Which of the following made you aware of the TF-CFP?

• Promotional e-mail messages
• Promotional posters/flyers
• Word of mouth from coordinator
• Word of mouth from co-worker
• Word of mouth from supervisor
• Other ________________________

Indicate your degree of agreement with the following statements regarding TF-CFP.

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
I would encourage others to participate.	1	2	3	4	5
I felt good about myself as I participated.	1	2	3	4	5
I felt positive support to participate from co-workers and/or home.	1	2	3	4	5
I felt positive support to participate from my supervisor/management.	1	2	3	4	5

Indicate your agreement with the following potential benefits as they relate to your participation in TF-CFP.

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
I have increased energy.	1	2	3	4	5
I have better control over my weight.	1	2	3	4	5
My clothes fit better	1	2	3	4	5
I am able to handle everyday stress more effectively.	1	2	3	4	5
I am less depressed.	1	2	3	4	5
I am less irritable.	1	2	3	4	5
I sleep better.	1	2	3	4	5
I feel better about how I look physically.	1	2	3	4	5
I feel I am more productive on the job.	1	2	3	4	5
I have better working relationships with my peers.	1	2	3	4	5
I am more able to concentrate.	1	2	3	4	5

Indicate which of the following tips for increasing physical activity proved helpful to you during your participation in TF- CFP.

• Bringing appropriate shoes/clothes to work.
• Walking or exercising with others.
• Keeping a record of my physical activity.
• Setting specific goals.
• Scheduling my physical activity time on my daily calendar.
• Learning to recognize the benefits of my activity.
• Taking a walk or exercising during duty hours.
• Being accountable to a structured program.
• Other ___________________________________________

Indicate which of the following barriers you encountered during your participation in TF-CFP. Place a check mark next to those you were able to overcome.

• _____ Lack of internal motivation.
• _____ Inclement weather.
• _____ Busy work schedule.
• _____ Out of town on TDY trips.
• _____ Busy social schedule.
• _____ Busy home/Family schedule.
• _____ None or loss of activity partner.
• _____ Lack of support from co-workers.
• _____ Lack of support from supervisor/ management.
• _____ Difficulty in scheduling time with others.
• _____ Difficulty in attending scheduled group program activities.
• _____ Lack of confidence in my ability to exercise.
• _____ Loss of interest in keeping records.
• _____ Inability to set attainable goals.
• _____ Boredom with exercise routine.
• _____ Other _____________________________________________

Which best describes your motivation to exercise at the end of TF-CFP compared to the beginning of the program?

• More motivated
• Less motivated
• About the same

When during TF-CFP did you experience motivational problems in continuing to reach your goals?

• At the beginning
• Months 1-2
• Months 3-4
• Months 5-6
• None

How difficult was it for you to understand and follow the program rules/policies? (i.e. required paperwork, activity logs, exercise time, exercise place)

• Very easy
• Somewhat easy
• Neither easy or difficult
• Somewhat difficult
• Very difficult
  In what area/areas? ________________________________________________________________________

Did TF-CFP help you be more successful in maintaining your physical activity level compared to past efforts?

• Much more successful
• More successful
• About as successful
• Less successful
• Much less successful

Do you believe the TF-CFP is a worthwhile and positive experience?

• Yes
• No
• I don't know

During the time you participated in TF-CFP have you:

• Increased your fruit and vegetable consumption
• Decreased your dietary fat intake
• Reduced your calorie intake
• Become more aware of nutrition labels on food
• Brought healthy lunches to work
• Substituted low fat recipes and foods
• Felt no need to change dietary habits

Which of the following health education classes did you attend? (mark all that apply)

• Orientation
• Introduction to Fitness/Nutrition
• Flexibility/Warm-up and Cool Down
• Aerobic Fitness
• Mid-point Check-in
• Strength Training
• Nutrition
• Spiritual Health
• Weight Loss/Control
• Stress Management
• Cardiovascular Risk

Did others in your Family become involved in physical activity as a result of your participation in TF-CFP?

• Yes
• No

Regarding your current level of physical activity, do you intend to:

• Increase your level of activity in the next 6 months
• Maintain you r level of activity in the next 6 months
• Decrease your level of activity in the next 6 months

My physical activity status before I participated in TF-CFP was best described as:

• I did not exercise or walk regularly, and I did not intend to start in the near future.
• I did not exercise or walk regularly, but had been thinking about starting.
• I was trying to start to exercise or walk, or I exercised or walked infrequently.
• I was doing vigorous exercise less than 3 times per week or moderate physical activity less than 5 times per week.
• I had been doing moderate physical activity 5 or more times per week (or more than 2 ½ hours per week0 for the last 1 - 6 months.
• I had been doing moderate physical activity 5 or more times per week (or more than 2 ½ hours per week) for 7 months or more.
• I had been doing vigorous exercise 3- 5 times per week for 1 -6 months
• I had been doing vigorous exercise 3-5 times per week for 7 or more months.

My physical activity after I participated in TF-CFP is best described as:

• I do not exercise or walk regularly, and I do not intend to start in the near future.
• I do not exercise or walk regularly, but am thinking about starting.
• I am trying to start to exercise or walk, or I exercise or walk infrequently.
• I am doing vigorous exercise less than 3 times per week or moderate physical activity less than 5 times per week.
• I have been doing moderate physical activity 5 or more times per week (or more than 2 ½ hours per week) for the last 1 - 6 months.
• I have been doing moderate physical activity 5 or more times per week (or more than 2 ½ hours per week) for 7 months or more.
• I have been doing vigorous exercise 3 - 5 times per week for 1 - 6 months
• I have been doing vigorous exercise 3-5 times per week for 7 or more months.

Targeting Fitness Customer Satisfaction Questionnaire
Supervisor Form

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
It improved morale.	1	2	3	4	5
It improved productivity.	1	2	3	4	5
It raised awareness about the need for physical activity.	1	2	3	4	5
It increased social support for physical activity.	1	2	3	4	5
It increased energy.	1	2	3	4	5
It increased ability to handle everyday stress more effectively.	1	2	3	4	5
It decreased depression.	1	2	3	4	5
It decreased irritability.	1	2	3	4	5
It improved working relationships with peers.	1	2	3	4	5
It increased concentration.	1	2	3	4	5
It took up too much work time.	1	2	3	4	5

The following statements reflect my support of TF-CFP. (circle one on each line)

	100-75%	75-50%	50-25%	25-0%	OF THE TIME
I encourage my staff to participate.	1	2	3	4
I encouraged my staff to complete the program.	1	2	3	4
I feel as a supervisor that it is important to serve as a role model for health promotion.	1	2	3	4
I would support more of my staff participating in TF-CFP.	1	2	3	4

Do you believe the TF-CFP is a worthwhile and positive experience?

• Yes
• No
• I don't know

I agree or disagree with the following statements concerning the administration of the program.

	Agree	Disagree
The MOU between the supervisor and participant was adequate.	1	2
The participant abided by the guidelines and provisions of the MOU.	1	2
The monitoring of exercise time and locations was adequate to ensure compliance.	1	2
My role as a supervisor was an administrative burden.	1	2
The chain of command supported the TF-CFP.	1	2

More employees would have participated if:

_________________________________________________________________________________________

_________________________________________________________________________________________

The TF-CFP could be improved by:

_________________________________________________________________________________________