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Minnesota Leisure-time Physical Activity 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.

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.

Listed below are a series of Leisure Time Activities. Related activities are grouped under general headings. Please read the list and check YES in column 3 for those activities which you have performed in the last 12 months and NO in column 21 for those you have not. Do not complete any of the other columns.

ACTIVITY Did you perform this activity? Month of activity Average number of times per month Time per occasion
NO YES J F M A M J J A S O N D hrs min
Section A: Walking and Miscellaneous
-Walking for pleasure                                  
-Walking to work                                  
-Walking during work breaks                                  
-Using stairs when elevator is available                                  
-Bicycling to work and/or for pleasure                                  
Section B: Conditioning exercise
-Jog/Walk combination                                  

 

Last Modified: 11 Apr 2014