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Table 1 Questions about physical activity, self-rated health, and medical history for the year 2007, BRFSS, United States

From: Physical activity and optimal self-rated health of adults with and without diabetes

Item Survey Questions
Physical activity  
  Moderate activity
  (1) When you are not working, in a usual week, do you do moderate activities for at least 10 minutes at a time, such as brisk walking, bicycling, vacuuming, gardening, or anything else that causes some increase in breathing or heart rate?
  (2) How many days per week do you do these moderate activities for at least 10 minutes at a time?
  (3) On days when you do moderate activities for at least 10 minutes at a time, how much total time per day do you spend doing these activities?
  Vigorous activity
  (1) When you are not working, in a usual week, do you do vigorous activities for at least 10 minutes at a time, such as running, aerobics, heavy yard work, or anything else that causes large increases in breathing or heart rate?
  (2) How many days per week do you do these vigorous activities for at least 10 minutes at a time?
  (3) On days when you do vigorous activities for at least 10 minutes at a time, how much total time per day do you spend doing these activities?
Self-rated health  
  Would you say that in general your health is excellent, very good, good, fair, or poor?
Medical history  
  Diabetes
  (1) Have you ever been told by a doctor that you have diabetes?
  (2) How old were you when you were told you have diabetes?
  (3) Are you now taking insulin?
  Cardiovascular diseases
  Have you ever been told by a doctor, nurse, or other health professional that you have had:
  (1) a heart attack, also called a myocardial infarction;
  (2) angina or coronary heart disease;
  (3) a stroke?
  Arthritis
  Have you ever been told by a doctor or other health professional that you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?
  Disability
  (1) Are you limited in any way in any activities because of physical, mental, or emotional problems?
  (2) Do you now have any health problem that requires you to use special equipment, such as a cane, a wheelchair, a special bed, or a special telephone?