1. SURVEY FOR HEALTH WEBSITE
1. Demographics
Interviewer’s
name
Age 0-15 16-20 21-30 31-40 41-50 51-60 61+
Gender
Male Female
First letters of
Postcode
Profession Professional Manager Skilled Semi-skilled Student Pensioner Unemployed
Salary
Religion Christian Atheist Muslim Jewish Hindu Other
/Catholic
……………
Personal Health
Smoker Yes No
Alcohol units 0-10 11-15 16-20 21+
consumed per week*
Please specifiy
. . . . . units
Hours of exercise per 0-5 6-10 11-15 16+
week
Please specify
. . . . . hours
Calorie intake per day Under 1000 1500 2000 2000+
Height: Weight:
*One alcohol unit is measured as 10ml or 8g of pure alcohol.
This equals one 25ml single measure of whisky, or a third of a
pint of beer or half a standard (175ml) glass of red wine.
2. Psychographics

2. Rate these topics in order of value
(please circle and use each number only once)
1 = least important, 10 = most important
Sexual Health 1 2 3 4 5 6 7 8 9 10
Education
STI’s 1 2 3 4 5 6 7 8 9 10
Anti-Smoking 1 2 3 4 5 6 7 8 9 10
Drug Awareness 1 2 3 4 5 6 7 8 9 10
Drink-Driving 1 2 3 4 5 6 7 8 9 10
Healthy Eating 1 2 3 4 5 6 7 8 9 10
Fitness 1 2 3 4 5 6 7 8 9 10
Women Well-being 1 2 3 4 5 6 7 8 9 10
NHS Direct 1 2 3 4 5 6 7 8 9 10
First Aid 1 2 3 4 5 6 7 8 9 10
3. “The public smoking ban is appropriate”
Please tick
strongly disagree disagree don’t know agree strongly agree
4. “Fad diets are overrated”
Please tick
strongly disagree disagree don’t know agree strongly agree
5. What sports do you play?
Please tick

3. Often Occasionally Never
Football
Rugby
Golf
Cricket
Hockey
Cycling
Tennis
Badminton
Swimming
Netball
Dancing
Gymnastics
Other
(please specify)
...............
...............
6. “I would cook more meals if the recipes are…”
Please circle
Strongly Disagree Don’t’ Agree Strongly
Not Time-
Consuming disagree know agree
Strongly Disagree Don’t’ Agree Strongly
Child-Friendly
disagree know agree
7. What would you like to see on a Health website?
Please circle the three most important boxes

4. Bright Colours Large, clear Organised A forum to ask and read Healthy
fonts information previous questions/answers recipes
Information on Audio/visual Useful links What to wear for your body Useful
how to lose weight information shape diets
8. What type of websites do you use most
regularly? Rate these from 1 – 5.
You can use the same number more than once
1 = lowest, 5 = highest
Social News Entertainment Health Games General
networking Information
12345 12345 12345 12345 12345 12345
9. Is Britain becoming overweight? Yes / No /
Don’t know
Please briefly explain your views on this
10. Do too many people rely on fast food? Yes / No /
Please briefly explain your views on this Don’t know