Women in Motion Consultation 2010

Do you currently participate in sports activities?

• Yes - I currently take part in sports activities
• No - I don't take part in any sports activities

If yes, what do you do? (Please tick all that apply)

Please select all that apply.

• Rounders
• Basketball
• Hockey
• Swimming
• Netball
• Badminton
• Football
• Running/Jogging
• Walking
• Cycling
• Dancing
• Rugby
• Athletics
• Other

How many days do you take part in a TOTAL of 30 minutes (can be done in 10-15 minute bouts) of moderate physical activity per week? (Moderate means getting slightly warm and slightly out of breathe)

• 1
• 2
• 3
• 4
• 5+

What stops you from taking part in sports activites? (Please tick all that apply)

Please select all that apply.

• Lack of childare provision
• Work commitments
• Time of day existing sessions are provided
• Choice of activity available
• Family commitments
• Lack of motivation
• Transport issues
• Not seen as a priority

If we could meet all your needs above, what types of sport would you like to do? (Please tick all that apply)

Please select all that apply.

• Rounders
• Basketball
• Hockey
• Swimming
• Netball
• Badminton
• Football
• Running/Jogging
• Walking
• Cycling
• Dancing
• Rugby
• Athletics
• Other

What would help you to take part in sports activites? (Please tick all that apply)

Please select all that apply.

• Free creche provision at sessions
• Free sessions
• Location of activities
• Evening sessions
• Being able to participate with family
• Weekend sessions
• Wider choice of activity
• Time of sessions
• Women only sessions
• Other

Where would you like to take part in sport activities? (Please tick all that apply)

Please select all that apply.

• Local Leisure Centre
• Local Community Centre
• Church Hall
• College/School premises
• Outdoor
• Other

What are the best times for you to take part in a sports activity? (Please tick all that apply)

Please select all that apply.

• School hours (9:00 - 3:00pm)
• Evenings
• Mornings
• Afternoons
• Weekends

Data Monitioring - Age (Please tick the relevant box)

• 0-4 years
• 5-9 years
• 10-14 years
• 15-19 years
• 20-24 years
• 25-29 years
• 30-34 years
• 35-39 years
• 40-44 years
• 45-49 years
• 50-54 years
• 55-59 years
• 60-64 years
• 65-69 years
• 70-74 years
• 75-79 years
• 80-84 years
• 85+

Data Monitoring - Ethnic Origin (Please tick the relevant box)

• Asian or Asian British - Bangladeshi
• Asian or Asian British - Indian
• Asian or Asian British - Pakistani
• Other Asian background
• Black or Black British - African
• Black or Black British - Caribbean
• Other Black background
• Mixed - White and Asian
• Mixed - White and Black African
• Mixed - White and Black Caribbean
• Other Mixed background
• Other Ethnic Group - Chinese
• Other Ethnic Group
• White - British
• White - Irish
• Other White background
• I do not wish to disclose my ethnic origin

Would you like to get involved in future Community Health Services needs assessments?

• Yes
• No