Youth Risk Behavior Questionnaire Template Page 13
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1490.
During the past 7 days, how many
93.
During the past 7 days, on how many
times did you eat carrots?
days did you eat breakfast?
A.
I did not eat carrots during
A.
0 days
the past 7 days
B.
1 day
B.
1 to 3 times during the past 7
C.
2 days
days
D.
3 days
C.
4 to 6 times during the past 7
E.
4 days
days
F.
5 days
D.
1 time per day
G.
6 days
E.
2 times per day
H.
7 days
F.
3 times per day
G.
4 or more times per day
The next 5 questions ask about physical
activity.
91.
During the past 7 days, how many
times did you eat other vegetables?
94.
During the past 7 days, on how many
(Do not count green salad, potatoes,
days were you physically active for a
or carrots.)
total of at least 60 minutes per day?
A.
I did not eat other vegetables
(Add up all the time you spent in any
during the past 7 days
kind of physical activity that
B.
1 to 3 times during the past 7
increased your heart rate and made
days
you breathe hard some of the time.)
C.
4 to 6 times during the past 7
A.
0 days
days
B.
1 day
D.
1 time per day
C.
2 days
E.
2 times per day
D.
3 days
F.
3 times per day
E.
4 days
G.
4 or more times per day
F.
5 days
G.
6 days
92.
During the past 7 days, how many
H.
7 days
times did you drink a can, bottle, or
glass of soda or pop, such as Coke,
95.
On an average school day, how
Pepsi, or Sprite? (Do not count diet
many hours do you watch TV?
soda or diet pop.)
A.
I do not watch TV on an
A.
I did not drink soda or pop
average school day
during the past 7 days
B.
Less than 1 hour per day
B.
1 to 3 times during the past 7
C.
1 hour per day
days
D.
2 hours per day
C.
4 to 6 times during the past 7
E.
3 hours per day
days
F.
4 hours per day
D.
1 time per day
G.
5 or more hours per day
E.
2 times per day
F.
3 times per day
G.
4 or more times per day
13
2015 Arizona HS YRBS
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