Community Health and Wellbeing (Roadshows 2024) Question Title * 1. Age group Under 18 18-24 25-34 35-44 45-54 55-64 65+ Question Title * 2. Which of the following options most closely aligns with your gender? Female Male Non-binary A gender not listed here Prefer not to answer Question Title * 3. Which session did you attend? Online Marrawah Smithton Irishtown Forest Mawbanna Rocky Cape Stanley Edith Creek Steven Bradbury event Question Title * 4. Where in Circular Head do you live or which area is the closest to you? Edith Creek Forest Irishtown Marrawah Mawbanna Rocky Cape Stanley Smithton Other (please specify) Question Title * 5. When was the last time you have a general check up with a GP? I go to the doctor regularly In the last 3 months In the last 6 months In the last 12 months 12 months or longer Can't remember the last time I went to a doctor Question Title * 6. What are the main reasons you don't go the doctor regularly? Not enough time/too busy Inconvenient doctor's hours Difficult to get an appointment Transport issues Cost Don't think it' important I feel ok/don't think I need a check up Fear of / don't trust doctors Fear of bad news/results Embarrassment Long waiting times Other (please specify) Question Title * 7. Do you smoke? Yes Yes socially No Other (please specify) Question Title * 8. If you answered yes to smoking, how keen are you to give up? Not at all I'm interested I would like to start now Question Title * 9. How many serves of vegetables (including fresh, frozen and tinned vegetables) do you usually eat each day? One serve or less Two serves Three serves Four serves Five serves Six or more I don't eat any vegetables Other (please specify) Question Title * 10. How many serves of fruit (including fresh, frozen and tinned fruit) do you usually eat each day? One serve Two serves Three or more serves I don't eat fruit Other (please specify) Question Title * 11. How many days of the week do you usually eat foods that are high in fat, salt, or sugar (such as deep-fried foods, hot chips, pies, pastries, chocolates, lollies, etc)? One day Two days Three days Four days Five days Six days Seven Days Other (please specify) Question Title * 12. Why do you usually choose fast food instead of something you prepared yourself? (tick all that apply) I never eat/drink fast food I rarely eat/drink fast food It's cheaper More convenient Tastes better/tastes good Availability The hours I work Makes me feel good/better when I am stressed I don't know how to prepare healthy meals I have access to vending machines/chocolate box or similar I can't be bothered I don't like cooking I don't have access to a kitchen/food preparation area Other (please specify) Question Title * 13. How many times a week do you do 20 minutes or more of vigorous-intensity physical activity that makes you sweat or puff and pant (for example, heavy lifting, digging or jogging)? (Two x 10 minute sessions count as 20 minutes) 0 1-2 3-5 5-7 7+ Other (please specify) Question Title * 14. How many times per week do you do 30 minutes or more of walking (for example, walking from place to place for exercise or recreation)?(Three 10-minute sessions or two 15 minute sessions could as one 30 minute session) 0 1-3 3-5 5-7 7+ Other (please specify) Question Title * 15. How many times per week do you do 30 minutes or more of other moderate-intensity physical activity that increases your heart rate or makes you breathe harder than normal (for example, carrying light loads, slow cycling)? 0 1-3 3-5 5-7 7+ Other (please specify) Question Title * 16. How much of your total physical activity is part of your job? (includes travelling to and from work) All Most Some None Question Title * 17. a) Do you exercise outdoors using local parks or outdoor spaces? Please list any you use.(eg: Godfrey’s Beach, Duck River walking track, Forest Recreation Ground) Question Title * 18. Why are you NOT more physically active? Tick all that apply to you. Too tired Not enough time Lack of facilities Shift work, night work or overtime Out on the road a lot Not encouraged or supported to No shower facilities Not motivated Not enough flexible time in work hours Health issues Weather Cost I am already active enough Other (please specify) Question Title * 19. How many hours do you spend at work in a typical day? (including travel) 0 1 to 3 4 to 6 7 to 9 More than 9 Other (please specify) Question Title * 20. How many hours per day do you spend sitting? 0 1 to 3 4 to 6 7 to 9 More than 9 Other (please specify) Question Title * 21. How many times per day do you interrupt your sitting by standing up, walking somewhere (ie to get a drink) 5 times or less 6-10 times 11-20 times More than 20 minutes Other (please specify) Question Title * 22. Which of the following would you most likely use if it was in your local community or workplace?Tick all that apply to you. Exercise/physical activity sessions Fatigue management information sessions Free health assessments - face to face Free health assessments - online Health coaching on physical activity or nutrition Healthy food options Information seminars/workshops Activities that promote good mental health Pedometer event or walking challenge Smoking cessation programs (e.g. Quit smoking program) Sports/activity days Stress management programs and strategies Stretching sessions Walking or running groups Other (please specify) Question Title * 23. When would you prefer health and wellbeing activities to occur?Tick all that apply to you. Morning 6am to 8am Morning 10am to 12pm Lunch time 12pm to 2pm Afternoon 2pm to 4pm Afternoon 4pm to 5.30pm Evening 5.30pm to 7.00pm Late evening 7.00pm or later Saturday Sunday Other (please specify) Question Title * 24. How often would you attend a health and well being activity if it was offered? Every day A few times a week Once a week A few times a month Once a month Less than once a month I don't think I would use it Other (please specify) Question Title * 25. How far from work or home are you prepared to travel for free or low cost activities? Walking distance less than 1km Walking distance 1km to 2km Car travel less than 5 minutes Car travel 5 to 15 minutes Car travel 20+ minutes I am unable to travel Other (please specify) Question Title * 26. How often do you drink alcohol? Never Rarely (less than 10 glasses per year) Sometimes (1-2 per month) 2-3 times per week 1-2 drinks per day 3+ drinks per day Question Title * 27. Do you have anything to add with regards to health and well being Question Title * 28. Would you like to be contacted about your answers? If yes please leave you contact details below: Name Email Address Phone Number Question Title * 29. Would you like to be added to a health and wellbeing data case to receive information about health and wellbeing events and activities.If your answer is yes please add your contact details. Name City/Town Email Address Phone Number Done