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  1. Surveys
  2. 2014
  3. June
  4. W
  5. Wellness Interests
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Exit Survey
 
 
Hello:
Thank you for participating in our Wellness Interest Survey! It will take approximately 5 minutes to complete the questionnaire. It is very important for us to learn your opinions.

If you choose to leave your name out, your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Alex Barrette at ext. 327 or by email at [email protected].

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

Please encourage your coworkers to complete the survey as well!!
 
 
 
Name
   
 
 
 
There are many ways to get health information at the worksite. Which of the following ways would you prefer? (Check all that apply)
 
Pamphlets and other written materials
 
Films and videos
 
Talks by experts (Seminars)
 
Discussion groups
 
Classes or courses
 
Screenings
 
Contests and incentive programs
 
Employee Assistance Programs

 
 
 
If the following were offered, which would you participate in? (Check all that apply)
 
Health Risk Assessment (health screening with questionnaire)
 
Health screenings (blood pressure, cholesterol check, etc.)
 
Educational classes (one hour or multiple-sessions)
 
Walking program
 
Smoking cessation program
 
Health and wellness information provided on the intranet
 
Other
 

 
 
 
What time of the day would be best for you to participate in a health promotion activity?
 
Before Work
 
Lunch Hour
 
After Work
 
Would not participate
 
Other
 
 
 
 
Would you be willing to cost-share with the company for some health promotion activities?
 
Not interested in any health promotion activities
 
Interested, but unwilling to contribute to cost
 
Interested, and willing to contribute a reasonable amount
 
 
Please indicate your interest level for the wellness topics listed below:
Not Interested Neutral Very Interested
Allergies
Asthma
Back Injury Prevention
Cholesterol
Diabetes
Emotional Health
Healthy Cooking
Men's Health
Nutrition
Physical Activity
Not Interested Neutral Very Interested
Smoking Cessation
Walking Program
Weight Management
Women's Health
Developing a personal fitness plan
Aerobics/Pilates/Fitness classes
Improving balance, flexibility, muscle endurance
Dancing
Team Sports
Strength Training
Not Interested Neutral Very Interested
Yoga
Bicycle/Trail riding
Health Screenings
Stress Management
Label and menu reading
Sports nutrition
Helping my children eat healthier
Healthy snack options
Time Management skills
Getting health information that I can read or watch at home
Learning about cancer prevention
Heart health options
CPR and First Aid
Parenting Topics
 
 
 
Please give any suggestions or recommendations for specific activities to include in the health promotion program.
   
 
 
 
If the company decided to offer incentives to promote participation in health promotion programs and healthy behaviors, what kind of incentive would prompt you to make healthy behavior changes?