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Industry-Specific

Diet and Exercise Habits & Motivation Survey

Captures real-world eating and activity patterns, what's blocking consistency, and what actually keeps people motivated — for wellness programs, coaches, and fitness apps designing support that matches how people actually live. An AI follow-up interview digs into the specific barrier behind someone's confidence score instead of settling for a generic checkbox.

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設問の例

テンプレートの内容をプレビューできます。すべての設問は公開前に自由に編集できます。

全13問・約7分
Q01
メッセージ

Thanks for taking a few minutes to share your diet and exercise habits! Your responses are completely confidential and anonymized. There are no right answers here — the more honest, the more useful this is for building support that actually fits your life. About 5 minutes.

Q02
選択式必須

In the last 7 days, on how many days did you do at least 7 minutes of physical activity (including brisk walking)?

  • 0 days
  • 1-2 days
  • 3-4 days
  • 5-6 days
  • Every day
Q03
選択式

Which types of exercise have you done in the last 30 days?

  • Cardio (running, cycling, swimming)
  • Strength or resistance training
  • Yoga, Pilates, or flexibility work
  • Team or recreational sports
  • Walking as exercise
Q04
マトリクス必須

How often do the following apply to your typical week?

5行 × 5列
  • I eat vegetables or fruit with most meals
  • I plan or prep meals in advance
  • I limit sugary drinks and processed snacks
  • I eat without distractions like a screen
  • I get enough sleep to support my activity level
列: Never · Rarely · Sometimes · Often · Always
Q05
オピニオンスケール必須

How confident are you that you can stick to healthy eating and exercise habits over the next 3 months?

スケール: 1 – 10
最小:Not at all confident最大:Extremely confident
Q06
ベスト・ワースト選択（MaxDiff）

For each set, pick what would help you stick to a diet and exercise routine most, and what would help least.

  • More free time in my schedule
  • More energy or less fatigue
  • Simple, ready-made meal plans
  • A workout buddy or community support
  • Clear tracking of my progress
  • Affordable access to healthy food
  • Professional coaching or guidance
各セットで最も良いもの・最も悪いものを選択最も良い:Would help most最も悪い:Would help least
Q07
ポイント配分

Thinking about what gets in the way, distribute 100 points across these barriers based on how much each one holds you back.

  • Lack of time
  • Cost of healthy food or gym access
  • Lack of motivation
  • Injury or health limitations
  • Lack of knowledge on what to do
  • Lack of support from others
100ポイントを配分
Q08
評価スケール必須

How satisfied are you with your current fitness level?

範囲: 1 – 5
最小:Very dissatisfied最大:Very satisfied
Q09
AIインタビュー

Explore the reasoning behind the respondent's confidence score for sticking to healthy habits over the next 3 months. If confidence was low or middling, identify the single biggest real-world barrier (time, cost, motivation, knowledge, support, or health limitation) and get a concrete recent example of it happening. If confidence was high, probe what specific system or habit is making it work so it can be reused with others.

Q10
メッセージ

That wraps up the survey portion — just two quick optional questions left about you.

Q11
選択式

Which age range do you fall into?

  • Under 18
  • 18-24
  • 25-34
  • 35-44
  • 45-54
  • 55-64
  • 65+
  • Prefer not to say
Q12
選択式

What is your gender?

  • Woman
  • Man
  • Non-binary
  • Prefer to self-describe
  • Prefer not to say
Q13
メッセージ

Thank you for sharing this! Your responses will be used to shape more realistic diet and exercise support — no generic plans, just habits and barriers that match real life.

含まれる機能

  • AIによる深掘り

    自由回答に合わせてAIが追加で質問し、固定のフォームでは拾えない具体的な内容を引き出します。

  • 注意確認設問

    急いだ回答や質の低い回答者を除外する仕組みを標準で備えています。

  • AIが作成する設問文

    文言、設問の順序、条件分岐をAIが調査の目的に合わせて作成します。

  • 自動レポート

    回答が集まると、テーマ、引用、わかりやすい要約が自動で作成されます。

他ツールとの比較

ほかのアンケートツールで最も近いテンプレートを調べました。それぞれの優れている点と、このテンプレートがさらに踏み込んでいる点をまとめています。

このテンプレートを選ぶ理由

  • Goes beyond a checkbox confidence score with an AI follow-up interview that digs into the specific barrier behind someone's rating, in the respondent's own words
  • Uses a constant-sum question to force respondents to weigh and distribute barriers rather than just picking one, giving more nuanced prioritization data
  • Pairs a max-diff exercise (what would actually help someone stick to a routine) with a weekly-frequency matrix to capture both stated motivators and real behavioral patterns
  • Frames the whole survey conversationally with chat-style intro/closing messages, making it feel like a guided conversation rather than a cold form

Jotform

Diet and exercise Form Template

This is a static, drag-and-drop form template rather than a survey instrument designed for behavioral research — it's built for quick data capture (e.g., logging habits) and easy customization. It's fielding-ready but light on structured question design like matrix or ranking logic. Good for simple intake, less suited to uncovering motivational nuance.

優れている点

  • Highly customizable form builder
  • Fast to deploy and embed
  • Simple, familiar Jotform ecosystem integrations

物足りない点

  • No adaptive follow-up questioning — respondents get the same static fields regardless of answers
  • No mechanism to explore the 'why' behind a rating or barrier
  • No published methodology or scoring transparency

SurveyMonkey

Exercise, Fitness, And Diet Survey Template

A standard fielding-ready survey template from an established survey platform, likely covering frequency and satisfaction questions similar in spirit to ours. It benefits from SurveyMonkey's broad distribution and analytics tools, but the question set is fixed once launched. No indication of AI-driven probing into individual responses.

優れている点

  • Established survey distribution and panel options
  • Built-in analytics and reporting dashboard
  • Familiar, trusted platform for respondents

物足りない点

  • Static question flow with no adaptive AI interviewing to probe motivation or barriers
  • No voice-based interview option
  • No per-response quality scoring

SurveySparrow

Diet and Exercise Survey Template

SurveySparrow's conversational, chat-style survey format makes this template feel more engaging than a plain form, and it's ready to field as-is. However, the conversational feel is a UI layer over pre-scripted questions, not true adaptive follow-up based on response content.

優れている点

  • Conversational, chat-like question presentation
  • Mobile-friendly, engaging UI
  • Ready-to-use healthcare template category

物足りない点

  • No AI-generated follow-up questions tailored to individual answers
  • No voice interview or screen-share task capability
  • No transparent prompt or scoring methodology published

Typeform

Health and Diet Survey Template

Typeform's one-question-at-a-time format is visually polished and fielding-ready, well-suited for casual respondent engagement. Logic branching can route respondents based on prior answers, but this is rule-based branching, not open-ended AI probing of the reasoning behind a score.

優れている点

  • Clean, engaging one-question-per-screen design
  • Conditional logic branching between questions
  • Strong brand reputation for respondent-friendly surveys

物足りない点

  • Branching logic is rule-based, not adaptive AI conversation that digs into open-ended reasoning
  • No voice AI interview mode
  • No automated per-response quality scoring or auto-generated qualitative reports

よくあるご質問

「Diet and Exercise Habits & Motivation Survey」テンプレートにはどのような設問が含まれていますか？

すぐに使える設問が13問含まれており、最初の設問は次のとおりです：「Thanks for taking a few minutes to share your diet and exercise habits! Your responses are completely confidential and a…」・「In the last 7 days, on how many days did you do at least 7 minutes of physical activity (including brisk walking)?」・「Which types of exercise have you done in the last 30 days?」。すべての設問は上でプレビューでき、自由に編集できます。

このアンケートの回答にはどのくらい時間がかかりますか？

回答者は通常、13問を約7分で回答し終えます。

テンプレートは編集できますか？

はい。公開前であれば、すべての設問、選択肢、順序を編集できます。設問の追加や削除のほか、調査の目的に合わせた作り直しをAIエディターに依頼することもできます。

このテンプレートは無料で使えますか？

はい。エディターで開けば、すぐに編集を始められます。お試しにアカウントは不要で、無料プランでアンケートを公開できます。

公開の準備はできましたか？

このテンプレートをエディターで開いてみてください。最初の回答者が目にする前に、すべてを自由に変更できます。

このテンプレートを使う無料で始める

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