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Worksite Wellness for Tompkins County

Worksite environments that support good nutrition and regular physical activity
in Tompkins County, NY

web site home page < http://www.tompkins-co.org/wellness/worksite/ >

Employee Interest Survey

This short survey is designed to get a feel for where employee interests lie, while at the same time giving employees a chance to better understand the concept of a wellness program. It is best to keep all responses anonymous.

Select one number for each question:

4=Very likely
3=Somewhat likely
2=Not very likely
1=Not at all likely


  1. I buy heart healthy snacks when they are available (for example, pretzels, cereals, yogurt, 1% or skim milk, fresh fruit, 100% juice, raisins or other dried fruit, NOT candy, chips, pastry, etc.)

  4   3   2   1  

  2. If I had a 5-minute break I would use it for a personal activity—like stretching, yoga, or a walk—if there were a place to do it.

  4   3   2   1  

  3. I would eat fruit if available at our staff meetings.

  4   3   2   1  

  4. I would participate in group activities encouraging healthy eating or physical activity if they were offered to staff

  4   3   2   1  

  5. I would use resource guides for healthy eating or physical activity (for example, how-to books, videos, and recipes) if they were available.

  4   3   2   1  

  6. I am satisfied with my current state of health.

  4   3   2   1  

  7. I make time for 20 or more minutes of physical activity most days of the week.

  4   3   2   1  

  8. I don’t think about health when deciding what to eat.

  4   3   2   1  

  9. It’s hard for me to get as much exercise as I should.

  4   3   2   1  

10. I try to look for healthier foods, but usually eat whatever is available.

  4   3   2   1  

11. I don’t know what is meant by “worksite wellness”.

  4   3   2   1  

12. Healthier people are more productive at work.

  4   3   2   1  

13. Paying attention to eating healthy and getting exercise is a lot of trouble.

  4   3   2   1  

14. I know what it takes to lead a healthy lifestyle.

  4   3   2   1  

15. Whether or not to live a healthy lifestyle is completely up to the individual.

  4   3   2   1  



Additional comments are welcome!
Please write them on a separate sheet of paper.

If you want to know more about this program and how you can help, please contact your supervisor.