Test-retest reliability of a measure of perceived activity compensation in primary school children and their parents: a mixed methods study

There is a lack of specific tools for assessing children’s activity compensatory responses. This study 1) determined test-retest reliability and internal consistency of survey items assessing children’s self-reported and parents’ proxy-reported perceived compensatory responses; and 2) described children’s and parents’ views of potential compensatory mechanisms. Children (n = 55; mean age 10.2 ± 0.9) and their parents (n = 60) completed a survey twice, seven days apart. A sub-sample (17 parents; 13 children) participated in a short, semi-structured interview. Intraclass Correlation Coefficients (ICCs) and Cronbach’s alpha assessed absolute agreement and internal consistency. Interviews were analysed via thematic analysis. Seven self- and proxy-reported survey sub-scales had excellent test-retest reliability (ICC ≥ 0.75), three had good (ICC ≥ 0.56) and one fair (ICC = 0.44). All survey items and sub-scales had acceptable internal consistency (alpha >0.67). Thematic analysis identified two overarching themes: awareness of compensation and mechanisms of compensation. After an active day at school, most participants perceived that compensation occurred later that day. Mechanisms of compensation included psychological, physiological, environmental, and interpersonal mechanisms. This reliable survey provides a new tool for assessing children’s and their parents’ perceptions of activity compensation and may inform future intervention designs. Future research is needed to establish concordance between perceived and device-assessed compensation.