Grade 3-5 Watertown PE Survey on MVPA #2of 4

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1. Please select your school

Please select your school

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2. What grade are you in?

What grade are you in? Gr 3

Gr 4

Gr 5

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3. Gender

Gender Boy

Girl

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4. During the past 7 days how many days did you exercise or participate in physical activity that made you sweat and breathe hard, such as basketball, soccer or running? Please check the appropriate box.

During the past 7 days how many days did you exercise or participate in physical activity that made you sweat and breathe hard, such as basketball, soccer or running? Please check the appropriate box. 1

2

3

4

5

6

7

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5. On how many of the past 7 days did you participate in physical activity that did not make you sweat or breathe hard, such as fast walking, slow bicycling, skating, or pushing a lawn mower? Please check the appropriate box.

On how many of the past 7 days did you participate in physical activity that did not make you sweat or breathe hard, such as fast walking, slow bicycling, skating, or pushing a lawn mower? Please check the appropriate box. 1

2

3

4

5

6

7

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6. Think about a day you were physically active. Estimate the average number of minutes you exercised hard enough to increase your heart rate and breathe hard.

Think about a day you were physically active. Estimate the average number of minutes you exercised hard enough to increase your heart rate and breathe hard.

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7. In the last week, were you physically active for a total of 150 or more minutes? ("Physically active" can mean exercising, taking a walk, bike riding, skating, running, dancing, swimming, playing, soccer, as well as other activities that increases your heart rate and make you breathe hard some of the time. Add up all the time you were physically active this week in and out of school.)

In the last week, were you physically active for a total of 150 or more minutes? ("Physically active" can mean exercising, taking a walk, bike riding, skating, running, dancing, swimming, playing, soccer, as well as other activities that increases your heart rate and make you breathe hard some of the time. Add up all the time you were physically active this week in and out of school.) Yes

No

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8. During a regular physical education class how much time is spent on learning or practicing a skill, like throwing, catching or striking with an implement?

During a regular physical education class how much time is spent on learning or practicing a skill, like throwing, catching or striking with an implement? Never

Less than 10 minutes

More than 10 minutes but less 15 minutes

More than 15 minutes but less that 20 minutes

More than 20 minutes

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9. During a regular physical education class how often do you practice fitness exercises such as push ups, sit ups, stretching, jogging, jumping rope?

During a regular physical education class how often do you practice fitness exercises such as push ups, sit ups, stretching, jogging, jumping rope? Never

sometimes

Most of the time

All of the time

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10. Have you used a heart rate monitor in physical education class during the current school year?

Have you used a heart rate monitor in physical education class during the current school year? I have not used a heart rate monitor in class this year

I have used a heart rate monitor once or twice in class this year

I have used a heart rate monitor several times in class this year

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11. When you use a heart rate monitor in physical education class, are you more active?

When you use a heart rate monitor in physical education class, are you more active? I have never used a heart rate monitor in class

I am not more active when I use a heart rate monitor

I am more active when I use a heart rate monitor

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12. During a regular physical education class how many minutes are you participating in an activity where you are sweating and breathing heavy?

During a regular physical education class how many minutes are you participating in an activity where you are sweating and breathing heavy? Never

Less than 10 minutes

More than 10 minutes but less 15 minutes

More than 15 minutes but less that 20 minutes

More than 20 minutes

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13. During the past 7 days, how many days did you eat 5 or more fruits or vegetables? (Do not count fruit juice)

During the past 7 days, how many days did you eat 5 or more fruits or vegetables? (Do not count fruit juice) 0 of the past 7 days

1 of the past 7 days

2 of the past 7 days

3 of the past 7 days

4 of the past 7 days

5 of the past 7 days

6 of the past 7 days

7 of the past 7 days

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14. During the past 7 days, how many times did you eat fast foods that were not a healthy choice?

During the past 7 days, how many times did you eat fast foods that were not a healthy choice? I did not eat fast food during the past 7 days

1 to 3 times during the past 7 days

4 to 6 times during the past 7 days

1 time a day

2 or more times a day

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15. How much water do you usually drink per day?

How much water do you usually drink per day? 1 eight ounce glass

2 eight ounce glasses

3+ eight ounce glasses

Grade 3-5 Watertown PE Survey on MVPA #2of 4
Exit this survey

1. Default Section

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1. Please select your school

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2. What grade are you in?

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3. Gender

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4. During the past 7 days how many days did you exercise or participate in physical activity that made you sweat and breathe hard, such as basketball, soccer or running? Please check the appropriate box.

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5. On how many of the past 7 days did you participate in physical activity that did not make you sweat or breathe hard, such as fast walking, slow bicycling, skating, or pushing a lawn mower? Please check the appropriate box.

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6. Think about a day you were physically active. Estimate the average number of minutes you exercised hard enough to increase your heart rate and breathe hard.

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8. During a regular physical education class how much time is spent on learning or practicing a skill, like throwing, catching or striking with an implement?

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9. During a regular physical education class how often do you practice fitness exercises such as push ups, sit ups, stretching, jogging, jumping rope?

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10. Have you used a heart rate monitor in physical education class during the current school year?

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11. When you use a heart rate monitor in physical education class, are you more active?

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12. During a regular physical education class how many minutes are you participating in an activity where you are sweating and breathing heavy?

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13. During the past 7 days, how many days did you eat 5 or more fruits or vegetables? (Do not count fruit juice)

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14. During the past 7 days, how many times did you eat fast foods that were not a healthy choice?

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15. How much water do you usually drink per day?

Grade 3-5 Watertown PE Survey on MVPA #2of 4Exit this survey

1. Default Section

*1. Please select your school

*2. What grade are you in?

*3. Gender

*4. During the past 7 days how many days did you exercise or participate in physical activity that made you sweat and breathe hard, such as basketball, soccer or running? Please check the appropriate box.

*5. On how many of the past 7 days did you participate in physical activity that did not make you sweat or breathe hard, such as fast walking, slow bicycling, skating, or pushing a lawn mower? Please check the appropriate box.

*6. Think about a day you were physically active. Estimate the average number of minutes you exercised hard enough to increase your heart rate and breathe hard.

*8. During a regular physical education class how much time is spent on learning or practicing a skill, like throwing, catching or striking with an implement?

*9. During a regular physical education class how often do you practice fitness exercises such as push ups, sit ups, stretching, jogging, jumping rope?

*10. Have you used a heart rate monitor in physical education class during the current school year?

*11. When you use a heart rate monitor in physical education class, are you more active?

*12. During a regular physical education class how many minutes are you participating in an activity where you are sweating and breathing heavy?

*13. During the past 7 days, how many days did you eat 5 or more fruits or vegetables? (Do not count fruit juice)

*14. During the past 7 days, how many times did you eat fast foods that were not a healthy choice?

*15. How much water do you usually drink per day?

Grade 3-5 Watertown PE Survey on MVPA #2of 4
Exit this survey

*
1. Please select your school

*
2. What grade are you in?

*
3. Gender

*
4. During the past 7 days how many days did you exercise or participate in physical activity that made you sweat and breathe hard, such as basketball, soccer or running? Please check the appropriate box.

*
5. On how many of the past 7 days did you participate in physical activity that did not make you sweat or breathe hard, such as fast walking, slow bicycling, skating, or pushing a lawn mower? Please check the appropriate box.

*
6. Think about a day you were physically active. Estimate the average number of minutes you exercised hard enough to increase your heart rate and breathe hard.

*
8. During a regular physical education class how much time is spent on learning or practicing a skill, like throwing, catching or striking with an implement?

*
9. During a regular physical education class how often do you practice fitness exercises such as push ups, sit ups, stretching, jogging, jumping rope?

*
10. Have you used a heart rate monitor in physical education class during the current school year?

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11. When you use a heart rate monitor in physical education class, are you more active?

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12. During a regular physical education class how many minutes are you participating in an activity where you are sweating and breathing heavy?

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13. During the past 7 days, how many days did you eat 5 or more fruits or vegetables? (Do not count fruit juice)

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14. During the past 7 days, how many times did you eat fast foods that were not a healthy choice?

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15. How much water do you usually drink per day?