PURPOSEI.

.-

The purpose of the self administered physical activity interview checklist (SAP AC) isto collect information from students about their physical activities and selectedsedentary activities occurring during the previous school day.

ll. STUDY SAMPLE AND ADMINISTRA nON

All grade 5 students enrolled in a CATCH school during the Spring 1994 follow-upadministration are eligible to participate in SAP AC. The SAP AC will be administeredin the classroom by a trained CATCH measurement staff person. The day before theadministration of SAP AC should have been a normal (no other CATCH measurements)school day.

ill. AD~TRA nON PROTOCOL

A.

STAFFING NEEDS

1.

2.

Two CATCH measurement staff (one to serve as administrator, the otherto assist)If there are Spanish-only speaking students in the class, there must be abilingual instructor present.

B. EQUIPMENT:

1.2.3.

4.5.

6.

7.

SAP AC ProtocolSAPAC formspencils (one per student plus extras)overhead projectortransparencies (clock and 15, 30, 60 minute paper pieces, pages 1 & 2 of

SAPAC)pen for overhead projectorposter of N-S-M (None -Some -Most)

CATCH SeIf-Ad~tcrcd Physical Activity Chcc~t (SAP Aq Protoool- Version 9{30/93-Page 1

c.

PREPARAnON:

12.3.4.

5.

6.

7.8.

9.

10.

Contact school 1-2 days prior to administration to confirm schedule withoffice and teachers.Check with school to determine availability of an overhead projector.Check in at the school office and locate the classrooms.Introduce yourself to the classroom teacher.Get previous day's schedule from all 5th grade teachers (school start,end, recess, FE, lunch).Set up overhead project and poster of N-S-M.Introduce yourself and other staff to students.Make sure all students have pencils and are in a good position to see theoverhead and hear instructions.Tell students that you will be asking questions about things they didyesterday.Distribute SAP AC forms to students.

NOTE:

Instructions to be read aloud to the students are in bold type. Instructions forthe CATCH staff administrators are in plain type.

D.

INSTRUCTIONS TO CLASS:

Introductory Dialogue to Students:

GOOD MORNING (TEACHER'S NAME), BOYSANDGlRLS. MY NAME IS (NAME). IAM THE (JOB TITLE) OF THE CATCH PROJECT AND THE INSTRUCTOR OF TODAY'SCLASS. MY ASSISTANT'S NAME IS (NAME). THANK YOU FOR PARTICIPATING INTHIS PROJECT TODAY. WE'RE HERE TO HELP YOU FlU OUT A SPECIAL FORM.

To TELL US ABOUT THE PHYSICAL ACTIVITY THAT YOU DID YESTERDAY, YOU HA VEA CHECKLIST OF ACTIVITIES TO HELP YOU REMEMBER. LET'S START BY

COMPLETING PAGE ONE OF THE FORM.

CATCH Self-Administered Physical Activity Chccklist (SAP Aq Protorol -Version 9/30f.13-Page 2

COMPLETION OF PAGE 1 OF SAPAC FORM:

1.

Section A, Items Ai -AS, should be completed by the CATCH Administratorprior to questionnaire administration.

Items A6 -A9 should be read aloud by the CATCH Administrator andcompleted by the students

(Use a blank form on an overhead projector to lead students.)

a.

b.

c.

d.

Dm YOU PARDClPATE IN PHYSICAL EDUCADON CLASS~AY? CIRCLE "I" FORNO OR "2" FOR~.IF YOU CIRCLED ~, HOW MANY MINUIm LONG WAS PHYSICALEDUCADON CLASS? (Use the schedule information obtained fromthe teacher to assist children in completing this question.)Dm YOU PARDClPATE IN RE~ YFSrERDAY? CIRCLE "I" FORNO AND "2" FOR~.IF YOU CIRCLED ~ HOW MANY MINUIm OF RE~S Dm YOUHAVE? IF YOU HAD MORE THAN ONE RE~S PERIOD, US!' THEMSEPARATELY. (Use the schedule information obtained from theteacher to assist children in completing this question.)

INSTRUCnONS FOR PAGE 2 OF mE FORM; RECORDINGPHYSICAL ACTIVITIES, DURA nON AND INTENSITY

2.

DEFINING PHYSICAL ACTIVITY

A.

ONE THING WE WANT TO LEARN IN CATCH IS THE AMOUNT AND TYPE OFPHYSICAL ACTIVITY FIFTH GRADERS DO IN A DAY. TODAY WE'RE GOING TO TALK

ABOUT THE PHYSICAL ACTIVITY THAT YOU DID YESTERDAY. WHAT DAY WAS

YESTERDAY?

PHYSICAL ACTIVITY IS BODILY MOVEMENT SUCH AS WHEN YOU MOVE YOUR ARMS

AND LEGS. You DO SOME PHYSICAL ACTIVITIES TO MOVE FROM PLACE TO PLACE,UKE RUNNING OR WALKING. WHAT ARE SOME OTHER PHYSICAL ACTIVITIES UKE

THAT? SOME PHYSICAL ACTIVITIES YOU DO IN ONE PLACE, UKE JUMPING JACKSOR SIT UPS. CAN YOU TELL ME ANY OTHER PHYSICAL ACTIVITIES THAT YOU CAN DO

IN ONE PLACE?

CATai Self-AdlniDmtercd Physical Activity Cbec~t (SAP Aq Protoool- Version 9{30/93-Page 3

B. TIME ESTIMATION (USE CWCK TRANSPARENCY)

WE'RE GOING TO ASK YOU HOW LONG YOU Dm PHYSICAL ACI1VITYYFSfERDA Y. THE CLOCK Wll..L HELP YOU TELL US. THIs WHOLE CLOCK IS 60~. WHAT LASI'S 60~? THIs IS 30~. WHAT LASl'S 30~? THIs IS 15 MINurFS. WHAT LASfS 15~? THIS IS 5~.

WE WANT YOU TO TELL US THE PHYSICAL A~ THAT YOU DmYFSfERDA Y FOR 5 MINurFS OR MORE. LET's SEE IF WE HAVE AN mEA OFWHAT LASl'S FOR 5 MINurFS OR MORE.

COMMERCIAL (MORE OR ~ THAN 5 ~?)BRUSH TEEm (MORE OR ~ THAN 5 ~?)RE~ (MORE OR ~ THAN 5 ~?)EATING LUNCH (MORE OR LESS THAN 5 ~?)

You MAY DO A PHYSICAL AcrIVrrY FOR 5, 10, 20 OR MORE mAN 60 ~.

c.

ACTUAL TIME ACTIVE

SOME'mOO DURING GAMES OR PHYSICAL AC'fIVITIES YOU MAY sfoP AND DOSOME-riliNG ElSE, LIKE RESTING OR W AlTING IN LINE. WE WANT TO KNOWABOUT THE TIME YOU WERE AC1UALLY AC11VE. WE WANT YOU TO WRlTEDOWN HOW MUCH TIME YOU WERE AC1UALL Y DOING AN ACI'IVITY. SO, IF YOUPLAYED BASKETBALL FOR 60 MINUTES, BUT YOU RESTED FOR 10 MINUTES,HOW MANY MINUTES Dm YOU AC1UALLY PLAY? (Answer is 50 minutes.)

D.

CHECKLIST OF ACTIVITIES

Now 1URN TO THE SECOND PAGE, Bur 00 NOT WRITE ANYTHING YET. THIs ISA usr OF DIFFERENT TYPES OF PHYSICAL AC11VITY, AND I AM GOING TO ASK

YOU ABour \\'~THER YOU Dm ANY OF THEM BEFORE SCHOOL, DURINGSCHOOL, AND AFTER SCHOOL YESTERDAY.

FOR EACH AC'TIVlTY, YOU Wll.L WRITE THE NUMBER OF MINUfES YOU WEREACTUALLY DOING THE AC'TIVlTY, BUT ONLY IF YOU Dm THE ACTIVITY FOR 5MINUfES OR MORE. (Demonstrate on the overhead recording 10 minutes of

bicycling before school.)

NONE -SOME -MOST (N-S-M)

IN ADDmON, FOR EACH ACI'IVITY YOU Dm ~AY, WE WANT TO KNOWW~l'~ IT MADE YOU BREATHE HARD OR FEEL TIRED, NONE, SOME, ORMOST OF THE TIME. You Wn.L PUT AN N FOR NONE, S FOR SOME, OR M FORMOST OF THE TIME IN THE BOX NEXT TO THE NUMBER OF MINUl'ES.

(Demonstrate putting S next to the 10 minutes of bicycling.)

CATCH Self-Ad~tcrcd Physical Activity Checklist (SAP AC) Protocol -V crsion 9/JOfJ3-Page 4

PROBABLY NO ONE Dm ALL THESE A~ ~A Y, AND IT'S OK IFYOU Dm NOT DO ANY OF THEM. FOR EVERY ACI1V1TY YOU DO NOT DOYFSrERDAY, OR Dm FOR ~ mAN 5 ~, PUr A ZERO IN THE BOX.(Demonstrate putting a zero for swimming laps before school.)

Do NOT COUNT THE SAME ACI'lVITY IN TWO DIFFERENr PLA~. FOREXAMPLE, IF YOU WERE RUNNING WHn.E PLAYING SOCCER FOR 20 MINUIm,YOU WOULD Pur 20 NEXT TO SOCCER. Do NOT LIST mAT SAME 20 MIN(n'ESAGAIN NEXT TO RUNNING.

REMEMBER, THERE ARE NO RIGHT OR WRONG ANSWERS. WE JUST WANT TOKNOW WHAT PHYSICAL A~ YOU ACI'UALLY Dill YESfERDA Y. IT ISIMPORTANT TO BE VERY HO~.

Do NOT WOK AT THE PAPERS OF PEOPLE SlTI'lNG AROUND yOU. Do NOTWORRY IF SOMEONE WOKS AT YOUR PAPER.

IF YOU HAVE A QUES'"nON, IF YOU NEED HELP, OR IF YOU GET BEHIND, 00 NOTSAY ANYTHING. RAISE YOUR HAND AND SOMEONE Wll.L HELP YOU.

Do

YOU HAVE ANY QUE5110NS?

PICK UP YOUR PENCll.s AND GET READY TO START.

E. COMPLETING THE SAPAC FORM

WE'RE GOING TO GO THROUGH THIS LIST OF ACTIVITIES THREE DIFFERENfTIMES. WE WANT YOU TO THINK ABO1:rr WHAT YOU Dm YESTERDAY. WE'LLDIVIDE THE DAY INTO THREE PARTS; BEFORE SCHOOL, DURING SCHOOL AND

AFTER SCHOOL. PLEASE LISTEN TO INSTRUC'I10NS AND 00 NOT WORK AHEAD.

1.

BEFORE SCHOOL

THINK ABour BEFORE SCHOOL YESfERDA Y. THIs IS THE TIME FROM WHEN

YOU WOKE UP UNIn., THE BELL RANG FOR SCHOOL TO START. IT INCLUD~ ANYBEFORE SCHOOL PROGRAM IN WHICH YOU PAR'nCIPATE. WHAT nm YOU DOBEFORE SCHOOL? Dm YOU DO ANYfHING sPECIAL? How nm YOU GET TO

SCHOOL? THINK ABOUT THE PHYSICAL AC11VITIES YOU nm FOR 5 ~ ORMORE YESfERDA Y BEFORE SCHOOL. Now WE Wll..L GO DOWN THE LISf OFA~ FOR BEFORE SCHOOL TOGETHER.

Go through the checklist from top to bottom. Read the number of each activityto help students follow along. Periodically remind them to put a zero if theydid not do the activity. For the first couple of activities and the first activity ineach block, use the complete prompts:

FOR S MINUfES OR MORE YESrERDA Ya. Dm YOU DOBEFORE SCHOOL?

CATCH SeIf-AdmiUtered Physical Activity Checklist (SAP AC) Protocol- Version 9130193-Page 5

IF YOU Dm, WRlTE THE NUMBER OF MINmm AND A LE n .~ (N,S OR M), IF YOU WERE BREA1HING HARD OR FELT TIRED FORNONE, SOME OR MOsr OF THE TIME.

b.

?".After a couple of activities, just say "Dm YOU.c.

Before asking about "mixed walking and running", explain the following:

WE WALK AND RUN MANY ~ DURING THE DAY. You MIGHT DO THIS IN AGAME OR TO GEl SOMEWHERE. MOST OF THOSE ~ ARE ~ THAN 5~, SO YOU Wll..L NOT WRITE mOSE DOWN.

SOMETIMFS WE DO A MIXruRE OF WALKING AND RUNNING, SO WE WALK A

LITTLE AND RUN A LITTLE.

Dm YOU DO 5 ~ OR MORE OF ~ WALKING AND RUNNING BEFORESCHOOL YESTERDAY?

IF YOU Dm, WRITE THE NUMBER OF MINUTFS AND W~l.~ YOU BREATHED

HARD OR FELT TIRED NONE, SOME, OR MOST OF THE TIME.

Before asking about "walking", explain the following:

THINK ABOUT ~ WHEN YOU MIGHT HAVE WALKED S MINUTES OR MORE ATONE TIME BEFORE SCHOOL YFSI'ERDA Y. Dm YOU TAKE A WALK, WALK TO

SCHOOL, OR WALK YOUR DOG?

Before asking about "Running", explain the following:

Dm YOU RUN 5 ~ OR MORE AT ONE TIME YESTERDAY BEFORE SCHOOL

STARTED?

Explain about "Other":

Ask about physical activity classes, lessons, teams before school. Ask if theydid any other physical activities before school yesterday that were not on thelist. Ask them to write the name of the class or lesson, the number of minutes,

and none, some or most.

Demonstrate with overhead how to list something in "other". Include name ofactivity, number of minutes, and the letter N, S or M

DURING SCHOOL2.

Now WE ARE GOING TO TALK ABour PHYSICAL Acn~ YOU DmDURING SCHOOL YFSI'ERDA Y. DURING SCHOOL MEANS B~ THEMORNING BELL AND THE LAST AFTERNOON BELL. TIDNK ABour WHAT

CATai Se1f-Ad~tered Physical Activity Chcc~t (SAP Aq ProtoaJl- Version 9/30/93-Page 6

YOU Dm IN SCHOOL YESrERDA Y. Dm YOU DO ANY SPECIAL ACrIVlTIES?THINK ABOUT PE, RE~, AND AFTER. LUNCH. Now WE Wn..L GODOWN THE LISf OF A~ FOR DURING SCHOOL TOG)!;l~.

Go through the checklist from top to bottom. Read the number of eachactivity to help them follow along. Periodically remind them to put azero if they did not do the activity. For the first couple of activities usethe complete prompts:

FOR 5 ~ OR MORE YESTERDAYa. Dm YOU DODURING SCHOOL?

b. IF YOU nm, WRITE THE NUMBER OF MINUTFS AND A LEl'l'EK (N-S-M) IF YOU WERE BREATHING HARD OR FELT TIRED FOR NONE,

SOME OR MOST OF THE TIME.

?"After a couple of activities, just say "Dm YOUc.

At the end of the list of activities done during school, ask students ifthey put down what they did during recess, PE or after lunch. This is~ important. Give them time to think and answer.

IF YOUR PHYSICAL AC11VITY IS NOT ON THE US1', PUT THE NAME OFYOUR A C11VITY UNDER n 0 THER n AND IN CL UD E NUMBER OF MINurES

ANDTHELE'l'l~N, S ORM.

3.AFfERSCHOOL

AFrER SCHOOL COVERS THE WHOLE TIME FROM WHEN THE LAST BELLRINGS AT THE END OF THE SCHOOL DAY AND ALL THE TIME RIGHT UPUNm., YOU GO TO SLEEP. THIs INCLUDES AFTER SCHOOL CARE. THINKABOUT ALL THE PLACES YOU WENT YESTERDAY AND ALL THE THINGSYOU Dm. WHAT Dm YOU DO AFTER SCHOOL? How Dm YOU GETHOME? WHEN WAS YOUR DINNER TIME? WHEN WAS YOUR BED TIME?

Dm YOU PLAY Otm>OORS? Now WE WllL GO DOWN THE usr OFAcnvITIES FOR AFTER SCHOOL TOGETHER.

Go through the checklist from top to bottom. Read the number of eachactivity to help students follow along. Periodically remind them to put azero if they did not do the activity. For the first couple of activities usethe complete prompts:

FOR 5 ~ OR MORE YESfERDA Ya. Dm YOU 00AFTER SCHOOL?

IF YOU Dm, WRITE 'mE NUMBER OF ~ AND A L~I-rER (N-

S-M) IF YOU WERE BREATHING HARD OR FELT TIRED FOR NONE,

SOME OR MOST OF 'mE TIME.

b.

CATCH SeIf-Ad~tercd Physical Activity Checklist (SAP AC) Protocol- VC~iOD 9/30t93-Page 7

After a couple of activities, just say "Dm YOU

?"

.c.

IF YOUR PHYSICAL ACl1VITY IS NOT IN THE UST, PUr THE NAMEOF YOUR ACI1VITY UNDER "OTHER". INCLUDE THE NUMBER OF

~ AND THE LE'rl]!;K N, S OR M.

4.

TV AND VIDEO; VIDEO AND C OMPUT ER GAMES B EFO RESCHOOL:

Now I'M GOING TO ASK YOU ABOUT TV WATCHING, VIDEO GAMF$ ANDCOMPmER GAMF$ BEFORE SCHOOL YFSrERDAY. LoOK AT THE BOX ATTHE BOTTOM OF THE PAGE.

TV and Video

a.

THINK ABom WHKrHEK YOU WATCHED ANY TV OR VIDEOSBEFORE SCHOOL YESTERDAY. You CAN RECORD THIS AS HOURS,~, OR BOTH. LET ME SHOW YOU AN EXAMPLE. LET'S SAYI WOKE UP EARLY AND WATCHED CARTOON SHOWS BEFORECOMING TO SCHOOL. I WATCHED TWO WHOLE SHOWS, SO THATWOULD BE ONE HOUR. THEN, I WATCHED ABOm HALF OF

ANOTHER SHOW, SO THAT WOULD BE ANOTHER 15 MINUTES. SOTHE TOTAL I WOULD WRITE DOWN WOULD BE 1 HOUR, 15~. Write these on the overhead.

IF YOU WATCHED 5 MINmm OR MORE OF TV BEFORE SCHOOLYESTERDAY, WRITE THE HOURS OR~. IF YOU WATCHEDLESS THAN 5 MINUfES, WRITE ZERO.

b.

Video/Computer Games

Now THINK IF YOU PLAYED ANY VIDEO OR COMPUTER GAMES

BEFORE SCHOOL ~AY. WHAT ARE SOME EXAMPLES OFVIDEO OR COMPUTER GAMES? (Answer: Nintendo, Game Boy,Wheel of Fortune, etc.) WRI1E THE HOURS OR MIN1JfES YOUPLAYED VIDEO GAMES OR COMPUTER GAMES BEFORE SCHOOLYESTERDAY.

IF YOU PLAYED 5 ~ OR MORE OF VIDEO OR COMPUTERGAMES BEFORE SCHOOL YESTERDAY, WRrrE THE HOURS ORMINmES. IF YOU PLAYED LESS THAN 5 MINUI'ES, WRrrE ZERO.

CATCH Self-Mmini~terOO Physical Activity Checklist (SAPAC) Protocol- Version 9/30i93-Page 8

5. TV, VIDEO GA'MF.S, COMPUTER GAMES AFrER SCHOOL:

TVa.

THINK ABour THE SHOWS YOU WATCHED AFfER SCHOOL,INCLUDING THE TIME BEFORE DINNER, DURING DINNER OR AFI'ERDINNER. IF YOU WATCHED THREE 1/2 HOUR SHOWS, WHATWOULD YOU WRITE? IF YOU WATCHED 3 MINUIm OF TV, WHATWOULD YOU WRITE? Now WRITE THE HOURS OR ~ OFTV YOU WATCHED YFSfERDAY AFfER SCHOOL. IF YOU NEED TOADD SEVERAL D IFFERENT ~ YOU W AT CHED TV FORM ORETHAN 5 ~, PLEASE USE THE BACK OF THE PAGE.

IF YOU WATCHED 5 ~ OR MORE OF TV AFTER SCHOOLYFSI'ERDA Y , WRITE THE HOURS OR MINUTFS. IF YOU WATCHEDLFSS THAN 5 ~, WRITE ZERO.

b. Video IComputer Games

Dm YOU PLAY ANY VIDEO OR COMPurER GAMES AFTER SCHOOLYFSfERDA Y? WRITE THE HOURS OR MINUI'ES YOU PLA YEllTHESE G AMES YFSrERD A Y AFTER S CH 0 0 L .

IF YOU PLAYED 5 ~ OR MORE OF VIDEO OR COMPUfERG~ AFTER SCHOOL YESTERDAY, WRlTE THE HOURS ORMINUTES.

IF YOU PLAYED LESS THAN 5 MINUrES, WRITE ZERO.

END OF CHECKLIST: Now YOU ARE FINISHED wrm THIS FORM. TuRN BACK TO THEFIRSf PAGE AND MAKE SURE YOUR NAME IS ON IT. THANK YOU VERY MUCH.

CATCH Sell-Adminicteroo Physical Activity Cbcc~t (SAP Aq Protoool- Version 9/30/93-Page 9

I IAFFIX m LABEL HERE ->

SECTION A. GENERAL INFORMAnON

(CATCH SlAFF USE ONLY)

FORM VERSION:AI. -2--2-M

1-L~/-2--L

D y

A2.

TODA Y'S DATE: I IM D y

A3.

ADMINISTRATOR'S INITIALS

A4. SCHOOL STARTING TIME:

AS.

SCHOOL ENDING TIME:

A6. Dffi YOU PARnCIPATE IN PHYSICAL EDUCAnON CLASS YESTERDAY?

NO 1YES 2

A7.

If~, HOW MANY MINUTES LONG W AS PHYSICAL EDUCA nON CLASS?

I Minutes

AS. DID YOU PARTICIPATE IN RECESS YESTERDA Y?

NO 1YES 2

A9.If~,

HOW MANY MINUTES OF RECESS DID YOU HAVE?

Minutes Second RecessMinutes First Recess

CATCH -SAPAC Form (235)- Ver8lon 9/30/93 -Page 1

sectJoo B. Adivties

111

221

331

441

551

6~61

771

881

991

10101

11112

121

13131

14141

15151

16161

17171

18181

19191

20201

21

T.V.Mdeo

CATCK-SAPAC Form- (235) Version 9/30/93 Page 2