Erasmus Plus HAPPENS 2015-2017 Initial Wellness Survey for adults.

1.
Erasmus Plus HAPPENS 2015­2017 Initial Wellness Survey
October/November 2015
Introduction:
This is a health and wellness check that is being conducted as part of the European
Union initiative under the Erasmus Plus Programme 'Erasmus Plus HAPPENS.' Six
Primary Schools across Europe are participating. The six schools are in Galway,
Ireland; Salerno, Italy; Cardiff, Wales; Athens, Greece; Radomsko, Poland and
Barcelona, Spain (our group's coordinating school). We would like you take this
survey so that we may find out what your health and wellness is in three areas. The
three areas are: 1: Physical fitness 2: Social/Emotional and Mental Health 3:
Nutrition/Sleep & Rest
The results of this survey are anonymous and we cannot see your name, your school,
your location, your email or any of your identifying information. We are merely
looking for an overall profile of the general health and well being of our staff and
parents (in the case of some schools) in our school community. We will also be
assessing the same in the students but this will be done with a paper and pencil survey
which will be more appropriate to their age and maturity level. This will also be
anonymous and they will not write their name on their paper.
The results of the initial health and wellness survey will guide the coordinators of the
project in choosing training and learning experiences for the staff and students which
will be most beneficial for them and which are the most appropriate taking into
consideration their specific needs and strengths.
The same survey will be conducted at the end of the project (in May/June 2017) to see
how successful the initiatives, training and projects we conducted during the two
years were. We will be obliged to report these quantitative results to our National
Agency, Léargas, in our final report which will be passed on to the European Union.
This survey is specifically for teachers/staff. There will be another survey for
parents/families.
We appreciate your participation and hope you have a fantastic day!

2.
Are you male or female? ​*
o ​Male
o ​Female
I would say my overall health and wellness on a scale from 1 to 5
is.... ​*
1 2 3 4 5
Excellen
t
Poo
r
Nutrition, Sleep and Rest
Q 1. How would you rate your diet? ​*
o ​Excellent
o ​Fair
o ​Poor
Q 2. Which is most important to you when planning meals? ​*
o ​Cost
o ​Convenience
o ​Provenance (Provenance means the food you eat is
sourced.)
o ​Quality
o ​Flavour / Tastiness
Q 3. Do you actively plan to avoid high sugar, high fat, highly
processed food in your diet? ​*
o ​Always
o ​Sometimes
o ​Never
Q 4. How aware are you of the ingredients of the food you eat? ​*
o ​Very aware
o ​A little aware
o ​Unaware
Q 5. How many hours sleep do you get per night? ​*
o ​9 hours plus

3. o ​6-8 hours
o ​3-5 hours
Q 6. Do you place high importance on good quality sleep? ​*
o ​Yes
o ​No
Q 7. How would you rate the quality of your sleep? ​*
o ​Good
o ​Fair
o ​Poor
Q 8. Which of these are you most likely to use to rest and relax? ​*
(You may choose more than one)
o ​Technology ​ Should we differentiate between TV and
computer games etc?
o ​Alcohol
o ​Reading
o ​Music
o ​An outdoor activity
o ​Socialising
o ​Yoga
o ​Meditation/Mindfulness
o ​Taking a short nap (less than an hour)
o ​None of the above
o ​Other:​
o What about leisure activity or exercise?
Q 9. Do you make time to rest when and if you need it? ​*
o ​Yes
o ​No
o ​I don't tend to need it.
o ​Other:​
Q 10. How much water do you drink on average daily? ​*
o ​0-3 glasses
o ​4-6 glasses

4. o ​7-9 glasses
o ​9 plus glasses
o ​Other:​
Physical Fitness
Q 11. Over a typical week, how many days are you physically active for
a total of at least 60 minutes per day? ​*
Options on this pull down menu:
0 days
1-3 days per week
3-5 days per week
5-7 days per week
I’m active several times a day
Q 12. How often do you travel to and from work by either cycling,
walking, running, skating etc? ​*
Options on this pull down menu:
Every day
A couple times a week
Once a week
A few times a month
Never
Q 13. How often do you take part in sports and physical activities in a
team sport? ​*
1 2 3 4 5
alway
s
neve
r
Q 14. Over a typical day, how long do you spend sitting down, either
watching TV, at your desk, relaxing, on the computer etc..? ​*
Options on this pull down menu:
1 hour
2 hours
3 hours
4 hours
5 + hours

5. Q 15. The recommended amount of weekly physical exercise is
150minutes per week. How much exercise do you get per week? ​*
Options on this pull down menu:
Less than 50 minutes per week
50-100 minutes per week
100-150 minutes per week
150-200 minutes per week
200+ minutes per week
Q 16. How important do you think being physically active is? ​*
Options on this pull down menu:
Extremely important
Important
Moderately important
Fairly important
Not important
Q 17. What are the main reasons you don't get enough physical
activity? (tick as many as apply to you) ​*
o ​too busy
o ​family committments
o ​lack of confidence in my fitness levels / abilities
o ​no access
o ​medical / physical reasons
o ​do not enjoy sports / physical activities
o ​Other:​
Q 18. I have some unhealthy habits (i.e smoking, over consumption of
alcohol, etc.) which I would like to reduce to become healthier. ​
Options on this pull down menu:
Yes
No
Does not apply to me.
Q 19. I feel strong and physically fit. ​*
1 2 3 4 5
Strongly
Agree
Strongly
Disagree

6. Q 20. I feel my physical health impacts on my professional
performance in a ... ​*
Options on this pull down menu:
My physical health impacts on my professional performance in a
positive way.
My physical health has no impact on my professional performance.
My physical health impacts on my professional performance in a
negative way.
Social Emotional Mental Health and Wellness
Q 21. I get emotional support from my family and friends.
1 2 3 4 5
Alway
s
Neve
r
Q 22. I have positive relationships with my colleagues.
1 2 3 4 5
Alway
s
Neve
r
Q 23. I am good at identifying how I feel.
1 2 3 4 5
Alway
s
Neve
r
Q 24. I am capable of dealing with stressful situations.
1 2 3 4 5
Alway
s
Neve
r
Q 25. Generally, I have ___________ to myself during the day.
o ​no time
o ​0 - 10 minutes
o ​10 - 30 minutes
o ​30 minutes - 1 hour
o ​1 hour or more
Q 26. I have a special interest/hobby that I engage in ...
o ​never
o ​daily

7. o ​weekly
o ​once a month
Q 27. People enjoy being in my company.
1 2 3 4 5
Alway
s
Neve
r
Q 28. I make achievable goals for myself.
1 2 3 4 5
Regularl
y
Neve
r
Q 29. I am _________ at maintaining and developing
friendships/relationships.
1 2 3 4 5
Excellen
t
Poo
r
Q 30. I am ____. ​(​(​good)​)​ at saying 'no' to people who ask me to
do things for them when I already have a full schedule of
responsibilities. ​*
1 2 3
Goo
d
Poo
r
Personal Goals...In two years time when this project has been
completed, I would like to to have achieved the following goal/s in any
or all of the areas above....
This is optional!
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