CCS

Combating Childhood Obesity: The GET LEAN Program
Required Required Question(s)
Required
We are interested in your valuable opinions about the GET LEAN Program being piloted in the Stafford Township School District. GET LEAN is a partnership program between the Stafford Township Education Foundation, Southern Ocean Pediatrics, Southern Ocean County Hospital (SOCH), The Ocean Club and Personal Fitness Training Association to combat childhood obesity. How familiar are you with this program?
Very familiar
Familiar
Neutral
Unfamiliar
Very unfamiliar
  • Comment:

  • 500 characters left.
Required
Do you have elementary age children?
YES
NO
If you answered YES to the previous question, we will benefit greatly from your responses to the remaining elements of this survey. Rate the degree to which you agree/disagree with the following statements.
 Highly Disagree Somewhat Disagree In the Middle Somewhat Agree Highly Agree 
My child is physically active.
My child has a regular healthy diet.
My child should be physically active.
My schedule permits me to assist my child in staying physically active
My schedule permits me to monitor my child's diet.
The schools should be responsible for my child's physical health.
The schools should be responsible for my child's diet.
My child's weight concerns me.
My child is overweight.
If a healthy lifestyle program existed, I would enroll my child.
  • Comment:

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If your child participated in GET LEAN last school year, please rate your satisfaction with the following aspects of the program.
 Very Dissatisfied Somewhat Dissatisfied In the Middle Somewhat Satisfied Very Satisfied 
Timing
Clearness of communications
Interactions with program/organization staff
Overall message of program
Training and experience provided
  • Comment:

  • 500 characters left.
If your child participated in GET LEAN last school year, how likely is it that you would recommend the program to another parent for her/his child?
Very likely
Somewhat likely
In the Middle
Somewhat unlikely
Very unlikely
  • Comment:

  • 500 characters left.
To help us adapt the GET LEAN Program to meet your specific parent needs, please respond to the following: Since the GET LEAN Program Pilot began, the Program has only been offered in the mornings. Please indicate the time frame you feel would make the Program most convenient for you and your child.
Weekdays, mornings before school (approx. 7am)
Weekdays, afternoons after school (approx. 2:15pm)
Weekdays, evenings after 4pm
Weekdays, both before and after school
Weekends ONLY, mornings
Weekends ONLY, afternoons
7 days a week, mornings
7 days a week, afternoons
  • Comment:

  • 500 characters left.
If I enrolled my child in the GET LEAN Program, she/he would be able to attend ______________ one-hour sessions each week.
7
6
5
4
3
2
1
Unknown
Other  
If I were to enroll my child in the GET LEAN Program transportation would...
be needed.
NOT be needed.
depend on when the Program was scheduled -based on the options previously listed
  • Comment:

  • 500 characters left.
Currently, the GET LEAN Program is only being offered at the McKinley Avenue School in Manahawkin during the week and at The Ocean Club on weekends. Does the location create challenges to enrolling your child in the GET LEAN Program?
YES
NO
  • Comment:

  • 500 characters left.
Required
The continuation of the GET LEAN Program is contingent upon parent interest and support. What would be the most effective way to share information with parents?
Flyers or brochures sent home with students from school
Flyers or brochures mailed home to parents
Posters on display in the schools and community
Newspaper advertising
School nurse referral
Other  
  • Comment:

  • 500 characters left.
Currently, the GET LEAN Program is a tuition based program with limited underwriting. Tuition for the 2008 - 2009 school year has been set at $75 per month (approx. $2.50 per day if your child attends 7 days or $3.75 per day if your child attends only the 5 days in the school week). The tuition does not include the cost of breakfast or snack. Breakfast and snack are offered in partnership with the Stafford School District at the current year's cafeteria prices (typically less than $2.20 for a hot breakfast option). How likely is it that your child would need either a full or partial scholarship in order to participate in the GET LEAN Program?
Not likely
VERY likely
  • Comment:

  • 500 characters left.
Required
What school in the Stafford Township School District does your child currently attend?
Stafford Intermediate School
McKinley Avenue Elementary School
Ocean Acres Elementary School
Oxycocus Elementary School
The Ronald L. Meinders Primary Learning Center
My child is homeschooled.
My child does not attend any of the above.
  • Comment:

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Would you be interested in learning more about the GET LEAN Program for your child?
YES
NO
  • Comment:

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If you would like additional information about the GET LEAN Program, please provide the following information. Please do NOT enter your child's name.

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Work Phone:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

If you are familiar with the GET LEAN Program, do you have any suggestions for improving the program? Do you feel the Program has made a difference in your child's health and well-being? We welcome your suggestions and comments.
 

  • 500 characters left.