| Global |
| When you are at work, which of the following best describes what you do? |
| ____Mostly sitting |
| ____Mostly walking |
| ____Mostly heavy labour or physically demanding work |
| From the 2001 Behavioral Risk Factor Surveillance System (occupational activity, one item) |
| http://www.cdc.gov/brfss/questionnaires/pdf-ques/2001brfss.pdf |
| Recall |
| Think about all the vigorous activities which take hard physical effort that you did in the last 7 days. Vigorous activities make you breathe much harder than normal and may include heavy lifting, digging, aerobics, or fast bicycling. Think only about those physical activities that you did for at least 10 minutes at a time |
| 1. During the last 7 days, on how many days did you do vigorous physical activities? |
| _____ Days per week |
| 2. How much time did you usually spend doing vigorous physical activities on one of those days? |
| _____ Hours per day |
| _____ Minutes per day |
| From the International Physical Activity Questionnaire—Short Format (seven items) |
| http://www.ipaq.ki.se/downloads.htm |
| Quantitative history |
| Below is a list of leisure time activities. Related activities are grouped under general headings. Check “yes” for activities you performed in the last 12 months and “no” for activities you did not perform. For each yes response, check the months, average days/month and average time/event you performed the activity. |
| Section A | Do this? | Months of year | Days/month | Hours:min/ event |
| Walking and miscellaneous | No | Yes | Jan | Feb | Mar | … | Oct | Nov | Dec |
| Walking for pleasure | __ | __ | __ | __ | __ | | __ | __ | __ | ____ | __:__ |
| Walking to work | __ | __ | __ | __ | __ | | __ | __ | __ | ____ | __:__ |
| Using stairs vs elevator | __ | __ | __ | __ | __ | | __ | __ | __ | ____ | __:__ |
| Cross-country Hiking | __ | __ | __ | __ | __ | | __ | __ | __ | ____ | __:__ |
| Bicycling to work/pleasure | __ | __ | __ | __ | __ | | __ | __ | __ | ____ | __:__ |
| From the Minnesota Leisure-Time Physical Activity Questionnaire (78 items) |