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Break The Boxes Survey Questions
This survey aims to understand the quality of living for people of color in job/school/family environments that affect overall physical and mental well being. It should take 5 - 8 minutes to complete. Thank you for your time and please feel free to share as much as you are comfortable with.
Email address *
What age group do you identify with? *
City, State, Country of residence *
Your answer
Gender *
Job Type *
Required
Which industry do you work in/intend to work in? *
Do you feel like the work you do has a meaningful impact on the world? *
How often do you experience stress on your job and/or in school? *
Coping Strategies
The following questions address coping strategies for dealing with stress and anxiety
What do you do to cope with stress? *
Your answer
Do you feel like you have access to knowledge about healthy holistic ways to decrease your stress-levels? *
Do you feel like you are consistent in your practice of incorporating the knowledge you have about wellness into your everyday life? *
Where do you usually go to workout? *
Your answer
How far do you travel from home to workout? *
Your answer
How much do you usually spend to workout per trip? *
Your answer
What modes of transportation do you normally use to exercise? *
Your answer
How much do you generally spend on activities that increase your wellness per month? *
Your answer
Team and Workplace Dynamics
These questions address how you interact on a daily basis
Does your job require you to work on a team? *
How many times have you encountered discrimination or bias in your workplace based on your race? *
Do you feel comfortable enough in your work-place to bring your authentic self to the space? *
Do you feel like understanding the strengths/weaknesses of your teammates would impact the quality of your job experience? *
Is having open and honest dialogue about racial bias at your workplace important to you? *
Have you participated in any arts education programs before? If so, which program? *
Your answer
Any extra comments?
Your answer
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