Preliminary Feasibility Survey for an Online Exercise Research Study

Dear student,We are conducting a preliminary survey to assess students' interest and availability for a potential research study involving a short online exercise program for musculoskeletal pain or discomfort.The proposed exercise program would consist of 10-minute online exercise sessions, 3 times per week, for 6 weeks (18 sessions in total). Participants would be able to complete the exercises remotely from their room/home without needing to attend the hospital or university in person.The purpose of this questionnaire is only to assess feasibility and students' willingness to participate. Completing this questionnaire does not mean that you have enrolled in the research study.Please do not provide your name. Your school identification number will be used instead.
School identification number Please enter your school/student identification number. Do not enter your name.
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What is your age group?
Under 18
18–20
21–23
24–26
27–30
Over 30
Are you currently experiencing any musculoskeletal pain or discomfort? For example, discomfort or pain in the neck, shoulders, upper back, lower back/waist, arms, wrists/hands, hips, thighs, knees, legs, ankles or feet.
Yes
No
Not sure
If yes, where are you currently experiencing musculoskeletal pain or discomfort? Select all that apply.
Neck
Shoulders
Upper back
Lower back/waist
Elbow/forearm
Wrist/hand
Hip
Thigh
Knee
Lower leg
Ankle/foot
Other
Not applicable — I currently have no pain/discomfort
How interested would you be in participating in a short online exercise program designed to help relieve musculoskeletal pain or discomfort?
Very interested
Somewhat interested
Not sure
Slightly interested
Not interested
The proposed program would involve 10-minute online exercise sessions, 3 times per week, for 6 weeks (18 sessions in total). How willing would you be to participate?
Very willing
Willing
Not sure
Probably unwilling
Definitely unwilling
How manageable would it be for you to complete a 10-minute exercise session three times per week?
Very manageable
Manageable
Neither manageable nor difficult
Somewhat difficult
Very difficult
What would be your preferred time for the online exercise sessions? Please select your preferred time.
Around 5:00 PM
Around 6:00 PM
Around 7:00 PM
Around 8:00 PM
Other
I have no particular preference
Would you be comfortable completing the exercises remotely from your room/home?
Yes, definitely
Probably yes
Not sure
Probably not
No
Which type of online exercise format would you prefer?
Pre-recorded exercise video that I can complete at my own convenience
Live online session with an instructor providing real-time guidance/feedback
A combination of pre-recorded videos and live online sessions
No preference
I would prefer not to participate in online exercise
What factors might make it difficult for you to participate in the program? Select all that apply.
Academic workload
Lack of time
Class schedule
Part-time work
Exercise/gym schedule
Difficulty remembering to exercise
Internet connection
Lack of suitable space to exercise
Lack of motivation
I dont experience musculoskeletal discomfort
Other
None
If you were eligible for the study, how likely would you be to complete all 18 sessions over the 6-week period?
Very likely
Likely
Not sure
Unlikely
Very unlikely
Would you be interested in being contacted about the research study if you meet the eligibility criteria?
Yes
Maybe — I would like more information first
No
Contact information Please enter your phone number only. Do not enter your name.
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