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Ainsworth New Physical Activity Questionniare and Physical Activity Log

Questionnaires:

About This Database

You are browsing a database of standardized questionnaires that ask about respondents' walking and bicycling habits.

The survey on this page is presented for informational purposes only, and is not intended to be filled out by visitors to this Web site.

The Applied Research Program maintains this database, but, except where noted, did not create and does not maintain the questionnaires themselves. For more information about a specific questionnaire, please contact its author(s). When possible, we cite the source of each questionnaire near the top of the page.

In: Ainsworth BE, Bassett DR Jr, Strath SJ, Swartz AM, O'Brien WL, Thompson RW, Jones DA, Macera CA, Kimsey CD. Comparison of three methods for measuring the time spent in physical activity. Med Sci Sports Exerc 2000 Sep;32(9 Suppl):S457-64.

PAQ:

Walking. I am going to ask you questions about three different levels of PA that you do when you are not at work. Last week, did you walk continuously for at least 10 minutes for recreation, exercise or to get to and from places? If yes, how many days last week did you spend walking each day? ____days

On average, how many total min did you spend walking each day? ___min

PA Log:

Fill this page out at the end of the day. For each activity, circle yes if you did the activity and no if you did not do the activity. For each activity you did, write down the number of hours and or minutes you were actually moving and the time you began the activity (am or pm). If you did an activity many times during the day, write down the total time you did that activity during the day. If you did many activities that are not on the list, please write them on the line labeled ‘other', circle yes and write tin the hours and /or minutes. Remember to record only the hours and /or minutes you were actively engaged in the activity.

Did you do this activity today? (only categories with walking/biking included here)

Yes
No
How Long?
Time start activity
(circle one)
__hrs __min
____AM or PM
Transportation (to and from)
Walk to work, school, shopping
Yes
No
___:___
____
Bicycle to work, school, shopping
Yes
No
___:___
____
Occupation
Walking at work
Yes
No
___:___
____
Conditioning Activities
Bicycling
Yes
No
___:___
____
Walking for Exercise
Yes
No
___:___
____
Leisure Activities
Walking for pleasure or social
Yes
No
___:___
____

Last Modified: 11 Apr 2014