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What I want you to do: Create a health promotion survey

What I want you to do: Create a health promotion survey

Health Promotion Survey

What I want you to do: Create a health promotion survey. Then, submit a report detailing your applied practice.

Scenario: You plan to conduct a needs assessment for a new health promotion program for California State University. Because there is limited secondary data, other than national data on college students, you decided to survey a random sample of CSU students using a written instrument (a survey).


  • PART 1 Create a draft of this survey that includes questions that will collect data about the student’s health behavior and demographic characteristics. Follow the guidelines in chapter 5 for wording your questions and presentation of the instrument.
  • PART 2 Pretest your survey on two (2) of your friends, colleagues, or classmates. Make changes based on the feedback you receive. If there are extensive changes, a second pretest should be conducted.
  • PART 3 Administer the survey to three (3) CSU students. The method is chosen (mail, e-mail, telephone) should fit the nature of the data to be gathered and the objectives of the survey.

Identify any flaws you see in your questionnaire and describe your findings and experience with this activity in paragraph form. Attach your first draft survey (pretest) AND your final draft (pilot test) to your activity report.

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