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Arizona Activity Frequency Questionnaire

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, Lisa Staten, via fax.

Please note:

  • Record only the amount of time you spent actually doing an activity. For example, if you take an aerobics class for exercise do not count the time you spend changing clothes or chatting before or after the class.
  • Remember if you select a Yes for an activity, THREE CIRCLES MUST BE FILLED IN ON THAT LINE. If you select NO, no other columns need to be marked on that line.
Recreational Activities
Did you do it in the last 4 weeks?
How many times did you do it in the last 4 weeks?
How much time did you spend on this activity each time (on average)?
Yes
No
1-3
5-10
11-19
≥20
<12 mins
13-29 mins
30-44 mins
≥45 mins
Walking upstairs or using a stair climber
O
O
O
O
O
O
O
O
O
O
Walking (include on a treadmill and walking to the store)
O
O
O
O
O
O
O
O
O
O

Other Recreational Activities
Did you do it in the last 4 weeks?
How many times did you do it in the last 4 weeks?
How much time did you spend on this activity each time (on average)?
Yes
No
1-2
3-5
6-11
≥12
<30 mins
>30 mins but <1.5 hrs
>1.5 hrs but < 3 hrs
≥3 hrs
Bicycling for pleasure or transportation (include riding exer-cycle or stationary bike)
O
O
O
O
O
O
O
O
O
O
Hiking
O
O
O
O
O
O
O
O
O
O

 

Last Modified: 11 Apr 2014