ࡱ> lnky Gbjbj 4v{{G RRRRRffffL4fqssssss$ tRRR RRqqPJy~]06#6#6#R6# : Appendix Survey Questionnaire Administered to Take-a-Stand Project Participants, Minneapolis, Minnesota, 2011 Demographics How old are you? (1st questionnaire only)[drop down]What is your gender? (1st questionnaire only)( Male ( FemaleHow tall are you? (1st questionnaire only) __________ feet, __________ inches (round to the nearest inch)How much do you weigh? (all 3 questionnaires)  __________ pounds Physical Activity How many days in a usual week do you do vigorous activities for at least 10 minutes at a time, such as running, aerobics, heavy yard work, or anything else that causes a large increase in your breathing or heart rate?( 0 ( 4 ( 1 ( 5 ( 2 ( 6 ( 3 ( 7On days when you do vigorous activities for at least 10 minutes at a time, how much total time (minutes) each day do you spend doing these activities?[drop down menu listing numbers from 10 through 120 and 120 minutes or more] ( I do not do vigorous activities for at least 10 minutes at a timeHow many days in a usual week do you do moderate activities for at least 10 minutes at a time, such as brisk walking, bicycling, vacuuming, gardening, or anything else that causes a small increase in your breathing or heart rate?( 0 ( 4 ( 1 ( 5 ( 2 ( 6 ( 3 ( 7On days when you do moderate activities for at least 10 minutes at a time, how much total time (minutes) each day do you spend doing these activities?[drop down 10 thru 120; 120 minutes or more] ( I do not do moderate activities for at least 10 minutes at a timeConsidering a 7-day period (a week), how many times on average do you do strenuous exercise (heart beats rapidly) for more than 15 minutes during your free time? [drop-down menu listing numbers from 0 through 20 or more] Sitting In a usual day, how much time do you sit at work? __________ hours____ ___minutes General Health Status In general, would you say your health is: ( Excellent ( Very Good ( Good ( Fair ( PoorIn the last month, how much difficulty did you have doing your work or other regular activities as a result of your physical health? ( Not at all ( A little bit ( Moderately (Quite a bit ( ExtremelyIn the last month, to what extent have you accomplished less than you would like in your work or other daily activities as a result of your emotional health such as feeling stressed, depressed or anxious? ( Not at all ( A little bit ( Moderately (Quite a bit ( Extremely Pain On a scale of 0-10, please rate your current level of:( 0 = No discomfort ( 1 ( 2 ( 3 ( 4 ( 5 ( 6 ( 7 ( 8 ( 9 ( 10 = Extremely uncomfortableLower back pain or discomfort [Use scale above]Upper back, neck and shoulder pain[Use scale above] Office Behavior What proportion of the time do you conduct your work within the Health Promotion Department HPD using the following methodsInformal face to face conversations_____%Moving breaks_____% Feelings (POMS Questionnaire) The following list describes feelings people have. Please read each one carefully and select the answer that best describes your feelings in the past week. ( Not at all ( A little ( Moderately ( Quite a bit ( ExtremelyWorn out [Use scale above for all feelings]PeevedCheerfulRestlessEmbarrassedBewilderedHopelessWearyBitterVigorousNervousAshamedForgetfulHelplessConcentrateResentfulFull of pepMiserableFuriousLivelyOn-edgeProudConfusedSadFatiguedGrouchyActiveTenseCompetentBushedWorthlessExhaustedAngryEnergeticUneasySatisfiedUncertainAnxiousDiscouragedAnnoyed What specific benefits did you gain by alternating between a seated and standing position:(check all that apply) ( Uncertain ( Less stressed ( More comfortable ( More productive ( More focused ( Happier ( Energized ( Healthier ( None of the above ( Other (please specify): __________________________________  mno{    µtmt[[mt" jh h CJOJQJaJ h h "h h 6CJH*OJQJaJh h 6CJOJQJaJh h CJOJQJaJh h 5CJOJQJaJh,p5CJOJQJaJh h,p5CJOJQJaJh h 5CJOJQJaJhoG5CJOJQJaJh hx5CJOJQJaJno} $IfgdWS[[kd$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[gd gd   B ^ $IfgdWS[ $IfgdWS[[kdd$$Ifl40!((2 s244 laf4ytWS[ ^ _ v w ñ⢒ӀӀnnnnnnnn" jh h CJOJQJaJ"h h 56CJOJQJaJh h 5CJOJQJaJh hrCJOJQJaJ"h h 6>*CJOJQJaJh h 6CJOJQJaJh h CJOJQJaJ h h ,h0h CJOJQJaJmH nH sH tH !^ _ 5[kd,$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[ $IfgdWS[[kd$$Ifl40!((2 s244 laf4ytWS[ G zk  $IfgdWS[ d$IfgdWS[[kd$$Ifl40!((2 s244 laf4ytWS[  $IfgdWS[ $IfgdWS[gd    G Q k r v z ~    4 H ䷫ph h 5CJOJQJaJ"h h 56CJOJQJaJ h h " jh h CJOJQJaJh7CJOJQJaJh h CJOJQJaJ;h0h 56B*CJOJQJaJmH nH phsH tH 5h0h B*CJOJQJaJmH nH phsH tH , tttt  $IfgdWS[ $IfgdWS[[kd$$Ifl40!((2 s244 laf4ytWS[   P$If^ `gdWS[ w x P$If^ `gdWS[  $IfgdWS[ $IfgdWS[[kdX$$Ifl40!((2 s244 laf4ytWS[ &'()?jkvwŸzczŨQQQQ" jh h CJOJQJaJ,h0h"CJOJQJaJmH nH sH tH ,h0hUCJOJQJaJmH nH sH tH ,h0h CJOJQJaJmH nH sH tH h h 5CJOJQJaJh,p5CJOJQJaJh 5CJOJQJaJh0CJOJQJaJh7CJOJQJaJ h h h h CJOJQJaJ 50gd [kd $$Ifl40!((2 s244 laf4ytWS[ $Ifgd0 $IfgdWS[[kd$$Ifl40!((2 s244 laf4ytWS['()?jvvv $IfgdWS[ $IfgdWS[[kd$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[ $IfgdWS[gd +:GT` $IfgdWS[[kd$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[ $IfgdWS[ +,:;GHTU`a/0<=KLXYefqrsxtttb" jh hpCJOJQJaJh hpCJOJQJaJh% jh hpCJOJQJaJhh h 5CJOJQJaJ,h0h CJOJQJaJmH nH sH tH 2 jh0h CJOJQJaJmH nH sH tH  h h " jh h CJOJQJaJh h CJOJQJaJ&`a/<KXeq{ $IfgdWS[ $IfgdWS[ $IfgdWS[ $IfgdWS[[kdL$$Ifl40!((2 s244 laf4ytWS[qrsx $Ifgdp $IfgdWS[gd [kd$$Ifl40!((2 s244 laf4ytWS[%&689\lnopᬥ񓄓}}n^nRnh0CJOJQJaJh h 5CJOJQJaJh h CJOJQJaJ h hphp6CJOJQJaJh"h hp6CJOJQJaJh h h h h CJOJQJaJh" jh hpCJOJQJaJ% jh hpCJOJQJaJhh hpCJOJQJaJhh hpCJOJQJaJ %89\5[kdx$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[ $IfgdWS[[kd$$Ifl40!((2 s244 laf4ytWS[\nop $IfgdWS[ $IfgdWS[gd [kd$$Ifl40!((2 s244 laf4ytWS[ $Ifgd +,-BCDb  %&'34?@IJNmnuvwٶْhp6CJOJQJaJh"h h 6CJOJQJaJh" jh h CJOJQJaJ% jh h CJOJQJaJhh h 5CJOJQJaJh h CJOJQJaJ h h h h CJOJQJaJh3$+~r $$Ifa$gdWS[ $IfgdWS[ $IfgdWS[nkd@$$Ifl4FH!    2 s244 laf4yt,p+,-;B~r $$Ifa$gdWS[ $IfgdWS[ $IfgdWS[nkd$$Ifl4FH!    2 s244 laf4yt,pBCDb %3?yyyyy $IfgdWS[ $IfgdWS[gd nkd$$$Ifl4FH!    2 s244 laf4yt,p ?@Imnu5[kd$$Ifl40!((2 s244 laf4ytWS[ $Ifgdp $IfgdWS[[kd$$Ifl40!((2 s244 laf4ytWS[uvw5[kd$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kd^$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[5[kd $$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kd& $$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[5[kdR $$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kd $$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[5[kd $$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kd $$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[ !",-.678?@AIJKQRS\]^bcdmnowxyh h CJOJQJaJhh h CJOJQJaJ h h V5[kd $$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kd~ $$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[5[kd $$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kdF $$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[5[kdr $$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kd $$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[ !",5[kd:$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kd $$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[,-.678?5[kd$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kd$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[?@AIJKQ5[kd$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kdf$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[QRS\]^b5[kd$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kd.$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[bcdmnow5[kdZ$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kd$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[wxy5[kd"$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kd$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[5[kd$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kd$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[5[kd$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kdN$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[5[kdz$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kd$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[5[kdB$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kd$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[5[kd $$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kd$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[ 5[kd$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[[kdn$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[  k EFG̽ hz^hz^" jhz^hz^CJOJQJaJhz^hz^6CJOJQJaJhz^hz^CJOJQJaJhz^5CJOJQJaJh h CJOJQJaJ h h h h CJOJQJaJh"  k"E $Ifgdz^[kd6$$Ifl40!((2 s244 laf4ytWS[ $IfgdWS[EFGgdz^^kd$$Ifl40!((2 s244 laf4ytWS[21h:p / =!"#8$% b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[p$$If !vh#v#v:V l455/ 2 s2af4yt,pp$$If !vh#v#v:V l455/ 2 s2af4yt,pp$$If !vh#v#v:V l455/ 2 s2af4yt,pb$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[b$$If !vh#v(:V l45(/ 2 s2af4ytWS[g$$If !vh#v(:V l45(/ 2 s2af4ytWS[j 666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ OJPJQJ_HmH nH sH tH D`D  NormalOJPJQJ_HmH sH tH DA D Default Paragraph FontRi@R 0 Table Normal4 l4a (k ( 0No List @@@  0Header ! mHsHtHFoF  0 Header CharCJOJPJQJ^JaJTOT 0Normal No ProofingOJQJmHnHu>O> 0Definition TermCJ@^@2@ 0 Normal (Web) ddCJRB@BR  0 Body TextdB*OJQJmHphsHtHVoQV  0Body Text Char!B*CJOJPJQJ^JaJphF%@bF 0Envelope Return CJOJQJP@rP 0 Balloon TextCJOJQJaJmHsHtHRoR 0Balloon Text CharCJOJPJQJ^JaJB'`B pm0Comment ReferenceCJaJ@@@ pm0 Comment Text mHsHtHFoF pm0Comment Text Char OJPJQJLj@L pm0Comment Subject5\mHsHtHRoR pm0Comment Subject Char5OJPJQJ\PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! I_TS 1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ x}rxwr:\TZaG*y8IjbRc|XŻǿI u3KGnD1NIBs RuK>V.EL+M2#'fi ~V vl{u8zH *:(W☕ ~JTe\O*tHGHY}KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4 =3N)cbJ uV4(Tn 7_?m-ٛ{UBwznʜ"Z xJZp; {/<P;,)''KQk5qpN8KGbe Sd̛\17 pa>SR! 3K4'+rzQ TTIIvt]Kc⫲K#v5+|D~O@%\w_nN[L9KqgVhn R!y+Un;*&/HrT >>\ t=.Tġ S; Z~!P9giCڧ!# B,;X=ۻ,I2UWV9$lk=Aj;{AP79|s*Y;̠[MCۿhf]o{oY=1kyVV5E8Vk+֜\80X4D)!!?*|fv u"xA@T_q64)kڬuV7 t '%;i9s9x,ڎ-45xd8?ǘd/Y|t &LILJ`& -Gt/PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!0C)theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] Gv G (8^ `q\+B?u,?Qbw EG  !"#$%&')*+,-./012345679:L# @0(  B S  ?I.2345BmQkrvz~&   FI!qnq<nX1oG:M_RWS[pmYWox+;yoy 0 z^>",p y674Up.^rGI@G@Unknown G*Ax Times New Roman5Symbol3. *Cx Arial7@Cambria7.@ Calibri;WingdingsCNComic Sans MS5. .[`)TahomaA$BCambria Math"hV'a'.SG G 8r0@@2KP  $P+;y2!xx nAppendix. Survey Questionnaire Administered to Take-a-Stand Project Participants, Minneapolis, Minnesota, 2011AFitness, employees, standing desks, aerobic exercise, MinneapolisSNicolaas P. Pronk, PhD; Abigail S. Katz, PhD; Marcia Lowry, MS; Jane Rodmyre Payfer#Immoor, Kristen (CDC/OD/OADC) (CTR)Oh+'0x  0 < H T`hpxpAppendix. Survey Questionnaire Administered to Take-a-Stand Project Participants, Minneapolis, Minnesota, 2011TNicolaas P. Pronk, PhD; Abigail S. Katz, PhD; Marcia Lowry, MS; Jane Rodmyre PayferDFitness, employees, standing desks, aerobic exercise, Minneapolis Normal.dotm$Immoor, Kristen (ob/OD/OADC) (CTR)4Microsoft Office Word@Ik@LZ0w@~@Dv~G ՜.+,D՜.+,| px  [FitnessHealthPartners@ oAppendix. Survey Questionnaire Administered to Take-a-Stand Project Participants, Minneapolis, Minnesota, 2011 TitleP 5= LanguageEnglish  !"#$%&'()*+,-./0123456789:;=>?@ABCDEFGHJKLMNOPQRSTUVWXYZ\]^_`abdefghijmRoot Entry F0Vy~oData <1TableI6#WordDocument4vSummaryInformation([DocumentSummaryInformation8cCompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q