Survey details | Â |
---|---|
Question | Response option |
A. Socio-demographics | Â |
Gender | Male |
 | Female |
 | Prefer not to say |
Age | [dropdown, age rollup] |
Nationality | Zambian |
 | Sierra Leonean |
Zambia/Sierra Leone Province | [dropdown, provinces rollup] |
Educational Level | [dropdown, specify] |
Type of Disabilities | [dropdown, specify] |
Family occupation/income per month | Very low (0$) to very high (1,3600$) |
Who owns land/housing | [dropdown, specify] |
B. Wellbeing | Â |
I’ve been feeling optimistic about the future | None of the time (1) |
I’ve been feeling useful | Rarely (2) |
I’ve been feeling relaxed | Some of the time (3) |
I’ve been dealing with problems well | Often (4) |
I’ve been thinking clearly | All of the time (5) |
I’ve been feeling close to other people |  |
I’ve been able to make up my own mind about things |  |
C. Social networks | Â |
I feel I have lots of close friends who support me | one of the time |
 | Rarely |
 | Some of the time |
 | Often |
 | All of the time |
I have a lot of friends and family around me who I can trust | Â |
Since the outbreak of COVID-19, I have felt more connected to others | Â |
D. My response to COVID-19 | Â |
We’d like to know how many people live in your household. Please tell us how many people, including yourself, are living with you: | I’m living alone |
 | 2 people |
 | 3 people |
 | 4 people |
 | 5 people |
 | 6 people or more |
How many rooms are in your home? (Not including any bathrooms or toilets) | [dropdown, number rollup] |
Do you have access to outside space where you can currently play, walk or hang out? | Yes in public places/private place |
 | No |
How would you rate your understanding to stay safe and well due to COVID-19 (Coronavirus)? | [Dropdown, specify] |
Have you or other members of your family had COVID-19 (Coronavirus)? | [Dropdown, specify] |
Are you worried about the long-term impact that COVID-19 (Coronavirus) and lockdown will have on your education, training and work? | [Dropdown, specify] |
Which statement applies for you during epidemics of COVID-19 (Coronavirus)? | [Dropdown, specify] |
Have you or any member of your family received any help response towards COVID-19? | [Dropdown, yes/no] |
Do you feel you would need to be supported in relation to your response to COVID-19 and thereafter? | Not at all |
 | Yes, a bit |
 | Yes, a lot |
 | Yes, completely |
What kind of supports would you like to receive in relation to your response to COVID-19 (Coronavirus) and isolation during epidemics and thereafter? | [Dropdown, specify] |
Have you exercised during social distancing and taken part in sport? | [Dropdown, specify] |
Is there anything else you would like to add about how COVID-19 has impacted on you and your life? | [Open-ended questions] |
Suggest ways in which sports can be used as a solution to COVID-19 | [Open-ended questions] |