Copy of Connect to Walk and Bike Rockaway Twp. Survey

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* 1. WOULD YOU SAY THAT YOU ARE MORE OR LESS PHYSICALLY ACTIVE THAN OTHER PEOPLE YOUR AGE?

More active than other people my age

Less physically active than other people my age

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* 2. IN AN AVERAGE WEEK, HOW MANY DAYS TO YOU ENGAGE IN LEISURE-TIME PHYSICAL ACTIVITY FOR 30 MINUTES OR MORE? Record # of days in box below

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* 3. HOW WOULD YOU DESCRIBE YOUR AVERAGE LEISURE-TIME PHYSICAL ACTIVITY?

Mild (active, but don't usually break a sweat)

Moderate (heart rate goes up, and usually break a sweat)

Strenuous (rapid breathing, heart rate goes up a lot, always break a sweat)

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* 4. How often to you engage in the following activities

	Never/rarely	Less than once a month	About once a month	2-3 times a month	Once a week	More than once a week
Swimming	Swimming Never/rarely	Swimming Less than once a month	Swimming About once a month	Swimming 2-3 times a month	Swimming Once a week	Swimming More than once a week
Hiking/Biking	Hiking/Biking Never/rarely	Hiking/Biking Less than once a month	Hiking/Biking About once a month	Hiking/Biking 2-3 times a month	Hiking/Biking Once a week	Hiking/Biking More than once a week
Walking for exercise/pleasure	Walking for exercise/pleasure Never/rarely	Walking for exercise/pleasure Less than once a month	Walking for exercise/pleasure About once a month	Walking for exercise/pleasure 2-3 times a month	Walking for exercise/pleasure Once a week	Walking for exercise/pleasure More than once a week
Walking as transportation to get places	Walking as transportation to get places Never/rarely	Walking as transportation to get places Less than once a month	Walking as transportation to get places About once a month	Walking as transportation to get places 2-3 times a month	Walking as transportation to get places Once a week	Walking as transportation to get places More than once a week
Biking/cycling for exercise/pleasure	Biking/cycling for exercise/pleasure Never/rarely	Biking/cycling for exercise/pleasure Less than once a month	Biking/cycling for exercise/pleasure About once a month	Biking/cycling for exercise/pleasure 2-3 times a month	Biking/cycling for exercise/pleasure Once a week	Biking/cycling for exercise/pleasure More than once a week
Biking for transportation	Biking for transportation Never/rarely	Biking for transportation Less than once a month	Biking for transportation About once a month	Biking for transportation 2-3 times a month	Biking for transportation Once a week	Biking for transportation More than once a week
Doing yard work (mowing, weeding)	Doing yard work (mowing, weeding) Never/rarely	Doing yard work (mowing, weeding) Less than once a month	Doing yard work (mowing, weeding) About once a month	Doing yard work (mowing, weeding) 2-3 times a month	Doing yard work (mowing, weeding) Once a week	Doing yard work (mowing, weeding) More than once a week
Aerobics/cardio	Aerobics/cardio Never/rarely	Aerobics/cardio Less than once a month	Aerobics/cardio About once a month	Aerobics/cardio 2-3 times a month	Aerobics/cardio Once a week	Aerobics/cardio More than once a week
Yoga/pilates/floor exercises	Yoga/pilates/floor exercises Never/rarely	Yoga/pilates/floor exercises Less than once a month	Yoga/pilates/floor exercises About once a month	Yoga/pilates/floor exercises 2-3 times a month	Yoga/pilates/floor exercises Once a week	Yoga/pilates/floor exercises More than once a week
running/jogging	running/jogging Never/rarely	running/jogging Less than once a month	running/jogging About once a month	running/jogging 2-3 times a month	running/jogging Once a week	running/jogging More than once a week
organized sports (soccer, tennis, baseball, etc)	organized sports (soccer, tennis, baseball, etc) Never/rarely	organized sports (soccer, tennis, baseball, etc) Less than once a month	organized sports (soccer, tennis, baseball, etc) About once a month	organized sports (soccer, tennis, baseball, etc) 2-3 times a month	organized sports (soccer, tennis, baseball, etc) Once a week	organized sports (soccer, tennis, baseball, etc) More than once a week
Fishing	Fishing Never/rarely	Fishing Less than once a month	Fishing About once a month	Fishing 2-3 times a month	Fishing Once a week	Fishing More than once a week

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* 5. Which of the following things do you consider before walking or biking in your community

Safety

Traffic Speed

Distance to stores, restaurants or other amenities

I do not walk or bike in my community

Location/condition of sidewalks/bike lane

Traffic density (# of cars)

#of other people walking or biking

Other (please specify)

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* 6. Do you feel that you get enough physical activity

Yes please say why

No please say why

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* 7. In the past year have you become more or less physically active than in other years?

More active, please share why

Less active, please share why

No change

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* 8. If you have children, about how many hours a day do they spend outside (if the weather is nice)?

# of hours:

I do not have children please mark with an x

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* 9. About how many hours a day do you spend on mobile
devices, TV, or video games

# of hours

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* 10. In the past 12 months, have you visited a park or recreation area/

Yes

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* 11. How easy is it to get to a park in/near your community

Very easy

Somewhat easy

Somewhat difficult

Very difficult

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* 12. How old are you?

15 - 19

20 - 24

25 - 29

30 - 34

35 - 39

40 - 44

45 - 49

50 - 54

55 - 59

60 - 64

65 - 69

70 - 74

75 - 79

80 - 84

85 and over

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* 13. What is your gender identity

Male

Female

You do not have an option that applies to me

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* 14. What is your race?

White

Black or African American

Asian Indian

Other Asian including Japanese, Chinese, Korean, Vietnamese, and Filipino/a

Pacific Islander including Native Hawaiian, Samoan, Guamanian/Chamorro

American Indian or Alaskan Native

You do not have an option that applies to me

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* 15. Are you of Hispanic, Latino, or Spanish Origin?

Yes

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* 16. Do you speak a language or than than English at home?

Yes what language do you speak at home?

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* 17. What is the highest level of education that you have finished?

Less than 9th grade

High school graduate (or GED/equivalent)

9-12th grade, no diploma

Some college (no degree)

Associate's degree or vocational training

Bachelor's degree

Graduate or professional degree

Other (please specify)

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* 18. How would you describe your household income?

Low-income

Middle-income

High-income

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* 19. What is your employment status

Employed full-time (40+ hours/week)

Employed part time ( up to 39 hours/week)

Unemployed looking for work

Unemployed and not looking for work

Self employed

Retired

Student

Homemaker

Unable to work

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* 20. Where do you live?

Street Name:

Zip code:

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* 21. Do you have any suggestions or comments about making physical activity easier for residents in the community?

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* 22. If you would like us to follow up with you or contact you, or you would like to be involved in these efforts, please provide your
name and email below

Connect to Walk and Bike is a project of the Morris Park Alliance, the Morris County Park Commission and your local community. In the interest of providing physical activity opportunities through walking and biking,
the project committee researches the community and its current resources and amenities. Materials are
then provided that include project summary, recommendations for connections, and maps. Materials are
prepared by the project team including graduates of Montclair State University working with The Nomad
Group. If you have any questions about Connect to Walk and Bike, this survey, or if you would like to be
involved in this initiative, please contact Denise Lanza at dlanza@morrisparks.net. Thank you for your time
and participation!

Question Title

* 1. WOULD YOU SAY THAT YOU ARE MORE OR LESS PHYSICALLY ACTIVE THAN OTHER PEOPLE YOUR AGE?

Question Title

* 2. IN AN AVERAGE WEEK, HOW MANY DAYS TO YOU ENGAGE IN LEISURE-TIME PHYSICAL ACTIVITY FOR 30 MINUTES OR MORE? Record # of days in box below

Question Title

* 3. HOW WOULD YOU DESCRIBE YOUR AVERAGE LEISURE-TIME PHYSICAL ACTIVITY?

Question Title

* 4. How often to you engage in the following activities

Question Title

* 5. Which of the following things do you consider before walking or biking in your community

Question Title

* 6. Do you feel that you get enough physical activity

Question Title

* 7. In the past year have you become more or less physically active than in other years?

Question Title

* 8. If you have children, about how many hours a day do they spend outside (if the weather is nice)?

Question Title

* 9. About how many hours a day do you spend on mobile devices, TV, or video games

Question Title

* 10. In the past 12 months, have you visited a park or recreation area/

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* 11. How easy is it to get to a park in/near your community

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* 12. How old are you?

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* 13. What is your gender identity

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* 14. What is your race?

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* 15. Are you of Hispanic, Latino, or Spanish Origin?

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* 16. Do you speak a language or than than English at home?

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* 17. What is the highest level of education that you have finished?

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* 18. How would you describe your household income?

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* 19. What is your employment status

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* 20. Where do you live?

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* 21. Do you have any suggestions or comments about making physical activity easier for residents in the community?

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* 22. If you would like us to follow up with you or contact you, or you would like to be involved in these efforts, please provide your name and email below

* 9. About how many hours a day do you spend on mobile
devices, TV, or video games

* 22. If you would like us to follow up with you or contact you, or you would like to be involved in these efforts, please provide your
name and email below