Physical Activity Study - Active Living Research



Physical Activity StudyParks and Recreation Areas: INSERT COMMUNITY NAME Dr. Sandy Slater, University of Illinois at Chicago 8/21/2012Thank you for answering these questions! This is not a test, or homework, or for a grade. There are no right or wrong answers, we just want to know what you think!Thanks again!<NAME> <INSERT PHOTO> Park/School/Facility<INSERT PHOTO> Park/School/Facility<NAME> Place 1. Which of the parks or recreation areas below do you go to most often? Please make a check mark () in one box to show which park or recreation area you go to most often. Remember, please choose only one answer. <INSERT PHOTO> Park/School/Facility<NAME> <INSERT PHOTO> Park/School/FacilityOther_________________ Write name here<NAME> A. How often do you usually visit this place?Please fill in the circle under your answer.Less than once per month About once a month A few times per monthAbout once a weekA few times a weekEvery DayB. When you visit this place, how long do you usually stay? Please fill in the circle under your answer.Less than 1 hourBetween 1 and 2 hoursBetween 2 and 3 hoursMore than 3 hoursC. Why do you usually visit this place?Put a check mark () in up to 3 boxes.To go to a camp/afterschool programTo attend a class (like dance, karate, boxing, swimming lessons, etc).To go swimmingTo play sports (soccer, volleyball, basketball, baseball, etc).To hang out and talk with friends or familyTo walk a dogTo exerciseTo walk through on the way to somewhere elseTo play on the playground equipmentTo have a picnicTo playTo relax or readTo go to a market, festival, party, etcOther_______________________________D. What does this place have to do for fun? For this section, Good/OK condition means that something is generally safe and works well. For example, tennis courts that are in good/ok condition might have a few cracks in the ground, but overall the court is smooth and safe to use. Tennis courts that are in poor or bad condition might have large cracks or broken and unusable nets. For each item, please make a check mark () in the correct box.Not at this placeGood or OK conditionPoor or bad conditionDon’t KnowPlayground EquipmentThere is no playground equipment at this placePlayground equipment is in good or OK conditionPlayground equipmentis in poor or bad conditionDon’t knowBaseball DiamondThere is no baseball diamond at this placeBaseball diamond is in good or OK conditionBaseball diamondis in poor or bad conditionDon’t knowOpen Grassy AreasThere is no open grassy area at this placeOpen grassy area is in good or OK conditionOpen grassy areais in poor or bad conditionDon’t KnowTennis CourtsThere are no tennis courts at this placeTennis courts are in good or OK conditionTennis courtsare in poor or bad conditionDon’t knowVolleyball CourtsThere are no volleyball courts at this placeVolleyball courts are in good or OK conditionVolleyball courtsare in poor or bad conditionDon’t knowBasketball CourtsThere are no basketball courts at this placeBasketball court is in good or OK conditionThe basketball courtis in poor or bad conditionDon’t knowSoccer Fields with GoalsThere are no soccer fields with goals at this placeSoccer field with goal is in good or OK conditionSoccer field with goal is in poor or bad conditionDon’t knowPaths/TrailsThere are nopaths/trails at this placePaths/trails are in good or OK conditionThe paths/trailsare in poor or bad conditionDon’t KnowD.(Continued) What does this place have to do for fun? For this section Good/OK condition means that something is generally safe and works well. For example, tennis courts that are in good/ok condition might have a few cracks in the ground, but overall the court is smooth and safe to use. Tennis courts that are in poor or bad condition might have large cracks or broken and unusable nets. For each item, please make a check mark () in the correct box.Not at this placeGood or OK conditionPoor or bad conditionDon’t KnowSkate Park (Ramps, ledges, pipes, or banks)There is no skate park (ramps, ledges, pipes, or banks) at this placeThe skate park (ramps, ledges, pipes, or banks) is in good or OK conditionThe skate park (ramps, ledges, pipes, or banks)is in poor or bad conditionDon’t knowFootball FieldsThere is no football field at this placeThe football field is in good or OK conditionThe football fieldis in poor or bad conditionDon’t knowWater PlaygroundThere is no water playground at this placeThe water playground is in good or OK conditionThe water playgroundis in poor or bad conditionDon’t KnowIndoor gymnasium There is no indoor gymnasium at this placeThe indoor gymnasium is in good or OK conditionThe indoor gymnasiumis in poor or bad conditionDon’t knowOutdoor or IndoorSwimming PoolThere is no outdoor or indoor swimming pool at this placeThe swimming pool is in good or OK conditionThe swimming poolis in poor or bad conditionDon’t Know14. Lake or pond where swimming is allowedThere is lake or pond where swimming is allowed at this placeThe lake or pond where swimming is allowed is in good or OK conditionThe lake or pond where swimming is allowedis in poor or bad conditionDon’t knowE. What other things are at this place? Please make a check mark () in the correct box for each listed item.For this question Good/OK condition means that something is generally safe and works well. For example, drinking fountains that are in good/ok condition have clean water, few leaks, and good water pressure. Drinking fountains that are in poor or bad condition may be broken, leaking, or have dirty water. Not at this placeGood or OK conditionPoor or bad conditionDon’t KnowRestrooms There are no restrooms at this placeRestrooms are in good or OK conditionRestrooms are in poor or bad conditionDon’t knowDrinking FountainsThere are no drinking fountains at this placeDrinking fountain is in good or OK conditionDrinking fountain is in poor or bad conditionDon’t KnowShelter/ShadeThere is no shelter/shade at this placeShelter/shade is in good or OK conditionShelter/shade is in poor or bad conditionDon’t KnowPicnic Facilities (tables, etc)There are no picnic facilities (tables, etc)Picnic facilities (tables, etc) are in good or OK conditionPicnic facilities (tables, etc) are in good or OK conditionDon’t KnowParking lotThere is no parking lot at this placeParking lot is in good or OK conditionParking lot is in poor or bad conditionDon’t KnowBike racks There are no bike racks at this placeBike racks are in good or OK conditionBike racks are in poor or bad conditionDon’t KnowF. What kinds of programs are at this place? For each question, please make a check mark () in the correct box.Not at this placeYes, at this place.I don’t knowDoes this place have classes, like dance, karate, boxing, swimming lessons, etc.?No, this place does not have classes like dance, karate, boxing, swimming lessons, etc. Yes, there are classes like karate, boxing, swimming lessons, etc at this place.I don’t know if there are classes like karate, boxing, swimming lessons, etc. at this place.Does this place have day camp or after school programs?No, this place does not have day camp or after school programs. Yes, this place does have day camp or after school programs.I don’t know if this place has day camp or after school programs.Do the programs at this place cost too much? No, the programs at this place do NOT cost too much. They are NOT too expensive.Yes, the programs at this place cost too much. They are too expensive.I don’t know if the programs at this place are cost too much.G. How Does this Place Look? Please make a check mark () in the correct box for each listed item.This place has enough lighting at nightYesNoThere is broken glass in this placeYesNoThere is spray paint, graffiti, or tagging in this placeYesNoThere is litter in this placeYesNoH. How Safe is this place? Please make a check mark () in the correct box for each listed item.I feel safe hereAgreeDisagreeOn my way to and from this place, I feel safe walking, riding my bike, or skatingAgreeDisagreeThere are mean or threatening people in or at this placeAgreeDisagreeThere are often gang members at this placeAgreeDisagreeThere are often gang members in the areaAgreeDisagreeThis place needs more parents or other adults to make me feel safeAgreeDisagreeI get bullied, teased, harassed hereAgreeDisagreeI. What improvements would you like to see at this place? Please list up to 3. Please be specific. 1. 2.3.Place 2 Which of the parks or recreation areas below do you go to the 2nd most often? Please make a check mark () in one box to show which park or recreation area you go to the 2nd most often. Please remember to choose only one answer. <INSERT PHOTO> Park/School/Facility<INSERT PHOTO> Park/School/Facility<INSERT PHOTO> Park/School/Facility<INSERT PHOTO> Park/School/Facility<NAME> <NAME> <NAME> Other_________________ Write name here<NAME> Place 2Please think about Place 2, the park or place you go to the 2nd most often, from page 10, as you answer these questions. A. How often do you usually visit this place?Please fill in the circle under your answer.Less than once a month About once a monthA few times per monthAbout once a weekA few times a weekEvery DayB. When you visit this place, how long do you usually stay? Please fill in the circle under your answer.Less than 1 hourBetween 1 and 2 hoursBetween 2 and 3 hoursMore than 3 hoursC. Why do you usually visit this place?Put a check mark () in up to 3 boxes.To go to a camp/afterschool programTo attend a class (like dance, karate, boxing, swimming lessons, etc).To go swimmingTo play sports (soccer, volleyball, basketball, baseball, etc).To hang out and talk with friends or familyTo walk a dogTo exerciseTo walk through on the way to somewhere elseTo play on the playground equipmentTo have a picnicTo playTo relax or readTo go to a market, festival, party, etcOther_______________________________D. What does this place have to do for fun? For this question, Good/OK condition means that something is generally safe and works well. For example, tennis courts that are in good/ok condition might have a few cracks in the ground, but overall the court is smooth and safe to use. Tennis courts that are in poor or bad condition might have large cracks or broken and unusable nets. Please make a check mark () in the correct box for each listed item.Not at this placeGood or OK conditionPoor or bad conditionDon’t KnowPlayground EquipmentThere is no playground equipment at this placePlayground equipment is in good or OK conditionPlayground equipmentis in poor or bad conditionDon’t KnowBaseball DiamondThere is no baseball diamond at this placeBaseball diamond is in good or OK conditionBaseball diamondis in poor or bad conditionDon’t KnowOpen Grassy AreasThere is no open grassy area at this placeOpen grassy area is in good or OK conditionOpen grassy areais in poor or bad conditionDon’t KnowTennis CourtsThere are no tennis courts at this placeTennis courts are in good or OK conditionTennis courtsare in poor or bad conditionDon’t KnowVolleyball CourtsThere are no volleyball courts at this placeVolleyball courts are in good or OK conditionVolleyball courtsare in poor or bad conditionDon’t KnowBasketball CourtsThere are no basketball courts at this placeBasketball court is in good or OK conditionThe basketball courtis in poor or bad conditionDon’t KnowSoccer Fields with GoalsThere are no soccer fields with goals at this placeSoccer field with goal is in good or OK conditionSoccer field with goal is in poor or bad conditionDon’t KnowPaths/TrailsThere are nopaths/trails at this placePaths/trails are in good or OK conditionThe paths/trailsare in poor or bad conditionDon’t KnowD.(Continued) What does this place have to do for fun? For this question Good/OK condition means that something is generally safe and works well. For example, tennis courts that are in good/ok condition might have a few cracks in the ground, but overall the court is smooth and safe to use. Tennis courts that are in poor or bad condition might have large cracks or broken and unusable nets. Please make a check mark () in the correct box for each listed item.Not at this placeGood or OK conditionPoor or bad conditionDon’t KnowSkate Park (Ramps, ledges, pipes, or banks)There is no skate park (ramps, ledges, pipes, or banks) at this placeThe skate park (ramps, ledges, pipes, or banks) is in good or OK conditionThe skate park (ramps, ledges, pipes, or banks)is in poor or bad conditionDon’t KnowFootball FieldsThere is no football field at this placeThe football field is in good or OK conditionThe football fieldis in poor or bad conditionDon’t KnowWater PlaygroundThere is no water playground at this placeThe water playground is in good or OK conditionThe water playgroundis in poor or bad conditionDon’t KnowIndoor gymnasium There is no indoor gymnasium at this placeThe indoor gymnasium is in good or OK conditionThe indoor gymnasiumis in poor or bad conditionDon’t KnowOutdoor or IndoorSwimming PoolThere is no outdoor or indoor swimming pool at this placeThe swimming pool is in good or OK conditionThe swimming poolis in poor or bad conditionDon’t Know14. Lake or pond where swimming is allowedThere is lake or pond where swimming is allowed at this placeThe lake or pond where swimming is allowed is in good or OK conditionThe lake or pond where swimming is allowedis in poor or bad conditionDon’t knowE. What other things are at this place? For this question Good/OK condition means that something is generally safe and works well. For example, tennis courts that are in good/ok condition might have a few cracks in the ground, but overall the court is smooth and safe to use. Tennis courts that are in poor or bad condition might have large cracks or broken and unusable nets. Please make a check mark () in the correct box for each listed item.Not at this placeGood or OK conditionPoor or bad conditionDon’t KnowRestrooms There are no restrooms at this placeRestrooms are in good or OK conditionRestrooms are inpoor or bad conditionDon’t KnowDrinking FountainsThere are no drinking fountains at this placeDrinking fountain is in good or OK conditionDrinking fountainis in poor or bad conditionDon’t KnowShelter/ ShadeThere is no shelter/ shade at this placeShelter/shade is in good or OK conditionShelter/shade is in poor or bad condition Don’t KnowPicnic Facilities (tables, etc)There are no picnic facilities (tables, etc)Picnic facilities (tables, etc) are in good or OK conditionPicnic facilities (tables, etc) are in poor or bad conditionDon’t KnowParking lotThere is no parking lot at this placeParking lot is in good or OK conditionParking lotis in poor or bad condition Don’t KnowBike racks There are no bike racks at this placeBike racks are in good or OK conditionBike racks are in poor or bad conditionDon’t KnowF. What kinds of programs are at this place? For each question, please make a check mark () in the correct box.Not at this placeYes, at this place.I don’t knowDoes this place have classes, like dance, karate, boxing, swimming lessons, etc.?No, this place does not have classes like dance, karate, boxing, swimming lessons, etc. Yes, there are classes like karate, boxing, swimming lessons, etc at this place.I don’t know if there are classes like karate, boxing, swimming lessons, etc. at this place.Does this place have day camp or after school programs?No, this place does not have day camp or after school programs. Yes, this place does have day camp or after school programs.I don’t know if this place has day camp or after school programs.Do the programs at this place cost too much? No, the programs at this place do NOT cost too much. They are NOT too expensive.Yes, the programs at this place cost too much. They are too expensive.I don’t know if the programs at this place are cost too much.G. How Does this Place Look? Please make a check mark () in the correct box for each listed item.This place has enough lighting at nightYesNoThere is broken glass in this placeYesNoThere is spray paint, graffiti, or tagging in this placeYesNoThere is litter in this placeYesNoH. How Safe is this place? Please make a check mark () in the correct box for each listed item.I feel safe hereAgreeDisagreeOn my way to and from this place, I feel safe walking, riding my bike, or skatingAgreeDisagreeThere are mean or threatening people in or at this placeAgreeDisagreeThere are often gang members at this placeAgreeDisagreeThere are often gang members in the areaAgreeDisagreeThis place needs more parents or other adults to make me feel safeAgreeDisagreeI get bullied, teased, harassed hereAgreeDisagreeI. What improvements would you like to see at this place? Please list up to 3. Please be specific. 1.2.3. ................
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