# Black Women's Health Study Survey Questions Through 2007

## Questionnaires:

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.

From the study site:
Delia Russell, MPH/Project Coordinator
Black Women's Health Study
Slone Epidemiology Center/Boston University
1010 Commonwealth Ave.
Boston, MA 02215

1. Q1. During the last year, how many hours each week did you spend (on average):
• Vigorous exercise (e.g., jogging, aerobics)
• None, less than 1 hr, 1-2 hrs, 3-4 hrs, 5-6 hrs, 7-9 hrs 10 or more hrs
2. Q2. On average, during the past year, how many hours each day did you spend:
• Walking as part of your job
• None, less than 1 hr, 1-2 hrs, 3-4 hrs, 5or more hrs
3. Q3. On average, during the past year, how many hours each week did you spend:
• None, less than 1 hr, 1-2 hrs, 3-4 hrs, 5-6 hrs, 7-9 hrs 10 or more hrs
• Walking to and from church, store, school, work
• None, less than 1 hr, 1-2 hrs, 3-4 hrs, 5-6 hrs, 7-9 hrs 10 or more hrs
• Walking for exercise
• None, less than 1 hr, 1-2 hrs, 3-4 hrs, 5-6 hrs, 7-9 hrs 10 or more hrs
4. Q24. How many city blocks or their equivalent do you walk each day?
• (12 blocks = 1 mile)     Blocks
5. Q26. How many flights of stairs do you climb up each day?
• Flights (1 flight = 10 steps)
6. Q25. What is your usual pace of walking?
• Casual or strolling (less than 2 mph)
• Average or normal (2 to 3 mph)
• Brisk or striding (4 mph or faster)
• Fairly brisk (3 to 4 mph) flights