Employee survey: SAMPLE

QUESTIONNAIRE Notes
Use this questionnaire as a template, including only the questions that will
provide the information you need. Your current eating habits
Information on how to 1 a) During the last week, on how many days did you
interpret the results of the questionnaire is provided on page 55.
consume 5 portions or more of fruit and vegetables?
The Introduction should:
Remember that fresh, frozen and tinned fruits and
• let the employee know what you are trying vegetables all count, but fruit juice and dried fruit only count
to fi nd out from them as 1 portion per day each, regardless of the amount you
and why
have. Potatoes are counted as starchy foods, not as
• tell them what you will do with their responses. vegetables.
Reassure them that
all surveys are
anonymous and that
individuals will not be On ______ days last week
contacted directly

b) During the last week, on how many days did you have a
• tell them if you are
offering any incentive to snack food or drink (other than water) during the working
respond – for example, day?
entering all responses into a prize draw
This includes, for example, fi zzy drinks, fresh fruit, cakes
• tell them how their trade union representatives
have been involved in
the process of producing the questionnaire. and biscuits, sweets or crisps. On ______ days last week

The aim of this section is to gain a baseline marker for employees’ current
eating habits. This information can be used in the ongoing
monitoring and evaluation of your workplace healthy eating programme.
Questions need to relate to the food and drink people consume in a typical
week.
This section should:

• aim to ask questions about areas where the workplace can have some
infl uence

• encourage employees to start thinking about their own health behaviour Notes

• measure the employees’ level of commitment to

Employee survey: SAMPLE
and enthusiasm for QUESTIONNAIRE
healthy eating

• identify potential barriers to changing dietary habits, particularly during

the
working day.

c) During the last week, on how many days did you have
48 | Think fit! Eat well!
between 4 and 6 glasses or cups of fl uid during the working
Introduction day?
Do you want the opportunity to have your say in the For example, water, tea, coffee, fruit juice or squash. The
development of a new healthy eating programme for recommended daily fl uid intake for the UK climate is 6-8
employees? If so, please take a few minutes to fi ll in this glasses, taken throughout the day, so it is important to drink
questionnaire. The information you provide will help us throughout your working day.
develop a programme to suit your needs.

Your participation is completely voluntary and all responses On ______ days last week

will be anonymous. Please return the survey to: d) During the last week, on how many days did you have
more than 2 to 3 units of alcohol if you are a woman, or
more than 3 to 4 units of alcohol if you are a man?
 For example, there is 1 unit of alcohol in: half a pint of Think fit! Eat well! | 49
standard beer, lager or cider (3% to 5% ABV), or in a pub
measure of spirits. A large glass of wine is about 2 units and
alcopops are about 1.5 units.

On ______ days last week

2 During the last week, on how many days did you:

a) eat breakfast? On ______ days last week b) skip lunch

because of work commitments? On ______ days c) eat

and/or drink during a work meeting? On ______ days d)

take part in ‘team-led’ eating, eg, a biscuit bin or birthday

cakes? On ______ days e) use the vending machine at

work? On ______ days f) bring your own lunch to work? On

______ days g) eat a meal at your desk? On ______ days

h) stop to eat lunch with work colleagues? On ______ days

i) make use of the employee restaurant? On ______ days j)

make use of the staff room to eat a meal? On ______ days

k) make use of employee areas for food preparation and/or

storage? On ______ days l) buy family food shopping during

your working day? On ______ days

Notes

3 a) At the moment, what prevents you from introducing

more healthy foods into your diet?

Tick whichever ones apply to you.

Special dietary needs
Dislike of healthy foods
Poor health
Family commitments
Family dietary preferences
Cost of healthy foods
Distance to supermarkets or food shops
Work commitments
Lack of nutritional knowledge
Lack of cooking skills
Lack of food storage and preparation areas in the workplace
Lack of healthy eating choices at lunchtime or for snacks

Other (Please state.) ____________________________________________________________

 b) Which of the following best describes you?

Please tick only ONE.

I am not interested in pursuing a healthy lifestyle.
I have recently been thinking about changing my diet.
I am intending to change my behaviour and to change my diet within
the next six months.
I have recently changed my behaviour and I am following a healthy eating plan.
I have been following a healthy eating plan for at least six months.
I have special dietary needs that prevent me from changing my diet.

The aim of this section is to gain an understanding of any special needs The aim of this section is to gain an understanding of employees’ healthy
related to employees’ health or medical conditions. eating interests. This will help to inform the development of the programme.
This section should: This section should:

• highlight any medical • identify the types of activities

that employees enjoy taking part in and
condition(s) that may affect an individual’s ability to how provision in the workplace can
participate facilitate this

• determine how the • determine employees’ motivation for participating

employee views his or her workplace to be related to their health and vice
versa. • assess which healthy eating activities employees would most like to
participate in at work and when.

Employee survey: SAMPLE

QUESTIONNAIRE

50 | Think fit! Eat well!

Health needs
4 How would you describe your general health?
Very good
b) Do you have any special dietary needs? (Please state.)
Good
Fair
Poor
Very poor
c) Do you suffer from any long-term medical illnesses or
conditions – for example, diabetes, high blood pressure, or
5 a) In the last 12 months, on roughly how many days have
stress?
you been absent from work due to personal illness or injury?
Yes
No

d) If Yes, what long-term illness do you suffer from? (Please

state.)

Notes
e) Is this long-term condition the reason for most of your
sickness absence? Yes
No

6 How would you describe the following when you are at

work? (Please tick.)

Very good Good Fair Poor Very poor Energy levels

Mood
Concentration
Stress levels
 Think fit! Eat well! | 51
Healthy eating interests
7 a) If the following healthy eating initiatives were offered at
work, how likely would you be to take part or use them?

Extremely Fairly Undecided Fairly Extremely likely likely

likely likely Recipes and tips for healthy eating
Cookery classes
Nutrition courses and qualifi cations
Talks, presentations and workshops on
healthy eating by health professionals,
dietitians or nutritionists
Access to health promotion materials
such as leafl ets and posters about
healthy eating
Access to weekly healthy eating messages
via email and/or bulletin boards
Notes

Extremely Fairly Undecided Fairly Extremely

likely likely likely likely
Access to drinking water for all employees
Free fruit in the workplace
Selection of healthy refreshments in
meeting rooms – for example, water
and fresh fruits
Fruit and vegetable box delivery scheme
with deliveries to the workplace
Self-check facilities, eg, weighing scales and
tape measures available in a private area
Weight management programmes
Health and fi tness assessments and/
or health screening
Health-related treatments
Healthy breakfast bar
Healthy meal choices available in the
employee restaurant
Healthy sandwich or lunch delivery service
Healthy meal options in the vending
machines – for example, sandwiches,
pasta, fresh fruit and yoghurts
Healthy snack options available in the
vending machines or snack bars
On-site facilities, eg, food preparation
and storage areas for employees’ use
Participation in local or national healthy
eating events
Team or individual ‘Eat well! challenges’

b) When would you be most likely to make use of the services listed in question 7a?
Please specify which of the above you would use at the following times:

Before work
 During work

At lunchtime

After work

Weekends

52 | Think fit! Eat well!

Notes Personal profile

Please provide some information about yourself.

9 a) On average how many hours do you work each day?

b) Does your work involve shift patterns outside 9am to

5pm?
Yes
No

c) In terms of physical effort, how would you describe your

work? (Please tick.) Very demanding
The aim of this section is to gain an understanding of employees’ work
habits and to identify opportunities for healthy eating within the working Fairly demanding
day.
Not very demanding
If your employees work shifts, some of these questions will probably need
to be adapted to re-adjust the focus away from lunchtime meals.
This section should:
10 Are you…
• give an idea of the structure of the employee’s normal working day Male
Female
• provide employee details such as age and gender.

Employee survey: SAMPLE

11 Age group. (Please tick the age group that applies to
QUESTIONNAIRE you.)
Under 21
21-30
31-40
41-50
51-60
Over 60
8 Please describe any workplace facilities that help you to
eat healthily and that you use regularly (once a week or
more).
For example, vending machines that offer healthy options,
using a fridge at the workplace to store your healthy packed
lunch, using a workplace kitchen to prepare food, using the
canteen for healthy choices, or using information provided
on healthy eating.
Think fit! Eat well! | 53
Notes

12 Would you be interested in becoming involved in our healthy eating programme?

Yes
No

If Yes, in what ways do you think you could contribute?

(If you would like to contribute, please tell the person who is organising this survey.)

13 Do you have any other comments or suggestions?

If you have any other ideas for how the workplace could be improved to support
those wanting to make healthy eating choices that you would like to suggest,
please let us know.

Thank youfor filling

in this questionnaire.
Your input will help us to ensure the success of the healthy eating programme!

54 | Think fit! Eat well!

Employee survey: SAMPLE QUESTIONNAIRE
 Evaluating the responses to the employee survey
Question 1
These questions have been included to provide you with a baseline that can be re-assessed at a later date to determine
the impact of your healthy eating programme.
1a) As a guide, only 27% of men and 33% of women in managerial and professional groups consume the recommended
5 portions of fruit and vegetables a day, and only 16% of men and 17% of women in routine and semi-routine
occupations achieve the target.1
1b) If a high percentage of staff snack during the day, consider ways in which you can encourage them to have healthier
snacks.
1c) 6-8 glasses or cups of fluid a day is the recommended amount of fluid intake for adults in the UK climate. If your
employees are not drinking this amount, consider including a campaign that will encourage increasing fluid intake. (See
the Hydration challenge, on page 128.)
1d) This question gives the recommended allowances for sensible drinking. If your employees are not meeting these
guidelines, consider including a sensible drinking campaign in your programme.

Question 2
These questions have been included to help you identify ways in which you may be able to influence healthy eating
choices within your workplace. For example, if a high percentage of employees make use of on-site lunch facilities, your
next step could be to find out what level of interest there might be in introducing healthier choices.

Question 3
These questions have been included to help you identify the obstacles that need to be overcome for individuals to make
healthier choices. However, not all of the barriers can be changed in or through the workplace. Question 3b will help you
find out how ‘ready’ people are for making changes to eat more healthily. You might want to concentrate programme
efforts on those people.

Reference
1 Sproston K and Primatesta P. 2003. Health Survey for England 2002. London: TSO.
Questions 4 to 6
These questions will provide confidential information about the health needs of your employees. You will need to take the
responses into account when you plan which actions to include in your healthy eating programme. For example, if you
have a number of employees with particular food allergies, you might want to consider offering alternative options in
vending machines.

Questions 7 and 8
These questions have been included to assess the level of interest in activities that could be included in your workplace
healthy eating programme.

Question 9
These questions will help you identify working patterns that will need to be accommodated in your programme.

Questions 10 and 11
These questions will help give you a profile your work colleagues.

Questions 12 and 13
These questions provide employees with an opportunity to get involved in the programme and have their say in how it is
developed. These comments can be very valuable at the start of a programme to identify employees who could make a
very positive contribution to your programme.
Think fit! Eat well! | 55