Healthy Lifestyle Questionnaire

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					                             Healthy Lifestyle Questionnaire

This research is being carried out by Tracey Price, PhD researcher at the University of
Worcester. The aim is to gain a deeper understanding into individual’s perceptions surrounding
the government’s recommendations on fruit and vegetables; alcohol units, weekly exercise
habits and salt intake. Questionnaires should be returned to t.price@worc.ac.uk

Personal details

   1.     Are you male / female



   2.     Which age group do you fall into?



             Under 18

             18-25

             26-39

             40-60

             Over 60



   3.     What is your highest educational qualification?



             No qualifications

             ‘O’ levels/CSE/GCSE’s

             ‘A’ levels

             Apprenticeship
                Professional qualification

                Vocational/work-related qualifications

                Degree BA, BSc

                Higher degree MSc, MA, PhD

                Foreign qualifications



   4.        Which county do you live in? ..................................



   5.        Would you describe the area you live as rural or urban? ...............................



Fruit and Vegetables



   6.      How many portions of fruit and vegetable do the government recommend that you
        should consume per day?

             

   7.      How many portions of fruit and vegetables do you think that you consume (on
        average) per day?

             



   8.        How many portions of fruit and vegetables are in the following?




        a)

        Two spears of broccoli + two apples + two oranges =
         b)



         Three tablespoons of blueberries + one handful of grapes + fourteen button mushrooms
         =




         c)



         Roast lunch with three heaped tablespoons of frozen carrots + three heaped
         tablespoons frozen peas+ two potatoes + portion of Christmas pudding =




         d)



         Spaghetti bolognaise made with one large onion + one tin of chopped tomatoes + one
         smoothie =




Alcohol Units

   9.       How many units of alcohol does the government recommend that men should not
         exceed per week according to current guidelines?

              

   10.      How many units of alcohol does the government recommend that women should not
         exceed per week according to current guidelines?

              
     11.   Do you know how to calculate the unitary content in alcoholic drinks

              Yes/ No



     12.   How many units (on average) do you think that you drink a week?

           



     13.   How many units are in the following alcoholic drinks?




a)              Whisky (25ml). Alcohol 40% =




b)             Measure of Gin (25ml) & Tonic. Alcohol 37.5% =




c)             Small white wine (125ml). Alcohol 12.5% =




d)             Pint of lager, alcohol 5% =




e)             Double Tequila (50ml). Alcohol 40% =



Exercise
14.     How many times does the government recommend that you should exercise per
      week?

           

15.        What type(s) of exercise did you do last week?

           




16.        How many hours of exercise do you do (on average) per week?

           

17.      Which of the following, if carried out per week, would comply with the government
      guidelines?




      a)

      Half an hour walking + half an hour swimming + half an hour housework. YES/NO




      b)



      Ten minutes walking the dog + one hour shopping + twenty minutes in the gym.

      YES/NO




      c)



      Twenty minutes tennis + half an hour yoga + half an hour fishing. YES/NO.
         d)



         One hour disco-dancing + half an hour roller skating + half an hour playing football in the
         park with the children. YES/NO




Salt Intake



   18.      Do you know what the maximum amount of salt is that the government recommend
         you should not exceed per day? YES/NO - How much ..............?

   19.        Do you add salt whilst cooking? NEVER/ SOMETIMES/ ALWAYS

   20.        Do you add salt to your food to taste? NEVER/ SOMETIMES/ ALWAYS

   21.        Which of the following exceed the maximum recommended daily salt limit?




         a)                       Bacon Sandwich and packet of crisps – YES/NO




         b)                       300g bowl of ‘All Bran’ and one glass of orange juice - YES/NO
           c)                                      Feta cheese salad and bowl of green olives – YES/NO




I am currently looking for participants to assist me with my PhD research; the title of my thesis is
‘Alcohol use in middle-aged adults’. If you are aged between 35-65 years and would be
interested in taking part in my study (confidentially and anonymously) regarding alcohol
consumption, please leave your contact details below.

                     I would be happy to participate in a focus group

                     I would be happy to participate in a face to face interview

                     I would be happy to participate in a telephone interview

                     I would be happy to complete a further questionnaire or short diary

                      Please tick all that apply.

Contact details: ...............................................................................................................

                      ....................................................................................................................

                      ....................................................................................................................

                      ....................................................................................................................

				
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