Canton Township Leisure Services is committed to community health and wellness. In an effort to better understand your and our community's needs we are asking you to participate in this survey. The results will help guide health and wellness programming, as well as park and recreation facility amenities. If you have questions about this survey or would like to learn more about health and wellness opportunities here in Canton, please email leisure@canton-mi.org.

We appreciate your feedback. At the end of the survey you will be given the opportunity to enter a drawing for a 3-Month Summit on the Park Membership or a Farmers Market Gift Basket.

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* 1. Where do you live? 

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* 2. What are the ages of people in your household?

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* 3. Can you safely walk or bike to your closest park?

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* 4. How has the COVID-19 Pandemic affected your health status?

  Improved Stayed the Same or No Difference Gotten Worse Unsure Prefer not to Answer
Physical Health
Mental Health
Chronic Illness

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* 5. Which of the following parks and recreation facilities do you prefer to participate in health, wellness, exercise or leisure programs?

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* 6. Overall, how would you rate your mental well-being?

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* 7. Have you or someone in your household sought professional advice for mental health?

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* 8. If needed, what prevents you or another member of your household from seeking professional advice on your mental health?

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* 9. Nutrition: How frequently do you meet the daily consumption of the following?

  1-2 days each week 3-5 days each week 6-7 days each week N/A None
1.5-2 cups of fruit
2-3 cups of vegetables
3-5 ounces of grain (whole grain bread, pasta, popcorn, rice)
5-7 ounces of protein (meat, fish, nuts, seeds, beans)
3 cups of dairy (milk, yogurt, cheese; do not include butter sour cream or cream cheese)

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* 10. How frequently do you cook at home?

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* 11. Do you or a member of your household participate in food assistance programs? (example: SNAP, WIC, TEFAP, Senior Project Fresh)

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* 12. What prevents you from achieving nutritional well-being?

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* 13. Are you interested in nutritional education programs? (check all that apply)

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* 14. Physical Activity: How often do you currently exercise?

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* 15. What prevents you from participating in regular physical exercise?

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* 16. Chronic Disease Management: Have you or someone in your household been diagnosed with one of the following chronic diseases?

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* 17. Have you been instructed to make lifestyle changes to help your condition? 

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* 18. What prevents you from making healthy lifestyle changes?

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* 19. How concerned are you that the following emergency will affect you?

  Not Concerned Neither Concerned or unconcerned Somewhat Concerned Very Concerned Currently or Previously Dealt With
House Fire
Power Outage
Tornado
Severe Winter Weather
Pool Drowning
Child Care Emergency (example: choking, injury)

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* 20. Which of the following do you have in your home?

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* 21. Which of the following have you participated in?

  I Have Completed I have not completed, but would like to learn I have no interest in learning
CPR training
AED training
First Aid training
Self-Defense training
Babysitter or Childcare training
Pet Sittter or Pet Care training
Designing a family emergency evacuation plan
Designing a family emergency preparedness plan
Virtual Crime Prevention and Response
CERT Community Emergency Response

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* 22. What prevents you from taking emergency preparedness precautions?

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* 23. What is the most important thing that Canton do to improve community health?

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* 24. If Canton could offer a program or service to improve your mental health, what would you like to see offered?

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* 25. If Canton could offer a program or service to improve your nutrition, what would you like to see offered?

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* 26. If Canton could offer a program or service to improve your physical health, what would you like to see offered?

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* 27. If Canton could offer a program or service to improve your chronic disease management, what would you like to see offered?

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* 28. If Canton could offer a program or service to improve your emergency preparedness, what would you like to see offered?

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* 29. If you are interested in learning more about health programs, please indicate the age group that we should target.

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* 30. If you are interested in a Health and Wellness Specialist contacting you about available health resources, please include your contact information. (if no interest, please skip)

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* 31. Is there anything else you would like to add related to community health and wellness?'

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* 32. Thank you for participating in our 2021 Health Survey. As a token of our appreciation we will be conducting a drawing for a 3-Month Summit on the Park Membership or a Farmers Market Gift Basket. If you would like to enter the drawing, please include your contact information: 

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