Form 5 Adolescent Physical Activity Survey Instrument (Attachme

The Family Life, Activity, Sun, Health, and Eating Study (NCI)

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0925-0686 can be found here:

Document [docx]

Download: docx | pdf

ATTACHMENT I:

Adolescent Physical Activity Survey Instrument

(includes demographics)

Those who answer ‘no’ to “Are you currently in school?” receive the following question series and then are routed to Section 2.

Those who answered ‘yes’ to “Are you currently in school?” (the last question on page 3 of this document) receive this question:

The questions for students in elementary school versus middle school and high school follow. Everyone resumes the same question series at Section 2.

Elementary School Student Series:

Middle and High School student series:

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	Katy Caperna
File Modified	0000-00-00
File Created	2021-01-28