Community Club Impact Survey 2022

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* 1. Name:

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* 2. Community Club:

Club Barnet

Club Brent

Club Hackney

Club Hillingdon

Club Hounslow

Club Islington

Club K&C

Club Lambeth

Club Lambeth Kids

Club Southwark

Club Sutton

Club Tower Hamlets

Club Wandsworth

Club Westminster

Not a Club member

Section 1
Physical Health and Wellbeing

Regular exercise is extremely important in helping us keep fit and healthy. This section will help us understand how much physical activity and sport you do and what motivates you to keep active.

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* 3. On average each week, how much time do you spend doing physical activity and sport (including your Community Club session)?

0-30 minutes

30-60 minutes

1-2 hours

2-3 hours

3-4 hours

4 hours or more

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* 4. Has joining your Community Club made you want to be more active?

Yes

Unsure

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* 5. From the list below, tick the 3 main reasons why you attend your Community Club?

To play sport and be active

To lose weight

To see friends

To meet new people

To feel part of your local community

To have fun

To see the coaches and volunteers

To be somewhere you feel safe

To improve your social skills e.g. communication, leadership, confidence

Other (please specify)

Section 2
Social and Mental Wellbeing

We hope that regular attendance at your Community Club will have a positive impact on your social and mental health. This can include feelings such as anxiety, loneliness and how you generally feel about yourself. By answering the following statements, we can get a better understanding of this.

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* 6. How would you rate the following:

	Hardly Ever	Sometimes	Often
How often do you feel you lack companionship (friendships, relationships)?	How often do you feel you lack companionship (friendships, relationships)? Hardly Ever	How often do you feel you lack companionship (friendships, relationships)? Sometimes	How often do you feel you lack companionship (friendships, relationships)? Often
How often do you feel left out?	How often do you feel left out? Hardly Ever	How often do you feel left out? Sometimes	How often do you feel left out? Often
How often do you feel lonely?	How often do you feel lonely? Hardly Ever	How often do you feel lonely? Sometimes	How often do you feel lonely? Often

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* 7. How would you rate your ability in the following:

	Very Poor	Poor	Satisfactory	Good	Excellent
Confidence – believing in your own ability	Confidence – believing in your own ability Very Poor	Confidence – believing in your own ability Poor	Confidence – believing in your own ability Satisfactory	Confidence – believing in your own ability Good	Confidence – believing in your own ability Excellent
Self-esteem – feeling that you have good qualities	Self-esteem – feeling that you have good qualities Very Poor	Self-esteem – feeling that you have good qualities Poor	Self-esteem – feeling that you have good qualities Satisfactory	Self-esteem – feeling that you have good qualities Good	Self-esteem – feeling that you have good qualities Excellent
Community cohesion – feeling that you are a valued member of the area where you live	Community cohesion – feeling that you are a valued member of the area where you live Very Poor	Community cohesion – feeling that you are a valued member of the area where you live Poor	Community cohesion – feeling that you are a valued member of the area where you live Satisfactory	Community cohesion – feeling that you are a valued member of the area where you live Good	Community cohesion – feeling that you are a valued member of the area where you live Excellent

Thank you for answering our survey. Your feedback will help us better understand how we can improve our services to allow more disabled people to lead happier and healthier lives.