Wellness Survey This is how I love to be healthy

Question Title

* 1. I would buy heart-healthy snacks during the day if they were available (for example pretzels, yogurt, fresh fruit, 100% fruit juice, dried fruit, etc.)

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 2. Before or after school, I would participate in a physical activity like stretching, aerobics, yoga, or walking, etc.

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 3. If I participated in an activity before or after school, I would prefer to do it.

Individually

In a group

Question Title

* 4. I would eat fruits and vegetables if available at staff meetings.

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 5. I would participate in group activities encouraging healthy eating or physical activity if offered.

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 6. I would like to get at least 30-minutes of physical activity most days of the week.

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 7. I would participate in a health promotion program for staff if it were offered.

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 8. I would be more likely to participate in a health promotion program for staff if there were incentives such as (please list).

Question Title

* 9. I would read health tips (articles, recipes, information on upcoming events) via e-mail, bulletin board, newsletter or another source.

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 10. I would like to improve my eating habits.

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 11. I would participate in wellness activities before school.

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 12. I would participate in wellness activities after school.

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 13. Would you be interested in becoming a wellness team member?

Yes

Question Title

* 14. Would you be interested in leading a wellness activity?

Yes

Question Title

* 15. Would you be interested in developing a personal fitness plan?

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 16. Would you be interested in aerobics/pilates/fitness classes?

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 17. Would you be interested in dancing, zumba, line dancing, etc?

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 18. Would you be interested in team sports, winter sports?

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 19. Would you be interested in walking and/or running programs?

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 20. Would you be interested in strength training?

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 21. Would you be interested in yoga?

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 22. Would you be interested in bike riding, trail riding or hiking?

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 23. Would you be interested in fitness testing?

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 24. Would you be interested in health screenings (blood pressure, blood sugar, cholesterol, BMI, etc)?

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 25. Would you be interested in weight management informational sessions (Weight Watchers at work, etc.)?

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 26. Would you be interested in stress management informational sessions?

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 27. Would you be interested in healthy cooking and meal planning classes?

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 28. Would you be interested in label and menu reading classes?

Not at all likely

Not very likely

Somewhat likely

Very likely

Not at all likely

Not very likely

Somewhat likely

Very likely

Question Title

* 1. I would buy heart-healthy snacks during the day if they were available (for example pretzels, yogurt, fresh fruit, 100% fruit juice, dried fruit, etc.)

Question Title

* 2. Before or after school, I would participate in a physical activity like stretching, aerobics, yoga, or walking, etc.

Question Title

* 3. If I participated in an activity before or after school, I would prefer to do it.

Question Title

* 4. I would eat fruits and vegetables if available at staff meetings.

Question Title

* 5. I would participate in group activities encouraging healthy eating or physical activity if offered.

Question Title

* 6. I would like to get at least 30-minutes of physical activity most days of the week.

Question Title

* 7. I would participate in a health promotion program for staff if it were offered.

Question Title

* 8. I would be more likely to participate in a health promotion program for staff if there were incentives such as (please list).

Question Title

* 9. I would read health tips (articles, recipes, information on upcoming events) via e-mail, bulletin board, newsletter or another source.

Question Title

* 10. I would like to improve my eating habits.

Question Title

* 11. I would participate in wellness activities before school.

Question Title

* 12. I would participate in wellness activities after school.

Question Title

* 13. Would you be interested in becoming a wellness team member?

Question Title

* 14. Would you be interested in leading a wellness activity?

Question Title

* 15. Would you be interested in developing a personal fitness plan?

Question Title

* 16. Would you be interested in aerobics/pilates/fitness classes?

Question Title

* 17. Would you be interested in dancing, zumba, line dancing, etc?

Question Title

* 18. Would you be interested in team sports, winter sports?

Question Title

* 19. Would you be interested in walking and/or running programs?

Question Title

* 20. Would you be interested in strength training?

Question Title

* 21. Would you be interested in yoga?

Question Title

* 22. Would you be interested in bike riding, trail riding or hiking?

Question Title

* 23. Would you be interested in fitness testing?

Question Title

* 24. Would you be interested in health screenings (blood pressure, blood sugar, cholesterol, BMI, etc)?

Question Title

* 25. Would you be interested in weight management informational sessions (Weight Watchers at work, etc.)?

Question Title

* 26. Would you be interested in stress management informational sessions?

Question Title

* 27. Would you be interested in healthy cooking and meal planning classes?

Question Title

* 28. Would you be interested in label and menu reading classes?

Question Title

* 29. What other items you would like to see or participate in? (please list)