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Kaiser Physical Activity Survey

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, Sternfeld B, Richardson MT, Jackson K. Evaluation of the Kaiser Physical Activity Survey in women. Med Sci Sports Exerc 2000 Jul;32(7):1327-38.

(Section I has no specific walking/biking questions.)

Section II. Occupational Activities

  1. When you are working at your current occupation, how often do you do each of the following:
    1. Walk

Section III. Active Living Habits

This next section asks about the general level of physical activity involved in your daily routine during the past year.

  1. How many minutes a day do you usually walk and/or bicycle to and from work, school or errands?
    (<5 / >5 but <15 / >15but <30 / >30 but <45 / >45) 1-2-3-4-5
  2. Did you walk (for at least 15 minutes at a time)? 1-2-3-4-5
    (Never or less than once a month/Once a month/2-3 times a month/once a week/More than once a week)
  3. Did you bike (for at least 15 minutes at a time)? 1-2-3-4-5
    (Never or less than once a month/Once a month/2-3 times a month/once a week/More than once a week)

Active Living Index=sum(q20, q22, q23, (6-Q21))/4

Last Modified: 11 Apr 2014