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1998

Survey form view entire document: text image

PAK.010

In the past 2 weeks (outlined on that calendar), beginning Monday, [fill date], and ending this past Sunday, [fill date], have you done any exercises, sports, or physically active hobbies?

HPACT

(1) Yes (PAK.020)
(2) No (END_PAK)
(7) Refused (END_PAK)
(9) Don't know (END_PAK)

PAK.020

What were they?

FR: ENTER THE NUMBER FOR EACH ITEM MENTIONED; ENTER (N) FOR NO MORE.

WALK (01) Walking
YARD (02) Gardening or yard work
STRETCH (03) Stretching exercises
LIFT (04) Weightlifting or other exercises to increase muscle strength
RUN (05) Jogging or running
AEROBICS (06) Aerobics or aerobic dancing
BIKE (07) Riding a bicycle or exercise bike
STAIRS (08) Stair climbing for exercise
SWIM (09) Swimming
TENNIS (10) Tennis
GOLF (11) Golf
BOWL (12) Bowling
BASEBALL (13) Baseball or softball
RACQUEB (14) Handball, racquetball or squash
SKIPH (15) Downhill skiing
SKICRS (16) Cross country skiing
SKIWAT (17) Water skiing
BASKETBL (18) Basketball
VOLLEYBL (19) Volleyball
SOCCER (20) Soccer
FOOTBALL (21) Football
OTR_ACT1 (22) Other specify 1
OTR_ACT2 (23) Other specify 2

(97) Refused
(99) Don't know

[If OTR_ACT1 mentioned, go to PAK.025/MOREA; If OTR_ACT2 mentioned go to PAK.025/MOREB; Else go to Check item LOOP]

PAK.030 - PAK.120

In the past 2 weeks (outlined on that calendar), beginning Monday, [fill date], and ending this past Sunday, [fill date], have YOU done any of the following exercises, sports, or physically active hobbies...

(1) Yes
(2) No
(7) Refused
(9) Don't know

WALK ... Walking for exercise?
YARD ... Gardening or yard work?
STRETCH ... Stretching exercises?
LIFT ... Weightlifting or other exercises to increase muscle strength?
RUN ... Jogging or running?
AEROBICS ... Aerobics or aerobic dancing?
BIKE ... Riding a bicycle or exercise bike?
STAIRS ... Stair climbing for exercise?
SWIM ... Swimming for exercise?
TENNIS ... Playing tennis?

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1995

Survey form view entire document: text image

ITEM E1
Mark from observation or previous information.

1[] SP is physically handicapped (Describe in notes, then 1)
8[] Other (2 on page 57)

HAND CALENDAR
1a. In the past 2 weeks (outlined on that calendar), beginning Monday (date) and ending this past Sunday (date), have you done any exercise, sports, or physically active hobbies?

1[] Yes (1b)
2[] No (3 on page 58)
9[] DK (3 on page 58)

b. What were they?

Record in 2a on page 57, then 1c

c. Anything else?

[] Yes (Reask 1b and c)
[] No (Mark "No" for all remaining activities in 2a, then go to 2b)

2a. In the past 2 weeks (outlined on that calendar), beginning Monday, (date) and ending this past Sunday (date), have YOU done any of the following exercises, sports, or physical activity hobbies --

(1) Walking for exercise

1[] Yes
2[] No

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1991

Survey form view entire document: text image

Hand calendar.
1a. In the past 2 weeks (outlined on that calendar), beginning Monday (date) and ending this past Sunday (date), have you done any exercises, sports, or physically active hobbies?

1[] Yes (1b)
2[] No (3 on page 40)
9[] DK (3 on page 40)

b. What were they?
Record on next page, then 1c.

c. Anything else?

[] Yes (Reask 1b and c)
[] No (2b)

Hand calendar.
2a. In the past 2 weeks (outlined on that calendar), beginning Monday, (date), and ending this past Sunday, (date), have you done any of the following exercises, sports, or physically active hobbies --

(1) Walking for exercise?

1[] Yes
2[] No

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1990

Survey form view entire document: text image

These next questions are about physical exercise.
Hand calendar.

1a. In the past 2 weeks (outlined on that calendar), beginning Monday (date) and ending this past Sunday (date), have you done any exercises, sports, or physically active hobbies?

1[] Yes
2[] No (3 on page 19)

b. What were they? ____
Record on next page, then 1c.

c. Anything else?

[] Yes (Reask 1b and c)
[] No (2b)

2a. In the past 2 weeks (outlined on that calendar), beginning Monday, (date), and ending this past Sunday, (date), have you done any (of the following exercises, sports, or physically active hobbies) --

(1) Walking for exercise?

1[] Yes
2[] No

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1985

Survey form view entire document: text image

1a. In the past 2 weeks (outlined on that calendar), beginning Monday (date) and ending this past Sunday (date), have you done any exercises, sports, or physically active hobbies? [6]

1 [] Yes
2 [] No (3, page 13)

b. What were they? ____
Record on next page, THEN 1c.

c. Anything else?

[] Yes (Reask 1b and c)
[] No (2b)

2a. In the past 2 weeks (outlined on that calendar), beginning Monday, (date), and ending this past Sunday, (date), have you done any (of the following exercises, sports, or physically active hobbies) --

(1) Walking for exercise?

1 [] Yes
2 [] No

Survey Text