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Standardized Questionnaires of Walking & Bicycling Database:
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About This Database
You are browsing a database of standardized
questionnaires that ask about respondents' walking and bicycling habits. 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.
Lifetime Physical Activity Questionnaire
http://dceg.cancer.gov/modules/Lifetime_PA.pdf
Note: reliability, but not validity, studies are available for this questionnaire.
STEP 1: Please place a check mark in the first column next to each activity that you have ever participated in more than 10 times during your lifetime.
STEP 2: For those activities you have checked, proceed to the right answering the questions in the columns above.
| Have you ever participated in any of the following? |
During the Past Year |
During ages 51-65 years (a 15-year span)
If younger than 51, skip to next column |
During ages 35-50 years (a 15-year span) |
During ages 22-34 years (a 12-year span) and Between age of onset of menstruation to 21 years |
Between age of onset of menstruation to 21 years |
| Check if yes ↓ |
# of months |
Typical # of hours per week |
# of years (15 max) |
Typical # of months per year |
Typical # of hours per week |
# of years (15 max) |
Typical # of months per year |
Typical # of hours per week |
# of years (12 max) |
Typical # of months per year |
Typical # of hours per week |
# of years (10 max) |
Typical # of months per year |
Typical # of hours per week |
| Leisure Time Activities: |
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| Walking for exercise (outdoor, indoor at mall, treadmill) |
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| Bicycling (stationery/outdoor) |
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