PACE-Life Subject Feedback Form
This survey will be used to help make the program better. We appreciate
your participation and honest feedback.
1.
I enjoyed being part of a group focused on physical activity and
health.
Not at all true 1 2 3 4 5 Very true
2.
Overall, I enjoyed goal-setting/if-then plan sessions once a week.
Not at all true 1 2 3 4 5 Very true
3.
I felt included in conversations during group.
Not at all true 1 2 3 4 5 Very true
4.
I had a good relationship with the other members of the group.
Not at all true 1 2 3 4 5 Very true
5.
I was motivated to attend groups because of the social interaction.
Not at all true 1 2 3 4 5 Very true
6.
I had a good relationship with the walking group leaders.
99
7.
I felt motivated by group leaders during walking.
Not at all true 1 2 3 4 5 Very true
8.
I was motivated to attend groups because of the health benefits I
would gain from walking.
Not at all true 1 2 3 4 5 Very true
9.
I enjoyed using a Fitbit to track my physical activity.
Not at all true 1 2 3 4 5 Very true
10.
I found the Fitbit easy to use.
Not at all true 1 2 3 4 5 Very true
11.
I am likely to continue to use my Fitbit after the study ends.
Not at all true 1 2 3 4 5 Very true
12.
I enjoyed tracking my heart rate during walks.
Not at all true 1 2 3 4 5 Very true
13.
I enjoyed receiving target heart rate goals throughout the
study.
Not at all true 1 2 3 4 5 Very true
14.
I felt the target heart rate goals were attainable for me.
100
15.
I enjoyed setting goals for home-based intensity walks.
Not at all true 1 2 3 4 5 Very true
16.
I felt that my if-then plans helped me overcome barriers to
walking.
Not at all true 1 2 3 4 5 Very true
17.
Overall, I feel that my health has improved since joining
PACE-Life.
Not at all true 1 2 3 4 5 Very true
18.
If given the chance, I would join PACE-Life again.
Not at all true 1 2 3 4 5 Very true
Questions about Home-Based Walks
19.
I completed my home-based intensity walks at the following
locations (e.g., my neighborhood, the gym)…
1.
_____________________________________________________
2.
_____________________________________________________
3.
____________________________________________________
101
Questions about Attendance and Fitbit Use
20.
I missed group due to the following reasons (Circle all that
apply):
1.
Issues with transportation
2.
Temperature being too hot outside
3.
Having to go to work or school at the same time as the
groups
4.
Being too tired
5.
Not feeling like exercising
6.
Not feeling well physically
7.
Not feeling well emotionally
8.
Forgetting the day/time of the group
9.
Not getting along with other participants
10.
Not getting along with group leaders
11.
Having different group leaders during the study (i.e.,
not having same group leaders for entire study)
12.
Other (Please list):
a.
________________________________
b.
________________________________
c.
________________________________
102
22. Which were the 2 BIGGEST reasons you missed groups from those
you listed above?
Reason 1: ________________________________
Reason 2: ________________________________
23.
I did not wear my Fitbit due to the following reasons (Circle
all that apply):
a.
I forgot to put it on after charging it
b.
I forgot to put it on after taking it off to shower
c.
I forgot to put it on after taking it off to sleep
d.
I found it uncomfortable to wear
e.
It did not work well
f.
I did not like having my physical activity monitored
g.
Other (Please list):
i.
________________________________
ii.
________________________________
iii.
________________________________
iv.
________________________________
24. Which were the 2 BIGGEST reasons you did not wear your Fitbit
from those you listed above?
Reason 1: ________________________________
Reason 2: ________________________________
103
Open Response Questions
25.
What I liked most about PACE-Life is…
___________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
26.
What I liked least about PACE-Life is…
____________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
104
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