Physical Activity in Burslem Community Conversation

We want to help people locally be more active to help with their physical and mental health.

We want to know more about what might stop you from being active, and what we can do to help you be more active.

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* 1. Do you want to be more physically active or feel you need to be?

Yes

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* 2. Is there anything that gets in the way and means you can’t be physically active or look after yourself?

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* 3. What helps you move more? What works well?

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* 4. What needs to change locally to help you move more?

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* 5. How could a community centre/lounge/hub (with lots of local people and services all in one place and near you) help you to be more physically active?

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* 6. Does where you live help you to be physically active?

Yes

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* 7. Do your family and friends support you in being physically active?

Yes

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* 8. Are your family and friends physically active?

Yes

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* 9. Do you make plans to help you move more?

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* 10. Would you choose being active over other activities?

Yes

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* 11. Do you have any other comments?

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* 12. What gender do you identify as?

Male

Female

Non binary

Transgender

Prefer not to answer

Other (please specify)

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* 13. What is your age?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

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* 14. What is your ethnic group?

White British / Welsh / Scottish / Northern Irish / English

Irish

Gypsy or Irish Traveller

White and Black Caribbean

White and Black African

White and Asian

Indian

Pakistani

Bangladeshi

Chinese

Arab

Prefer not to say

Any other ethnic group, please specify.

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* 15. Do you consider yourself to have a physical disability?

Yes

Prefer not to say

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* 16. Do you consider yourself to have a mental illness?

Yes

Prefer not to say

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* 17. Please provide your email address or a phone number to enter the prize draw to win a £50 Amazon voucher

Thank you for taking the time to complete this survey.

Your answers will help us to improve services local to you and support the needs of your community.