KOAA - U of R Dept of Pediatrics survey about obesity management services U of R Pediatrics survey 2014 A children's hospital is exploring a variety of options in developing treatment programs for childhood obesity. They are in the process of surveying parents find out what factors make family obesity management easiest and most convenient. KidsOutAndAbout is proud to partner with them by helping them access the opinions of parents who read our web site. If you are a parent or primary caregiver of children between the ages of 2 and 18, we invite you to lend your voice to help mold future childhood obesity treatment programs by taking this short survey. This information will be used to help craft ideal childhood obesity treatment models for future programs across the country. Those who complete the survey may be entered into a drawing for one of four $50 Amazon gift cards. You may remain anonymous in the survey if you don't want to enter the drawing; if you decide to enter, there is space for providing your name and email address at the end. Thank you in advance for your ideas and opinions! Question Title * 1. What age child(ren) are in your care? 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Question Title * 2. Please indicate your age: 18-24 25-34 35-44 45-54 55 and over Question Title * 3. Are you a single parent? No Yes Question Title * 4. Are you male or female? Male Female Question Title * 5. What state do you live in? AK Alaska AL Alabama AR Arkansas AZ Arizona CA California CO Colorado CT Connecticut DE Delaware FL Florida GA Georgia HI Hawaii IA Iowa ID Idaho IL Illinois IN Indiana KS Kansas KY Kentucky LA Louisiana MA Massachusetts MD Maryland ME Maine MI Michigan MN Minnesota MO Missouri MS Mississippi MT Montana NC North Carolina ND North Dakota NE Nebraska NH New Hampshire NJ New Jersey NM New Mexico NV Nevada NY New York OH Ohio OK Oklahoma OR Oregon PA Pennsylvania RI Rhode Island SC South Carolina SD South Dakota TN Tennessee TX Texas UT Utah VA Virginia VT Vermont WA Washington WI Wisconsin WV West Virginia WY Wyoming Question Title * 6. What is your zip code? Question Title * 7. Is/are your child or children affected by excess weight? Yes No Maybe Question Title * 8. Please indicate your level of concern for your child’s weight: I am not concerned about my child’s weight. I am somewhat concerned about my child’s weight. I am very concerned about my child’s weight. Question Title * 9. Would you consider obesity a concern among your family? Yes, obesity is a major issue in our family. Obesity is somewhat of an issue in our family. Obesity is not an issue in our family. Question Title * 10. If your child's doctor told you your child needed to be treated for obesity, where would you prefer to take your child to address their weight? (Rate each option: 1 is NOT AT ALL favorable, 10 is MOST favorable) 1 2 3 4 5 6 7 8 9 10 Pediatrician’s office Pediatrician’s office 1 Pediatrician’s office 2 Pediatrician’s office 3 Pediatrician’s office 4 Pediatrician’s office 5 Pediatrician’s office 6 Pediatrician’s office 7 Pediatrician’s office 8 Pediatrician’s office 9 Pediatrician’s office 10 Local/regional children's hospital Local/regional children's hospital 1 Local/regional children's hospital 2 Local/regional children's hospital 3 Local/regional children's hospital 4 Local/regional children's hospital 5 Local/regional children's hospital 6 Local/regional children's hospital 7 Local/regional children's hospital 8 Local/regional children's hospital 9 Local/regional children's hospital 10 Local community center or church Local community center or church 1 Local community center or church 2 Local community center or church 3 Local community center or church 4 Local community center or church 5 Local community center or church 6 Local community center or church 7 Local community center or church 8 Local community center or church 9 Local community center or church 10 Local school Local school 1 Local school 2 Local school 3 Local school 4 Local school 5 Local school 6 Local school 7 Local school 8 Local school 9 Local school 10 Local recreation center or YMCA Local recreation center or YMCA 1 Local recreation center or YMCA 2 Local recreation center or YMCA 3 Local recreation center or YMCA 4 Local recreation center or YMCA 5 Local recreation center or YMCA 6 Local recreation center or YMCA 7 Local recreation center or YMCA 8 Local recreation center or YMCA 9 Local recreation center or YMCA 10 Your place of work Your place of work 1 Your place of work 2 Your place of work 3 Your place of work 4 Your place of work 5 Your place of work 6 Your place of work 7 Your place of work 8 Your place of work 9 Your place of work 10 Doing it on my own without professional intervention Doing it on my own without professional intervention 1 Doing it on my own without professional intervention 2 Doing it on my own without professional intervention 3 Doing it on my own without professional intervention 4 Doing it on my own without professional intervention 5 Doing it on my own without professional intervention 6 Doing it on my own without professional intervention 7 Doing it on my own without professional intervention 8 Doing it on my own without professional intervention 9 Doing it on my own without professional intervention 10 Question Title * 11. On a scale of 1-5, where 1 is unimportant and 5 is extremely important, how important do you think it is to start or continue a professional weight management program for your child(ren)? 1 – Unimportant 2 – Slightly Important 3 – Somewhat important 4 – Very Important 5 – Extremely Important Question Title * 12. Would you be interested in answering 8 more survey questions about professionally-guided weight management treatment options for children? Yes No Next