Survey of causes of the health problems of families in the community on Philippines?
To conduct a survey on the causes of health problems in families in the community in the Philippines, you can use the following questionnaire:
1. What is your gender?
a) Male
b) Female
2. What is your age group?
a) 18-24
b) 25-34
c) 35-44
d) 45-54
e) 55 and above
3. Are you married?
a) Yes
b) No
4. Do you have children living with you?
a) Yes
b) No
5. How many family members live in your household?
6. Are you aware of the common health problems faced by families in your community?
a) Yes
b) No
7. In your opinion, what are the primary causes of health problems in families? (You can select multiple options)
a) Poor access to healthcare facilities
b) Lack of health education and awareness
c) Unhealthy lifestyle choices (smoking, unhealthy diet, lack of exercise)
d) Environmental pollution
e) Insufficient sanitation and hygiene practices
f) Lack of clean drinking water
g) Poverty and limited resources
h) Lack of vaccination and immunization
i) Overcrowded living conditions
j) Others (Please specify)
8. Have you or any family member experienced any health problems in the past year?
a) Yes
b) No
9. If yes, please specify the health problems faced by you or your family members.
10. Have you sought medical help for the health problems identified in question 9?
a) Yes
b) No
11. If not, what were the reasons for not seeking medical help?
12. How satisfied are you with the healthcare services available in your community?
a) Very satisfied
b) Satisfied
c) Neutral
d) Dissatisfied
e) Very dissatisfied
13. What improvements would you suggest to address the health problems faced by families in your community?
14. Are you aware of any government initiatives or programs addressing these health problems?
a) Yes
b) No
15. If yes, please specify the government initiatives or programs you are aware of.
16. How frequently do you engage in health-promoting activities (e.g., regular exercise, balanced diet, adequate sleep)?
17. Are there any factors that hinder you from engaging in health-promoting activities?
a) Lack of time
b) Lack of motivation
c) Lack of knowledge
d) Financial constraints
e) Others (Please specify)
Thank you for participating in this survey!