Let's Talk Cafe: Feedback Survey

Thank you for participating in the Let's Talk Cafe. Your perspective and thoughts will help to shape our intervention. This survey may take 10 minutes to complete.

For more information about our initiative, check out our website at: Kujenga Wellness Project. Please feel free to email your questions or thoughts to us.

Thank you, the Kujenga Team!!

	Very Difficult	Somewhat Difficult	Neutral	Somewhat Easy	Very Easy
Education & learning	Education & learning Very Difficult	Education & learning Somewhat Difficult	Education & learning Neutral	Education & learning Somewhat Easy	Education & learning Very Easy
Spirituality & faith	Spirituality & faith Very Difficult	Spirituality & faith Somewhat Difficult	Spirituality & faith Neutral	Spirituality & faith Somewhat Easy	Spirituality & faith Very Easy
Finances	Finances Very Difficult	Finances Somewhat Difficult	Finances Neutral	Finances Somewhat Easy	Finances Very Easy
Social Relationships	Social Relationships Very Difficult	Social Relationships Somewhat Difficult	Social Relationships Neutral	Social Relationships Somewhat Easy	Social Relationships Very Easy
Health	Health Very Difficult	Health Somewhat Difficult	Health Neutral	Health Somewhat Easy	Health Very Easy
Social Media	Social Media Very Difficult	Social Media Somewhat Difficult	Social Media Neutral	Social Media Somewhat Easy	Social Media Very Easy
Friends & extended family	Friends & extended family Very Difficult	Friends & extended family Somewhat Difficult	Friends & extended family Neutral	Friends & extended family Somewhat Easy	Friends & extended family Very Easy
Intimate partner relationships	Intimate partner relationships Very Difficult	Intimate partner relationships Somewhat Difficult	Intimate partner relationships Neutral	Intimate partner relationships Somewhat Easy	Intimate partner relationships Very Easy
Career	Career Very Difficult	Career Somewhat Difficult	Career Neutral	Career Somewhat Easy	Career Very Easy
Mental Health	Mental Health Very Difficult	Mental Health Somewhat Difficult	Mental Health Neutral	Mental Health Somewhat Easy	Mental Health Very Easy
My identity (i.e. gender, race, culture) & self-worth	My identity (i.e. gender, race, culture) & self-worth Very Difficult	My identity (i.e. gender, race, culture) & self-worth Somewhat Difficult	My identity (i.e. gender, race, culture) & self-worth Neutral	My identity (i.e. gender, race, culture) & self-worth Somewhat Easy	My identity (i.e. gender, race, culture) & self-worth Very Easy
Mentorship & coaching	Mentorship & coaching Very Difficult	Mentorship & coaching Somewhat Difficult	Mentorship & coaching Neutral	Mentorship & coaching Somewhat Easy	Mentorship & coaching Very Easy

Very Difficult

Somewhat Difficult

Neutral

Somewhat Easy

Very Easy

Education & learning

Education & learning Very Difficult

Education & learning Somewhat Difficult

Education & learning Neutral

Education & learning Somewhat Easy

Education & learning Very Easy

Spirituality & faith

Spirituality & faith Very Difficult

Spirituality & faith Somewhat Difficult

Spirituality & faith Neutral

Spirituality & faith Somewhat Easy

Spirituality & faith Very Easy

Finances

Finances Very Difficult

Finances Somewhat Difficult

Finances Neutral

Finances Somewhat Easy

Finances Very Easy

Social Relationships

Social Relationships Very Difficult

Social Relationships Somewhat Difficult

Social Relationships Neutral

Social Relationships Somewhat Easy

Social Relationships Very Easy

Health

Health Very Difficult

Health Somewhat Difficult

Health Neutral

Health Somewhat Easy

Health Very Easy

Social Media

Social Media Very Difficult

Social Media Somewhat Difficult

Social Media Neutral

Social Media Somewhat Easy

Social Media Very Easy

Friends & extended family

Friends & extended family Very Difficult

Friends & extended family Somewhat Difficult

Friends & extended family Neutral

Friends & extended family Somewhat Easy

Friends & extended family Very Easy

Intimate partner relationships

Intimate partner relationships Very Difficult

Intimate partner relationships Somewhat Difficult

Intimate partner relationships Neutral

Intimate partner relationships Somewhat Easy

Intimate partner relationships Very Easy

Career

Career Very Difficult

Career Somewhat Difficult

Career Neutral

Career Somewhat Easy

Career Very Easy

Mental Health

Mental Health Very Difficult

Mental Health Somewhat Difficult

Mental Health Neutral

Mental Health Somewhat Easy

Mental Health Very Easy

My identity (i.e. gender, race, culture) & self-worth

My identity (i.e. gender, race, culture) & self-worth Very Difficult

My identity (i.e. gender, race, culture) & self-worth Somewhat Difficult

My identity (i.e. gender, race, culture) & self-worth Neutral

My identity (i.e. gender, race, culture) & self-worth Somewhat Easy

My identity (i.e. gender, race, culture) & self-worth Very Easy

Mentorship & coaching

Mentorship & coaching Very Difficult

Mentorship & coaching Somewhat Difficult

Mentorship & coaching Neutral

Mentorship & coaching Somewhat Easy

Mentorship & coaching Very Easy

	Very Important	Important	Somewhat Important	Important
Unity	Unity Very Important	Unity Important	Unity Somewhat Important	Unity Important
Self-Determination	Self-Determination Very Important	Self-Determination Important	Self-Determination Somewhat Important	Self-Determination Important
Collective work & work ethic	Collective work & work ethic Very Important	Collective work & work ethic Important	Collective work & work ethic Somewhat Important	Collective work & work ethic Important
Building wealth & financial literacy	Building wealth & financial literacy Very Important	Building wealth & financial literacy Important	Building wealth & financial literacy Somewhat Important	Building wealth & financial literacy Important
Purpose: Being able to accomplish your dreams and goals	Purpose: Being able to accomplish your dreams and goals Very Important	Purpose: Being able to accomplish your dreams and goals Important	Purpose: Being able to accomplish your dreams and goals Somewhat Important	Purpose: Being able to accomplish your dreams and goals Important
Creativity	Creativity Very Important	Creativity Important	Creativity Somewhat Important	Creativity Important
Faith	Faith Very Important	Faith Important	Faith Somewhat Important	Faith Important
Spirituality	Spirituality Very Important	Spirituality Important	Spirituality Somewhat Important	Spirituality Important
Physical Health	Physical Health Very Important	Physical Health Important	Physical Health Somewhat Important	Physical Health Important
Mental wellness	Mental wellness Very Important	Mental wellness Important	Mental wellness Somewhat Important	Mental wellness Important
Belongingness	Belongingness Very Important	Belongingness Important	Belongingness Somewhat Important	Belongingness Important

Very Important

Important

Somewhat Important

Important

Unity

Unity Very Important

Unity Important

Unity Somewhat Important

Unity Important

Self-Determination

Self-Determination Very Important

Self-Determination Important

Self-Determination Somewhat Important

Self-Determination Important

Collective work & work ethic

Collective work & work ethic Very Important

Collective work & work ethic Important

Collective work & work ethic Somewhat Important

Collective work & work ethic Important

Building wealth & financial literacy

Building wealth & financial literacy Very Important

Building wealth & financial literacy Important

Building wealth & financial literacy Somewhat Important

Building wealth & financial literacy Important

Purpose: Being able to accomplish your dreams and goals

Purpose: Being able to accomplish your dreams and goals Very Important

Purpose: Being able to accomplish your dreams and goals Important

Purpose: Being able to accomplish your dreams and goals Somewhat Important

Purpose: Being able to accomplish your dreams and goals Important

Creativity

Creativity Very Important

Creativity Important

Creativity Somewhat Important

Creativity Important

Faith

Faith Very Important

Faith Important

Faith Somewhat Important

Faith Important

Spirituality

Spirituality Very Important

Spirituality Important

Spirituality Somewhat Important

Spirituality Important

Physical Health

Physical Health Very Important

Physical Health Important

Physical Health Somewhat Important

Physical Health Important

Mental wellness

Mental wellness Very Important

Mental wellness Important

Mental wellness Somewhat Important

Mental wellness Important

Belongingness

Belongingness Very Important

Belongingness Important

Belongingness Somewhat Important

Belongingness Important

	Yes, I need to work on this	No, I feel competent in this area
Financial Literacy	Financial Literacy Yes, I need to work on this	Financial Literacy No, I feel competent in this area
Building Wealth	Building Wealth Yes, I need to work on this	Building Wealth No, I feel competent in this area
Obtaining further education	Obtaining further education Yes, I need to work on this	Obtaining further education No, I feel competent in this area
Managing a household	Managing a household Yes, I need to work on this	Managing a household No, I feel competent in this area
Parenting my children (if applicable)	Parenting my children (if applicable) Yes, I need to work on this	Parenting my children (if applicable) No, I feel competent in this area
Maintaining my physical health	Maintaining my physical health Yes, I need to work on this	Maintaining my physical health No, I feel competent in this area
Attending to my mental health	Attending to my mental health Yes, I need to work on this	Attending to my mental health No, I feel competent in this area
Accessing support in my community	Accessing support in my community Yes, I need to work on this	Accessing support in my community No, I feel competent in this area
Planning for retirement	Planning for retirement Yes, I need to work on this	Planning for retirement No, I feel competent in this area
Being and feeling "part" of a community	Being and feeling "part" of a community Yes, I need to work on this	Being and feeling "part" of a community No, I feel competent in this area
Maintaining healthy relationships	Maintaining healthy relationships Yes, I need to work on this	Maintaining healthy relationships No, I feel competent in this area
Healthy dating or marriage relationships	Healthy dating or marriage relationships Yes, I need to work on this	Healthy dating or marriage relationships No, I feel competent in this area
Establishing goals for myself	Establishing goals for myself Yes, I need to work on this	Establishing goals for myself No, I feel competent in this area
Finding or changing my career	Finding or changing my career Yes, I need to work on this	Finding or changing my career No, I feel competent in this area
Accessing mentors who can support me	Accessing mentors who can support me Yes, I need to work on this	Accessing mentors who can support me No, I feel competent in this area

Yes, I need to work on this

No, I feel competent in this area

Financial Literacy

Financial Literacy Yes, I need to work on this

Financial Literacy No, I feel competent in this area

Building Wealth

Building Wealth Yes, I need to work on this

Building Wealth No, I feel competent in this area

Obtaining further education

Obtaining further education Yes, I need to work on this

Obtaining further education No, I feel competent in this area

Managing a household

Managing a household Yes, I need to work on this

Managing a household No, I feel competent in this area

Parenting my children (if applicable)

Parenting my children (if applicable) Yes, I need to work on this

Parenting my children (if applicable) No, I feel competent in this area

Maintaining my physical health

Maintaining my physical health Yes, I need to work on this

Maintaining my physical health No, I feel competent in this area

Attending to my mental health

Attending to my mental health Yes, I need to work on this

Attending to my mental health No, I feel competent in this area

Accessing support in my community

Accessing support in my community Yes, I need to work on this

Accessing support in my community No, I feel competent in this area

Planning for retirement

Planning for retirement Yes, I need to work on this

Planning for retirement No, I feel competent in this area

Being and feeling "part" of a community

Being and feeling "part" of a community Yes, I need to work on this

Being and feeling "part" of a community No, I feel competent in this area

Maintaining healthy relationships

Maintaining healthy relationships Yes, I need to work on this

Maintaining healthy relationships No, I feel competent in this area

Healthy dating or marriage relationships

Healthy dating or marriage relationships Yes, I need to work on this

Healthy dating or marriage relationships No, I feel competent in this area

Establishing goals for myself

Establishing goals for myself Yes, I need to work on this

Establishing goals for myself No, I feel competent in this area

Finding or changing my career

Finding or changing my career Yes, I need to work on this

Finding or changing my career No, I feel competent in this area

Accessing mentors who can support me

Accessing mentors who can support me Yes, I need to work on this

Accessing mentors who can support me No, I feel competent in this area

	A great deal	Somewhat	A little	Not at all
My identity & personality	My identity & personality A great deal	My identity & personality Somewhat	My identity & personality A little	My identity & personality Not at all
My family, i.e. my children or other family members	My family, i.e. my children or other family members A great deal	My family, i.e. my children or other family members Somewhat	My family, i.e. my children or other family members A little	My family, i.e. my children or other family members Not at all
My relationships with my partner	My relationships with my partner A great deal	My relationships with my partner Somewhat	My relationships with my partner A little	My relationships with my partner Not at all
My career or work aspirations	My career or work aspirations A great deal	My career or work aspirations Somewhat	My career or work aspirations A little	My career or work aspirations Not at all
Travelling	Travelling A great deal	Travelling Somewhat	Travelling A little	Travelling Not at all

A great deal

Somewhat

A little

Not at all

My identity & personality

My identity & personality A great deal

My identity & personality Somewhat

My identity & personality A little

My identity & personality Not at all

My family, i.e. my children or other family members

My family, i.e. my children or other family members A great deal

My family, i.e. my children or other family members Somewhat

My family, i.e. my children or other family members A little

My family, i.e. my children or other family members Not at all

My relationships with my partner

My relationships with my partner A great deal

My relationships with my partner Somewhat

My relationships with my partner A little

My relationships with my partner Not at all

My career or work aspirations

My career or work aspirations A great deal

My career or work aspirations Somewhat

My career or work aspirations A little

My career or work aspirations Not at all

Travelling

Travelling A great deal

Travelling Somewhat

Travelling A little

Travelling Not at all

Let's Talk Cafe: Feedback Survey

Feedback Survey

Question Title

* 1. Describe (in your own words) characteristics of “wellness” being well in your physical body, your mental health, your relationships, and more?

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* 2. Rate the following potential stressors that may impact you from difficult to easy.

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* 3. Describe how these stressors impact your life?

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* 4. Explain the importance of these values for you?

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* 5. What factors make it difficult for you to upload these values?

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* 6. Describe your gaps or areas to develop within yourself?

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* 7. What barriers do you experience in trying to address these gaps for yourself?

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* 8. Kujenga Wellness Project hopes to facilitate support groups and educational workshops to support families. What topics would you like to see from the project?

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* 9. In your experiences, how does anti-Black Racism or other forms of discrimination (i.e. anti-Indigenous racism, homophobia, sexism, anti-Islamophobia) impact the following areas of your life?

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* 10. What resources will help you address the impact of anti-Black racism or other forms of discrimination that you experience?