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International Physical Activity Questionnaire (Long, Telephone)

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.

(November 2002 version)

LONG LAST 7 DAYS TELEPHONE FORMAT

For use with Young and Middle-aged Adults (15-69 years)

READ: Now think about the time you spend walking for at least 10 minutes at a time as part of your work. Please do not count any walking you did to travel to or from work.

  1. During the last 7 days, on how many days did you walk as part of your work?
    [OWDAY; Range 0-7, 8, 9] _____ Days per week [If respondent answers 0, skip to PART 2] 8. Don't Know/Not Sure [Skip to PART 2] 9. Refused [Skip to PART 2]

    [Interviewer clarification: Think about only the walking that you did for at least 10 minutes at a time.]

    [Interviewer clarification: Include all jobs.]
  2. How much time did you usually spend on one of those days walking as part of your work?
    ___ ___ Hours per day [OWDHRS; Range 0-16] ___ ___ ___Minutes per day [OWDMIN; Range 0-960, 998, 999] 998. Don't Know/Not Sure 999. Refused

    [Interviewer clarification: Think about only the walking you did for at least 10 minutes at a time.]

    [Interviewer probe: An average time per day is being sought. If the respondent can't answer because the pattern of time spent varies widely from day to day, or includes time spent doing a variety of paid and unpaid work, ask: "What is the total amount of time you spent walking over the last 7 days as part of your work?"]
    ___ ___ Hours per week [OWWHRS; Range 0-112] ___ ___ ___ ___ Minutes per week [OWWMIN; Range 0-6720, 9998, 9999] 9998. Don't Know/Not Sure 9999. Refused

READ: Now, think about how you traveled from place to place, including to places like work, stores, movies and so on.

READ: Now think only about the bicycling you did to travel to and from work, to do errands, or to go from place to place. Only include bicycling that you did for at least 10 minutes at a time.

  1. During the last 7 days, on how many days did you bicycle to go from place to place?
    [TBDAY; Range 0-7, 8, 9] _____ Days per week [If respondent answers 0, skip to Question 12] 8. Don't Know/Not Sure [Skip to Question 12] 9. Refused [Skip to Question 12]

    [Interviewer clarification: Think only about the bicycling that you did for at least 10 minutes at a time.]
  2. How much time did you usually spend on one of those days to bicycle from place to place?
    ___ ___ Hours per day [TBDHRS; Range 0-16] ___ ___ ___Minutes per day [TBDMIN; Range 0-960, 998, 999] 998. Don't Know/Not Sure 999. Refused

    [Interviewer clarification: Think about only the bicycling that you did for at least 10 minutes at a time.]

    [Interviewer probe: An average time per day is being sought. If the respondent can't answer because the pattern of time spent varies widely from day to day, ask: "What is the total amount of time you spent bicycling over the last 7 days to travel from place to place?"]
    ___ ___ Hours per week [TBWHRS; Range 0-112] ___ ___ ___ ___ Minutes per week [TBWMIN; Range 0-6720] 9998. Don't Know/Not Sure 9999. Refused

READ: Now think only about the walking you did to travel to and from work, to do errands or to go from place to place. Only include walking that you did for at least 10 minutes at a time.

  1. During the last 7 days, on how many days did you walk to go from place to place?
    [TWDAY; Range 0-7, 8, 9] _____ Days per week [If respondent answers 0, skip to PART 3] 8. Don't Know/Not Sure [Skip to PART 3] 9. Refused [Skip to PART 3]

    [Interviewer clarification: Think only about the walking that you did for at least 10 minutes at a time.]
  2. How much time did you usually spend on one of those days walking from place to place?
    ___ ___ Hours per day [TWDHRS; Range 0-16] ___ ___ ___ Minutes per day [TWDMIN; Range 0-960, 998, 999] 998. Don't Know/Not Sure 999. Refused

    [Interviewer clarification: Think about only the walking that you did for at least 10 minutes at a time.]

    [Interviewer probe: An average time per day is being sought. If the respondent can't answer because the pattern of time spent varies widely from day to day, ask: "What is the total amount of time you spent over the last 7 days walking from place to place?"
    ___ ___ Hours per week [TWWHRS; Range 0-112] ___ ___ ___ ___ Minutes per week [TWWMIN; Range 0-6720, 9998, 9999] 9998. Don't Know/Not Sure 9999. Refused

PART 4: RECREATION, SPORT, AND LEISURE-TIME PHYSICAL ACTIVIITY

READ: Now, think about all the physical activities that you did in the last 7 days solely for recreation, sport, exercise or leisure. Please do not include any activities you have already mentioned.

  1. Not counting any walking you have already mentioned, during the last 7 days, on how many days did you walk for at least 10 minutes at a time in your leisure time?
    [LWDAY; Range 0-7, 8, 9] _____ Days per week [If respondent answers 0, skip to Question 22] 8. Don't Know/Not Sure [Skip to Question 22] 9. Refused [Skip to Question 22]

    [Interviewer clarification: Think about only the walking that you did for at least 10 minutes at a time.]
  2. How much time did you usually spend on one of those days walking in your leisure time?
    ___ ___ Hours per day [LWDHRS; Range 0-16] ___ ___ ___ Minutes per day [LWDMIN; Range 0-960, 998, 999] 998. Don't Know/Not Sure 999. Refused

    [Interviewer clarification: Think about only the walking that you did for at least 10 minutes at a time.]

    [Interviewer probe: An average time per day is being sought. If the respondent can't answer because the pattern of time spent varies widely from day to day, ask: "What is the total amount of time you spent over the last 7 days walking in your leisure time?"]
    ___ ___ Hours per week [LWWHRS; Range 0-112] ___ ___ ___ ___ Minutes per week [LWWMIN; Range 0-6720, 9998, 9999] 9998. Don't Know/Not Sure 9999. Refused

Last Modified: 11 Apr 2014