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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.
NHANES Physical Activity and Physical Fitness PAQ-SP 12-15 Version 12/9/98
http://www.cdc.gov/nchs/data/nhanes/cpaq.pdf
PAQ.040
The next series of questions are about physical activities that {you/SP} {have/has} done over the past 30
days. First I will ask about activities that are related to transportation. Then I'll ask about physical
activities that {you/he/she} {do/does} at school or in {your/his/her} leisure time.
Over the past 30 days, {have/has} {you/SP} walked or bicycled as part of getting to and from work, or school, or to do errands?
CODE 'UNABLE TO DO' ONLY IF RESPONDENT VOLUNTEERS.
YES . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . 2 (PAQ.200)
UNABLE TO DO ACTIVITY . . . . 3 (PAQ.200)
REFUSED . . . . . . . . . . . 7 (PAQ.200)
DON'T KNOW . . . . . . . . . 9 (PAQ.200)
PAQ.050
[Over the past 30 days], how often did {you/SP} do this? [Walk or bicycle as part of getting to and from work, or school, or to do errands.]
PROBE: How many times per day, per week, or per month did {you/s/he} do these activities?
|___|___|___|
ENTER NUMBER (OF DAYS, WEEKS OR MONTHS)
REFUSED . . . . . 777 (PAQ.200)
DON'T KNOW . . . . 999 (PAQ.200)
ENTER UNIT
DAY . . . . . . . 1
WEEK . . . . . . . 2
MONTH . . . . . . 3
REFUSED . . . . . 7 (PAQ.200)
DON'T KNOW . . . . 9 (PAQ.200)
PAQ.080
On those days when {you/SP} walked or bicycled, about how long did {you/s/he} spend altogether doing this?
|___|___|___|
ENTER NUMBER (OF MINUTES OR HOURS)
REFUSED . . . . . 777
DON'T KNOW . . . . 999
ENTER UNIT
MINUTES . . . . . 1
HOURS . . . . . . 2
REFUSED . . . . . 7
DON'T KNOW . . . . 9
PAQ.200
The next questions are about physical activities including exercise, sports, and physically active hobbies that {you/SP} may have done in {your/his/her} leisure time or at school over the past 30 days.
(Information statement): First I will ask you about vigorous activities that cause heavy sweating or large increases in breathing or heart rate. Then I will ask you about moderate activities that cause only light sweating or a slight to moderate increase in breathing or heart rate.
Over the past 30 days, did {you/SP} do any vigorous activities for at least 10 minutes that caused heavy sweating, or large increases in breathing or heart rate? Some examples are running, lap swimming, aerobics classes, or fast bicycling.
CODE 'UNABLE TO DO' ONLY IF RESPONDENT VOLUNTEERS
YES . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . 2 (PAQ.320)
UNABLE TO DO ACTIVITY . . . . 3 (PAQ.320)
REFUSED . . . . . . . . . . . 7 (PAQ.320)
DON'T KNOW . . . . . . . . . 9 (PAQ.320)
PAQ.220
[Over the past 30 days], what vigorous activities did {you/SP} do?
CODE ALL THAT APPLY
BICYCLING . . . . . 13
WALKING . . . . . . 42
REFUSED . . . . . . 77
DON'T KNOW . . . . 99
BOX 1
LOOP 1:
ASK PAQ.280 AND PAQ.300 FOR EACH ACTIVITY ENTERED IN PAQ.220.
PAQ.280
[Over the past 30 days], how often did {you/SP} {ACTIVITY}?
PROBE: How many times per day, per week, or per month?
CAPI INSTRUCTION:
FILLS FOR ACTIVITY SHOULD BE AS FOLLOWS:
13. bicycle, 42. walk, 47. DISPLAY ACTIVITY IN 'OTHER SPECIFY'.
|___|___|___|
ENTER NUMBER (OF DAYS, WEEKS OR MONTHS)
REFUSED . . . . . 777
DON'T KNOW . . . . 999
ENTER UNIT
DAY . . . . . . . 1
WEEK . . . . . . . 2
MONTH . . . . . . 3
REFUSED . . . . . 7
DON'T KNOW . . . . 9
PAQ.300
[Over the past 30 days], on average about how long did {you/SP} {ACTIVITY} each time?
|___|___|___|
ENTER NUMBER (OF MINUTES OR HOURS)
REFUSED . . . . . 777
DON'T KNOW . . . . 999
ENTER UNIT
MINUTES . . . . . 1
HOURS . . . . . . 2
REFUSED . . . . . 7
DON'T KNOW . . . . 9
BOX 2
END LOOP 1:
ASK PAQ.280 AND PAQ.300 FOR NEXT ACTIVITY.
IF NO NEXT ACTIVITY, CONTINUE WITH PAQ.320.
PAQ.320
Information Statement: [Over the past 30 days], did {you/SP} do moderate activities for at least 10 minutes that cause only light sweating or a slight to moderate increase in breathing or heart rate? Some examples are brisk walking, bicycling for pleasure, golf, or dancing.
CODE 'UNABLE TO DO' ONLY IF RESPONDENT VOLUNTEERS
YES . . . . . . . . . . . . . 1
NO . . . . . . . . . . . . . 2 (PAQ.440)
UNABLE TO DO ACTIVITY . . . . 3 (PAQ.440)
REFUSED . . . . . . . . . . . 7 (PAQ.440)
DON'T KNOW . . . . . . . . . 9 (PAQ.440)
PAQ.340
[Over the past 30 days], what activity or activities did {you/SP} do?
CODE ALL THAT APPLY
BICYCLING . . . . 13
WALKING . . . . . 42
REFUSED . . . . . 77 (PAQ.440)
DON'T KNOW . . . . 99 (PAQ.440)
BOX 3
LOOP 2:
ASK PAQ.400 AND PAQ.420 FOR EACH ACTIVITY ENTERED IN PAQ.340.
PAQ.400
[Over the past 30 days], how often did {you/SP} {ACTIVITY}?
PROBE: How many times per day, per week, or per month?
CAPI INSTRUCTION:
FILLS FOR ACTIVITY SHOULD BE AS FOLLOWS:
13. bicycle,
42. walk,
|___|___|___|
ENTER NUMBER (OF DAYS, WEEKS OR MONTHS)
REFUSED . . . . . 777
DON'T KNOW . . . . 999
ENTER UNIT
DAY . . . . . . . 1
WEEK . . . . . . . 2
MONTH . . . . . . 3
REFUSED . . . . . 7
DON'T KNOW . . . . 9
PAQ.420
[Over the past 30 days], on average about how long did {you/SP} {ACTIVITY} each time?
|___|___|___|
ENTER NUMBER (OF MINUTES OR HOURS)
REFUSED . . . . . 777
DON'T KNOW . . . . 999
ENTER UNIT
MINUTES . . . . . 1
HOURS . . . . . . 2
REFUSED . . . . . 7
DON'T KNOW . . . . 9
BOX 4
END LOOP 2:
ASK PAQ.400 AND PAQ.420 FOR NEXT ACTIVITY.
IF NO NEXT ACTIVITY, CONTINUE WITH PAQ.440.
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