questionnaire - Community Food and Health

CFHS Moray 091. About youCommunity First (Moray), who run the Handyperson Service, are working with Community Food andHealth Scotland, to improve and support healthy eating.We would be really pleased if you could help by taking some time to answer a few questions.1. Interviewer code - Please put 'Self' if filling in survey online yourself.2. Please enter your postcode3. Please describe the type of housing you live in. (bungalows to becounted as houses)nmlkjOwn HousenmlkjCouncil FlatnmlkjPrivately rented HousenmlkjOwn FlatnmlkjHousing Association HousenmlkjPrivately rented FlatnmlkjCouncil HousenmlkjHousing Association FlatnmlkjSheltered accommodation4. Please tell us who you live with?nmlkjOn your ownnmlkjWith other family membersnmlkjWith other, non familynmlkjWith your spouse or partnernmlkjWith your spouse AND othermembersfamily members5. Are you -nmlkjMalenmlkjFemale6. Please tell us which age group you are innmlkj 65-74nmlkj 75-84nmlkj 85-94nmlkj 95+Page 1

CFHS Moray 097. Do you make use of or go to any of the following services? Please tickall that apply.gfedcThe Handyperson ServicegfedcCouncil Day Care CentregfedcWRVS Meals on WheelsgfedcBALL groupgfedcRed Cross Befriendersgfedca Church Social GroupgfedcCrossroads CaregfedcLuncheon clubgfedcNHS Dietician ServicegfedcAlzheimers Support groupgfedcOccupational Therapy Servicegfedcother support group or organisationOther (please specify)8. Do you have any pets that you look after?nmlkjYesnmlkjNoPlease tell us about any pets you havePage 2

CFHS Moray 092. Food shopping1. Who mostly does the food shopping in your house?nmlkjMenmlkjMy SpousenmlkjOther people InmlkjMy CarernmlkjEveryone shareslive with2. Where do you usually buy your food?nmlkjSupermarketnmlkjLocal shopsnmlkjBothnmlkjOther3. How often do you buy food?nmlkjEvery daynmlkjMore than oncenmlkjOnce a weeknmlkjOnce a monthnmlkjMore than oncea weeka month4. How do you mostly get to the shops to do your food shopping?nmlkjWalknmlkjBy publicnmlkjDrive own carnmlkjSomeone elsenmlkjTaxitransporttakes me5. Do you experience any difficulties in doing your food shopping? Tick asmany as apply to you.gfedcShops too far awaygfedcShopping can be too heavygfedcCan't buy small amounts of foodgfedcGood food too expensivegfedcOther - please use comment box belowOther (please specify)6. Do these difficulties affect the sort of food you buy?nmlkjYesnmlkjNonmlkjSometimes7. Do you look for bargains or special offers when you go food shopping?nmlkjAlwaysnmlkjSometimesnmlkjNever8. Do you use a shop delivery service?nmlkjNevernmlkjOccasionallynmlkjA lotnmlkjAlwaysPage 3

CFHS Moray 099. Which shops do you have food deliveries from?10. How do you order your food for delivery? Tick all that applygfedcOn the phonegfedcOnlinegfedcGet someone to drop a list in11. Do you need help with your shopping?nmlkjYesnmlkjNo12. Are you able to get that help?nmlkjYes - AlwaysnmlkjSometimesnmlkjNoPage 4

CFHS Moray 099. Have you got a freezer?nmlkjYesnmlkjNo10. Do you check for use by dates and throw things out?nmlkjYesnmlkjNo11. Do you re-heat/re-use left overs?nmlkjOftennmlkjNevernmlkjSometimesPage 6

CFHS Moray 094. Your diet1. Do you eat breakfast.....nmlkjEvery day within an hour of getting upnmlkjevery day sometime during the morningnmlkjnot regularlynmlkjnever2. What do you eat for breakfast? - tick all that applygfedcCerealgfedctoast/breadgfedccooked breakfastgfedcOtherOther (please specify)3. Do you have a meal in the middle of the day?nmlkjEvery daynmlkjmost daysnmlkjsome daysnmlkjnever4. What do you eat in the middle of the day? please tick all that applygfedcSnack/sandwichgfedcsoupgfedchome-cookedgfedcpre-gfedcothermealprepared/frozenmealOther (please specify)5. Do you have a meal in the evening/tea time?nmlkjEvery daynmlkjmost daysnmlkjsome daysnmlkjnever6. What do you eat in the evening?gfedcSnack/sandwichgfedcsoupgfedchome-cookedgfedcpre-gfedcothermealprepared/frozenmealOther (please specify)7. Do you have a hot drink before you go to bed?nmlkjYesnmlkjNonmlkjOccasionallyPage 7

CFHS Moray 098. How often do you eat fruit (fresh or tinned or dried)?nmlkjMore thannmlkjonce a daynmlkja few timesnmlkjonce a weeknmlkjrarelynmlkjneveronce a daya week9. How often do you eat vegetables (not potatoes)?nmlkjMore thannmlkjonce a daynmlkja few timesnmlkjonce a weeknmlkjrarelynmlkjneveronce a daya week10. How often do you eat salad stuff?nmlkjMore thannmlkjonce a daynmlkja few timesnmlkjonce a weeknmlkjrarelynmlkjneveronce a daya weekPage 8

CFHS Moray 095. food and drink cont1. What is your favourite food/meal?2. What sort of food would be a real treat for you?3. What sort of drinks do you take during the day? Please tick all thatapplygfedcStill water,gfedcfresh fruit juice,gfedccoffee,gfedcfizzy water,gfedcfizzy soft drink,gfedcmilk,gfedcdiluting juice,gfedctea,gfedcother hot drink4. Do you like an alcoholic drink?nmlkjOccasionallynmlkjNevernmlkjRegularly (more than once aweek)further comment?5. Do you smoke?nmlkjOccasionallynmlkjNevernmlkjRegularlyfurther comment?6. Do you regularly take any dietary supplements? Please tick all thatapply.gfedcNonegfedcvitaminsgfedcmineralsgfedcparticulargfedcothervit/min mixOther (please specify)Page 9

CFHS Moray 096. Thank you!The answers you have given us will help make sure that older people in Moray get the support theyneed to live longer and live better lives. In particular this survey should identify any problems peopleface in terms of eating well.If you want to say any more about what might support your independent living needs please feel freeto put this in the box below.Community First (Moray)1. Your space to add things.Page 10