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The Modifiable Activity Questionnaire/Pima Indian

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: Kriska AM, Knowler WC, LaPorte RE, Drash AL, Wing RR, Blair SN, Bennett PH, Kuller LH. Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians. Diabetes Care 1990 Apr;13(4):401-11.

Activity Survey - occupational activities

Occupational activity - Past year Age at start of job Walk or bike to work? Job schedule
Average past year
mo/yr
    min/day mo/yr days/wk hr/dy
Job title*
List all jobs held over past year for more than 1 mo (account for full 12 mo)
         

Activity Survey - leisure activities

Leisure activity code 12-18 yr (7 yr total) 19-34 yr (15 yr total) 35-49 yr (16 yr total) >50 yr (__ yr total) Past year Past week
  No. yr Mo/yr hr/wk No. yr Mo/yr hr/wk No. yr Mo/yr hr/wk No. yr            
04 (bicycling)                                
19 (walking for exer-cise)                                

Last Modified: 11 Apr 2014