Keep in Touch Project Survey Week One
Email *
Survey for Exercise One: Touching Your Breath (Just Breathe)
Each week as survey will be paired with the exercises. Please note: all information will be kept confidential. I am only collecting email addresses for the purposed of tracking how your relation to touch changes over the course of the project. If you have any concerns at all, please do not hesitate to reach out.
This first set of questions focuses on general demographics and baseline information about the average amount of physical contact you experience.
Name *
Age *
Gender *
Location (city, state, country) *
Current Living Situation *
If family, how people in the household including children and adults?
If roommates, how many?
Amount of physical contact in the average week (pre shelter in place) *
1) None 2) Very Little 3) Little 4) Moderate 5) Frequent 6) Very Frequent 7) Nearly Constant
None
Nearly Constant
Of that, rank where contact originated: family, friends, co-works/work related, strangers through accidental contact. 1 being the most and 4 being the least *
1
2
3
4
Family
Friends
Co-workers/Work Related
Strangers Through Accidental Contact
For each group please rank your feelings towards the amount of contact *
Too Little
Little
Enough
A Lot
Too Much
Family
Friends
Co-workers/Work Related
Strangers Through Accidental Contact
Please elaborate on any group if desired
Amount of physical contact in the average week (after shelter in place) *
1) None 2) Very Little 3) Little 4) Moderate 5) Frequent 6) Very Frequent 7) Nearly Constant
None
Nearly Constant
Of that, rank where contact originated after shelter in place: family, friends, co-works/work related, strangers through accidental contact. 1 being the most and 4 being the least *
1
2
3
4
Family
Friends
Co-workers/Work Related
Strangers Through Accidental Contact
What is the importance of physical contact in your everyday life? *
Not Important
Somewhat important
Important
Very Important
Crucial to my well-being
Please rank
Please rank these types of interactions *
Not Important
Somewhat important
Important
Very Important
Crucial to my well-being
Handshake
Hug
Kissing
Cuddling
Sexual Intimacy
This next section asks questions specific to the Touching Your Breath exercise
Have you done the exercise? *
Have you done the exercise more than once? *
If so, how many times? *
Did you use the accompanying videos in this practice? *
Did you find the video helpful to the practice? *
This question asks you to evaluate your state of mind in terms of anxious to clam through the process of participating in these exercises. *
Very anxious
Somewhat anxious
Usual balance of anxious and calm
Calm
Very Calm
Before practicing the exercise
During the exercise
After
This section is for open ended questions.
What is your preferred form of touch? (A texture, a feeling, a type of contact?)
What type of contact do you miss most?
What strategies are you using to fulfill your need for contact? (Video chats, group meetings/online games, etc)
Are they working?
Do you use clothing/blankets/objects to fulfill any needs for physical contact (weighted blankets, favorite shirt, pillow forts, etc)
Any other thoughts at this time?
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