Portsmouth Hospitals Healthy Lifestyle at Work Survey 2008 If you choose to participate, please complete and submit your response by 30th September 2008.   The Trust is keen to promote the health of its staff.  A fit and healthy workforce is key to success and will support the goals of the Trust.  This survey is intended to help the Trust to be a healthier place to work and to support a positive experience for patients who come to us for their healthcare. The survey is entirely confidential - you will not be personally identified in any way.     We hope you will participate and help the Trust to:         -Learn more about the health of its staff         -Learn how their working day impacts on their health         -Develop an understanding of what is important to staff in terms of improving their health         -Identify how  the Trust can support them in doing this. Your feedback will inform the Trust about what is happening now and how you can be supported in achieving a healthier lifestyle while at work.  Then, we can start working together to make it happen!   Q1 Please state your gender:   Male Female Q2 Age group:   16 - 29 30 - 45 46 - 60 over 60 Q3 Staff group:   Medical Nursing and Midwifery Allied Health Professionals (AHPs) All other staff Q4 How active are you at work? Please select one of the categories:  1=inactive and 4=very active   1 = inactive i.e. sitting all day 2 = fairly inactive i.e. mostly sitting, some walking 3 = fairly active i.e. mostly walking, some sitting 4 = very active i.e. climbing stairs/walking all day Q5 Do you check your weight?   Never Daily Weekly Monthly Infrequently Q6 How would you classify your weight?   Underweight About right for my height and age A little overweight Very overweight Q7 Would you like some support with weight management?  (loss or gain)   Yes No Q8 Do you normally take a meal break within your working day? i.e. leave your normal place of work   Yes No Sometimes Q9 Where do you usually eat your meals at work?   At your desk Staff room Canteen or staff restaurant Retail food outlet Outdoors (in hospital grounds or nearby) Away from the hospital site Car Q10 Where do the meals you eat at work usually come from?   Bring in food from home Local shop off-site Shop on-site Staff restaurant Vending machine Q11 Do you normally eat/drink :  (please tick all that apply)   Daily   Sometimes   Never           5 portions of fruit & vegetables               Breakfast               Mainly caffeine based drinks (e.g. coffee/cola/tea)               Sugar-free drinks / water     Q12 Do you think your meal choice is healthy?   Yes, always Most of the time Sometimes No, not usually Q13 How do you normally get to work?   Walk/run Cycle Car / motorcycle Public transport Q14 If you normally run or cycle do you feel you have adequate:   Yes   No   N/A           Changing areas               Wash facilities               Lockers               Bike stores     Q15 Would you like the Trust to provide information about physical activity and/or diet?   Yes No Q16 If you answered yes to the last question, how would you prefer this information to be made available? (please tick all that apply)   Links to websites Leaflets Posters displayed in food areas Training & education sessions   Other:  (please specify) Q17 A high fibre, low fat, low sugar and low salt diet is a healthy one for most people.  Do you feel a good variety of this kind of food is obtainable from the various food outlets on site?   Yes No N/A  (e.g. I don't know as I've always brought my own) Q18 Do you have any suggestions for how the Trust could improve the availability of healthier diet options? Q19 Do you feel there is enough information available to you to make a healthy choice at mealtimes?   Yes No Q20 Do you usually use the stairs to go from one floor to another at work?   Yes, wherever I can Sometimes Never Q21 Do you have ready access to drinking water during the working day (including bottled or tap water)   Yes No Q22 Do you use sports leisure facilities e.g. gym/swimming pool?   Yes No Sometimes Q23 If you don't use sports leisure facilities, please indicate reasons: (please tick all that apply)   Time Cost I choose not to Other:   If other, please specify: Q24 Is there anything the Trust could be providing? Q25 Any Other Comments: Q26 Your email address: Q27 Please confirm you email address: You must ensure you have given the correct email address.  Please check this and then confirm by repeating it in the last box. Thank you for participating in this audit.   This audit was developed by the The Department of Nutrition & Dietetics at Southampton University Hospitals Trust in collaboration with the Department of Nutrition & Dietetics at Portsmouth Hospitals NHS Trust.   You will receive a receipt confirming successful submission within a month of submitting your form.