Community Health Behavior Change Survey
Please answer the following questions to help us understand health behavior changes in the community.
Age Group
Option 1
Option 2
Option 3
Gender
Option 1
Option 2
Option 3
Have you changed any health behaviors in the past 12 months?
Option 1
Option 2
Option 3
If yes, please specify which behaviors you have changed (e.g., diet, exercise, smoking, alcohol consumption).
What motivated you to change these behaviors?
What challenges have you faced in making these changes?
Do you feel you have adequate support to maintain these changes?
Option 1
Option 2
Option 3
What additional resources or support would help you maintain or improve your health behaviors?
Submit
Should be Empty: