CUVA post survey

National Park Service’s Evaluation of Pilot Interventions to Increase Healthful Physical Activity in Parks

AttachL_CUVA_Post_Student

CUVA post survey

OMB: 1024-0253

Document [doc]
Download: doc | pdf

OMB control #:

Expiration date:



Student Number:_________________


Homeroom Teacher:______________




Draft Middle School Student Survey (Post)

Evaluation of Pilot Project on Community-based Promotion of Healthful Recreation in Cuyahoga Valley NP


SCRIPT FOR STUDENT DATA COLLECTION


Good Morning! Today you get a chance to participate in another survey about parks and recreation activities. You might remember doing this last school year. This year the 7th and 8th grades are doing the survey.


We will complete the survey on the Internet. Take your time and think about each question before giving an answer. This should take about 20 minutes. Let me know when you are finished. Any questions?


1. Below are activities some young people do. For each activity listed below, think about whether you did that activity yesterday and check the correct box. Then, think how often you usually do that activity and check the box that best fits how often you usually do it.


Activity

A. Yesterday, I did it…

B. Usually, I do it…

Bicycling

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Exercise: push-ups, sit-ups, jumping jacks

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Basketball

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Baseball, softball

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Football

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Soccer

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Volleyball

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Racket sports: badminton, tennis

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Climbing on playground equipment

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Ball playing: four square, dodge ball, kickball, Frisbee

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Water play (swimming pool, lake, or sprinkler)

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Swimming laps

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Jump rope

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Dance

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Outdoor chores: mowing, raking, gardening

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Outdoor play: climbing trees, hide & seek

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Indoor chores: mopping, vacuuming, sweeping

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Walking

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Running or jogging

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Skateboarding,

skating, or rollerblading

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Gymnastics

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Hiking on a trail

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Weight lifting/Strength training

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Martial arts

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Cheerleading or drill team

Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot

Other

______________


Not at all

Less than 15 minutes

15 minutes or more

Not at all

A little

A lot




2. Are there outdoor activities that you like doing other than these? _____________________


______________________________________________________________________________


______________________________________________________________________________




3. What is your favorite outdoor activity?______________________________ ____________


______________________________________________________________________________


______________________________________________________________________________



4. For each activity listed below, think about whether you did that activity yesterday and, if so, how much time you spent doing the activity. Please check the box that best fits how much time you spent doing each activity yesterday.


YESTERDAY…

Activity







Watched TV, videos

None

Less than 30 minutes

30 minutes – 1 hour

1-3 hours

More than 3 hours

Played

computer games, video games

None

Less than 30 minutes

30 minutes – 1 hour

1-3 hours

More than 3 hours

Played board games

None

Less than 30 minutes

30 minutes – 1 hour

1-3 hours

More than 3 hours

Did

homework, read

None

Less than 30 minutes

30 minutes – 1 hour

1-3 hours

More than 3 hours

Talked on the phone, hung out with friends

None

Less than 30 minutes

30 minutes – 1 hour

1-3 hours

More than 3 hours

Listened to music, played an instrument

None

Less than 30 minutes

30 minutes – 1 hour

1-3 hours

More than 3 hours







5. For each activity listed below, think about whether you usually do that activity each day. If you don’t do the activity each day, check “Don’t do.” If you usually do the activity, then check the box that best fits how often you usually spend doing that activity each day.

USUALLY…

Activity







Watch TV, videos

Don’t do

Less than 30 minutes

30 minutes – 1 hour

1-3 hours

More than 3 hours

Play

computer games, video games

Don’t do

Less than 30 minutes

30 minutes – 1 hour

1-3 hours

More than 3 hours

Play board games

Don’t do

Less than 30 minutes

30 minutes – 1 hour

1-3 hours

More than 3 hours

Do

homework, reading

Don’t do

Less than 30 minutes

30 minutes – 1 hour

1-3 hours

More than 3 hours

Talk on the phone, hang out with friends

Don’t do

Less than 30 minutes

30 minutes – 1 hour

1-3 hours

More than 3 hours

Listen to music,

play an instrument

Don’t do

Less than 30 minutes

30 minutes – 1 hour

1-3 hours

More than 3 hours



6. Are there other indoor activities that you usually do? ______________________________


______________________________________________________________________________


______________________________________________________________________________




7. Think about places for recreation, sports, and outdoor activities you have used. During the past 7 days, how many days did you do an activity or sports at these locations? Circle the days you went to this place. For example, if you played at the park Sunday and Monday, circle “Sunday” and “Monday.” If you went every day, circle all of the days. If you didn’t go to a place, circle 0 (zero).



Number of Days

School grounds

0

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

School field trip


0

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Field trip, but not related to school

0

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Public recreation center

0

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Park or playground

0

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

YMCA/YWCA, Boys and Girls Club

0

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Neighborhood street near my house

0

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Other location, describe: _____________

0

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday










8. Below is a list of things that people believe may happen in the woods. Imagine that you are taking a walk or hike in a wooded area nearby. Using the boxes below, circle a number between 0 and 4 to tell how much of a chance you think there is that each situation might happen to you.

Situation

No chance

A little chance

Good chance

Very good chance

Extremely

good chance

Seeing a snake

0

1

2

3

4

Stepping on a snake

0

1

2

3

4

Being bitten by a spider

0

1

2

3

4

A spider falling on me

0

1

2

3

4

Getting lost

0

1

2

3

4

Getting separated from my friends

0

1

2

3

4

Getting chased by bees

0

1

2

3

4

Getting stung by bees

0

1

2

3

4

Seeing a frog

0

1

2

3

4

Being attacked by bears or other wild animals

0

1

2

3

4



9. Like before, imagine that you are taking a walk or a hike in a wooded area nearby. This time tell how scary each situation might be if it actually happened to you.


Situation

Not scary

A little scary

Somewhat scary

Very scary

Extremely

scary

Seeing a snake

0

1

2

3

4

Stepping on a snake

0

1

2

3

4

Being bitten by a spider

0

1

2

3

4

A spider falling on me

0

1

2

3

4

Getting lost

0

1

2

3

4

Getting separated from my friends

0

1

2

3

4

Getting chased by bees

0

1

2

3

4

Getting stung by bees

0

1

2

3

4

Seeing a frog

0

1

2

3

4

Being attacked by bears or other wild animals

0

1

2

3

4





10. The following questions ask about your neighborhood. Tell me how much each statement describes the area where you live.


Not at all

A little bit

Some

Quite a bit

A lot

There are stores and shops to buy things


0


1


2


3


4

There is a bus stop close to my house or apartment


0


1


2


3


4

There are sidewalks on most of the streets


0


1


2


3


4

There are places to ride bikes, such as sidewalks or bike paths


0


1


2


3


4

Traffic in my neighborhood makes it hard to walk or ride a bike


0


1


2


3


4

My neighborhood has parks and playgrounds


0


1


2


3


4

There are safe places to hang out with friends


0


1


2


3


4

Gangs are a big problem in my neighborhood


0


1


2


3


4

You see lots of people being active doing things like walking, running, or playing sports


0


1


2


3


4

There are trees along the streets in my neighborhood


0


1


2


3


4




11. Look at the list of parks and places below. Circle the number to show whether you have ever heard of the parks. Also, tell whether you have ever been to the parks for recreation, ridden your bike, played sports, or exercised.



Have you heard of…

Yes, I’ve heard of This

No, I have not heard of This

Not sure

Towpath Trail

0

1

2

Mustill Store


0

1

2

Indigo Lake


0

1

2

Sand Run MetroPark


0

1

2

Virginia Kendall Park


0

1

2

Cuyahoga Valley Scenic Railroad

0

1

2

Cuyahoga Valley National Park

0

1

2



Have you been to…

Yes, I’ve been to this place

No, I have not been to this place

Not Sure

Towpath Trail

0

1

2

Mustill Store


0

1

2

Indigo Lake


0

1

2

Sand Run MetroPark


0

1

2

Virginia Kendall Park


0

1

2

Cuyahoga Valley Scenic Railroad

0

1

2

Cuyahoga Valley National Park

0

1

2




12. The following questions ask you to think about things you might do next school year and when you are an adult.



Definitely will not

Probably will not

About a 50/50 chance

Probably will

Definitely will

How likely is it that you will do regular outdoor physical activity next year?


0


1


2


3


4

How likely is it that you will do regular outdoor physical activity when you are an adult?


0


1


2


3


4

How likely is it that you will visit a national park next year?


0


1


2


3


4

How likely is it that you will visit a national park when you are an adult?


0


1


2


3


4

How likely is it that you will walk or ride a bike on a wooded trail by yourself next year?


0


1


2


3


4

How likely is it that you will walk or ride a bike on a wooded trail with friends next year?


0


1


2


3


4


13. Have you heard of “Get Up, Get Out, & Go!” (Check one answer)


Yes, I’ve heard of this

No, I have not heard of this

Not sure



14. (If YES, Did you attend any “Get Up, Get Out, & Go!” activities at the Cuyahoga Valley National Park last summer? (Check one answer)



No, I didn’t attend any activities

Yes, I attended some activities

Yes, I attended all the activities

Not sure



The last questions are about you.



15. I am (Check one): MALE FEMALE



16. What grade are in you in (Check one): 7th 8th



17. When were you born? Month_____________ Year___________________


Thank You for Completing the Survey!


PRIVACY ACT and PAPERWORK REDUCTION ACT statement:

16 U.S.C. 1a-7 authorizes collection of this information. This information will be used by park managers to better serve the public. Response to this request is voluntary. No action may be taken against you for refusing to supply the information requested. Your name is requested for follow-up mailing purposes only. When analysis of the questionnaire is completed, all name and address files will be destroyed. Thus the permanent data will be anonymous. Please do not put your name or that of any member of your group on the questionnaire. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.


Person collecting and analyzing information: Myron Floyd, Ph.D., Dept. of Parks, Recreation and Tourism Management, College of Natural Resources, Box 8004, Biltmore Hall, Raleigh, NC 27695-8004, (919) 513-8026.


Burden estimate statement: Public reporting burden for this form is estimated to average 20 minutes per response. Direct comments regarding the burden estimate or any other aspect of this form to: Mary Pat Doorley, Cuyahoga Valley National Park, 15610 Vaughn Road, Brecksville, OH, 44141, phone (440) 546-5995.


File Typeapplication/msword
File TitleFor each activity listed below, think about whether you did that activity yesterday and check the correct box
AuthorTimia D. Thompson
Last Modified ByMegan McBride
File Modified2007-05-08
File Created2007-05-03

© 2024 OMB.report | Privacy Policy