Student

Section A: Eating Behavior and Nutritional Knowledge

1.How often do you choose to eat the following food items in a week? Put a tick mark where applicable.

2. Please put a tick mark beside the option which applies to you.

1. I eat a balanced diet with healthy proportions of different food groups.Almost AlwaysSometimesRarely Never

2. I consciously try to avoid foods that are high in fat.Almost AlwaysSometimesRarely Never

3. I try to avoid foods with high salt and sugar content.Almost AlwaysSometimesRarely Never

4. I drink 8-12 glasses of water a day.Almost AlwaysSometimesRarely Never

5. I am concerned about getting enough calciumAlmost AlwaysSometimesRarely Never

6. I read nutritional information/ingredient list before purchasing food itemsAlmost AlwaysSometimesRarely Never

Section B: Physical Activity Knowledge

1. What is your height?

2. What is your weight?

3. According to your height are you in the ideal weight range?YesNoDon’t know

4. Do you make time each week to do a few hours of exercise?YesNo

5. If yes, can you specify the duration of your exercise? < 60 mins / week1-2 hrs/weekMore than 2.5 hours

6. What type of exercise do you do?Moderate (Walking, swimming, cycling)Vigorous ( weight lifting, running, sports)

7. When do you wake up?

8. What time do you go to bed?

Section C: Health Motivation and Sense of Responsibility

3. Please put a tick mark beside the option which applies to you.

1. I am concerned about common health hazards and try to take action to prevent them.Almost AlwaysSometimesRarelyNever

2. I believe my health depends on how well I take care of myself (eating right, exercising, and taking preventive measures).Almost AlwaysSometimesRarelyNever

3. I don’t worry about common health hazards until they become a problem for me or someone close to me.Almost AlwaysSometimesRarelyNever

4. Because so many illnesses can hurt me these days, I don’t worry about them.Almost AlwaysSometimesRarelyNever

Section D: Health Motivation and Sense of Responsibility

1. On average, how long do you spend on your computer/smartphone?Less than 1h/day 1-4 hours/dayMore than 4 h/day

2. Is social media more preferable to you than your real life?YesNo

3. Do you think your mobile usage is excessive?YesNo

5. What can be done to reduce our dependence on mobile phones?

6. Do you like to spend quality time with your family (parents, grandparents, siblings, cousins)?YesNoNot reallyI don’t get to spend time with my family

7. Does your school provide opportunities for maintaining your physical fitness?YesNo

8. Does your school provide opportunities for extracurricular activities?YesNo

9. Do you think your school should provide more opportunities for physical and extracurricular activities?YesNo

10. Would you follow a guideline for better health and fitness if available?YesNo

11. If it is a book, how much will you be willing to pay for it?100-300 tk300-500 tk500-800 tkAround 1000 tk

Student (Happy Home)

Section A: Eating Behavior and Nutritional Knowledge

Section B: Physical Activity Knowledge

Section C: Health Motivation and Sense of Responsibility

Section D: Health Motivation and Sense of Responsibility

4. If yes, can you specify the reasons?