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Yale Physical Activity Survey for Older Adults

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.

[read] Here is a list of common types of physical activities. Please tell me which of them you did during a typical week in the last month. Our interest is learning about the types of physical activities that are a part of your regular work and leisure routines.

For each activity you do, please tell me how much time (hours) you spent doing this activity during a typical week.

  Time Intensity
Work
Stair climbing while carrying a load    
Yard work
No specific walking/bicycling questions    
Caretaking
No specific walking/bicycling questions    
Exercise
Brisk walking (10+ minutes in duration)    
Cycling, exercycle    
Recreational Activities
Leisurely walking (10+ minutes in duration)    

New section:

  1. Think about the walks you have taken during the past month. About how many times per month did you walk for at least 10 minutes or more without stopping which was not strenuous enough to cause large increases in breathing heart rate or leg fatigue, or cause you to perspire?
  2. Score:
    0= not at all (go to Q5)
    1= 1-3 times per month
    2= 1-2 times per week
    3= 3-4 times per week
    4= 5+ times per week
    7= refused
    8= don't know

  3. When you did this walking for how many minutes did you do it?

    Score:
    0= not applicable
    1= 10-30 minutes
    2= 31-60 minutes
    3= 60+ minutes
    7= refused
    8= don't know

  1. About how many flights of stairs do you climb up each day? (let 10 steps = 1 flight)

Last Modified: 11 Apr 2014