Background The development of accurate methods to measure health-behaviours forms an integral component in behavioural epidemiology. Population surveillance of physical activity often relies on self/proxy reported questionnaires due to cost and relative ease of administration. The aim of this study was to examine the criterion validity and measurement agreement between the Youth Physical Activity Questionnaire (YPAQ) and accelerometry before being included in a Scotland-wide study.

Methods Forty four participants (12–13 years old; 61% girls) completed the YPAQ following 7 days wearing the Actigraph GT3X+. Mean moderate-to-vigorous physical activity (MVPA) per day was derived from YPAQ and accelerometer and validity was assessed using Spearman's correlation; Bland-Altman plots examined absolute agreement between methods.

Results Pearson's and Spearman’s correlations between YPAQ and accelerometer were r = 0.47 and r_s = 0.39 (p<0.01) respectively. The YPAQ over reported mean MVPA by 25.6 ± 50.2 minutes (95% CI 10.4-40.9 minutes; p <0.001), with 95% limits of agreement of −72.69 minutes and + 123.99 minutes. Evidence of underreporting at lower levels of activity and over reporting at higher levels of activity was evident (Pearson's r=0.81), in addition to heteroscedasticity, where variances increased as MVPA increased.

Conclusions Although a moderate correlation between the two methods was apparent, the YPAQ should not be used interchangeably with accelerometry. The YPAQ does demonstrate a reasonable ability to rank MVPA, although it tends to under-report lower levels and over-report higher levels. This, and other administering factors, should be taken into consideration if being used for group or individual level analyses.