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Short Retrospective 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: Schmidt ME, Slanger T, Chang-Claude J, Wahrendorf J, Steindorf K. Evaluation of a short retrospective questionnaire for physical activity in women. Eur J Epidemiol 2006;21(8):575-85. [View Abstract]

Basic 24-hour Questionnaire

At the beginning of the interview I would like to ask you to recall the time when you were 30-49 years old:

  • This is a period of about 20 years, from 19XX to 19XX; have you been employed during that time? Did you have small children; did you live in a house or an apartment; did you have a garden?
  • I would like to ask you how much time you spent on average during the day -- that is 24 hours -- sleeping, sitting moderate or vigorous physical activities. At first I will ask you about your activities during a weekday:
    • How many hours on average did you spend on a weekday with physically vigorous activities: e.g., lifting or carrying heavy objects, heavy gardening, climbing stairs, cycling uphill, jogging, circuit training fast swimming?
    • How many hours on average did you spend on a weekday with physically moderate activities, e.g., fast walking, cycling without going uphill.....?
    • XX.X hours are left for physically light activities e.g., cooking....walking activities.
  • I would now like to ask you about physical activities at your job, during your leisure time, and at home during periods of your life.

First, please consider the time period when you were 30-49 years old.

  1. Please specify how many years you work/have worked at your job or education

    (30-49) years (50+) years

  2. On average, how many hours per week did you work? hours
  3. Was/is the work:
    • Predominantly physically moderate (that is walking or standing activities.)
    • How often during this time period did/do you typically walk (only outside the house and not at work)? I would like to know in detail:
      1. How many hours (minutes) total did/do you walk on weekdays?

        hours min

      2. How many hours (minutes) total did/do you walk on weekends?

        hours min

    • How often during this time period did/do you typically ride a bicycle (ordinary cycling for transportation, not for exercise)? I would like to know in more detail:
      1. How many hours (minutes) total did/do you bicycle on weekdays:

        hours min

      2. How many hours (minutes) total did/do you bicycle on weekends:

        hours min

Last Modified: 11 Apr 2014