Active Lifestyle Wellbeing Programme Survey

Page 1: Page 1

1.1. Name:

2.2. Email address:

3.3. What is your age group?

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 or over

4.4. Are you a staff member or a student?

Staff

Student

5.5. Are you an International Staff member or Student

Yes

No

6.6. Are you a current member of UofG Sport?

Yes

No

This part of the survey uses a table of questions, view as separate questions instead?

7.7. Do you currently exercise? (minimum 20 minutes vigorous excerise i.e. increasing heart rate and increasing breathing rate for a minimum of 20 minutes)

Please don't select more than 1 answer(s) per row.

	No	1-2 times per month	3-4 times per month	1-2 times per week	3-4 times per week	more often
current activity levels

This part of the survey uses a table of questions, view as separate questions instead?

8.8. How likely would you say the following statements as your reasons that prevent you from exercising?

Please don't select more than 1 answer(s) per row.

	Agree	Somewhat agree	Neutral	Slightly disagree	Disagree
I don't have enough time
Cost of membership
I don't know where to start
I have no one to exercise with
I don't know what to do
I don't know what to wear
I don't like it
I feel self-conscious about exercising

This part of the survey uses a table of questions, view as separate questions instead?

9.9. Please indicate how you feel about each of the statements below regarding taking part in exercise.

Please don't select more than 1 answer(s) per row.

	Agree	Somewhat agree	Neutral	Somewhat disagree	Disagree
Exercise should be fun and enjoyable
I feel too weak to exercise
It fills me with fear
I don't have the motivation for it
Exercise is boring
I am worried about getting injured
I don't like exercise
I prefer to exercise as part of a group
I prefer to exercise on my own but with a programme to follow
I don't like getting hot and sweaty
I am too tired to exercise
I don't see the point in exercising
Exercise makes me feel energised

10.10. What type of exercise / activity are you interested in? (tick all that apply)

Walking

Jogging

Programme using weights

Programme using cardiovascular equipment (treadmill, bikes etc)

Group exercise classes

Yoga

Pilates

Hill walking

Swimming

Cycling

I don't know

Other

This part of the survey uses a table of questions, view as separate questions instead?

11.11. How would you classify your current physical health on a scale of 1 to 5 (5 excellent, 1 low)

Please don't select more than 1 answer(s) per row.

	1 Low	2	3 Satisfactory	4	5 Excellent
Physical Health

This part of the survey uses a table of questions, view as separate questions instead?

12.12. How would you classify your current mental health on a scale of 1 to 5 (where 5 is excellent and 1 is Low)

Please don't select more than 1 answer(s) per row.

	1 Low	2	3 Satisfactory	4	5 Excellent
Mental Health

This part of the survey uses a table of questions, view as separate questions instead?

13.13. Percieved Stress Scale, please rate each statement

Please don't select more than 1 answer(s) per row.

	0-never	1-almost never	2-sometimes	3-fairly often	4-very often
In the last month, how often have you been upset because of something that happened unexpectedly?
In the last month, how often have you felt that you were unable to control the important things in your life?
In the last month, how often have you felt nervous and stressed?
In the last month, how often have you felt confident about your ability to handle your personal problems?
In the last month, how often have you felt that things were going your way?
In the last month, how often have you found that you could not cope with all the things that you had to do?
In the last month, how often have you been able to control irritations in your life?
In the last month, how often have you felt that you were on top of things?
In the last month, how often have you been angered because of things that happened that were outside of your control?
In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?

14.14. Any additional comments