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Questionnaire Survey

The document is a questionnaire survey for adolescent girls to assess their risk of developing obesity. It collects information on the girls' profiles, lifestyles, dietary habits, nutritional knowledge, and family history of obesity. The survey contains multiple choice and open-ended questions in three sections on demographic information, lifestyle factors, and nutritional knowledge. It aims to gather data on factors that influence obesity risk for a school project.

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111 views5 pages

Questionnaire Survey

The document is a questionnaire survey for adolescent girls to assess their risk of developing obesity. It collects information on the girls' profiles, lifestyles, dietary habits, nutritional knowledge, and family history of obesity. The survey contains multiple choice and open-ended questions in three sections on demographic information, lifestyle factors, and nutritional knowledge. It aims to gather data on factors that influence obesity risk for a school project.

Uploaded by

Sultaan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Questionnaire survey

AN INVESTIGATION TO FIND OUT HOW FAR A GROUP OF ADOLESCENT GIRLS OF MY


CLASS ARE AT RISKS OF DEVELOPING OBESITY, Why IT MATTERS?
Dear friends,
Being a food studies student, I am conducting this questionnaire to collect
data for my project of HSC Cambridge Examinations. Please kindly complete the
survey questionnaire below approximately.
INFORMATION WILL BE STRICTLY PRIVATE AND CONFIDENTIAL.
Thank you in advance!

❖ Please kindly tick/fill in the appropriate box/es.


Code:
Section A: Profile
1. Residential Address:

Urban ☐ Rural ☐

2. To which ethnic group do you belong to?

(a) Hindu ☐ (c) Christian ☐

(b) Muslim ☐ (d) Others ☐

3. What is your parent’s occupation?


Mother ☐ Father ☐

4. Describe yourself;

(a) slim ☐ (e) Obese ☐

(b) Underweight ☐

(c) Overweight ☐

(d) Healthy ☐

1
5. BMI=
(a) Height/m ☐ (b) Weight/kg ☐

6. Family history of obesity

(a) Yes ☐ (b) No ☐

Section B: Lifestyle
7. Do you practice any physical activity or sport?
(a) Yes ☐ (b) No ☐
If yes, state the physical activity or sport

8. How often do you practice physical activity or sport

(a) Daily ☐ (e) Any other ☐

(b) 3 times a week ☐

(c) Only weekends ☐

(d) Never ☐

9. What is the time span for which you exercise?


(a) <30 mins ☐ (c) 45 mins ☐

(b) >30 mins ☐ (d) >60 mins ☐

10. How much money do you spend on food daily?

(a) < Rs50 ☐ (c) Rs 150-Rs 200 ☐

(b)Rs 50-Rs 150 ☐ (d) > Rs 200 ☐

2
11. Do you prefer homemade foods or fast foods?
(a) Homemade foods ☐ (b) Fast foods ☐
Justify your answer;

12. How many meals do you consume daily? (you may tick one or more than one
option)

(a) Breakfast ☐ (c) Dinner ☐

(b) Lunch ☐ (d) Snack ☐

13. What do you usually consume as snacks in between meals? You may tick one or
more than one option.

(a) Fruits ☐ (e) Oily foods(nuggets) ☐

(b) Yoghurt ☐ (f) Soft drinks(e.g. Coke, Soda) ☐

(c) Pastries( e.g. Donuts, tarts) ☐ (g) Chocolate ☐

(d) Junk foods( e.g. Fries, pizzas) ☐

14. How would you describe majority of your meals?

(a) Healthy ☐ (b) Unhealthy ☐

15. Do you skip meals?

(a) Yes ☐ (b) No ☐


If yes, Which meal/s do you skip particularly? You may tick one or more than one
option.

(a) Breakfast ☐ (c) Dinner ☐

(b) Lunch ☐

3
16. Do you take fast foods frequently?

(a) Daily ☐ (d) Monthly ☐

(b) 2-3 times per week ☐ (e) Rarely ☐

(c) Weekly ☐ (f) Never ☐

17. Do you consume fruits and vegetables?


(a) Yes ☐ (b) No ☐
If yes, give examples of fruits and vegetables you consume;

If no, Why?

18. What are the factors that influence your choice of foods? You may tick one or
more than one option

(a) Likes/dislikes ☐ (f) Cost of foods ☐

(b) Habit ☐ (g) Availability ☐

(c) Peer pressure ☐ (h) Accessibility ☐

(d) Family influence ☐ (i) Nutritional knowledge ☐

(e) Traditions/ cultures ☐ (j) Food advertising ☐

19. How many hours do you sleep?

(a) 4 hours ☐ (c) 8 hours ☐

(b) 6 hours ☐ (d) More ☐

4
Section C: Nutritional Knowledge
20. Are you aware of the consequences associated with the consumption of
unhealthy foods? (e.g. Fast foods, Sweets)
(a) Yes☐ (b)No ☐
If yes, Please specify some of the consequences

21. Excess of fats leads to

(a) Diabetes ☐ (c) Hypertension ☐

(b) Obesity ☐

22. Why dietary fibre is important?


(a) To prevent constipation ☐

(b) To be in good health ☐

(c) To prevent anaemia ☐

(d) For strong bones and teeth ☐

23. What measures can be taken to reduce the excess of weight?


(a) Diet ☐ (d) Skipping meals ☐

(b) Proper exercise ☐ (e) Any other ☐

THANK YOU FOR YOUR COOPERATION.

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