Modifiable Activity Questionnaire for Adolescents
DATE _______________ NAME ____________________________________ ID ___ ___ ___ ___
SCHOOL _________________________ CLASS
1. How many times in the past 14 days have you done at least 20 minutes of exercise hard enough to make you
breathe heavily and make your heart beat fast? (Hard exercise includes, for example, playing basketball,
jogging, or fast bicycling; include time in physical education class)
( ) None
( ) 1 to 2 days
( ) 3 to 5 days
( ) 6 to 8 days
( ) 9 or more days
2. How many times in the past 14 days have you done at least 20 minutes of light exercise that was not enough
to make you breathe heavily and make your heart beat fast? (Light exercise includes playing basketball,
walking or slow bicycling; include time in physical education class)
( ) None
( ) 1 to 2 days
( ) 3 to 5 days
( ) 6 to 8 days
( ) 9 or more days
3. During a normal week how many hours a day do you watch television and videos, or play computer or video
games before or after school?
( ) None
( ) 1 hour or less
( ) 2 to 3 hours
( ) 4 to 5 hours
( ) 6 or more hours
4. During the past 12 months, how many team or individual sports or activities did you participate in on a
competitive level, such as varsity or junior varsity sports, intramurals, or out-or-school programs?
( ) None
( ) 1 activity
( ) 2 activities
( ) 3 activities
( ) 4 or more activities
What activities did you compete in?
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PAST YEAR LEISURE-TIME PHYSICAL ACTIVITY
Check all activities that you did at least 10 times in the PAST YEAR. Do not include time spent in school physical
education classes. Make sure you include all sport teams that you participated in during the last year.
1. Aerobics 11. Gymnastics 21. Swimming
2. Band/Drill Team 12. Hiking 22. Tennis
3. Baseball 13. Ice Skating 23. Volleyball
4. Basketball 14. Roller Skating 24. Water Skiing
5. Bicycling 15. Running for Exercise 25. Weight Training (Competitive)
6. Bowling 16. Skateboarding 26. Wrestling
7. Cheerleading 17. Snow Skiing 27. Others:
8. Dance Class 18. Soccer ____________________________
9. Football 19. Softball ____________________________
10. Garden/Yard Word 20. Street Hockey ____________________________
List each activity that you checked above in the "Activity" box below.
Check the months you did each activity and then estimate the amount of time spent in each activity.
J F M A M J J A S O N D Months Days Minutes
Activity A E A P A U U U E C O E per per per
N B R R Y N L G P T V C Year Week Day
Reproduced with permission of Oxford University Press from Aaron DJ, Kriska AM, Dearwater SR, Cauley JA, Metz KF, LaPorte RE.
Reproducibility and validity of an epidemiologic questionnaire to assess past year physical activity in adolescents. Am. J. Epidemiol. 142(2):
191-201, 1995.
Modifiable Activity Questionnaire for Adolescents
Activity component(s) assessed:
Leisure
Time frame of recall:
Past year
Original mode of administration:
Interviewer-administered or Self-administered with supervision
INSTRUCTIONS:
If the Questionnaire is being interviewer-administered, the interviewer first reads through the list of activities
provided. The participant is instructed to identify all leisure activities from this list in which he/she participated
at least 10 times in the past year (as the interviewer checks all positive responses). After the list has been read
and all of the positive responses have been checked, the interviewer writes down each activity that was checked
in the “Activity’ column provided. Estimates of frequency and duration are then obtained for each of these
activities. Specifically, for each activity, the months that the activity was performed over the past year (past 12
mo) is checked, and then the average number of days per week and the average minutes per day is entered in the
appropriate columns. The participant also responds to four multiple choice questions that assess “hard and light
exercise” over the past 2 wk, daily television watching, and competitive athletic participation. These questions
were adapted from the Youth Risk Behavior Survey.
CALCULATIONS:
1. Past year: (mo) X (4.3 wk/mo) X (days/wk) ÷ (60 min/h) ÷ (52 wk/yr) = h/wk averaged over the past year
The hours per week of all activities are summed to determine total pas-year hours per week. This estimate can
also be weighted by its estimated metabolic cost and expressed as MET-h per week by multiplying hours per
week for each specific activity by the estimated MET value.
EXAMPLE
Activity Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Mo/yr D/wk Min/d
Soccer 5 5 90
Basketball 6 5 120
Soccer:
(5 mo) X (5 days/wk) X (4.3 wk/mo) X (90 min/time) ÷ 60 min/h ÷ 52 wk/yr = 3.1 h/wk
Basketball:
(6 mo) X (5 days/wk) X (4.3 wk/mo) X (120 min/time) ÷ 60 min/h ÷ 52 wk/yr = 5.0 h/wk
Total year leisure activity = 3.1 h/wk + 5.0 h/wk = 8.1 h/wk
Conversion to MET-h/wk:
Soccer: 3.1 h/wk X 7.5 METs = 23.3 MET-h/wk
Basketball: 5.0 h/wk X 9.0 METs = 45.0 MET-h/wk
Total past-year leisure activity = 23.3 MET-h/wk + 45.0 MET-h/wk = 68.3 MET-h/wk
Reproduced with permission from Lippincott Williams & Wilkins/Wolters Kluwer Health from A Collection of Physical Activity Questionnaires for
Health-Related Research. Med. Sci. Sports Exerc. 29 (6 supplement): S79-S82. 1997.
