Health Survey

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Hola!

You have been invited to participate in this survey. Here, approximately 250 people will be asked to complete a survey that asks questions about student and general health. It will take approximately 10 minutes to complete the questionnaire.

Your participation in this study is completely voluntary. If you find a question that you are uncomfortable with or cannot respond accurately to, feel free to skip that question.

Your survey responses will be strictly confidential. Your privacy is the #2 priority for me. (Getting this research done is #1)

When you're done with this survey, please forward this survey to everyone else on your contact list. I would like as many responses as I can get for this survey, because the larger the sample size, the more accurate my results will be. (Statistics 101!)

I appreciate your time and help. Please start with the survey now by clicking on the Continue button below.

-3. Are you male or female? (If you wanted "Other," too bad!)

Male

Female

-2. How old are you?

Pre-teen (less than 14)

High school student (15 to 18)

College student (18 to 25)

Adult (25 to 65)

Senior citizen (more than 65)

-1. Which grade are you currently enrolled in if you are in high school?

9 (I'm a freshie! High school is cool!)

10 (Freshies are stupid)

11 (OMG! The ACTs and SATs are knocking on my door!)

12 (High school is sooooo boring! I'm sooo outta here!)

0. According to the U.S. Census, what is your race or ethnicity? ("None" or "I don't know" is not a choice. If you need help, ask a friend.)

African American/Black

Asian American/Pacific Islander

Caucasian/White

Hispanic/Latin

Mix of 2 or more races

1. On average, how much sleep do you get on weekdays during the school year?

Less than 3 hours (Sleeping is overrated. It's a major study party for me every night.)

3 to 5 hours

5 to 7 hours (I get what I need)

7 to 9 hours

9 or more hours (My life is paradise)

2. How many AP (or college level 100 and above) or Honors classes did you enroll in this year? (This question is intended for high school students only)

0 to 2 (I live on the bare minimum)

4 (I like to challenge myself or save money with AP credits)

6 (Harvard here I come!)

3. On average, how frequently do you exercise per week? Exercise can be defined by 20 consecutive minutes of physical activity, including walking.

Never (I'm a potato on a couch)

1 to 2 days

3 to 4 days (I don't like to overdo things)

5 to 6 days

Every day (If I skip a day, I might die)

4. What kind of extracurricular activites do you engage in? (select all that apply)

Academic club (Science Olympiad or similar)

Culture or language club (Spanish Club or similar)

Community service (Library, hospital, or similar)

Debate or speech

Editorial work or journalism

Music (Orchestra or band; in-school or out-of-school)

Paid work (wearing that ridiculous suit in McDonald's)

Political organization (Go Obama!)

Religious organization

Sports (JV or Varsity or out-of-school club sports)

Theatre or choir

Student government (the one where the head of state has the least power)

5. How many extracurricular activities do you participate in?

0-1: I do as little as possible so that I can go home and play video games.

2-3

4-5: I do quite a bit but not to overdo things.

6-7

8+: Who knows? Maybe Yale will like it.

6. Which of the following do you have and regularly use?

An MP3 player (e.g. Apple iPod, Microsoft Zune)

Calling other people on cell phone

"Txt"ing other ppl on cell phone

E-mail (e.g. Hotmail, G-mail, as long as it's fast and free)

Social networking site (e.g. MySpace, Facebook, Last.fm, eHarmony.com ... oh wait that's not for teens)

Video games (e.g. Nintendo Wii is the best, Xbox 1 and the other that did a 360, PS 1, 2, and 3)

7. How much time do you spend on the computer each day?

Less than 30 minutes (I don't need a computer!)

30 minutes to 1 hour

1 hour to 2 hours (I do what I need)

2 hours to 4 hours

More than 4 hours (YouTube does wonders!)

8. Some people do have a 20/20 vision, or the so-called "perfect sight," without any vision-correcting instrument. Do you require prescription glasses or contact lenses so that you can see properly?

Yes

9. Rate the prescription of your glasses or contact lenses.

Minimal prescription (less than 1): I don't need glasses. I'm almost perfect.

Some prescription (1 to 2)

Moderate prescription (2 to 4): Okay. I might need some help seeing.

Heavy prescription (4 to 6)

Extremely heavy prescription (6 or more): I'm blind! Too much time on the computer for me!

For questions 10 through 22, rate how likely you are to follow or exhibit these habits:

	Never	Unlikely	Likely	Very likely	Certain
10. Stressing out because you just might fail	Never	Unlikely	Likely	Very likely	Certain

11. Being aggressive and competitive because getting into a top school like MIT guarantees success	Never	Unlikely	Likely	Very likely	Certain

12. Demonstrating a sincere desire to learn for no real reason (aka "nerd")	Never	Unlikely	Likely	Very likely	Certain

13. Being pressured by parents to succeed or they'll kill you and ship your remains off to Siberia	Never	Unlikely	Likely	Very likely	Certain

14. Sleeping in class (fishing with your head)	Never	Unlikely	Likely	Very likely	Certain

15. Maintaining a healthy diet (and hoping to not pay for medications when you get older)	Never	Unlikely	Likely	Very likely	Certain

16. Taking a shower to get rid of the PU	Never	Unlikely	Likely	Very likely	Certain

17. Skipping school when sick (heck you can do whatever you want at home)	Never	Unlikely	Likely	Very likely	Certain

18. Flushing the toilet at school for the common good	Never	Unlikely	Likely	Very likely	Certain

19. Washing hands with anti-bacterial soap and murdering unwanted bacteria (but it's legal!)	Never	Unlikely	Likely	Very likely	Certain

	Never	Unlikely	Likely	Very likely	Certain
20. Sticking a carrot stick up your nose because it adds decent flavor	Never	Unlikely	Likely	Very likely	Certain

21. Covering nose when sneezing because other people don't need to get sick	Never	Unlikely	Likely	Very likely	Certain

22. Getting sick (maybe from that obnoxious kid who sneezed on you)	Never	Unlikely	Likely	Very likely	Certain

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