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Standardized Questionnaires of Walking & Bicycling Database:

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Questionnaires:

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.

Neighborhood Physical Activity Questionnaire (NPAQ)

In: http://www.sph.uwa.edu.au/research/cbeh/projects/?a=382545External Web Site Policy

WALKING

In the next section, we ask you about walking in and around your neighbourhood, then in section B, we ask about walking outside your neighbourhood.

In both sections we ask you about two types of walking: walking for transport (e.g. to the shop), then walking for recreation, health and fitness. If the walking that you do for transport is also for recreation, health or fitness, please record it only once.

For example:

Linda lives 20 minutes away from work. She chooses to walk there rather than drive mainly because she wants to improve her fitness. If Linda records that she walks for transport (3 times per week for a total of 120 minutes), she would not repeat that information under walking for recreation, health, or fitness.

Section A: This section is about walking IN AND AROUND your new neighbourhood or local area - we mean everywhere within a 10-15 minute walk of your home. Section B is about walking OUTSIDE your neighbourhood.

  1. In a USUAL WEEK, do you walk in or around your new neighbourhood or new local area to get to or from somewhere (such as walking to a shop or to public transport) or for recreation, health or fitness (including walking your dog)?

    NO [GO TO question 8]
    YES

WALKING FOR TRANSPORT IN AND AROUND YOUR NEW NEIGHBOURHOOD

  1. In a USUAL WEEK, how many times do you walk as a means of transport, such as going to and from work, walking to the shop or walking to public transport in your neighbourhood or local area?

    Write in number of times _____ if 0 GO to question 5

  2. Please estimate the total time you spend walking as a means of transport in your neighbourhood or local area in a USUAL WEEK. (eg. 5 times by 10 minutes = 50 minutes).

    Hours _____ Minutes _____

  3. Tick all the places where you walk to as a means of transport in or around your neighbourhood or local area in a USUAL WEEK. Places you might walk to as a means of transport IN your neighbourhood or local area in a USUAL week:

    E.g. To or from shops Tick ALL the places you walk to in a USUAL week
    To or from work [or study] ___
    To or from public transport ___
    To or from shops (1) ___
    To or from shops (2) ___
    To or from school ___
    To or from café or restaurant ___
    To or from friend's house ___
    Somewhere else (1): Please write where
    ______________    		 ___
    Somewhere else (2): Please write where
    ______________    		 ___

WALKING FOR RECREATION, HEALTH OR FITNESS IN AND AROUND YOUR NEW NEIGHBOURHOOD. If you have included recreational walking in the previous section, please do not repeat it in this section.

  1. In a USUAL WEEK, how many times do you walk for recreation, health or fitness (including walking your dog) in or around your neighbourhood or local area?

    Write in number of times _____ if 0 GO to question 8

  2. Please estimate the total time you spend walking for recreation, health or fitness in or around your neighbourhood or local area in a USUAL WEEK. (Eg. 5 times by 20 minutes = 100 minutes).

    Hours _____ Minutes _____

  3. Please tick all the places where you walk for recreation, health or fitness in or around your neighbourhood or local area in a USUAL WEEK.

    Places you might walk for recreation, health or fitness IN your neighbourhood or local area in a USUAL week

    E.g. Park, oval or bushlands Tick ALL the places you walk to in a USUAL week
    Beach ___
    Park, oval or bushlands (1) ___
    Park, oval or bushlands (2) ___
    Park, oval or bushlands (3) ___
    Around the neighbourhood using the streets/footpaths (no specific destination) ___
    Walking trails/paths NOT in a park or beach ___
    To or from café or restaurant ___
    To or from a shop ___
    Somewhere else (1): (Please write where)
    ______________    		 ___
    Somewhere else (2): (Please write where)
    ______________    		 ___

Section B: This section is about walking OUTSIDE your new neighbourhood or local area - we mean everywhere further than a 15 minute walk from your home. (For example, somewhere you walk to in the next suburb, or somewhere you drive to)
  1. In a USUAL WEEK, do you walk outside your neighbourhood or local area to get to or from somewhere (such as walking to a shop or to public transport) or for recreation, health or fitness (including walking your dog)?

    NO [GO to Section C]
    YES

WALKING FOR TRANSPORT OUTSIDE YOUR NEW NEIGHBOURHOOD

  1. In a USUAL WEEK, how many times do you walk as a means of transport, such as going to and from work, walking to the shop or walking to public transport outside your neighbourhood or local area?

    Write in number of times _____ if 0 GO to question 12

  2. Please estimate the total time you spend walking as a means of transport outside your neighbourhood or local area in a USUAL WEEK. (Eg. 5 times by 10 minutes = 50 minutes).

    Hours _____ Minutes _____

  3. Tick all the places where you walk to as a means of transport outside your neighbourhood or local area in a USUAL WEEK.

    Places you might walk to as a means of transport OUTSIDE your neighbourhood or local area in a USUAL week

    E.g. To or from shops Tick ALL the places you walk to in a USUAL week
    To or from work [or study] ___
    To or from public transport ___
    To or from shops (1) ___
    To or from shops (2) ___
    To or from school ___
    To or from café or restaurant ___
    To or from friend's house ___
    Somewhere else (1): (Please write where)
    ______________    		 ___
    Somewhere else (2): (Please write where)
    ______________    		 ___

WALKING FOR RECREATION, HEALTH OR FITNESS OUTSIDE YOUR NEW NEIGHBOURHOOD. If you have included recreational walking in the previous section, please do not repeat it in this section.

  1. In a USUAL WEEK, how many times do you walk for recreation, health or fitness (including walking your dog) outside your neighbourhood or local area?

    Write in number of times _____ if 0 GO to Section C.

  2. Please estimate the total time you spend walking for recreation, health or fitness outside your neighbourhood or local area in a USUAL WEEK. (Eg. 1 time for 30 minutes = 30 minutes).

    Hours _____ Minutes _____

  3. Tick the places where you walk for recreation, health or fitness outside your neighbourhood or local area in a USUAL WEEK

    Places you might walk for recreation, health or fitness OUTSIDE your neighbourhood or local area in a

    E.g. Park, oval or bushlands Tick ALL the places you walk to in a USUAL week
    Beach ___
    Park, oval or bushlands (1) ___
    Park, oval or bushlands (2) ___
    Park, oval or bushlands (3) ___
    Around another neighbourhood using the streets/footpaths (no specific destination) ___
    Walking trails/paths NOT in a park or beach ___
    To or from café or restaurant ___
    To or from a shop ___
    Somewhere else (1): (Please write where)
    ______________    		 ___
    Somewhere else (2): (Please write where)
    ______________    		 ___

CYCLING

Section C: This section is about cycling IN AND AROUND your new neighbourhood or local area - we mean everywhere within a 10-15 minute walk of your home. Section D is about cycling OUTSIDE your new neighbourhood.

In both sections we ask you about two types of cycling: cycling for transport (e.g. to the shop), then cycling for recreation, health and fitness. If the cycling that you do for transport is also for recreation, health or fitness, please record it only once.

For example: Linda lives 20 minutes away from work. She chooses to cycle there rather than drive mainly because she wants to improve her fitness. If Linda records that she cycles for transport (3 times per week for a total of 120 minutes), she would not repeat that information under cycling for recreation, health, or fitness.

Section A: This section is about cycling IN AND AROUND your new neighbourhood or local area - we mean everywhere within a 10-15 minute walk of your home. Section B is about cycling OUTSIDE your neighbourhood.

  1. In a USUAL WEEK, do you cycle in or around your new neighbourhood or new local area to get to or from somewhere (such as cycling to a shop or to public transport) or for recreation, health or fitness (including cycling with your dog)?

    NO [GO to question 8]
    YES

CYCLING FOR TRANSPORT IN AND AROUND YOUR NEW NEIGHBOURHOOD

  1. In a USUAL WEEK, how many times do you cycle as a means of transport, such as going to and from work, cycling to the shop or cycling to public transport in your neighbourhood or local area?

    Write in number of times _____ if 0 GO to question 5.

  2. Please estimate the total time you spend cycling as a means of transport in your neighbourhood or local area in a USUAL WEEK. (eg. 5 times by 10 minutes = 50 minutes).

    Hours _____ Minutes _____

  3. Tick all the places where you cycle to as a means of transport in or around your neighbourhood or local area in a USUAL WEEK.

    Places you might cycle to as a means of transport IN your neighbourhood or local area in a USUAL week:

    E.g. To or from shops Tick ALL the places you cycle to in a USUAL week
    To or from work [or study] ___
    To or from public transport ___
    To or from shops (1) ___
    To or from shops (2) ___
    To or from school ___
    To or from café or restaurant ___
    To or from friend's house ___
    To or from a shop ___
    Somewhere else (1): Please write where
    ______________    		 ___
    Somewhere else (2): Please write where
    ______________    		 ___

CYCLING FOR RECREATION, HEALTH OR FITNESS IN AND AROUND YOUR NEW NEIGHBOURHOOD. If you have included recreational cycling in the previous section, please do not repeat it in this section.

  1. In a USUAL WEEK, how many times do you cycle for recreation, health or fitness (including cycling your dog) in or around your neighbourhood or local area?

    Write in number of times _____ if 0 GO to question 8.

  2. Please estimate the total time you spend cycling for recreation, health or fitness in or around your neighbourhood or local area in a USUAL WEEK. (Eg. 5 times by 20 minutes = 100 minutes).

    Hours _____ Minutes _____

  3. Please tick all the places where you cycle for recreation, health or fitness in or around your neighbourhood or local area in a USUAL WEEK.

    Places you might cycle for recreation, health or fitness IN your neighbourhood or local area in a USUAL week

    E.g. Park, oval or bushlands Tick ALL the places you cycle to in a USUAL week
    Beach ___
    Park, oval or bushlands (1) ___
    Park, oval or bushlands (2) ___
    Park, oval or bushlands (3) ___
    Around the neighbourhood using the streets/footpaths (no specific destination) ___
    Cycling trails/paths NOT in a park or beach ___
    To or from café or restaurant ___
    To or from a shop ___
    Somewhere else (1): Please write where
    ______________    		 ___
    Somewhere else (2): Please write where
    ______________    		 ___

Section B: This section is about cycling OUTSIDE your new neighbourhood or local area - we mean everywhere further than a 15 minute cycle from your home. (For example, somewhere you cycle to in the next suburb, or somewhere you drive to)

  1. In a USUAL WEEK, do you cycle outside your neighbourhood or local area to get to or from somewhere (such as cycling to a shop or to public transport) or for recreation, health or fitness (including cycling your dog)?

    NO [GO to section C]
    YES

CYCLING FOR TRANSPORT OUTSIDE YOUR NEW NEIGHBOURHOOD

  1. In a USUAL WEEK, how many times do you cycle as a means of transport, such as going to and from work, cycling to the shop or cycling to public transport outside your neighbourhood or local area?

    Write in number of times _____ if 0 GO to question 12.

  2. Please estimate the total time you spend cycling as a means of transport outside your neighbourhood or local area in a USUAL WEEK. (Eg. 5 times by 10 minutes = 50 minutes).

    Hours _____ Minutes _____

  3. Tick all the places where you cycle to as a means of transport outside your neighbourhood or local area in a USUAL WEEK.

    Places you might cycle to as a means of transport OUTSIDE your neighbourhood or local area in a USUAL week

    E.g. To or from shops Tick ALL the places you cycle to in a USUAL week
    To or from work [or study] ___
    To or from public transport ___
    To or from shops (1) ___
    To or from shops (2) ___
    To or from school ___
    To or from café or restaurant ___
    To or from friend's house ___
    Somewhere else (1): Please write where
    ______________    		 ___
    Somewhere else (2): Please write where
    ______________    		 ___

CYCLING FOR RECREATION, HEALTH OR FITNESS OUTSIDE YOUR NEW NEIGHBOURHOOD. If you have included recreational cycling in the previous section, please do not repeat it in this section.

  1. In a USUAL WEEK, how many times do you cycle for recreation, health or fitness (including cycling your dog) outside your neighbourhood or local area?

    Write in number of times _____ if 0 GO to question 12.

  2. Please estimate the total time you spend cycling for recreation, health or fitness outside your neighbourhood or local area in a USUAL WEEK. (Eg. 1 time for 30 minutes = 30 minutes).

    Hours _____ Minutes _____

  3. Tick the places where you cycle for recreation, health or fitness outside your neighbourhood or local area in a USUAL WEEK

    Places you might cycle for recreation, health or fitness OUTSIDE your neighbourhood or local area in a USUAL week

    E.g. Park, oval or bushlands Tick ALL the places you cycle to in a USUAL week
    Beach ___
    Park, oval or bushlands (1) ___
    Park, oval or bushlands (2) ___
    Park, oval or bushlands (3) ___
    Around the neighbourhood using the streets/footpaths (no specific destination) ___
    Cycling trails/paths NOT in a park or beach ___
    To or from café or restaurant ___
    To or from a shop ___
    Somewhere else (1): Please write where
    ______________    		 ___
    Somewhere else (2): Please write where
    ______________    		 ___


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14 Mar 2013
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