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Past Year Total Physical Activity Questionnaire (PYTPAQ)

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.

At: http://www.p3gobservatory.org/catalogue.htm?questionnaireId=276External Web Site Policy

The Physical Activity Questionnaire is one of three questionnaires that will describe your past and current health as you begin to participate in The Tomorrow Project cancer research study.

The questions are about your physical activities in the past 12 months, including:

  • Employment and Volunteer activities
  • Household and Do-it-yourself activities-(contains no walking/biking questions)
  • Recreation and Leisure activities

This questionnaire may take about 15-20 minutes to answer.

If you are not sure of how to answer a question, please feel free to contact us:

  • Call our toll free number: 1.877.919.9292
  • E-mail us: tomorrow@cancerboard.ab.ca

Directions:

First, record the types of activities you took part in over the past 12 months.

Next, record how often you took part in each activity, for how long, and at what intensity level.

The timing and intensity of your activities may have varied over the 12 months. Do your best to estimate your average or usual activity pattern.

Do not "double-count" hours - your total activity hours should add up to no more than the hours you are awake:

In each section, the top pages provide examples of how to fill in the charts. Read through the examples and then fill in your activities on the bottom pages.

If a whole page does not apply to you, please write NA in the first column. We will then know you did not miss the page.

PHYSICAL INTENSITY LEVELS: Choose the one that best describes your experience.

1 = Activities done mainly sitting down
2 = Activities done mainly standing, that do not increase your heart rate and cause no sweating
3 = Activities that cause your heart rate to increase slightly and cause some light sweating
4 = Activities that cause your heart rate to increase substantially and cause heavy sweating

EXAMPLE:

Activity 1

  • In the past 12 months, Joe's job has been farming. He took 2 weeks of holidays.
  • His main physical activities = drive equipment, walk.

Activity 2

  • In the past 12 months Joe has been volunteering for a 4H Club.
  • His physical activities are sitting and standing and shovel.
  • He volunteers 10 months a year, 1 day a week 2 hours/day.
  • He farms 11.5 months a year, 6 days a week, 9.5 hours.
  • He rates his physical intensity level as 1 because his main activity is sitting.
  • He drives and walks 8.5 hours a day and rates his physical intensity level for those activities as 2.
  • He shovels 1.0 hours a day and rates his physical intensity level for shoveling as 4.
Job Title
Employment and volunteer work
Main Physical Activities
List up to 3 main activities that you did on the job in the past 12 months e.g., sit, stand, walk, carry loads
Months per Year Days per Week Hours per Day Physical Intensity Level
1,2,3,4

Choose the level for you
OFFICE USE ONLY
Farmer Drive, walk 11.5 6 8.5 2




Your Employment and Volunteer Activities

  1. Start a new line for each job that you did in the past 12 months (paid or volunteer).
  2. Start a new line when the pattern changed, such as when the activities, intensity level, or the number of months, days or hours of the job changed.
  3. Remember to deduct weeks or months you were on vacation.
  4. If you are involved in a volunteer or work activity less than once a week, record the days and the appropriate interval in the "Days per week" column, e.g., "Bingo 1 day/month".
Job Title
Employment and volunteer work
Main Physical Activities
List up to 3 main activities that you did on the job in the past 12 months e.g., sit, stand, walk, carry loads
Months per Year Days per Week Hours per Day Physical Intensity Level
1,2,3,4

Choose the level for you
OFFICE USE ONLY
           




           




Walking, Biking to and From Employment and Volunteer Activities

PHYSICAL INTENSITY LEVELS: Choose the one that best describes your experience.

2 = Activities (walking, biking etc.) that do not increase your heart rate and cause no sweating
3 = Activities that cause your heart rate to increase slightly and cause some light sweating
4 = Activities that cause your heart rate to increase substantially and cause heavy sweating

EXAMPLE:

Activity 1

  • Sandra works part-time as a nurse in a community health centre near her home.
  • She walks to and from work 5 months of the year, 3 days a week, (15 minutes each way); the rest of the year she drives.

Activity 2

  • Sandra also volunteers 1 day a week at her children's school 10 months per year.
  • 4 months of the year she bikes to and from the school (30 minutes each way); the rest of the year she drives.
  • She rates her physical activity level for biking as 3.
 
Job Title
Employment and volunteer work
Type of Activity
To go to and from work or volunteer activity
e.g., walk, bike, in-line skate, etc.
Months per Year Days per Week Minutes per Day Physical Intensity Level
2,3,4

Choose the level for you
OFFICE USE ONLY
Nurse Walk 5 3 30 mn 2
School Volunteer Bike 4 1 60 mn 3

Your Walking, Biking to and From Employment and Volunteer Activities

  1. Start a new line for each job from page 3 (paid or volunteer) that involves walking or biking to and/or from work in the past 12 months.
  2. Do not include walking that is part of your job at work. (Walking at work should be recorded on page 3.)
  3. Include any other means of transportation you use for getting to work, like in-line skating etc.
  4. Include the time you walk to and from the bus or your car.
  5. Record your time in minutes. (This is the only section that asks for your answer in minutes - continue to enter your time in hours in the rest of the questionnaire.)
  6. OR: If this section does not apply to you, please write NA on the first line.
Job Title
Employment and volunteer work
Type of Activity
To go to and from work or volunteer activity
e.g., walk, bike, in-line skate, etc.
Months per Year Days per Week Minutes per Day Physical Intensity Level
2,3,4

Choose the level for you
OFFICE USE ONLY
        min  
        min  

Household, Childcare and Do-It-Yourself Activities

This section does not include Walking/Biking questions.

Recreation and Leisure Activities

For this category, DO NOT include activities that are done SEATED (playing cards, reading, etc.).

PHYSICAL INTENSITY LEVELS: Choose the one that best describes your experience.

2 = Activities done mainly standing, that do not increase your heart rate and cause no sweating
3 = Activities that cause your heart rate to increase slightly and cause some light sweating
4 = Activities that cause your heart rate to increase substantially and cause heavy sweating

EXAMPLE:

Activity 1

  • Greg went on a fishing trip this past year.
  • He went on a 10 day trip.
  • He fished about 4 hours each day.
  • For him, fishing is a level 2.

Activity 2

  • Greg also walks regularly.
  • He walks for 6 months of the year.
  • He walks 4 days a week, for 30 minutes.
  • For him, walking is a level 3.

Activity 3

  • Greg also cycles regularly.
  • He cycles 8 months of the year.
  • He cycles 8 days a month, for 3 hours.
  • For him, cycling is a level 4.
 
Recreation or Leisure Activity
Please be specific when possible
Months per Year Frequency
Please specify how many days per week, -per month, or -per year
Hours per Day Physical Intensity Level
2,3,4

Choose the level for you
OFFICE USE ONLY
Walking 6 4 days per Week 0.5 3
Cycling 8 4 days per Month 3 4

Your Recreation and Leisure Activities

  1. Start a new line when the pattern changed, such as when the activity, intensity level, or the number of months, days or hours of your recreational activities in the past 12 months changed.
  2. Do not include walking that you did as part of your job or volunteer activities - this type of walking should be recorded on page 3.
  3. Before you start, see below for examples of activities.
Recreation or Leisure Activity
Please be specific when possible
Months per Year Frequency
Please specify how many days per week, -per month, or -per year
Hours per Day Physical Intensity Level
2,3,4

Choose the level for you
OFFICE USE ONLY
    days per    
    days per    

Examples of Recreation and Leisure Activities -- 50+activities listed

  • Hiking
  • Bicycling
  • Jogging
  • Walking
  • Running

Last Modified: 10 Jun 2014