Adventist Medical Center College

Tibanga, Iligan City

QUESTIONNAIRE
Dear Respondent,
We are 4th year Bachelor of Science in Nursing Students of Mindanao
Sanitarium and Hospital College presently conducting a research study
entitled, Prevalence between Sedentary Lifestyle and Obesity among
Freshmen Student of Adventist Medical Center College. This is in partial
fulfillment of the requirements for the degree Bachelor of Science in Nursing.
In connection to this, the researchers humbly ask your cooperation and
time to answer the questionnaire. Rest assured that the gathered data will be
kept confidential.
The Researchers
Direction: Please fill up the blank space provided.
I

PERSONAL PROFILE
Height: _____
Weight: _____
Age: (1 ) 15-18 y/o

( 2) 19-21 y/o

( 3) 22-25 y/o

Gender: ( 1) Male ( 2) Female

Religion: ( 1) SDA (2 ) Islam ( 3) Roman Catholic
(4 ) Others: ___________
Family Income: ( 1 ) 5,000 9,999Php ( 3 ) 15,000 19,999Php
( 2 ) 10,000 14,999Php ( 4 ) 20,000 30,000Php
( 5 ) Others: _______
Obesity Incidence of Parents: ( 1 ) Mother ( 2 ) Father ( 3 ) Both Parents ( 3 ) None

II

SEDENTARY BEHAVIOR LIFESTYLE

Please check the box that corresponds to your answer.

1- Never
3- Sometimes

2- Rarely
4- Very Often

5- Always

On a typical WEEKEND DAY, how much do you spend (from you wake up until you
go to bed) doing the following?

1 Watching television (Q1)

2 Playing computer or video games
(Q2)
3 Sitting listening to music on the
radio, tapes, CDs or cellphones
(Q3)
4 Sitting and talking on the phone
(Q4)
5 Doing paperwork or Computer
work (Q5)
6 Sitting reading a book or a
magazine (Q6)
7 Playing a musical instrument (Q7)
8 Doing artwork or crafts (Q8)
9 Sitting or driving in a car, bus or
train. (Q9)

On a typical WEEKDAY, how much do you spend (from you wake up until you go to
bed) doing the following?

5
1. Watching television (Q1)
2. Playing computer or video games
(Q2)
3. Sitting listening to music on the
radio, tapes, CDs or cellphones (Q3)
4. Sitting and talking on the phone
(Q4)
5. Doing paperwork or Computer work
(Q5)
6. Sitting reading a book or a
magazine (Q6)
7. Playing a musical instrument (Q7)
8. Doing artwork or crafts (Q8)
9. Sitting or driving in a car, bus or
train. (Q9)