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Please choose the most correct answers to the questions below.
Thanks!
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| PHYSICAL ACTIVITY |
1. How many times per week do you participate in physical activity? |
a. Everyday
b. 4-6 times/week
c. 2-3 times/week
d. Once a week
e. Rarely
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2. When physically active, how long do you exercise? |
a. 2 or more hours
b. 1.5 - 2 hours
c. 30 minutes -1hour
d. less than 30 minutes
e. Does walking to class count?
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3. In the past week, did you participate in activities or tasks for at least ten minutes that required moderate or more physical effort? (light sweating, increased heart rate, increased breathing, etc. ) |
a. Yes
b. No
c. Unable to do activity
d. Don. t know
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| NUTRITION INFORMATION AND FOOD CHOICES |
4. On average, do you feel that you eat enough fruits and vegetables? |
a. All the time
b. Most of the time
c. Sometimes
d. Rarely
e. Never
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5. How many servings of fruits do you eat daily? |
a. Above 4
b. 4
c. 3
d. 2 or less
e. None
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6. How many servings of vegetables do you eat daily? |
a. More than 4
b. 4
c. 3
d. less than 2
e. None
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7. If you were to estimate how much of your diet comes from fat, how much would it consist of? |
a. 3/4
b. 1/2
c. less than 1/2
d. less than 1/10
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8. Where do you eat most of your meals? |
a. The residence hall dining centers
b. The food court
c. Restaurants and fast food establishments
d. Make them at home or in the residence halls
e. Other
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9. How often do you eat meals outside the home? |
a. Rarely or Never
b. Once a week
c. 2-3 times/week
d. 4-5 times/week
e. 6-7 times/week
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10. How many alcoholic drinks do you consume in one week? |
a. 1 or less
b. 2-5 drinks
c. 6-9 drinks
d. more than 10 drinks
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| OTHER |
11. What year are you in school? |
a. Freshman
b. Sophomore
c. Junior
d. Senior
e. Graduate student
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12. What is your gender? |
a. Male
b. Female
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13. Would you agree that you are at a healthy or ideal body weight? |
a. Strongly agree
b. Agree
c. Disagree
d. Strongly disagree
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14. Do you feel that you need to lose weight? |
a. Strongly agree
b. Agree
c. Disagree
d. Strongly Disagree
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15. Do you feel that you need to change your eating and/or exercise habits? |
a. Strongly agree
b. Agree
c. Disagree
d. Strongly Disagree
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16. What options would you consider using to lose weight? |
a. Healthy eating
b. Exercise
c. Diet plus exercise
d. Fad diets (Atkins, cabbage, flavor-point, popular diets, etc. )
e. Diet pills
f. Surgery
g. Other
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18. If made available would you participate in an EIU sponsored program to improve health across the campus? |
a. Definitely
b. Maybe, I need more information.
c. Indifferent
d. No, thank you.
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19. I use supplements or single nutrient vitamins to enhance my health. |
a. Strongly agree
b. Agree
c. Disagree
d. Strongly Disagree
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20. I feel that I need help making the right decisions regarding food. |
a. Strongly agree
b. Agree
c. Disagree
d. Strongly Disagree
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21. I feel that there are many opportunities to maintain a healthy lifestyle at EIU. |
a. Strongly agree
b. Agree
c. Disagree
d. Strongly Disagree
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22. I have attended a lecture or seminar regarding better health here at EIU. |
a. Yes
b. No
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Do you have any suggestions or ideas you would like to see implemented on EIU's campus regarding health and nutrition?
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