Questionnaires

Below is a list of our currently available questionnaires:

Diet

Physical Activity

Tobacco Use

Quality of Life

If you have not found what you need on this page, please contact us.

 

Diet Questionnaires

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Food Frequency Questionnaire

The Arizona Food Frequency Questionnaire (AFFQ) is a modification of the NCI Health Habits and History Questionnaire (HHHQ) food frequency component (Block, et al, 1986). It has been tested for reliability as well as relative validity (Martinez et al, 1999; Thomson et al, 2003). This semi-quantitative, scannable 175-item food frequency questionnaire asks respondents to report how often they usually consume each particular food over the prior 12-month period as a number of times per day, week, or month and to indicate whether their usual portion size of that food was small, medium, or large. Vitamin/mineral supplement use information is collected and modification questions assess dietary behavioral practices related to fat consumption to each line item in the food list. The database contains over 800 foods and output is provided for 91 nutrients in addition to 34 derived variables such as percent of DRI, grams of red meat, grams of cruciferous vegetables, etc. The data is available in several formats including daily nutrient totals, nutrients per individual foods, vitamin/mineral supplement intake values, number of servings of specific foods, and food groups. This questionnaire is available in both English and Spanish.

AFFQ Sample

Martinez ME, Marshall JR, Graver E, Whitacre RC, Woolf K, Ritenbaugh C, Alberts DS. Reliability and validity of a self-administered food frequency questionnaire in a chemoprevention trial of adenoma recurrence. Cancer Epidemiol Biomarker Prev, 8:941-946, 1999.

 

Southwestern Food Frequency Questionnaire

The Southwestern Food Frequency Questionnaire (SWFFQ) consists of 158 food items and was adapted from the Arizona Food Frequency Questionnaire. It provides a culturally appropriate means of collecting dietary information for the Southwestern U.S. Hispanic populations predominantly of Mexican descent. It is the only Spanish bicultural and bilingual questionnaire in widespread use in the country. Examples of food items that are included in the questionnaire are nopalitos (cactus leaves), corn and flour tortillas, refried beans, machaca, and chorizo. The SWFFQ has been tested for validity and reliability (Taren et al, 2000). The output provides 87 nutrients in addition to 25 derived variables such as percent of calories from fat.

SWFFQ Sample

Taren D, Tobar M, Ritenbaugh C, Graver E, Whitacre R, Aickin M. Evaluation of the Southwest Food Frequency Questionnaire. Ecology of Food and Nutrition 38:515-547, 2000.

 

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Tea Consumption Questionnaire

The Arizona Tea Questionnaire is a short 3.5-page, 28-item scannable questionnaire that has been tested for short and long term reliability as well as relative validity (Hakim et al, 2001). It was developed using focus groups and semi structured interviews. This questionnaire asks about usual tea intake over the past year, as well as lifetime consumption patterns including amount, type, and preparation technique. The output is provided in total flavonoids, total polyphenols, catechins, theaflavins, thearubigins, caffeine, and gallic acid.

Tea Questionnaire Sample

Hakim IA, Hartz V, Harris R, Balentine D, Weisburger UM, Graver E, Whitacre R, Alberts D. Reproducibility and Relative Validity of a Questionnaire to Assess Intake of Black Tea Polyphenols in Epidemiological Studies. Cancer Epidemiology, Biomarkers and Prevention, 10:667-678, 2001.

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Citrus Consumption Questionnaire

The Arizona Citrus Questionnaire is a short 3-page, 22-item scannable questionnaire that has been tested for short and long term reliability as well as relative validity (Hakim et al 2002). It was developed using focus groups and semi structured interviews. This questionnaire asks detailed information on consumption of each type of citrus fruit and juice intake, how the juice is stored, i.e., types of containers, and whether citrus juices and peel were added during food preparation and/or food serving. The output provides d-limonene per day from each citrus food item. 

Citrus Questionnaire Sample

Hakim IA, Hartz V, Graver E, Whitacre R. Development of a questionnaire and a
database for assessing dietary d-limonene intake. Public Health Nutrition 5(6A):939-945, 2002.

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Meat Preparation Questionnaire

The Arizona Meat Preparation Questionnaire assesses the mutagenic activity of cooked meat, poultry, and fish and their heterocyclic amine (HAA) content. It is a short 4-page, 50-item self-administered scannable instrument that utilizes color photographs showing varying degrees of cooked meat, poultry, and fish. It was adapted from an existing questionnaire used by NCI, and it includes detailed information on meat preparation methods and degree of doneness. The output provides MeIQx, PhIP, DiMeIQx, BaP, and actual and predicted revertant colony values.

Meat Preparation Questionnaire Sample

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Special Population Food Frequency Questionnaires

Special population food frequency questionnaire development is available. Food frequency questionnaires have been designed for Mexican-American, African-American, and Native American populations including Yaqui, White Mountain Apache, Hopi, Wichita, and Hualapai.

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Cruciferous Vegetable Food Frequency Questionnaire

The Cruciferous Vegetable Food Frequency Questionnaire (CVFFQ) is a 6-page, 79-item questionnaire that assesses cruciferous vegetable intake over the previous 12-month period has been tested for short and long term reliability as well as relative validity (Thomson et al, 2007). Respondents answer questions related to number of servings consumed of individual cruciferous vegetables and whether their serving size was small, medium, or large. Questions are asked regarding both raw and cooked vegetables including typical method of cooking. The final portion of the questionnaire is aimed at assessing intake of oriental mixed dishes and condiments such as mustard that, along with the more well known cruciferous vegetables, have been shown to be a significant source of isothiocyanates. The questionnaire can be completed in an average of 20 minutes. Pictures of the cruciferous vegetables are available to assist respondents as needed. Pilot data from our research suggests that only respondent with very low cruciferous vegetable intake require pictures to complete the questionnaire. Gram weights for each food item as well as a total gram intake of cruciferous vegetables can be assessed from the self-reported data.

Cruciferous Vegetable Questionnaire Sample

Thomson CA, Newton TR, Graver EJ, Jackson KA, Reid PM, Hartz VL, Cusslerman EC, Hakim IA. Cruciferous vegetable intake questionnaire improves cruciferous vegetable intake estimates. Journal of the American Dietetic Assoc. 2007; 107:631-643.

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Physical Activity Questionnaire


Activity Frequency Questionnaire

The Arizona Activity Frequency Questionnaire (AAFQ) is a 59-item scannable questionnaire available in both Spanish and English. The AAFQ groups physical activity by leisure, recreational, household, and "other” activity categories. The output is provided in MET (metabolic equivalents) units per day and per activity, kilojoules, number of hours per day per activity, and number of activities reported for each category. The AAFQ has been validated in an eight-day doubly labeled water protocol to measure total energy expenditure (Staten et al, 2001). It has been upgraded with the compendium of physical activity codes and MET intensities (Ainsworth, et al, 2000). 

Physical Activity Questionnaire Sample

Staten, LK, Taren DL, Howell WH, Tobar M, Poehlman ET, Hill A, Reid PM, Ritenbaugh C.  Vaidation of the Arizona Activity Frequency Questionnaire using doubly labeled water.  Medicine and Science in Sports and Exercise 33:1959-1967, 2001

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Tobacco Use Questionnaire


Smoking Assessment Questionnaire

The Arizona Smoking Assessment Questionnaire (ASAQ) is a 4-page, 27-item scannable questionnaire which assesses past and current use of tobacco products by recording past years of exposure including environmental tobacco smoke, types of tobacco used, measures of addiction, attempts to quit, and age at onset. The ASAQ was tested in a sample of 600 participants, showing the number of cigarettes per day and portion of each cigarette smoked significantly predicted plasma cotinine levels (p < .001).
 

Basic Smoking Assessment Questionnaire Sample

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Quality of Life Questionnaire


The Smoking Cessation Quality of Life (SCQoL) Questionnaire

The Smoking Cessation Quality of Life (SCQoL) questionnaire was developed to assess health-related quality of life among persons going through the smoking cessation process. In designing the SCQoL questionnaire, the goal was to develop a measure that would be sensitive to the changes in health-related quality of life (HRQOL) occurring during the early stages of the nicotine withdrawal process as well as responsive to the long-term HRQOL consequences of successful or unsuccessful cessation attempts. The 51-item SCQoL consists of the SF-36 as its generic core and 15 cessation-targeted items. It produces 13 individual scale scores along with mental and physical component summary scores from the SF-36. Exploratory factor analyses of the 15 cessation-targeted items revealed five distinct dimensions: self-control/mastery, cognitive functioning, sleep, anxiety, and quality of social interactions. Initial results provide support for the reliability and validity of this questionnaire, but further use and testing of the SCQoL will be valuable. The SCQoL takes about eight to nine minutes to complete and is available upon request.

Smoking Quality of Life Questionnaire Sample

Olufade AO, Foster SA, Shaw JW, Leischow SJ, Hays RD, Coons SJ. Development of the Smoking Cessation Quality of Life (SCQoL) questionnaire. Clinical Therapeutics 1999;21:2113-2130.

Shaw JW, Coons SJ, Foster SA, Leischow SJ, Hays RD. Responsiveness of the Smoking Cessation Quality of Life (SCQoL) Questionnaire. Clinical Therapeutics 2001;23:957-969.

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Contact Us

If you have not found what you need on this page, please contact us. Often we can provide information you need via email, fax, or telephone. We are also happy to arrange a conference call.

Lynn Hamilton
Technical and Operational Director
The Arizona Diet, Behavior, and Quality of Life Assessment Lab
Part of the Arizona Cancer Center/The University of Arizona
2601 N. Campbell Suite 109
Tucson, Arizona 85719
(520) 626-8316 phone
(520) 626-3355 fax
lhamilton@azcc.arizona.edu

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