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# Active Australia Survey: Physical Activity Survey: From the National Physical Activity Survey

## Questionnaires:

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.

The Hunter Valley Research Foundation
A.C.N. 000 185 393
Downie Street, Maryville, NSW 2293
Telephone: (049) 69 4566
Facsimile: (049) 61 4981

We would like to ask you about the physical activity you did in the last week:

1. Q8. IN THE LAST WEEK how many times have you walked continuously, for at least 10 minutes, for recreation, exercise or to get to or from places?
• Content: # number of times
• 99 = Don't know -- use only as an absolute last resort
• If: Q8 = 0, skip to Q12
2. Q9. What do you estimate was the total time that you spent walking in this way IN THE LAST WEEK? [INTERVIEWER: THIS IS ‘CONTINUOUS' WALKING]
• Content: Minutes Hours
• 77 = Don't know 777 = Don't know
• If: Q9M < 1 AND Q9H < 1, skip to Q9m
3. Q12. IN THE LAST WEEK how many times did you do any vigorous gardening or heavy work around the yard, which made you breathe harder or puff and pant?
• Content: # number of times
• 99 = Don't know -- use only as an absolute last resort
• If: Q12 = 0, skip to Q14
4. Q14. N THE LAST WEEK, how many times did you do any vigorous physical activity which made you breathe harder or puff and pant?
• (e.g., jogging, cycling, aerobics, competitive tennis)
• Content: # number of times
• 99 = Don't know -- use only as an absolute last resort
• If: Q14 = 0, skip to Q16
5. Q15. What do you estimate was the total time that you spent doing this vigorous physical activity IN THE LAST WEEK?
• Content: Minutes Hours
• 77 = Don't know 777 = Don't know
INTERVIEWER: USE THE FOLLOWING FIELD TO DESCRIBE ANY UNUSUAL ASPECTS OF THIS RESPONDENT OR HIS/HER ACTIVITIES.]
• Content: Used when the respondent noted issues/characteristics which might have influenced the survey answers. For example ‘respondent is a farmer -- walks 5 kilometres every day'.