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  1. Surveys
  2. 2014
  3. May
  4. M
  5. Mediator Outcomes
 
 
When is the last time you cooked a meal from scratch?
 
Less than 1 month
 
2 months to less than 6 months
 
6 months to less than 1 year
 
Only on the holidays
 
I never cook
 
 
 
Which form of physical activity do you most participate in?
 
Walking
 
Running
 
Bicycling
 
Dancing
 
Swimming

 
 
 
How frequently do you dine at restaurants?
 
Every day
 
Every week
 
Every 2 - 3 weeks
 
Every month
 
Every 2 - 3 months
 
Every 4 - 6 months
 
Once or twice a year
 
 
 
How would you rate your level of satisfaction with your healthy living efforts?
 
Highly satisfied
 
Somewhat satisfied
 
Neutral
 
Somewhat dissatisfied
 
Highly dissatisfied
 
 
How much do you eat the following food groups?
0-1 2 3 4 5+
Fatty foods
Dairy
Fruits
Vegetables
Meats
Grains
 
 
Comment:
   
 
 
 
How likely are you to join a health and nutrition program in the workplace?
 
Very likely
 
Somewhat likely
 
Neutral
 
Somewhat unlikely
 
Very unlikely
 
 
 
How likely is it that you would exercise in the workplace if the facility was available?
 
Very likely
 
Somewhat likely
 
Neutral
 
Somewhat unlikely
 
Very unlikely
 
 
 
Do you smoke cigarettes?
   
 
 
 
Do you smoke?
 
1 pack a day
 
1 pack a week
 
Only when I'm stressed.
 
 
 
Which category describes your age?
 
Younger than 18
 
18 - 24
 
25 - 34
 
35 - 44
 
45 - 54
 
55 - 64
 
65 or older
 
Prefer not to answer
 
 
 
What best describes your employment status?
 
Employed full-time
 
Employed part-time
 
Self-employed
 
Not employed, but looking for work
 
Stay-at-home mom
 
Retired
 
Student
 
Military
 
House wife
 
Prefer not to answer
 
Other
 
 
 
 
How many children do you have?
 
10 or more
 
9-10
 
7-8
 
5-6
 
3-4
 
1-2
 
No children yet
 
Prefer not to answer