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KIHD 12-Month Leisure-time Physical Activity History

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: Pereira MA, FitzGerald SJ, Gregg EW, Joswiak ML, Ryan WJ, Suminski RR, Utter AC, Zmuda JM. A collection of Physical Activity Questionnaires for health-related research. Med Sci Sports Exerc 1997 Jun;29(6 Suppl):S1-205.

Which of the following activities have you performed during the last 12 months? Please estimate the most usual intensity category of each activity by choosing one of the following classes:

Class Activity Breathlessness Sweating
0 recreational, outdoor activities no no
1 conditioning exercise yes no
2 brisk conditioning exercise yes some
3 competitive, strenuous exercise yes a lot

  How Many Times per Month? Duration
hr, min
Intensity class (0-3)
J F M A M J J A S O N D
Walking on work trips                            
Conditioning walking                            
Bicycling                            
Bicycling on work trips                            

Last Modified: 11 Apr 2014