Surveys
2014
November
H
Healthy Kids Live Here Program Survey

Healthy Kids Live Here Program Survey

Exit Survey

I am a...

Program participant

Parent/guardian of program participant

Other

I have participated in this program for...

1 year

2 years

3 years

4 or more years

My age range is...

younger than 5 years old

5-7 years old

8-10 years old

11-13 years old

14-16 years old

17 years or older

I am a...

Male

Female

I chose to participate in this program because...

PHYSICAL ACTIVITY
Please rate the following on a scale from 1 to 5
1=strongly disagree
2=disagree
3=indifferent/unsure
4=agree
5=strongly agree

I enjoyed the sports taught and played in this program.

I enjoyed the fitness activities taught in this program.

I learned useful skills from the sports/fitness aspect of this program.

I feel that I am more fit now than I was before I joined this program.

I feel that I make healthier choices now than before I joined the program.

I enjoy being physically active as a result of this program.

I feel that I learned useful life skills in this program.

In the future, I would like to see the following sports/fitness activities integrated in the program:

Comments/suggestions to improve the physical activity aspect of the program:

NUTRITION
Please rate the following on a scale from 1 to 5
1=strongly disagree
2=disagree
3=indifferent/unsure
4=agree
5=strongly agree

I enjoyed the nutrition lessons taught in this program.

I learned skills that will improve my ability to create healthy meals.

I have a greater desire to eat healthier foods as a result of this program.

I have influenced family or friends to make healthier choices because of what I have learned.

I have utilized the skills I learned regarding cooking recipes.

I have utilized the skills I learned regarding grocery shopping.

I have utilized the skills I learned regarding budgets.

I have utilized the skills I learned regarding nutrition labels.

PERSONNEL
Please rate the following on a scale from 1 to 5
1=strongly disagree
2=disagree
3=indifferent/unsure
4=agree
5=strongly agree

I have built positive peer relationships in this program.

I have built positive adult-youth relationships in this program.

I feel safe when I am in this program.

I feel as though the program staff cares about me.

I feel like my voice is heard.

I made new friends in the program.

I would recommend this program to a friend or family member.

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