The UCR Healthy Campus Initiative is interested in your feedback about the current campus environment and your thoughts on how UCR can become a healthier campus. Your input is important to the development and progress of the initiative.

Your responses will be used in planning new initiatives and programs for our campus. All results will be kept confidential and results will only be shared in an aggregate format. This survey is expected to take no more than 15 minutes of your time.

Upon turning in the survey, completed or not, you are encouraged to enter a drawing for five $25 Barnes & Noble gift cards by submitting your email address at the end of this survey. Please note: your email will not be associated with your survey response.

If you have any questions about this survey, please contact healthycampus@ucr.edu.

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* 1. Which of the following health concerns would you like to know more about? (Check all that apply)

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* 2. There are many ways to get health information on campus. Which way would you most prefer?

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* 3. Which barriers, if any, prevent you from participating in UCR’s campus health and wellness programs? (Check all that apply)

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* 4. How helpful have current wellness programs been in helping you reach your wellness goals?

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* 5. In which of the following categories do you place yourself?

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* 6. In which of the following health and wellness activities would you participate in at UCR? (Check all that apply)

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* 7. UCR has a culture and environment that promotes and supports health and well-being for its faculty, staff and students.

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* 8. Leaders at UCR are actively engaged in promoting and role-modeling health and well-being.

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* 9. UCR cares about my health and personal well-being.

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* 10. In general, how would you describe your overall health?

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* 11. A healthful well-balanced diet consists of a daily intake from all food groups with an emphasis on fresh produce, lean protein, whole grains and heart-healthy unsaturated oils; keeping sugar, sodium and saturated fat to a minimum.

Based on the aforementioned parameters, how would you rate your own dietary intake?

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* 12. How many minutes of moderate physical activity do you usually get per week? (Examples of moderate physical activity include: walking briskly, gardening, water aerobics or tennis (doubles))

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* 13. In the past week, how much has your mood interfered with your social life and relationships? (Examples of mood interference: disrupted my social activities, strained family relations)

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* 14. How many hours of sleep do you usually get per night?

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* 15. Do you currently use tobacco products? (cigarettes, smokeless tobacco, electronic nicotine device systems: e-cigs, etc.)

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* 16. In the past 30 days how many days did you:

  None 1-2 days 3-5 days 6-9 days 10-19 days 20 or more days
Have at least one drink of any alcoholic beverage such as beer, wine, a malt beverage or liquor?
Use Marijuana or hashish without a license?
Use other illicit drugs, such as cocaine/crack, heroin, hallucinogens (LSD, PCP, ecstasy), inhalants or methamphetamine, etc.?
Use prescription drugs for recreational purposes?

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* 17. One drink is equivalent to a 12 oz. beer, a 5 oz. glass of wine, or a drink with one shot of liquor. During the past 30 days, on the days when you drank, about how many drinks did you drink on the average?

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* 18. Which of the following preventive exams do you do annually? (Check all that apply)

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* 19. Please give any suggestions or recommendations for specific activities to include in the UCR Healthy Campus Initiative.

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* 20. We are taking inventory of all the health and well-being assets at UCR in order for us to plan our initiative goals and direction.

Please list all of the health and well-being programs, resources, and/or committees that your unit is involved in.

You are welcome to add more that you know of around campus so that we are aware of additional resources.

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* 21. Are you interested in participating in the Healthy Campus Initiative Resource Network? (Subcommittees focused on Healthy Eating/Nutrition, Physical Activity, Mental Health, Built Environment, Alcohol Tobacco and Other Drugs, Preventive Health, Marketing and Communications, Data/Metrics)

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* 22. What is your age?

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* 23. What is your gender?

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* 24. What is your UCR affiliation?

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* 25. If you would like to be included in the drawing for one of several prizes, please include the following information: (please note that your name, email and phone will not be shared or linked to your survey response)

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