Health Promoting Practices - Patient follow up survey (Dental) * 1. I recall completing the Health Promoting Practices Health Self-Assessment questionnaire at my dental practice Yes No * 2. Eating at least 2 serves of fruit and 5 serves of vegetables every day and reducing consumption of salt and saturated fats reduces your risk of being overweight, obese and developing diabetes. I eat at least 5 serves of vegetables and 2 serves of fruit per day I eat less than 5 serves of vegetables and 2 serves of fruit per day I do not eat fruit and vegetables * 3. Being physically active and limiting your sedentary behaviour every day is essential for your health and wellbeing I am physically active on most days of the week (5-7 days per week) I am physically active on some days (1-4 days per week) Physical activity is not a part of my weekly routine * 4. Limiting the amount of alcohol that you consume each day reduces your lifetime risk of alcohol related disease or injury, mental illnesses and liver damage On average I consume less than 2 drinks per day On average I consume 3-4 drinks per day On average I consume more than 5 drinks per day on 5 or more days per week * 5. Eliminating tobacco use decreases your risk, and the risk of those around you, of cancer, lung diseases, heart attack and stroke No, I never use or have stopped using tobacco No, but I live with someone who does Yes, I use tobacco Health Promoting Practices - Patient follow up survey (Dental) 1
* 6. Please answer the following about the Health Self Assessment questionnaire and resources (please select your response to each statement) I found completing the questionnaire about my general health behaviour within my dental practice to be a useful exercise I found the questionnaire easy to understand My dentist had a discussion with me about my questionnaire results I think the questionnaire is a useful tool to initiate discussions about healthy behaviour I found the red, orange, green colouring in the questionnaire to be useful in highlighting the goal behaviour Completing the questionnaire helped me consider making lifestyle changes to improve my overall health I found the brochure I was given by my dentist explaining healthy behaviours useful I have referred to the health promoting practices website (www.healthpromotingpractices.net) for further information I found the website content informative and useful My dental practice sees my overall wellbeing as very important 7. Do you have any additional comments about the Health Self-Assessment questionnaire or patient resources? Health Promoting Practices - Patient follow up survey (Dental) 2
* 8. I recall discussing the following health behaviours with my dentist I have no recollection We did not discuss it Yes we did discuss it but it was NOT useful Yes we did discuss it and it was useful Healthy Eating Physical Activity Alcohol Consumption Tobacco Use Health Promoting Practices - Patient follow up survey (Dental) * 9. It is part of a dentists' role to discuss The benefits of a healthy diet The benefits of physical activity The benefits of a tobacco-free lifestyle The benefits of reducing alcohol consumption * 10. It is part of the dentists' role to suggest: Ways to increase daily consumption of fruit and vegetables Ways to increase daily physical activity Ways to quit smoking Ways to decrease alcohol consumption Health Promoting Practices - Patient follow up survey (Dental) 3
11. Please include your level of agreement with the following statements: An unhealthy diet increases the risk of: Being overweight Being obese Developing oral diseases 12. Lack of physical activity increases the risk of: Cardiovascular disease Strongly disagree Disagree Not Sure Agree Strongly agree Diabetes Some cancers 13. Tobacco use increases the risk of: Cancer Lung diseases Heart attack Stroke 14. Harmful use of alcohol increases the risk of Mental illness Strongly disagree Disagree Nor sure Often Very often Liver damage Other alcohol related deaths Health Promoting Practices - Patient follow up survey (Dental) 4
15. Do you have any additional comments or suggestions about Health Promoting Practices project you would like to share? 5
HPP -physiotherapy patients follow-up survey * 1. I recall completing the Health Promoting Practices Health Self-Assessment questionnaire at my physiotherapy practice Yes No * 2. Eating at least 2 serves of fruit and 5 serves of vegetables every day and reducing consumption of salt and saturated fats reduces your risk of being overweight, obese and developing diabetes. I eat at least 5 serves of vegetables and 2 serves of fruit per day I eat less than 5 serves of vegetables and 2 serves of fruit per day I do not eat fruit and vegetables * 3. Being physically active and limiting your sedentary behaviour every day is essential for your health and wellbeing I am physically active on most days of the week (5-7 days per week) I am physically active on some days (1-4 days per week) Physical activity is not a part of my weekly routine * 4. Limiting the amount of alcohol that you consume each day reduces your lifetime risk of alcohol related disease or injury, mental illnesses and liver damage On average I consume less than 2 drinks per day On average I consume 3-4 drinks per day On average I consume more than 5 drinks per day on 5 or more days per week * 5. Eliminating tobacco use decreases your risk, and the risk of those around you, of cancer, lung diseases, heart attack and stroke No, I never use or have stopped using tobacco No, but I live with someone who does Yes, I use tobacco 1
HPP -physiotherapy patients follow-up survey * 6. Please answer the following about the Health Self Assessment questionnaire and resources (please select your response to each statement) I found completing the questionnaire about my general health behaviour within my physiotherapy practice to be a useful exercise I found the questionnaire easy to understand My physiotherapist had a discussion with me about my questionnaire results I think the questionnaire is a useful tool to initiate discussions about healthy behaviour I found the red, orange, green colouring in the questionnaire to be useful in highlighting the goal behaviour Completing the questionnaire helped me consider making lifestyle changes to improve my overall health I found the brochure I was given by my physiotherapist explaining healthy behaviours useful I have referred to the health promoting practices website (www.healthpromotingpractices.net) for further information I found the website content informative and useful My physiotherapy practice sees my overall wellbeing as very important 2
7. Do you have any additional comments about the Health Self-Assessment questionnaire or patient resources? 3
HPP -physiotherapy patients follow-up survey * 8. I recall discussing the following health behaviours with my physiotherapist Yes we did discuss it but Yes we did discuss it and I have no recollection We did not discuss it it was NOT useful it was useful Healthy Eating Physical Activity Alcohol Consumption Tobacco Use 4
HPP -physiotherapy patients follow-up survey * 9. It is part of a physiotherapists' role to discuss The benefits of a healthy diet The benefits of physical activity The benefits of a tobacco-free lifestyle The benefits of reducing alcohol consumption * 10. It is part of the physiotherapists' role to suggest: Ways to increase daily consumption of fruit and vegetables Ways to increase daily physical activity Ways to quit smoking Ways to decrease alcohol consumption 5
HPP -physiotherapy patients follow-up survey 11. Please include your level of agreement with the following statements: An unhealthy diet increases the risk of: Being overweight Being obese Developing oral diseases 12. Lack of physical activity increases the risk of: Cardiovascular disease Strongly disagree Disagree Not Sure Agree Strongly agree Diabetes Some cancers 13. Tobacco use increases the risk of: Cancer Lung diseases Heart attack Stroke 14. Harmful use of alcohol increases the risk of Mental illness Strongly disagree Disagree Nor sure Often Very often Liver damage Other alcohol related deaths 6
HPP -physiotherapy patients follow-up survey 15. Do you have any additional comments or suggestions about Health Promoting Practices project you would like to share? 7