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 Type | application/msword |
File Title | For each activity listed below, think about whether you did that activity yesterday and check the correct box |
Author | Timia D. Thompson |
Last Modified By | Megan McBride |
File Modified | 2007-05-08 |
File Created | 2007-05-03 |