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Breast Cancer Detection Demonstration Project (BCDDP)

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.

http://dceg.cancer.gov/modules/Physical.pdf

No true validation studies were found for this group of questionnaires.

SECTION D. PHYSICAL ACTIVITY

D2. The following is a list of activities with which some people have difficulty because of a health or physical reason. Please read the activity, and then check for each activity whether you currently have no difficulty, some difficulty, much difficulty, or are unable to do the activity at all, when you are by yourself and without aid. (PLEASE CHECK ONE BOX FOR EACH ACTIVITY.)

 
1. NO DIFFICULTY
2. SOME DIFFICULTY
3. MUCH DIFFICULTY
4. UNABLE TO DO
5. NEVER DO THIS ACTIVITY
a. Walk a quarter of a mile (that is, two or three blocks)          
b. Walk up 10 steps without resting          

Last Modified: 11 Apr 2014