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Behavioral Risk Factor Surveillance System Questionnaire - 2011


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.


Section 10: Exercise (Physical Activity)

10.1 During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?

1 Yes
2 No [Go to Q10.8]
7 Don't know / Not sure [Go to Q10.8]
9 Refused [Go to Q10.8]

10.2. What type of physical activity or exercise did you spend the most time doing during the past month?

_ _ (Specify) [See Coding List A]
7 7 Don't know / Not Sure [Go to Q10.8]
9 9 Refused [Go to Q10.8]

10.3 How many times per week or per month did you take part in this activity during the past month?

1_ _ Times per week
2_ _ Times per month
7 7 7 Don't know / Not sure
9 9 9 Refused

10.4 And when you took part in this activity, for how many minutes or hours did you usually keep at it?

_:_ _ Hours and minutes
7 7 7 Don't know / Not sure
9 9 9 Refused

Last Modified: 11 Apr 2014