Thinking in more detail about your Health and Wellbeing
1. Thinking about the things that make you feel good… what makes you feel good?
a. Your relationship with your parent(s)?
b. Your relationship with your brother(s) or sister(s)?
c. Spending time with your friend(s)?
d. Going to school or college?
e. Taking part in activities outside of school or college?
f. Being on the computer or your phone?
g. Spending time with your boyfriend, girlfriend or special friend?
h. Something else?
2. Thinking about worries… are you worried about anything?
a. The way you look?
b. Where you live?
c. The people who you live with?
d. Your health?
e. Someone else’s health?
g. Your family?
i. The future?
j. Your friends?
3. Thinking about bullying…have you been bullied before and, if so, who bullied you?
a. Was it someone in person?
b. Was it cyberbullying on a phone?
c. Was it cyberbullying on the internet (such as on Social Media / Facebook)?
4. Thinking about discrimination…have you ever experienced discrimination before?
a. Was it due to your age?
b. Was it due to your sex or gender?
c. Was it due to disability?
d. Was it due to nationality?
e. Was it due to appearance or dress?
f. Was it due to religion, faith or belief?
g. Was it due to sexual orientation?
5. Thinking about your general health…
a. Do you have a condition such as…
viii. Learning disability
ix. Physical disability
b. Does any medical condition or disability limit what you can do?
6. Thinking about your dental health…
a. When did you last go to a dentist?
b. How often do you brush your teeth?
7. Thinking about any exercise you do…how many days in the last week were you physically active for at least 60 minutes?
a. 0 days
b. 1 day
c. 2 days
d. 3 days
e. 4 days
f. 5 days
g. 6 days
h. 7 days
8. Thinking about how you travel to and from places… what is the main way you get around?
i. Do you drive yourself?
ii. Do any of your friends drive?
iii. Does anyone in your family drive?
9. Thinking about whether you are eating ok… what did you have for breakfast this morning?
a. A drink
g. Cooked breakfast
h. Cereal bar
10. Thinking about what you do for lunch… where do you normally get your lunch from?
a. School or college lunch
b. Packed lunch
c. Go home for lunch
d. Buy from a shop or van
e. Don’t usually have lunch
11. Thinking about what you eat in the evening…
a. Meal with family
b. Make your own food
c. Meal with friends
d. Take away
e. Don’t usually have evening meal
12. Thinking about healthy eating…
a. How many portions of fruit did you have yesterday?
b. How many portions of vegetables did you have yesterday?
c. When was the last time you had some salad?
13. Thinking about smoking…
a. Do any of your family smoke?
b. Do any of your friends smoke?
c. What about you:
i. Never tried smoking
ii. Tried once or twice
iii. Smoke some days
iv. Smoke every day
d. If you do smoke:
i. What do you smoke?
2. Roll own
5. Weed / Cannabis
6. Another drug
ii. How many per day?
iii. Would you like to stop smoking?
iv. Where do you get the things you smoke from:
1. Buy from a shop
2. Buy from people you know
3. Get a friend to buy for you
4. Get someone you don’t know to buy for you
5. Get them from a friend
6. Take them from someone without their knowledge
7. Get them from a family member
e. Do you know where to access services about stopping smoking?
14. Thinking about alcohol…
a. How often do you drink alcohol?
ii. Once a day
iii. Once a week
iv. Every 1-2 weeks
v. Every 2-4 weeks
vi. Every 2-3 months
vii. Less frequently
b. How often would you say you get drunk?
ii. Most days
iii. One a week
iv. Twice a month
v. Once a month
vi. Every few months
c. Have you ever had any injuries after you have had some alcohol?
d. What do you drink?
viii. Another spirit
ix. Alcopops (WKD, Bacardi breezer)
e. Do you know where to access services about alcohol?
15. Thinking about drugs… which of the following have you ever taken?
a. Cannabis (weed, marijuana, dope, hash, wacky baccy)
e. Amphetamine (speed, whizz)
f. LSD (acid, tabs, trips)
g. Ecstasy (pills)
i. Tranquilisers (downers, valium, temazi, temazepam)
j. Heroin (smack, skag)
k. Magic mushrooms
m. Ketamine (ket)
o. Cocaine (coke)
p. Anabolic steroids
q. Legal highs
r. Prescription drugs from other people
16. Do any of your friends take any of these drugs?
a. If so, which ones?
17. Do any of your family take any of these drugs?
a. If so, which ones?
18. How often do you take any of these drugs?
b. Every day
c. Every week
d. Every 2 weeks
e. Once a month
f. Every few months
g. Less frequently
19. If you do take drugs, who do you take them with?
d. People you don’t know
a. Are you having sex with anyone?
b. How is or was that experience for you?
viii. Not as you expected
xi. Exactly as you expected
c. How old is the person you are having sex with?
i. More than 10 years younger than you
ii. 6-10 years younger than you
iii. 1-5 years younger than you
iv. The same age as you
v. 1-5 years older than you
vi. 6-10 years older than you
vii. More than 10 years older than you
d. Do you need to use any contraception?
i. What do you use?
e. What sort of sex are you having?
i. Oral sex
ii. Vaginal sex
iii. Anal sex
iv. Non-penetrative sex
f. Do you use condoms every time you have sex?
i. Do you use these for:
1. Oral sex
2. Vaginal sex
3. Anal sex
g. Are you happy with the person you have had / are having sex with?
h. Have you ever been made to feel scared or uncomfortable by a person you have had sex with?
i. Have you ever felt pressurised to do something sexual…
i. For money
ii. For a gift (phone, clothes, alcohol, food)
iii. For shelter (somewhere warm, dry, safe)
iv. For alcohol
v. For drugs
vi. For affection
vii. For protection
viii. For something else
j. Have you ever been made to do something sexual due to…
ii. Sexual assault
v. Being drunk
vi. Being high
vii. Something else
k. How many people have you done something sexual with in the last six months?
l. Have you ever been checked out for sexually transmitted infections?
f. Not great
h. Don’t know
i. Something else
22. Do you experience any of these:
h. Mood swings
j. Not wanting to eat
k. Wanting to vomit (sick) up food
l. Thoughts of harming yourself
m. Attempting to harm yourself
n. Actually harming yourself
q. Difficulty falling asleep
23. Do you ever do crash diets ?