach, and/or picnic area.
47 Reading Self-Improvement
48 Listening to music Social
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49 Doing volunteer work Includes activities volunteered for without pay. Self-Improvement
50 Doing a chore Includes helping out around the house on a regular basis, Self-Improvement
such as taking out the garbage, cutting the grass, and/or
folding laundry. This may or may not include payment.
51 Doing a paid job Includes working at restaurants, stores, or community Active Physical
center that is done for hire or profit.
52 Making food Includes meals, snack, cooking, and/or baking. Social
53 Doing homework Includes work required for school but completed outside Self-Improvement
of school hours.
54 Shopping Includes shopping on-line or in s store for groceries, Self-Improvement
clothing, or other items.
55 Taking care of a pet Includes grooming and feeding. Recreational