YesNo
Activity Value Unit
PART 1: JOB-RELATED PHYSICAL ACTIVITY
1. During the last 7 days, on how many days did you do vigorous physical activities like heavy lifting, digging, heavy construction, or climbing up stairs as part of your work? Think about only those physical activities that you did for at least 10 minutes at a time.days per week
2. How much time did you usually spend on one of those days doing vigorous physical activities as part of your work?minutes per day
3. Again, think about only those physical activities that you did for at least 10 minutes at a time. During the last 7 days, on how many days did you do moderate physical activities like carrying light loads as part of your work? Please do not include walking.days per week
4. How much time did you usually spend on one of those days doing moderate physical activities as part of your work?minutes per day
5. During the last 7 days, on how many days did you walk for at least 10 minutes at a time as part of your work? Please do not count any walking you did to travel to or from work.days per week
6. How much time did you usually spend on one of those days walking as part of your work?minutes per day
PART 2: TRANSPORTATION PHYSICAL ACTIVITY These questions are about how you traveled from place to place, including to places like work, stores, movies, and so on.
7. During the last 7 days, on how many days did you travel in a motor vehicle like a train, bus, car, or tram?days per week
8. How much time did you usually spend on one of those days traveling in a train, bus, car, tram, or other kind of motor vehicle?minutes per day
9. During the last 7 days, on how many days did you bicycle for at least 10 minutes at a time to go from place to place?days per week
10. How much time did you usually spend on one of those days to bicycle from place to place?minutes per day
11. During the last 7 days, on how many days did you walk for at least 10 minutes at a time to go from place to place?days per week
12. How much time did you usually spend on one of those days walking from place to place?minutes per day
PART 3: HOUSEWORK, HOUSE MAINTENANCE, AND CARING FOR FAMILY. This section is about some of the physical activities you might have done in the last 7 days in and around your home, like housework, gardening, yard work, general maintenance work, and caring for your family.
13. Think about only those physical activities that you did for at least 10 minutes at a time. During the last 7 days, on how many days did you do vigorous physical activities like heavy lifting, chopping wood, shoveling snow, or digging in the garden or yard?days per week
14. How much time did you usually spend on one of those days doing vigorous physical activities in the garden or yard?minutes per day
15. Again, think about only those physical activities that you did for at least 10 minutes at a time. During the last 7 days, on how many days did you do moderate activities like carrying light loads, sweeping, washing windows, and raking in the garden or yard?days per week
16. How much time did you usually spend on one of those days doing moderate physical activities in the garden or yard?minutes per day
17. Once again, think about only those physical activities that you did for at least 10 minutes at a time. During the last 7 days, on how many days did you do moderate activities like carrying light loads, washing windows, scrubbing floors and sweeping inside your home?days per week
18. How much time did you usually spend on one of those days doing moderate physical activities inside your home?minutes per day
PART 4: RECREATION, SPORT, AND LEISURE-TIME PHYSICAL ACTIVITY. This section is about all the physical activities that you did in the last 7 days solely for recreation, sport, exercise or leisure. Please do not include any activities you have already mentioned.
19. Not counting any walking you have already mentioned, during the last 7 days, on how many days did you walk for at least 10 minutes at a time in your leisure time?days per week
20. How much time did you usually spend on one of those days walking in your leisure time?minutes per day
21. Think about only those physical activities that you did for at least 10 minutes at a time. During the last 7 days, on how many days did you do vigorous physical activities like aerobics, running, fast bicycling, or fast swimming in your leisure time?days per week
22. How much time did you usually spend on one of those days doing vigorous physical activities in your leisure time?minutes per day
23. Again, think about only those physical activities that you did for at least 10 minutes at a time. During the last 7 days, on how many days did you do moderate physical activities like bicycling at a regular pace, swimming at a regular pace, and doubles tennis in your leisure time?days per week
24. How much time did you usually spend on one of those days doing moderate physical activities in your leisure time?minutes per day
PART 5: TIME SPENT SITTING. The last questions are about the time you spend sitting while at work, at home, while doing course work and during leisure time. This may include time spent sitting at a desk, visiting friends, reading or sitting or lying down to watch television. Do not include any time spent sitting in a motor vehicle that you have already told me about.
25. During the last 7 days, how much time did you usually spend sitting on a weekday?minutes per day
26. During the last 7 days, how much time did you usually spend sitting on a weekend day?minutes per day