In this section we will ask for your permission to take part in this survey and for some contact details so that we can get in touch if you are eligible for the coaching.
Are you over 18 years old?
* must provide value
Yes
No
We are sorry, if you are under the age of 18, we are unable to include you in this study and will not be asked to fill in the rest of this questionnaire.
You do not need to complete the rest of this questionnaire and can close this web page.
Are you pregnant?
* must provide value
Yes
No
We are sorry, if you are pregnant we are unable to include you in this study and will not be asked to fill in the rest of this questionnaire.
You do not need to complete the rest of this questionnaire and can close this web page.
Have you previously been diagnosed with heart disease?
* must provide value
Yes
No
We are sorry, if you have already been diagnosed with heart disease we are unable to include you in this study and will not be asked to fill in the rest of this questionnaire.
You do not need to complete the rest of this questionnaire and can close this web page.
Is English your first language?
* must provide value
Yes
No
Can you understand everyday English?
* must provide value
Yes
No
We are sorry. We do not have capacity to meet language needs as part of this project, therefore you will not be able to take part in the survey or the free questionnaire.
In the future we hope to improve the accessibility of our project meeting more language needs.
You do not need to complete the rest of this questionnaire and can close this web page.
What is this study about?
Brighton and Sussex Medical School is part of an international team looking at ways to prevent heart disease by working with local communities. Heart disease is now the biggest cause of death around the world, and one of the leading causes of disability. Researchers and doctors know a lot about what causes heart diseases and what reduces the risk. The more we all know what the doctors know, the better we can all protect ourselves and maintain a good quality of life.
Healthy Hearts East Sussex is a health project which is part of an international project called called 'SPICES.' Here in East Sussex we are working with Community Health Volunteers to provide health coaching sessions to people with a medium risk of heart disease.
What will happen if you take part?
If you choose to take part we will ask you to complete a simple questionnaire about the health of your heart. From there we will be able see what small but important changes you could make that will reduce your risk of heart disease in the future. Then you will be given one of three results:
You are in the 'Low Risk' Group: If the data you provide suggests you have a healthy lifestyle, then this is positive news and we may contact you about how you could be involved in the project.
If you are in this middle group you are eligible to take part in the health coach intervention study. You will be offered coaching sessions with our local team of community health volunteers who will provide health coaching sessions on how you can improve your heart health.
You are in the 'High Risk' group: If you are in this high-risk group we would recommend that you make an appointment to see your doctor. As researchers we cannot give any medical advice, but it is important that we do not ignore signs of a high risk of heart problems.
If you are eligible to complete the questionnaire we will ask for your contact details, so we can let you know what comes next. Regardless of which risk group you are in it is important for you to understand that the questionnaire that you have completed is not a medical assessment or diagnosis and cannot be relied upon to reach conclusions about your health.
If you are in
'Medium Risk' group you will be asked to take part in the
health coaching intervention study in which you will be paired with one of our community health volunteers who will provide coaching with the aim of improving your heart health. We will contact you to set up these sessions.
There will be monthly coaching sessions over the course of the next six months. In the health coaching sessions one of our volunteers will encourage you to think about and try out some simple and realistic ways that you can improve your heart health. In your first and last session we will ask you to complete three short questionnaires which will focus on your heart health, diet, and exercise levels.
To note, due to safety concerns related to COVID-19 all coaching session are being run virtually online using Zoom. We will provide help and support to use Zoom if needed.
After you have completed the coaching intervention part of the study you will be asked if you would like to take part in either an interview or group discussion with a member of our research team. We would like to talk about which parts of the health coaching intervention you thought were most helpful and which we could improve. Together we will try to work out how the intervention can be made better in the future.
Will you be paid to take part?
There are no financial incentives for this project.
Do you have to take part and can you withdraw?
It is up to you to decide whether to take part. If you decide to take part, you are still free to withdraw at any time and without giving a reason. If you provide us with your personal details you can withdraw your data at any time up to, but no later than, June 30 2022 (when the project finishes) by contacting the team (see the contact details section below).
Why have you been asked to take part?
You have been invited to take part in the project because you are over 18 and you live in East Sussex.
Is the study confidential?
Your name and personal details will not be used in any publication. These details will be collected, stored and destroyed in line with the Data Protection Act 2018. Any information we collect will be kept securely and not shared outside of the research team. The research team includes a small group of researchers at Brighton and Sussex Medical School, our volunteer coordinators and our Community Health Volunteers. Please see the SPICES website for more information about who is involved in the project.
https://www.bsms.ac.uk/research/primary-care-and-population-health/public-health/spices/spices.aspx
Participant Observations
During some parts of the study a member of the research team may ask if you are willing to be observed whilst you take part. This researcher will be interested in checking how the project works in the real world so that we can learn how it might work better in the future. They are not there to judge you and you should try to act as if they are not there.
They will ask you if you are willing to be observed and they will not do so if you don't want them to. You can also ask them to stop observing you if it is making you uncomfortable.
Contact details
If you wish to discuss participation in the study, any aspects of this information sheet or have any questions or concerns about the study please contact the team at SPICES.SUSSEX@bsms.ac.uk.
Happy to take part? Great! Please complete our survey. (It will take about 5 minutes)
Let's start with your agreement to participate in the study.
If you do not agree to any of the consent agreement questions you will not be eligible for this study and will not be asked to complete the rest of this questionnaire.
Have you read and understood the participant information sheet?
* must provide value
Yes
No
Are you aware that your participation is voluntary, that you can choose not to participate in part or all of the project, and that you can withdraw at any stage of the project without being penalised or disadvantaged in any way?
* must provide value
Yes
No
Do you agree to be contacted by the research team using the details that you will be asked for below?
* must provide value
Yes
No
If the heart health questionnaire shows that you are at Medium Risk of heart disease, do you agree to take part in the main coaching intervention study which is described in the participant information sheet?
* must provide value
Yes
No
Do you understand that the collected data is not part of a medical assessment or diagnosis and cannot be relied upon to reach conclusions about your health?
* must provide value
Yes
No
Do you understand that you may be invited to participate in interviews or group discussions, and you are happy to be contacted for this purpose?
* must provide value
Yes
No
Do you understand that the information you provide during your participation can be deleted at your request up to but no later than June 30 2022?
* must provide value
Yes
No
Do you understand that any information you provide as part of this research will be managed in accordance with the Data Protection Act 2018?
* must provide value
Yes
No
Do you agree to be contacted by a member of the research team for project evaluation purposes? This may involve observations of your participation. You can choose not to take part in this evaluation.
* must provide value
Yes
No
Full Name
* must provide value
Date of Birth
* must provide value
Today D-M-Y
Post Code
* must provide value
Email Address
* must provide value
Telephone number (landline or mobile)
* must provide value
If you are eligible to take part in the free health coaching, do you agree to share some information from your Heart Health questionnaire with your Community Health Volunteer?
* must provide value
Yes
No
Readiness to Change - Please choose the answer which most closely fits your readiness to make some healthy lifestyle changes.
* must provide value
Not ready (to even think about it right now)
Getting ready (thinking, give me time and information)
Ready (can you give me some help?)
Trying (already working on it, not sure if I will succeed)
Active (making good progress, trying not to slip back)
Please sign if you agree to take part in this research project
Click the 'Add Signature' link to provide your signature
* must provide value
In this section we will ask some questions about your heart health. We will use your answers to this questionnaires to check if you are eligible for the coaching.
Age of participant
* must provide value
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Gender
* must provide value
Male Female
Smoking. Pick the
description which
matches you best:
* must provide value
Never smoked
Former smoker
1-5 cigarettes per day
6-10 cigarettes per day
11-15 cigarettes per day
16-20 cigarettes per day
More than 20 cigarettes per day
Over the past 12 months, what has been your typical exposure to OTHER people's tobacco smoke?
* must provide value
Less than 1 hour exposure per week or no exposure
One or more hours of second hand smoke exposure per week
Do you have Diabetes? (Type 1 or type 2)
* must provide value
Yes No or unsure
Do you have high blood pressure?
* must provide value
Yes No or unsure
Have either or both your biological parents had a heart attack?'
* must provide value
Yes No or unsure
You will now need a tape measure to measure your hip and waist circumferences. You can choose either centimetres or inches.
Watch this video if you'd like to find out how to measure your hips properly.
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Watch this video if you'd like to find out how to measure your waist properly.
View media
Unit of measurement
* must provide value
Inches
CM
Waist circumference
Waist circumference: This measurement is taken at a specific spot along your side.
Please watch the videos above this question to find out how to do this properly.
* must provide value
CM( minvalue: 57cm and maxvalue: 175cm)
Hip Measurement
Please watch the videos above this question to find out how to do this properly.
* must provide value
CM(min=50cm , max=175)
Waist circumference
Waist circumference: This measurement is taken at a specific spot along your side.
Please watch the videos above this question to find out how to do this properly.
* must provide value
inches(min: 22.4, max=68.9)
Hip Measurement
Please watch the videos above this question to find out how to do this properly.
* must provide value
inches( min=15.7, max=68.9)
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How often have you felt work or home life stress in the last year?
* must provide value
Several periods or permanent stress
Never or some periods
During the past 12 months, was there ever a time when you felt sad, blue, or depressed everyday for two weeks or more in a row?
* must provide value
Yes No
Do you eat salty food or snacks one or more times a day?
* must provide value
Yes No
Do you eat deep fried foods or snacks or fast foods 3 or more times a week?
* must provide value
Yes No
Do you eat fruit one or more times daily?
* must provide value
Yes No
Do you eat vegetables one or more times daily?
* must provide value
Yes No
Do you eat meat and/ or poultry 2 or more times daily?
* must provide value
Yes No
How active are you during your leisure time?
* must provide value
I am mainly sedentary or perform mild exercise (requiring minimal effort)
I perform moderate or strenuous physical activity in my leisure time
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