Comprehensive Neighborhood Environment Physical Activity Questionnaire (CNEPAQ): development and psychometric validation in Nagpur, India

Perception-based studies of urban neighborhoods and physical activity often focus narrowly on walkability, overlooking broader social, design, and environmental domains. This study developed and validated the Comprehensive Neighborhood Environment Physical Activity Questionnaire (CNEPAQ), comprising 82 items across 11 factors (destination proximity, destination accessibility, residential density, street connectivity, infrastructure for walking/cycling, safety, urban design qualities, social environment, recreational facilities, fitness and sports facilities, ambient environment). Content validity was evaluated through expert review and cognitive testing in Nagpur, India. A cross-sectional survey (N = 425 across four neighborhoods) assessed construct validity using exploratory and confirmatory factor analyses; known-group differences were tested using ANCOVA. The content validity of CNEPAQ was high (item CVR ≥0.60). The 11-factor CFA demonstrated excellent fit (χ2 [3184] = 4869.51, p < .001; CFI = 0.989; TLI = 0.989; AGFI = 0.969; RMSEA = 0.05; CMIN/DF = 1.53). ANCOVA indicated significant neighborhood differences (p < .001). Test-retest reliability on a subsample (N = 121) was almost perfect at the factor level and substantial to almost perfect at the item level. CNEPAQ is a valid and reliable instrument; further research is needed to evaluate its applicability across diverse neighborhoods and cities in India, and other low- and middle-income countries.