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Allied Dunbar Survey of Activity and Health

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.

From author, Rhonda Brownbill, via fax.

Walking:

Now, walking:

  1. Can you walk for a quarter of a mile on your own without stopping and without severe discomfort?
    Yes No
  2. For how long can you walk on your own without stopping or without severe discomfort? Would you say...
    1. less than 5 minutes
    2. 5, but less than 10 minutes
    3. 10, but less than 15 minutes
    4. 15, but less than 30 minutes
    5. 30 minutes or more?

IF YOU CAN WALK FOR 30 MINUTES OR MORE (Q9. code 5)

  1.  
    1. I'd like you to think now about all the walking you've done in the past 4 weeks, either locally or away from here including any country walks. First, I'm interested in walks of 2 miles or more. These are long continuous walks that would usually take at least 40 minutes. Don't include anything shorter than that. Did you do any walks of that kind during the past 4 weeks, that's from ...up to yesterday?
      Yes No
  2. IF ANY WALKS OF AT LEAST 2 MILES IN PAST 4 WEEKS

    1. During the past 4 weeks how many times did you do any long walks of 2 miles or more?
      No. of times ____
    2. And during the last week, that's to last ....day, how many times did you do any long walks of 2 miles or more?
      No. of times ____
    3. How long did you spend walking on the most recent occasion you did a long walk of 2 miles or more?
      __hours ___minutes

IF YOU CAN WALK FOR 15 MINUTES OR MORE (Q. 9 codes 4 and 5)

  1.  
    1. Now, I'd like to ask you to think about all the walking you've done in the past week, that's back to last .... day. Did you do any walks either locally or away from here of between 1 and 2 miles? That would usually be continuous walking for about 20 to 30 minutes.
      Yes No
  2. IF YES AT a)

    1. During the past week how many times did you do any of these walks?
      No. of times ____
    2. And yesterday, that is...(day of week) how many times did you do any of these walks?
      No. of times ____

IF YOU CAN WALK FOR 5 MINUTES OR MORE (Q9 codes 2-5)

  1. Have you done any (shorter) walks which lasted at least 5 minutes in the last week, that's back to last ....day?
    Yes No

Ask ALL

  1. Which of the following best describes your usual walking pace...
    1. a slow pace
    2. a steady average pace
    3. a fairly brisk pace
    4. or a fast pace -- at least 4 mph.

Now I'd like to talk about any sports or exercise activities you've done regularly at any time since you left school.

  1.  
    1. First, long walks. During the time from when you left school up to the present, have you, at any time, walked for 2 miles or more on a regular basis, for a period of at least 2 years?
      Yes No
  2. IF YES AT a)

    1. For about how many years in total did you do these long walks regularly?
      No. of years ____
    2. At what age did you stop doing long walks regularly or do you still do long walks at least once a week for a few months of the year?
      Age stopped___ Still regular____

Last Modified: 11 Apr 2014