THE CONSTRUCTION OF FOOD CHOICE IN LATER LIFE · Web viewthe construction of food choice in later life. interviewer manual. departments of health care for the elderly, social studies

THE CONSTRUCTION OF FOOD CHOICE IN LATER LIFE

INTERVIEWER MANUAL

DEPARTMENTS OF HEALTH CARE FOR THE ELDERLY,SOCIAL STUDIES & FOOD SCIENCE UNIVERSITY OF NOTTINGHAM CLIFTON BOULEVARDNOTTINGHAMNG7 2UH(0115 9709 777 / 9709 413)

CONTENTS

Overall project plan 1

Interviewer training and payment 2

Interviewer safety guidelines 4

Introduction 5

Outline of questionnaire sections 5

Approaching the contact and starting the interview 8

General points on the questionnaire structure 11

Presentation of questions and instructions 11

Coding 11

Post coding 13

Running order 13

Queries 14

Interviewer skills 14

Contact sheets 15

Coding the contact sheets 15

Information/Orientation questions 16

Educational attainment 17

Social class 18

Household composition 19

Housing tenure 21

Facilities for cooking and storing food 21

Social engagement 22

Eating out/food gifts and exchanges 24

General health status 25

Drug use 27

Use of health and social services 28

Dentition 28

Appetite 28

Special diets 29

Ability to shop and prepare food 30

Shopping for food 31

Mobility 32

Transport and accessibility 32

Health behaviours - smoking 33

Health behaviours - drinking 34

Income 34

Life satisfaction index 36

Cooking skills 37

Measurement of body weight 38

Measurement of half body span 38

Fridge temperature 39

Food Diary Instructions 41

Section One - Eating Habits 41

Procedure 42

Buying and Cooking Habits 44

Section Two - Shopping Diary 45

Procedure 45Collecting Diaries 47

Coding Diaries - Food Frequency Questionnaire 49

Coding Diaries - Multiple Choice 50

Multiple Choice - not pre-coded 51

Post coding 51

Numerical Answers 51

Examples 52

Follow-up Interview Manual 56

What you need to take with you 56

Design of the Follow-up Questionnaire 56

Starting the Interview 58

Collecting and Coding the Diaries 58

Conducting the Interview 58

Appendix One - sample script sheet 63

Appendix Two - sample contact sheets 64

FOOD CHOICE QUESTIONNAIRE MANUAL

OVERALL PLAN

Who is Involved ?

The project is based at the Department of Health Care of the Elderly (HCE), but is actually a joint effort between us, the School of Agriculture and Food Science at Sutton Bonnington and Social Studies and Economics on the main University campus. In order to simplify things your contact will be with -

Jeannette Lilley (Research Officer) - Room B113, DHCE - Notts 924 9924 ext 44506

Jennifer Brookes (Research Secretary) - Room B109, DHCE - tel Notts 970 9413

Sally Herne (Research Fellow) - B109, DHCE - tel Notts 970 9777

How Long is the Project for ?

The project has been funded by the Economic and Social Research Council and the Ministry of Agriculture Fisheries and Food for three years - April 1994-97. The first year of the study will concentrate on getting a study of the city of Nottingham area up and running. A study of older people living in rural areas will be beginning in 1995. A new research fellow will be appointed to oversee this from October.

How will the Project be Organised ?

The project is based at DHCE. You will collect and return computers, sample sheets, scales etc from the B109 office. This is also where reference information for coding drugs and social class will be kept.

During the course of the fieldwork the research will be carried out in three phases :

Phase One - 800 and 500 people respectively will be drawn from the lists of GPs practising in the Nottingham City and rural Lincolnshire/Leicestershire/Notts area will be selected for interview. These interviews will be carried out by yourselves using a questionnaire which has been put onto a lap top computer. This manual is designed to guide you on filling in the data on both lap top and paper versions.

Phase Two - From the original group approximately two thirds will be asked to complete a diary which gives details of what they have eaten. Instructions on the diary are also included here.

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Phase Three - A further group will be re-interviewed to determine why they chose to eat particular foods, shop at particular places etc.

INTERVIEWER TRAINING AND PAYMENT

How will I be given names to interview ?

Our sample will be taken from a computerised list supplied by the Family Health Services Authorities in Nottinghamshire and Lincolnshire. Jennifer will update the sample list and try to ensure you don't call to interview someone who is deceased but we obviously cannot guarantee that we will be completely up-to-date. She will also supply you with contact sheets which contain the details of a group of interviewees - a sample of this is given in Appendix II. You will need to take the sheets with you to every interview {whether you manage to see the interviewee or not} and fill in the details of the outcome. Please make sure that you give Jennifer at least one days notice if you run out of names to contact. Contact sheets are white for the first interview, pink for those doing a diary and green for those being followed up. You will be given all the relevant contact sheets for your respondent when you collect names - this means you know from the beginning how many times you need to visit that person.

What will I be paid for ?

Training : It is expected that all interviewers will have six hours of initial training at HCE with some regular follow up sessions as the interviewing progresses. These sessions will help you understand the terminology of the questionnaire, introduce you to the use of the computer and let you raise any queries. You will be paid 4 per hour for attending these sessions.

Interviews : You are paid 13.25 for each completed interview. An interview is regarded as being 'complete' when the questionnaire has been filled in with the interviewee and any relevant post-coding has been done. Interviews which are discontinued because the interviewee has failed the CAPE score (see page 5) or is ill will also be paid in full. Because of the length of the questionnaire and the time needed to post-code you are not expected to do more than eight interviews per week. Follow up interviews will be paid at 10 per completed interview, with interviewers expected to carry out approximately five per week.

Mileage : Interviewers are currently paid at the standard University rate of 33p per mile. For interviewers in the Nottingham city area this includes mileage from HCE to the home of the interviewee rather

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than mileage from your own home. Mileage for the rural area will be calculated from the nearest point of A46 to the interviewers home .

We are keen to keep mileage down to a minimum to allow us to spend more on training, phone calls, equipment etc. To help us achieve this and also to save you making wasted journeys please bear the following ideas in mind :

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* Try to interview people living in the same locality on the same day.* If possible try to get a phone number for the interviewee. We may be able to get this from the GP for you, otherwise try the appropriate phone directory. The University medical library on A floor has all regional phone books.* If you call at an inconvenient time for the respondent try to make an appointment to see them another time or get their phone number and arrange to call them to make an appointment.* If the respondent has been difficult to contact try to telephone them before you make the third and final call at their home.

Telephone calls : Because we have only a limited budget to cover telephone calls, you will not be reimbursed for calls made to the respondent from your own home. Please feel free to make use of the telephone in B109.

How do I claim my mileage and wages ?

Jennifer will deal with all your claims in B109 and send them to payroll. We leave it up to interviewers to decide whether they wish to claim every week, fortnight, month etc but please make sure you have completed all the post-coding for the appropriate interviews before putting in your claim. All claims need to be completed by Friday morning for payment to be made at the end of the following week.

What happens if I need to discuss a problem or query a claim?

Please feel free to contact any of the team by telephone whenever you have a problem. If you need to speak to one of us in person please make an appointment with Jennifer at least a couple of days in advance so that we can guarantee to be available.

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INTERVIEWER SAFETY GUIDELINES

In carrying out your job as an interviewer you will obviously be visiting strangers in their own homes and not all the areas you visit will be pleasant. We understand that you may feel apprehensive about some of the people or addresses that you are given. Bearing this in mind we have a set of safety rules we advise you to keep to :

1. Always let someone know the address(es) of the places you are visiting. If you wish to do so call the HCE office as you are leaving home and when you return then we know you have completed your days interviews safely. We can send one of the HCE staff with you if necessary. Make sure you take our telephone number with you in case you need to make contact. It is printed on the front of most of the things you will be given.

2. Restrict your interviews to daylight hours only. In winter we advise that you finish interviewing by four o'clock. Only conduct evening or weekend interviews if you have made an appointment with the interviewee and you are happy with that arrangement.

3. Make sure that your car is in good working order, that you have plenty of petrol and an up to date map of the interviewing area.

4. Park your car as close to the house as possible and in a well lit place. Make sure windows, doors and the boot are secure before you begin your contact.

5. Have your keys ready to open the car door as you leave the interviewees house.

6. We will supply you with a personal alarm. It needs to be close to hand to be of use so please don't leave it in you hand bag or the glove box. If possible keep it in your skirt or trouser pocket.

7. If the behaviour of the respondent gives you cause for concern terminate the interview and leave as soon as possible.

8. Avoid leaving anything of value on display in your car - this includes the lap top computers. Please put the lap tops in the boot of your car between visits to interviewees and leave them with us at HCE while you are on holiday.

9. If you have any doubts or problems please telephone HCE. The numbers on page 1 are direct lines to help you get through quickly. There is usually someone in the office between 8:30 and 5:30.

IntroductionThe manual has two functions - you will use it when you are being trained and also for consultation during and after and interview. This will be particularly important for post coding information.

In addition to the questionnaire, each interviewer will be given a contact sheet for each person to be visited. These sheets contain the details of the person to be interviewed and which can be partly filled in before the visit. These pages must be filled in for every member of the sample.

Questionnaire

1. Information/Orientation questions.This is an amended version of our usual format for assessing whether people are competent enough to be interviewed fully. There are six questions in this category which provide a measure of mental competence. In the event someone fails to answer all six correctly, we can assume they are not up to the full interview. The exception to this is those people who only get their date of birth wrong. They will be allowed to continue. This is because we cannot guarantee that the date of birth we have for the respondent is 100% correct.Contacts failing the CAPE score will be asked a set of general questions on food. This will be the extent of their interview. You will not be required to enter the data from these food questions into the computer but make a few notes on an A4 pad which will be provided by Jennifer. Their contact sheet will be coded as '5 - Interview discontinued, failed CAPE'.

2. Educational Attainment.Seven questions focus on the level of education and training of the interviewee. This covers both time at school and also any education or training courses they have taken since then. The results from this section will be used to examine whether education has any bearing on the quality and quantity of food, access to services etc.

3. Social Class. Thirty questions determine the social class of the respondent by reference to a) their current employmentor b) their previous employmentor c) their spouse's employmentor d) their father's employment.

Although there are numerous questions here you only need to probe until you are satisfied you have enough information. We consider this to be :- you have details of the main occupation of the respondent/their father/spouse i.e. what they did for the longest time during their working life

- you know whether they were self employed or not- you have details of whether they were a manager/foreman/supervisor or employee if they weren't self employed- you know if the job was full or part time

The responses here will be post coded using the OPCS Standard Occupational Classification Volumes 1 to 3. This will be available from B109. Instructions for using the Classification are on page 19 of this manual.

4. Household Composition.This section of 20 questions examines who makes up the household and what effect their - ethnic background- income- dependency- help with daily tasks has on the members of the household.

5. Housing Tenure.Six questions are designed to establish what the tenure of the respondent's property is and whether they share it with anyone else.

6. Household Facilities.Seven questions examine the facilities the respondent has for cooking, shopping, storing and preparing food.

7. Social Engagement.Twenty questions establish some features of social engagement. You will only need to ask seventeen of these because three are filled from the answers to earlier questions.The respondent will be given an overall score for this section out of twenty.

8. Eating Out.Eleven questions look at whether the respondent eats out, has food delivered to their home, or grows, swaps or has foods as gifts.

9. Measuring Health.Q1 is the General Health Index which establishes a score out of 14 for the respondent. This is followed by a section on other conditions which may affect eating.

This is followed by questions on a) The use of drugs and supplements b) Use of health and social services c) Dentition d) Respondents' appetite and changes in eating patternse) Any special diet or distinctive eating patterns followed by respondents

and members of their household f) Ability to shop and prepare food

10. Shopping for Food.Fifteen questions look at the frequency of shopping, which shops are chosen and why.

11. Mobility.Six questions address the general walking abilities of the respondent.

12. Transport and Accessibility.Twenty five questions examine the transport facilities available to the respondent for shopping and how these influence the accessibility of food stores.

More contentious questions are left until the end of the questionnaire :-

13. Health Behaviours.This is divided into two sections - one on smoking and one on drinking alcohol.

14. Income and Financial Status.Twelve questions ask how much weekly income, assets and freedom to spend the respondent has.

15. Life Satisfaction IndexThirteen questions examine the respondents degree of satisfaction with their current lifestyle. Score out of twenty six will be calculated.

16. Cooking Skills.To end the interview on a lighter note seventeen questions look at how much interest in and experience of cooking. The actual interview ends here. You will need to record the time on the contact sheet.

17. Physical Measures.Your last task is to record the weight and demi span of the respondent - instructions on how to do this are included later in this manual.

Before leaving the respondent you will also check the temperature of their refrigerator. Thermometers are available from Jennifer.

APPROACHING THE CONTACT AND STARTING THE INTERVIEW

IT IS IMPORTANT THAT THE PROJECT NUMBER (UNIQUE NUMBER FOR EACH RESPONDENT) IS FILLED IN ON PAGE ONE OF THE INTERVIEW SCHEDULE.

1. Before leaving for the interview check that you have the following with you

- Identity badge- Map of Nottingham- Lap top- Contact sheet with details of respondents- Showcards (numbered 1-11)- Clipboard, pad and pens - for use with CAPE failures- Thermometer, Weighing scales and Tape measure- Bag of 50p coins- Appointment diary- Sample respondent letter.- Paper copies of the questionnaire, diaries and follow-up interview schedules as necessary- Our telephone number- Copies of the three leaflets - 'Food Sense', 'Food Safety' and 'Keeping Food Cool and Safe'- This manual !If you lose anything or need a replacement please give us plenty of warning.

2. Check that the details on the contact pages are filled in before the interview.

3. When you have met the contact explain who you are and why you are calling (see script sheet for how you might approach this). Refer to the letter they were sent if they look unsure. Always show then your QMC identity card and give them time to look at it properly. Explain that you would like to interview them and take a couple of measurements. Explain that this will probably take an hour and a half. If it is not possible for you to interview them then, make an appointment to go back.

4. Once the contact has agreed to take part, explain the procedure in more detail. Explain that we are working on a study on Diet and Health in the over 55s, and would like to ask them some questions and take a few measurements. Explain that their answers will be recorded on computer and you would need to plug this in somewhere. We can offer to reimburse people for the electricity we use. A token sum of around 50p is likely.

5. The questionnaire has been designed to cover the likely problems of

anyone over the age of 55 - this obviously encompasses a wide variety of physical and mental abilities, class, income, housing etc. Because of this some of the questions may sound strange e.g. asking a 55 year old about their walking speed. If the respondent queries why you are asking these questions explain the diversity of out sample to them and apologise if they find the questions rather obvious or embarrassing.

6. If possible interview the respondent on their own, or so that any other person present maintains as low a profile as possible. If a second person is present try not to make eye contact with them. It may even be necessary politely to ask them to stay quiet until you have finished.

7. What to do if.....

The respondent is not in when you call at their home : It is important to find out why they are unobtainable by asking another occupant of the house or a neighbour. General guidelines are as follows.

Abandon the contact if the respondent has : a) died handle this sensitively and then confirm this from the weekly list sent to Jennifer b) been admitted permanently to hospital or a home c) moved outside the study area d) cannot be located despite a trace

Trace the respondent if they have : a) gone away or into hospital for a more than a month b) moved within the study area - ask a neighbour if they know the new address or we can write to the GP Revisit the address if the respondent is away or in hospital for less than a month

You have called to see a respondent and they have been out more than three times on different days : Make sure you have tried different days of the week to avoid us losing someone who has regular commitments on particular days of the week. Also avoid going back to visit someone who is on holiday less than two weeks after your first visit. If the respondent is still unavailable, fill in the contact page of their questionnaire, return it to Sally or Jennifer and substitute another respondent.

You have come across someone who says they have already taken part in the MRC/ESRC studies: apologise and exclude them from the study.

Respondent loses interest or becomes too tired halfway through: Try to arrange to call again on another day and make an appointment if possible.

Someone is unwilling to participate in the study: Try gently to persuade

them, and make it as easy/convenient as possible for them to take part. Offer to come back another day if that day is inconvenient. Finally, if they say they are too busy, you could ask: 'Can I call again in a few weeks or months time?'

A respondent you've interviewed is in need of help: Speak to a neighbour or relative if possible. We can contact their GP if necessary.

Respondent is not capable of completing enough of the CAPE questions: Terminate the interview politely after the general questions on food. Record their comments on the pad provided rather than the computer.Respondent cannot read or is having trouble reading the showcards : Avoid making the respondent feel embarrassed. Ask them if they would like you to read through the list with them. If this agreeable to them read through the options on the card slowly, repeating them as necessary. For sensitivity avoid asking the questions on reading in the social engagement section (Q2), and those in the cooking skills section on food magazines.

Respondent's spouse would like to keep a diary too: This is fine, but write 'Respondent's spouse' in the space provided for the ID number on the front of the diary so that data from this diary are not included in any analysis.

If for some reason you don't wish to go to an interview alone: one of us will arrange to come with you, or you can arrange to go together.

Respondent is ill during the interview: Ring their GP or an ambulance in the usual way. We cannot refer anyone directly to any of the doctors in our department. This has to be done by a GP.

If you need to make phone calls to respondents: Both phones in B109 are available. Sally/Jennifer can send any letters which need to be written.

If you're running out of diaries/follow-up interview schedules : Please let us know in plenty of time, so that we can arrange to have some more printed.

If you have made an appointment and cannot keep it through illness etc.: Please try to let the respondent know and keep us informed too.

If the computer breaks down : Use the paper copies of the questionnaire to complete the rest of interviews you have that day. Telephone Jennifer to let her know you are having problems and if possible give us a description of what happened/what doesn't work etc. We will need you to bring the lap top in to be repaired and will give you extra paper copies of the questionnaire to use in the meantime.

If you run out of disks : Please let us know in plenty of time so that we

can have more ready for you. If you find you have no disk when you have started the interview or for an interview the following day use a paper copy of the questionnaire and call in to HCE as soon as possible.

If you don't understand something in the questionnaire : Look at the guidance in this manual. If you cannot get a satisfactory answer leave that question and make a note of your problem at the end of the questionnaire.

If the respondent asks you a question you don't know the answer to : Tell the respondent you will try to find out for them. Note their query at the end of the questionnaire.

WE SHALL KEEP YOU INFORMED IF ANYONE YOU ARE SCHEDULED TO INTERVIEW APPEARS ON THE LIST OF RECENTLY DECEASED, AND IF ANYONE PHONES TO CHANGE THEIR APPOINTMENT, OR REFUSE AN INTERVIEW.

GENERAL POINTS ON THE QUESTIONNAIRE STRUCTURE

Presentation of questions and instructions

1. Instructions to interviewers are written in bold italics.

2. The sections of the questionnaire you actually need to read out to the respondent are in inverted commas. Some questions will have words in brackets e.g.

"How long have you been (separated/divorced)?""What (is /was) your (husband/partner's) occupation?"

In these instances it is up to you to select the appropriate wording for the question based on the information you already know about the respondent.

Coding

3. There are over 250 questions in the questionnaire ; these are coded in one of four ways

i) The majority of questions are dichotomous or multiple choice questions. These may have either one answer only e.g. Q1. " How has your appetite been in the last month ?"____

1: Very good 2: Good 3: Fair

4: Poor 5: Very poor 7: Can't remember /not sure 8: No answer 9: Not asked

In this case you will enter one number only for the answer to this question.Other questions are still multiple choice but there are several possible answers e.g.

"Have any of the following affected your eating habits in the last year?"Change in appetiteChange in the taste or smell of foodA health problemChange in living situationNo longer prepare my own mealsLow moodChange in financial statusRetirement from workOtherThe respondent could have been affected by several of these factors. In these questions you must enter an individual response for each part of the question. For example someone who has retired from work, moved to a smaller house and has less money to spend on food would be coded as follows

Change in appetite (code '0' - not mentioned by respondent)Change in taste or smell of food (code as '0' - not mentioned by respondent)A health problem (code as '0' - not mentioned by respondent)Change in living situation (code as '1' - Yes, is applicable)No longer prepare my own meals (code as '1' - Yes, is applicable)Low mood (code as '0' - not mentioned by respondent)Change in financial status (code as '1' - Yes, is applicable)Retirement from work (code as '0' - not mentioned by respondent)Other (code as '0' - not mentioned by respondent )

You can identify these questions easily because each possible answer does not have an individual number preceding it like the options for the appetite question.

During the interview one response is recorded for each question or part of a question. You will enter the appropriate number taken from the coding scheme into the space provided. The instruction "code as appropriate" is used in this manual for these questions.

ii) Other questions have an answer which can be quantified in some way e.g. the respondents' body weight. Instructions for each of these

measures is given in this manual.

iii) For a few questions the final result is a score from several questions e.g. the General Health Index. You may not have time during the interview to work these out. Leave them and enter the score when the interview is over, preferable before you come to post code. In other cases you will need to consult a reference manual to find the answer (particularly social class and drugs questions). Instructions on how to do this are available either in this manual or from Jeannette or Sally.

iv) Some questions are left open for the respondent to answer as they wish. These questions are always followed by '(open)' and a space has been left for you to enter the information. Please remember that if you type in note form it must be intelligible to us afterwards!

4. Dichotomous and multiple choice response options are written in italics preceded by a number followed by a colon.

"What is your full name ?"

0: Incorrect / Can't remember 1: Correct

Circle the number or type in the number when we are on the full scale survey for the appropriate response. It is NOT necessary to read out all the possible options unless they appear in inverted commas, instead wait for a response to the direct question and then code that reply as appropriate. In cases where the response is chosen from a list of options showcards have been provided as an aid. These are clearly marked with the question number. Please make sure you use the right one. Read through the showcard with the respondent.

5. For questions which require a "yes" or "no" answer always code 0 for no and 1 for yes. In a similar vein for consistency certain key responses have been assigned the same code all the way through the questionnaire -

Don't know or can't remember (7)No answer given by the respondent (8)Information is missing because the question wasn't asked of the respondent when it should have been. (9)

6. Code missing information as '9' using as many 9s as there are spaces to fill.

7. Do not try to code a skipped item (this should not be possible on the computer set up). Questions which are part of skips are not ones which should have been asked of the respondent and therefore should not be coded as a 9.

It is important to distinguish between missing and skipped information.

Missing data ('not asked' in the questionnaire) are data which should have been collected but for some reason were not e.g. the respondent was too frail to be weighed. Here there are no data to code. A '9' should be entered into the space where the information should be. If the missing information is at the beginning of a decision tree then each question will be affected and should have a 9 or 9s in the appropriate space. In certain questions there are possibilities that the respondent doesn't know or cannot remember the answer. There is a code for this response - do not interpret it as missing information (see point 6).

Skipped items are not coded because these are questions which were not meant to be put to the respondent. These form a large part of the decision trees. In the computerised version of the questionnaire we should automatically be able to skip through the correct series of questions.

Post-coding

8. It is helpful if you can do the post coding for drug usage and social class as soon as possible after the interview while your recall of the encounter is still clear. Please phone us and let us know you would like to do some post coding a couple of days in advance. All post-coding will be done in B109.

Running order

9. Many of the questions in the questionnaire are part of 'decision trees'; that is, depending on the response to one or more questions, the interviewer does or does not ask other questions. Most of this should happen automatically but it has not always been possible to fit this into the computer programme for the full scale study. Brief instructions are printed in the questionnaire, but the 'tree' may be complex and it is essential that the correct questions are asked clearly and confidently, if the respondent is to retain confidence in the interviewer. It is vital that each interviewer should study and practise the questionnaire thoroughly before interviewing. In addition some answers will be filled automatically as part of the programme. If you do find any errors in the skips and fills for the computerised questionnaire, please contact Sally as soon as possible.

Queries

10. Should any queries be made by the respondent as to whom they might approach for help with a particular problem, please note the query on the final pages for the team to decide later on an appropriate response.

Interviewer skills

11. If you come to a question to which the answer is clear - you can see the telephone, have been introduced to the husband, etc. - either tone down the question or skip it and fill in the appropriate response. Some specific instructions appear in the questionnaire on this theme.

12. Certain sections of the questionnaire will not be completed by all respondents - non-smokers will not be asked how many cigarettes they smoke. This will generally be clear from the questionnaire, but there may be instances where the sensitivity of the interviewer to the situation is important.

13. If a respondent comments that they have a friend or acquaintance who has also received a letter and will be interviewed, explain to them that it is important that they do not discuss the interview beforehand as we are interested in immediate responses.

14. Any variation from the questionnaire should be noted on the final page with reasons. Please record the question number, the change and why you altered the format.

15. Questions which require an answer of the form 'how long ago?', are coded to the nearest quarter if they are less than a year or to the nearest year if they are more than a year. Record the answer in the form in which it is given, and write/type in the code as appropriate. It may be necessary to prompt the respondent by changing the form of the question slightly (eg 'What is your date of birth', 'How old are you, when is your birthday', 'When were you born').

It should be made clear that questions which refer to this/last year/month/week etc., all refer to the year/month/week immediately prior to the interview and not to calendar years/months/weeks.

16. For some multiple choice questions, the instruction 'Running Prompt' is given to the interviewer. The full list of options should be read out with the question, and then again, more slowly, whilst the respondent considers which is the appropriate answer.

CONTACT SHEETS

The person to be interviewed is referred to as the 'contact' on the contact pages, and the 'respondent' in the main part of the questionnaire. The following details about the contact are filled in before the contact is approached: the name, address, sex, date of birth, respondent number, and GP code number. The dates of the visits of the interviewer to the respondent should be recorded as they occur.

Once a contact has been traced, there are a number of possible outcomes, the contact may refuse to participate, the interview may begin but be discontinued because of a low CAPE score or some other problem which becomes apparent during the course of the interview. Make sure you record the reason clearly on the lap top/paper questionnaire.

Record the time the interview started, and after the interview record its duration in minutes. The length of time recorded, refers only to the actual interview, not to the taking of measurements.

If English is not the respondent's first language and they are unable to participate independently in the questionnaire, abandon the interview.

CODING THE CONTACT SHEETS :

The initial details of the respondent will have already been filled in for you at QMC. You will need to fill in :-a). Date of interview - fill this with two characters each for the day, month and year e.g. 12.11.94 = 12th November 1994.

b). Map Reference - use the copies of the Nottingham A-Z provided. This will be particularly useful when trying to revisit farms, flats and obscure roads for follow ups.

c). Contact Outcome - 1= GP advised not to visit2= Respondent refused at approach letter3= Respondent refused at interviewer approach4= Interview discontinued (use this if the respondent is ill/tired/fed up!)5= Interview discontinued (use this where the contact has failed the CAPE score)6= Successful interview7= Died prior to interview but after 1/1/958= Not found9= Moved out of study area or into an institution prior to interviewer approach10= Moved into institution after initial interview11= Moved out of study area after initial interview12= Died prior to sample date 1/1/9513= Address located outside the study area e.g. Beeston, Clifton

14= Address was nursing or residential home15= Refused follow up interview17= Died after interview/diary and before follow up18= Refused diary and follow up21= Not found at follow up22= Speaks very little or no English24= Refused to keep diary25= Diary incomplete28= Follow up abandoned

d) Time interview started

e) Time interview ended - this is when you have finished asking the questions on cooking skills

f) Length of the interview in minutes

g) Dates of attempts to contact the respondent if you are unsuccessful in getting an interview at the first attempt.

QUESTIONNAIRE

INFORMATION/ORIENTATION QUESTIONS

All 6 questions have to be asked of every respondent. Use the guidelines provided above Q1 when asking the questions. It is particularly important to maintain eye contact with the respondent when asking these questions so that the effect is that of a conversation. If the respondent is unable to answer any of the questions, the programme will automatically skip to a section which covers general aspects of food choice. As a general rule :

If the answer is incorrect code as '0'If the answer is correct code as '1'

If the correct answer is given with help (e.g. looked up or suggested by a member of the household) it is up to the interviewer to decide whether the respondent knew the answer.

The correct answers required are indicated below.

Q1. First name and surname.

Q2. Age in years, or age next birthday (eg 83 next July).

Q3. The day, month and year.

Q4. This question requires that the respondent shows some recognition that they are in their own/their relative's home etc. The following wording is appropriate for this question. "Is this your own home?" "Whose house

is this?" "Do you live here?".

Q5. Street address of home (ie number and street name)

Q6. The correct name of the town, city or suburb in which they are currently located. This need not be asked if the city or suburb were given in the last answer.

Q7. When the respondent has completed the questions, calculate their score. Note that 'don't know' and 'can't remember' are treated the same as incorrect responses. If the respondent scores less than 6 then some degree of brain failure can be assumed. Discontinue the interview if the score is associated with evident anxiety, agitation or if it takes an unduly long time to answer. Do not expect many respondents with low scores, in the Clarke et al (1984) study in Melton Mowbray less than 5% failed the CAPE test.

For those with a score less than six :If it does prove necessary to discontinue the interview at this stage we have included a few general questions to ask on food. Ask the respondent these questions, but if they are taking a considerable time there is no need to ask all of them. Thank the respondent for participating and terminate the interview. The CAPE questions may seem absurdly simple to some respondents, if so, explain to them that it will be important at the analysis stage that all respondents have been asked the same questions.

EDUCATIONAL ATTAINMENT

In this section we are interested in formal education and training courses only. As such wherever the term 'examination' is used we only want to know about academic exams which have some sort of qualification attached to them not competence tests such as a driving test. Similarly, a 'training course' is a course designed to improve work skills (typing, word processing, carpentry, English etc) rather than a leisure activity such as learning to swim.

Q1. School in this instance is their first school (primary or infant) and does not refer to nursery education. Enter the age in years.

Q2. Enter the age in years. If the respondent cannot remember, prompt them for the year they left school and work out the age from their date of birth. Alternatively ask them what stage of their schooling they had just completed.

Q3. Enter number of years at school.

Q4. In this case we are interested in final exams rather than annual e.g. if

someone passed their first year school exams but did not pass their leaving certificate or eleven plus this is counted as a 'no'. Similarly, if the respondent left school early without having taken their final examinations this is also counted as a 'no'. Probe to make sure you have the highest level qualification.

Q5. If the respondent cannot remember, probe before coding as '7'. Try to phrase the question differently "what was it called?" or read them the list of options as a running prompt if necessary.

Q6. Formal qualifications only.Q7. The abbreviations used in this question are as followsONC = "Ordinary National Certificate"OND = "Ordinary National Diploma"HNC = "Higher National Certificate"HND = "Higher National Diploma"

All these exams are awarded by BTEC - if the respondent says they have a BTEC probe to find out if it is at Ordinary or Higher level.

Membership of a professional body includes institutes, societies or fellowships where the member has to have a particular qualification or experience to qualify. In cases where the respondent has gained a qualification after they have left school and membership of a professional body, the qualification is counted as the highest level.

SOCIAL CLASS

Although this section does appear lengthy it is unlikely that you will need to ask all the questions. Just ask enough to satisfy yourself that you have details of their usual occupation or that of their partner/father.

Q1. Code as appropriate.

Q2. Record number of years to the nearest quarter if less than a year or to the nearest year if more than a year. If the respondent cannot remember prompt them by re-phrasing the question - e.g. "what year did you get married/how old were you when you got married?"

Q3 and 4. Enter the number of years to the nearest quarter if less than a year, to the nearest year if more than a year.

Q5. The respondent must not be involved in any paid work to be coded as a 'yes'. If a respondent appears to be hedging when you ask him or her about employment explain a) why you want to know and b) assure them that the information you are given will be confidential. If the respondent reports two jobs, record the details of the second on the space left for

notes at the end of the questionnaire.

NB We are only interested if the respondent has been employed on a weekly basis for the last month or more. If the respondent is sometimes employed, code the current situation.

Part time work is a job which is less than sixteen hours per week. Full time - 16 hours or more.

Q6. Enter the number of years to the nearest quarter if less than a year, to the nearest year if more than a year.


Q8. Record the number of hours worked to the nearest quarter.

Q9. Record what the respondent does in terms of job description. Examples collected from previous DHCE surveys have included gardening, driving for social services or working for meals-on-wheels.

Q10. We want to know the occupation immediately before reaching retirement age. This is 65 years for men and 60 years for women, or at an earlier age if the respondent was forced to retire through illness/disability/job cuts etc.

Q11-20. Only ask as many of these questions as are necessary to classify the respondent's social class. If the respondent had more than one occupation, code according to which was pursued for the longest time. If times were similar, code the most recent occupation. Q21-28. For married, widowed, divorced women ask about the husband's occupation and for single women ask about the father's occupation (in both case the occupation he followed for most of his working life).

Q29. In order to qualify as unpaid the respondent must receive no salary or wage for the work. They are counted as unpaid, however, if they only receive reimbursement for travel and/or meals.

Q30. Type/write in the answer to the nearest quarter.

Q31. This will be post coded at DHCE. In order to determine the correct social class category look up the occupation of the respondent, e.g. mining signalman in the alphabetical list in Volume 2. Note the code number given. Look up the number in Table A1 in the appendix of Volume 3, and read off the social class category according to whether the respondent was a manager/supervisor/ foreman or employee etc. (Volume 1 describes jobs in detail in classification number order.)

NB FOR WOMEN WITH MORE THAN ONE HUSBAND, USE THE FOLLOWING RULES:

For widows, record details of the husband from the longest marriage. If the marriages were of the same length, record details of the husband from the most recent marriage. For women in their second marriage, record details of the present husband (whatever the fate of the first one). For divorced/separated women, record details of the husband from the longest marriage. If the marriages were of the same length, record details of their husband from the most recent marriage. A common-law husband is a spouse.

HOUSEHOLD COMPOSITION

Q1. Include current permanent members of the household only. A temporary guest does not count.

Q2. Code as appropriate for each member of the household. If there are less than eight people in the household code the remaining columns as2, 3 then 0. e.g. Household of five people - Female respondent aged 67 lives withher husband aged 72their daughter-in- law aged 39their son aged 41their grandchild aged 18

Input as follows : - sex - 1 (Female)age - 2 (aged 65+)relationship to respondent - 0 (not applicable - is the respondent)

0 (Male)2 (aged 65+) 1 (spouse of respondent)

1 (Female) 1 (aged 19-64) 3 (child of respondent including in law/step)

0 (Male)1 (aged 19-64)3 (child of respondent including in laws)

0 (Male)0 (aged 0-18)4 (grandchild of respondent)

All other spaces enter 2, 3, 0 for not applicable - less than 8 people

Q3. If the respondent is unsure prompt them for the person who has the

household bills in their name. If the household is considered to be joint code as '10'. Enter a number from the list of relationships codes.

Q4 and 5. Code as appropriate.

Q6. Enter the length of time to the nearest six months if less than a year, to the nearest year if over a year. Code the answer as a decimal.


Q8. Code as appropriate using codes for Q5.

Q9-11. We are looking to establish the dependency of the people in the household and how much someone might be constrained by caring for other people. Only count the response as a 'yes' if the respondent is caring for someone as part of their family or neighbourly duties, not if it is part of their job e.g. if they work in a care home or school.

Q12-15. Record the name of the person who does these duties in an average week. This should be the relationship of the helper to the respondent rather than a name."Persons outside the household" - this would be someone like a neighbour, friend, relative or a paid helper who does household tasks"Voluntary or statutory workers outside the household" - this includes home helps, home care aids, church workers or members of local community groups.

Q16. Which people does the cook make meals for during the course of a typical week. Prompt for the relationship of these people to the respondent rather than their name.

Q17. Which people does the person doing the shopping shop for during the course of a typical week. Prompt for the relationship of these people to the respondent rather than their name.

Q18. Part time work is less than sixteen hours a week. Full time 16 hours or more.

Q19. Enter appropriate number.

Q20. This could be in the form of rent or money for bills or money specifically for household shopping. We are only interested in payments made on a regular basis - monthly or more frequently.

HOUSING TENURE

Q1. Record the number of years or to the nearest quarter if less than one year.

Q2. If the respondent has a stake in the mortgage for the house/flat code as '1' whether this has been paid off or not.


Q5. If the respondent cannot remember prompt them by changing the wording of the question "How long ago did you buy it?" or "What year did you buy it?". Record the length of ownership of the house/flat to the nearest quarter if less than a year or to the nearest year if more than a year.

Q6. If the respondent is unsure try an alternative wording "Who do you pay rent to ?" for example.

Q7. If you are unsure of the tenure of the respondent's accommodation please make a note of your provisional answer on the final screen/page and seek advice back at DHCE.

FACILITIES FOR COOKING AND STORING FOOD

Q1. We are only interested in what they currently own. Code as appropriate. In the case of access to a telephone this includes telephones which are only available for outgoing calls e.g. pay phone in the sitting room in warden supervised accommodation.To score '1' for TV and radio the respondent must have both.A larder or pantry is a specially designed food storage room.

Q2. Type/write in answer and we will post code it.


Q4. Type/write in the answer and we will postcode it later.

Q5. Here we are basically trying to find out the capacity of the freezer. If you cannot determine this from asking the question, ask to see the freezer. If it is only a small drawer in the top of the fridge count as '1'. If it is a separate freezer unit the same size or larger than the fridge count as '2'.


Q7. The star rating should appear as a panel on the freezer cabinet (usually on the door). The number of stars appearing in the panel is the star rating of the freezer. Ask the respondent to show you the freezer if necessary.

Q8. If the respondent is prompted by another person use your discretion

to decide whether they actually know or not.

SOCIAL ENGAGEMENT

Time span :Here we are interested in finding out the social contact the respondent has had in the previous seven days (rather than in the week of the interview), so take care that the respondent doesn't interpret the question as meaning "received a personal telephone call etc since the beginning of this week".

Code No, don't know or not asked as '0'; Yes as '1'

Q1. If the respondent replies yes to this question, check that the call or letter was personal - ie from a friend or relative and not making a dentist's appointment etc.

Q2. This includes a free newspaper only if they read it. Use the following definitions Frequently = daily or weeklyOccasionally = less often than weekly but more than once every two monthsRarely = once every two months or less.

Q3. If the participation in religious gatherings only involved the priest coming to the respondent, exclude. Use the following definitions :Frequently = daily or weeklyOccasionally = less often than weekly but more often than once every two monthsRarely = once every two months or less

Q4. The respondent needs to have voted in one of the elections asked about.

Q5 and 6. A holiday is a visit away from home of at least four nights duration. It includes both travel abroad and in this country staying in a hotel or guest house, caravan or campsite with relatives or friends. It does not include a sudden unexpected trip in response to an emergency e.g. staying with someone for a few days when they are ill.

Q7. Using a public library includes using a mobile library but not a books on wheels service (ie books brought into the respondent's home). It is necessary that the respondent borrows books from the library. S/he may go there to read the newspapers etc. Use the following definitions :Frequently = monthly or more oftenOccasionally = less often than monthly but more than once or twice a yearRarely = once or twice a year or less.

Q8. Include attendance at a keep fit class, bingo, day centres, church groups and other more informal but pre-planned meetings e.g. whist drive or dominoes.

Q9. Stress that the rail card must be current. Passes given to ex or current British Rail employees and their families which allow cheaper or free rail travel should be accepted provided they are current.

Q10. Paid employment is any job for which the respondent receives a salary or wageVoluntary work receives no payment beyond remuneration for travel and/or mealsFull time = 16 hours or morePart time = less than 16 hours


Q12. To count as yes the respondent must have received a letter or card from a friend or relative. Official mail, such as receiving a bill etc, is not included.


Q15. Let the respondent use their own definition of 'district' . If asked to give more information define it in terms of the city area e.g. Wollaton, Hyson Green etc.

Q16. Often scores '1' , other responses score '0'.

Q17. We want to know if they have friends who could help out in an emergency within an hour or so in a response to a call for help.

Q18-20. These answers will be filled from the computer programme on the full scale study. At the pilot stage fill these in with reference to the answers in the Facilities section.

Note that the respondent must have a TV and a radio to score a point on Q20.

Q21. Add up the score and input here. This can be done after the interview has been completed.

Q22. The visit need not have been for the purpose of having an alcoholic drink. If the respondent visited a pub to take part in a quiz or competition or another leisure activity this is counted as yes.

EATING OUT / FOOD GIFTS AND EXCHANGES

Q1. A meal or snack includes items such as a sandwich, hot meal or

salad. Less substantial pub snacks such as crisps, pork scratchings or peanuts are not counted as applicable.


Q3. "Café/restaurant" - this includes any relevant eating house (including in-store cafés) other than a hospital cafeteria or day centre cafeteria."Relative's house" - this does not include eating at the house of a relative if the same relative shares the house with the respondent."Luncheon club" - a luncheon club is a centre which individuals attend regularly for lunch. Basically it is a social club. Such clubs are funded by local authorities, charities or sometimes a cooperative made up of the participants themselves. "Day centre" - a community centre operating on a non-clinical basis where some of the participants may work and others are involved in social activities. Participants tend to go on a regular basis and may spend 3-4 hours there every day. Day centres can be run by local authorities or charities.

Q4. If the respondent is unsure prompt them by asking "Do you receive any meals on wheels?", "Do any of the local shops bring anything to your house for you ?", "Do you have deliveries from a milkman?"

Q5. If the respondent has already indicated the source of their food avoid repeating this fill in those responses you already know about as you read through the prompt list.

Q6. Code for the most frequently delivered food if they have more than one.


Q9. i) Accept any measure of cost being prohibitive - "it's too dear"/ "can't afford it etc" ii) Accept any response which indicates that the respondent cannot get the types of food they want or need from the delivery service. iii) Accept any measure of the size of food either being too big or too small to be convenient for their use e.g. they only sell 10lb bags of potatoes. Q10. Which of the items listed on the card (or any others they can suggest) would they like to have delivered (from whatever source) to their home if the service was available?Code as appropriate.

Q11. i) Code as yes if they have a stake in any land where food is grown for their own use.

ii) Does the respondent get a free meal (instead of a wage) where they work for example or payment in food for doing jobs for neighbours/friends/relatives e.g. gardening. iii) Code as yes if there is any arrangement between the respondent and a friend/ relative/ neighbour to swap food items e.g. one person makes the main course the other a dessert for a meal. iv) Any gift of food either formal to celebrate an occasion (e.g. chocolates for birthdays) or informal such as someone taking food round when they pay a visit.

GENERAL HEALTH STATUS

Q1. Score '0' if the respondent doesn't know or is not sure of the answer. '1' if they are a sufferer of this condition currently.

This question is asked of all respondents. The list is read out to the respondent in the exact wording given in the questionnaire (poor eyesight, hard of hearing, arthritis or rheumatism, heart trouble, stomach trouble, giddiness, high blood pressure, headaches, sleep problems, leakage of urine, problems with your feet etc). Do not prompt the respondent other than in reply to queries raised by him/her. The respondent will either answer 'yes' or 'no' directly to the item on the check list or will reply by describing symptoms which may or may not represent the condition. Only code current condition (eg don't include high blood pressure when pregnant, a previous operation etc) and exclude short term conditions (eg flu, a twisted ankle, a 'one-off' headache etc). It is not possible to give a definition of all the items in the check list but the following may be useful in deciding how to code the respondent's answer.

1. Heart trouble Include angina, bad valve, rheumatic heart disease, palpitations, heart attack.

2. Stomach trouble Include problems such as indigestion, dyspepsia, heartburn, wind, constipation etc..

3. Giddiness Loses balance, "wobbly", dizzy. If the respondent reports giddiness associated with postural hypotension, code a positive response.

4. Headaches Migraines, sinusitis, neuralgia.

5. Leakage of urine This includes all degrees of incontinence (ie occasional leakage of urine to total incontinence). This is probably the most sensitive question in the questionnaire and needs to be asked with great tact and sensitivity. The respondent may (consciously or

otherwise) mislead the interviewer. Therefore, if there is a negative response, check the answer with a further prompt such as "Do you ever accidentally wet yourself?", or "Do you ever have any accidents where you lose some urine?" If the respondent has a catheter, code this as 2.

6. Poor Eyesight To be coded as poor eyesight, the respondent must have eyesight which is sufficiently poor to interfere with day to day living (eg reading, watching TV, getting out and about), even when wearing glasses. Therefore if the respondent wears spectacles all the time or in certain conditions (close work) but otherwise reports no problem, code NO. If the respondent is blind, this should be noted and coded as 2. If the respondent is registered partially sighted, code as 1 (YES). Ask subsequent questions as appropriate.

7. Arthritis or rheumatism In any part of the body, include persistent joint pain.

8. Problems with your feet This includes conditions such as ingrowing toenails, corns, bunions, crooked toes, foot ulcers. Only include conditions which cause problems, check by prompting "Is it painful?" or "Does it affect your walking?" Only record problems with the feet, ie exclude swollen ankles or leg ulcers. NB Include gout if this is present in the feet.

9. Sleep problems - any condition which interferes with the quality or quantity of sleep the respondent has. This may be something direct - e.g. insomnia or a more indirect problem such as diabetes causing frequent visits to the toilet during the night.

10. Falls. Any accident involving falling to the ground, whether the respondent was injured or not.

11. Trouble walking. Any impairment to the speed or ease of mobility of the respondent.

12. Long term illness. Only record those conditions which are current and long-term, as in the previous question. Problems which may be given here include hiatus hernia, diabetes, having a colostomy, pernicious anaemia, stroke, Parkinson's disease, phlebitis, emphysema. 13. Drugs. These MUST have been prescribed for the respondent by a GP or hospital doctor and not be over the counter.

14. Seeing a GP or nurse This includes any visit made by either a GP or nurse to the respondents' home or a visit paid by the respondent to a hospital department.

Add up the score and enter in the appropriate field. This may be done after the interview has been completed.

Q2. Approach asking this question in the same way to Q1. Do not prompt the respondent but you may answer their queries. We are interested in what the respondent perceives to be their health problems rather than just conditions which have been medically diagnosed. In some cases the respondent may have been told they have a condition but not recognise the spelling or pronunciation of it from the showcard. If this is the case pronounce it for them. If you are in any doubt how to pronounce some of these conditions please ask - we don't expect you to be experts!

DRUG USE

For the purposes of this section a 'drug' is any tablet, medicine, capsule, suppository, pessary, inhaled medication or injection taken by the respondent to alleviate the unpleasant symptoms of a physical or mental condition.

Q1 and 3. Drugs must have been prescribed by a GP or hospital doctor.

Q2 and 4. Enter appropriate number according to how many different drugs they take e.g. two doses of aspirin a day is counted only as one drug. A respondent who takes paracetamol and aspirin takes two kinds of drugs.

Q5. Includes any drug (see definition in Q1) bought without a prescription.

Enter the total number of drugs taken for the three categories in the appropriate field.

Q6. Type in the name of the drug e.g. amoxycillin rather than its function e.g. antibiotic. This is very important as different drugs even within the same category have different effects on the body. Confirm the exact spelling of the drug by asking to see the label.In the next text field enter details of the dose - remember to type in both the number and the units e.g. 5g, 10 mg, 5ml etc. This is very important !Then enter the frequency of the dose e.g. once daily, as needed. if the label says 'as directed' ask the respondent how often they take the drug.

Lastly note any reference to the drug being taken on an empty stomach, before meals, after or with food. If there is no mention of this type of instruction ask the respondent if they have to take the drug at any particular time in relation to meals.The results from these questions will be post coded at HCE. Ask Sally or Jeannette for advice.

Q7. i) Only code as yes if the drink taken is a meal replacement drink

taken when someone is ill or convalescing i.e. when they cannot eat a full meal. Drinks taken as slimming aids are not counted here.ii) Tonics are drinks with some nutritive content designed as a pick-me-up e.g. Sanatogen or rose hip syrup. Drinks and syrups with a medicinal purpose e.g. cough syrup are not included here.vi) Only include tablets or drinks specifically designed as a Vitamin C supplement not food or drink products eaten/drunk normally which have added/high Vitamin C e.g. Ribena.vii) Do not count fresh garlic unless this is taken raw specifically for a cited health benefit.

If your respondent takes a supplement which is combined e.g. zinc and Vitamin C, or Multivitamins with iron then code this as an 'other' and write in the combination involved.

Q8. Make a note of the answer and we will post code these later.

USE OF HEALTH AND SOCIAL SERVICES

For each item on the check list ask the respondent if s/he has seen ... (this includes visits to and from)... in the last six months. If a respondent replies exactly one week, one month, six months ago, code as within the last week, month etc. It is necessary that the respondent actually saw the person being asked about.

Q1.a) Don't include a visit to the surgery to collect a repeat prescription as seeing the GP. If the GP/District Nurse called at the respondent's home to see someone else living at that address, then this is not included. However, if the GP/District Nurse attended to the respondent while s/he was there, include this as a visit to the respondent.

b) A Community (District) Nurse is generally attached to the respondent's general practice and attends a patient's home to provide nursing care such as bed baths, administering drugs, changing dressings etc. In some practices or hospitals these nurses are referred to as 'liaison nurses'. If the respondent mentions this term include this. A CPN (Community Psychiatric Nurse) is a hospital nurse and therefore not counted.

c) A Health Visitor is employed by the Local Authority and provides advice on primary health care (ie checks that a patient's requisites for health care are being met).

d) A Home Help/Community Care Assistant is an employee of the Local Authority and provides help with domestic work (ie does the cleaning, washing etc) but does not help with any of the nursing. The Home Help/ Community Care Assistant is either paid by the individual or the Local Authority (depending on a means test).

DENTITION

Q1. If the respondent is not forthcoming go through the list of options as a running prompt "Would you say it was ....."Very often = more than once a day to weekly in frequencyFairly often = monthly to once every three months in frequencyOccasionally = once every three months to once every six months frequencyHardly ever = Twice a year or less

Q2 and 3. Enter details in text field.

Q4 -7. Use same definitions as Q1.

Q8 and 9. Enter details in text field.

APPETITE

Q1. If the respondent is not forthcoming prompt them using the list as a running prompt.If they offer a blanket "good", ask them to qualify their answer. "Would you say that was good or very good?"


Q3. i) Change in appetite - either deteriorated or improved ii) Accept any statement which implies that food either doesn't have the same appealing smell or taste or that taste or smell have improved. iii) Accept any mental or physical condition iv) Change in living situation - this could either mean a change of residence (e.g. moving in with one of their children) or a move to a place with different facilities for preparing and cooking food e.g. having to share a kitchen. v) Receives meals on wheels or is living with someone who cooks for them vi) Accept any statement relating to depression or anxiety vii) Either improved or worsened viii) Retirement effects could be ones relating to time available to

cook or income available. If the respondent specifically mentions that they have less money now they have retired code (app9) and (app10) as '1'.

Q4. Since the list of food for this question is long you will need to use it as a running prompt and remind the respondent of the options at regular intervals. Build this into the way you ask the question. e.g. "The next on the list is white bread. Would you say that you eat more, less or the same amount of white bread as you did a year ago?"

Note any reasons offered for the changes in the text field

SPECIAL DIETS

Q1. Clarify this if necessary by asking "Can you eat anything you like?" or another suitable phrasing.

Q2. If the respondent replies that they don't like the taste / texture etc do not count this as 'yes' unless this reflects a change in their taste. Normal taste preferences are not what we are after here.

Q3. Enter details in the text field.

Q4. Enter the details in the text field. This will be post coded at HCE.

Q5. Use same definitions as Q1.

Q6. If the respondent is unsure what you mean here rephrase "How does this show itself?""What sort of things can they eat or not eat?"

Q7. i) Accept any inference the respondent makes about the subject being on a reducing diet.

ii) Accept answers that are along the lines of the subject wanting to follow current dietary guidelines and/or reduce the risk of diet related disease e.g. "they want to eat less fat"; "they want to avoid a heart attack", "to improve their health", "they want to eat food that's better for you".

iii) Health problem - mental or physical problem which has either a direct or indirect effect on what the subject can eat e.g. dementia patient who forgets to eat or someone with a stroke or diabetes who can only eat certain types or forms of food.

iv) Religious rules on food - certain faiths prohibit the use of specific foods by their followers. You may come across orthodox Jews who avoid pork

products, 7th Day Adventists who are vegetarians, Hindus (no beef and often no eggs) etc.

v) Subject uses ethnic foods rather than traditional British e.g. shops at Chinese supermarket, Asian shops, eats West Indian foods such as plantain, sweet potatoes and okra.

vi) Subject avoids eating certain foods because of the way in which they are produced e.g battery eggs. If someone says that a member of their household is a vegetarian find out what the reasons are behind their decision.

viii) Other reasons - might be that they are pregnant (rather than describing this as a health problem) or because of certain drug treatments they are taking. Make a note of their answer and we can post code these later.


Q9. Here we are trying to assess whether the dietary habits of one person rebound on what the rest of the household cooks, eats, where they can go out for meals etc. Prompt the respondent for how it affects their lifestyle e.g. "Does the person doing the cooking have to make two meals or does everyone eat what the person on the special diet eats"

ABILITY TO SHOP AND PREPARE FOOD

Q1. If the respondent uses a trolley to transport their shopping code as '2'.

Q2 -3. Code as appropriate.

Q4. If the respondent is not in the habit of hand washing clothes code as '2'


Q7. If the respondent does not have food or drink which comes in jars or bottles code as '2'.Q8 and 9. Code as appropriate.

Q10. If the respondent does not use any cartons code as '2'

Q11-15. Code as appropriate.

Q16. If the respondent does not eat fried food code as '2'.


Q19. If the respondent does not drink tea ask for any hot drink. If they don't drink ANY code as '2'.


Q22. If the respondent does not eat tinned food code as '2'.


SHOPPING FOR FOOD


Q2. If the respondent cannot remember use the list as a running prompt.

Q3. "That week" - refers to the calender week which includes the day they went shopping. For example if the respondent said they went shopping last Wednesday, July 20th how many times did they go shopping in the week 18th-24th July.


Q5 and 7. Prompt the respondent for the relationship of the person they shopped for to themselves.


Q9. As Q5 and 7.

Q10 and 11. Code as appropriate. This includes anyone in or outside the household.

Q12. Enter names of shops or type of shop in the text field.

Q13. Enter the details in the text field.

Q14. Make sure the respondent has plenty of time to read through this list. If they are having trouble remembering where they shopped ask them what kinds of food they bought as a prompt.

MOBILITY

Q1. Includes any kind of artificial aid such as a stick or frame or walking with the assistance of another person.


Q3. Prompt for conditions which affect actual movement or alternatively fitness e.g. breathing problems, arthritis pain etc.

Q4. Enter details in text field.

Q5. This question is only asked of those respondents who are ambulant and not housebound, the housebound respondent is not asked about walking speed around the house - this would be coded as 1, which option is not listed on the showcard. When asking about the respondent's usual walking speed read out the options to the respondent and at the same time give them the showcard. Use the exact wording given.

Therefore, read out the question as written followed by: "Do you stroll at an easy pace? walk at a normal speed? walk fairly briskly? or walk fast? Read out the four options slowly and carefully with a question mark after each. If it is clear that the respondent is only just ambulant and therefore walks very slowly, do not ask the question but circle option 1. NB We are interested in the respondent's usual walking speed. Therefore if s/he usually 'strolls at an easy pace' because their partner is disabled and can only walk at this speed, then code stroll at an easy pace.

Q6. Code as appropriate. If there is not a food shop within walking distance of the respondent's home, code as '2'.

TRANSPORT AND ACCESSIBILITY

Q1. The car must be owned by the respondent solely or jointly with another person. Cars bought on loan or HP are counted as being owned.

Q2 and 3. Code as appropriate

Q4. If the respondent is driven by members of a voluntary agency or charity such as Help the Aged, code as 6 and specify the name of the organisation in the text field.

Q5. Code as yes if the respondent can only go shopping on days or at times which are convenient for the driver of the car rather than themselves.

Q6. Enter the data in the text field.Q7. Code as appropriate.

Q8. Enter the data in the text field.

Q9. Code as yes if the respondent can drive or get a lift in another person's car.

Q10. As Q5.

Q11. As Q6.

Q12. ' The car' refers either to a car the respondent owns or has access to. If the respondent has access to more than one car, code as appropriate for the car they use most frequently.

Q13 - 16. Code as appropriate.

Q17. Here we are mainly concerned to find out how people get their bags of shopping home. Note down what influences the respondent's choice of transport e.g. being able to get dropped off at the door, having to carry their bags to and from the bus stop etc.


Q19. If the respondent is unsure rephrase the question e.g. "How would you improve the service?", "What would you like to see changed?".

Q20. Enter the usual means.

Q21. Enter the typical time taken.

Q22. If the respondent is unsure which shop you are referring to, check the answer to Q12 in the shopping for food section.

Q23. As Q21.

Q24. "Doctors' surgery" refers to that of family doctor. If the respondent receives home visits only and does not pick up their own prescriptions code as '10' not applicable.

Q25. As Q21.

HEALTH BEHAVIOURSSMOKING

Q1. "Smoking" includes pipes, cigars, cigarettes and chewing tobacco.


Q4. If the respondent is unsure rephrase the question e.g. "How old were you when you stopped smoking?", "Can you remember what year it was when you stopped smoking?".

Q5. If the respondent is not forthcoming, prompt them for reasons e.g. "Did anyone ask you to stop smoking?", "Why was this?"

We are particularly concerned to get details of health problems related to smoking e.g. the respondent was advised to stop smoking by their GP because of a previous heart attack or because a relative was concerned. In addition we are interested in people who have taken an interest in improving their health.

DRINKING

Q1. This question should be asked of all respondents unless they are emphatic they never drink alcohol at all.

Q2. Confirm no alcohol is drunk with these questions.

Q3. Includes any measure of alcohol in drinks e.g. whisky in tea, liqueur coffees etc.


INCOME

Q1. When asking the respondent this question emphasise the purpose of asking them this question and that none of the information given out in the interview is passed on to anyone. Confidentiality is assured. Remind the respondent of what we include as 'income' - pensions (both state and private), investments, savings, earnings and benefits.

Give the respondent the showcard and ask them to give the number of the appropriate category rather than reading out details of the actual sum.Code as appropriate for either a single person or household of two or more.If the respondent gives an answer in the top category, probe to try and get and estimate.

Q2. If the respondent is unsure what we mean by a State pension this is the old age pension which they will claim from aged 60 (women) and 65 (men) using their pension book. Please make sure that the respondent has not confused a state pension with a private one or a state pension given for any other reason - see next question.Code as appropriate.

Q3. Read through the list slowly and wait for the respondent to answer 'yes' or 'no'. If they are unfamiliar with any of the benefits it is unlikely they receive them but in order to clarify what they are:

Income Support - a top up for people on a low income. Used to be called Supplementary Benefit.

Housing Benefit - means tested benefit paid out to cover part or whole of rent.Invalidity Benefit - paid to people who have been unable to work through illness for 28 weeks or more or when statutory sick pay runs out.

Severe Disablement Allowance - this is also paid to people who have been unable to work through illness. Given to people who cannot claim Invalidity Benefit because they haven't paid enough National Insurance.

Invalid Care Allowance - a weekly benefit paid to people of working age who are caring for a severely disabled person.

Widows Pension - a weekly benefit paid to widowed women aged 45 and over or 40 if widowed before 11th April 1988.

Attendance Allowance - a weekly benefit for people aged 65 and over who need care because of an illness or disability. Paid at a lower and higher rate.

Disability Living Allowance - a benefit given to people who need help getting around and with personal care. This can be claimed by people under retirement age.

Obviously it is not necessary to ask some people all the questions - i.e. men won't be claiming a widow's pension! Use your discretion here.

Q4. Again read through the list slowly and wait for the respondent to answer 'yes' or 'no' to each section. For clarification -

Occupational pension - scheme taken out through the employer. The contributor has access to the payments as does their spouse should they be bereaved.

Personal pension - private plans taken out with a specific company e.g. the Prudential, Pearl Assurance etc. Not done through the employer.

Earnings - covers wages and salaries and also share of the profits if they own or part own a business.

Investment income - interest or dividend on shares, deposit accounts etc.

Other income or gifts - this may be payments made by family members to the respondent.

Q5. Read the question to the respondent and hand them the showcard. Tell them that they need only tell you the number of the category that applies to them rather than the precise amount. We just need a general idea. If they are reluctant to part with any information please explain to

them that we are trying to get a general picture of what their assets are and how this affects what they spend on food. If a respondent gives an answer in the top category probe to try and get an estimate from them.


Q7. Here we are trying to assess whether the wage or benefit paid to the respondent is enough to allow them to buy what they need in the way of food each week. If the respondent is not paid weekly re-phrase the question as appropriate e.g. 'Do you have enough money for food throughout the month?'

Q8. Only record as 'yes' if money was the main reason for missing the meal(s) not because of ill health etc. Code as appropriate.

Q9. 'How often' can be interpreted as 'on which occasions' (e.g. at the end of the week when pension is running out) or 'how many times' (once a week, every breakfast skipped etc). If the respondent is unsure of the answer, probe by trying both possible phrasings of the question.

Q10. Hand the respondent the showcard and read the question out carefully. If necessary read through the list as a running prompt. If the respondent cannot decide re-phrase the question - "Which would you make sure was paid for first?" , "Which one is a must?","Which one you would not be able to or like to cut back on?". Remind the respondent that they only need to choose one. If they really can't decide then code as 7.

Q11. Most electricity and gas boards have schemes which help people on low incomes spread the cost of their bills. We are trying to find out whether respondents use these schemes or the similar ones in operation for telephone bills and television licenses. Code as appropriate.

Q12. Does the respondent have a fixed food budget or an amount of money that they choose to allot for food out of their income. Code as appropriate.

LIFE SATISFACTION INDEX

When you have introduced a change of subject as directed in the questionnaire, explain to the respondent that you are going to read through a list of statements and you want him or her to tell you whether they agree or disagree with the statement or is unsure. Offer the respondent the showcard. Read out the first statement and ask the respondent if they agree or disagree with it. Continue in this fashion for each question as they are written in the questionnaire. Repeat any questions as necessary. Under some circumstances it may be necessary to translate each question into the second person to avoid confusing the

respondent.

e.g. "Do you think you are as happy now as when you were younger?" If the respondent is not able to give an unambiguous, unequivocal answer code as 'don't know'. Take care when recording the responses because of the tricky wording for instance Q10.

"When I look back on my life I didn't get most of the things that I wanted" Here a "No" response to this question means that the respondent did get what they wanted out of life, "Yes" means that they didn't.

It is very important to listen to the respondent's answer and interpret it correctly in the coding.

COOKING SKILLS

Q1. Include courses which are televised or taken at a local college/night school. All we require is that someone has been taught cookery skills - they don't need to have done cordon bleu!

Q2. Code as yes if the respondent has had any informal tuition in cooking.

Q3. If the respondent is unsure prompt the respondent for jobs such as cook, school dinner lady, catering corps in the forces, nannying if it involved cooking.

Q4. Include both magazines which are specifically about food e.g. "BBC Good Food" or magazines with a food content. Only include weekly women's magazines ("Woman"/ "Woman's Own"/ "Woman's Realm" etc) if the respondent actually uses the recipes or food information in them.


Q6. If the respondent cannot remember what the programme is called please make some note of what they can remember to help us post code it e,g, the names of the presenter(s), the day it is shown on and what time.

Q7. Show the respondent the examples - we are interested in whether they use either recipes or general information provided on food. This could be leaflets on food safety, on healthy eating or specific subjects e.g. low calorie product. Code as yes if the respondent uses the leaflets more than once a year. Code as no if they use them less often or if they pick them up but don't read them.

Q8. As Q1.

Q9. As Q2.

Q10. As Q3.

Q11. As Q4.

Q12. As Q5.

Q13. As Q6.

Q14-17. In these questions we are merely assessing people's basic skill level. When you read out the question explain to the respondent that this is our purpose and the questions are not a test. It will be important to pitch the questions correctly according to the capabilities of the respondent to avoid be patronising. This is left to your discretion.

The respondent must be able to make the specified dish or meal without assistance from another person, but with reference to a cookery book if necessary.Use of convenience foods is allowed e.g. tinned or frozen vegetables or a cake mixture.

If the respondent claims the question is not applicable to them because they are not responsible for the cooking, suggest another scenario where they may have to cope alone e.g. "If your wife had to go into hospital and you were left to cook for yourself do you think..."

MEASUREMENT OF BODY WEIGHT

1. Place the scales on a level floor (if possible an uncarpeted piece of floor). Check that the scales are reading zero. Adjust if necessary.

2. Weigh the respondent without their shoes on and having removed any heavy indoor clothing such as a jacket, chunky cardigan etc.

3. Record the respondent's weight to the nearest kg on the measurement sheet. Always round up to the nearest kg (kilogramme) if the pointer is between kg.

4. Record which set of scales were used.

5. If the respondent is unable to take off shoes or a heavy jacket, make a note of this on the questionnaire and subtract 1kg from the total recorded.

6. Three digits have been allowed for the weight of respondents. This is important to remember when you are entering the weight. If a respondent weighs 60 kg enter this as '060'.

MEASUREMENT OF HALF BODY SPAN

Definition: half body span is the distance measured with a metal tape (to the nearest metre) from the right side of sternal notch to the root of the middle and ring fingers of the left hand, with the arm stretched out horizontally to the side and the palm facing forward.

Procedure

1. The measurement is usually made on the left arm. Enquire whether there has been damage or injury on the left side (hand, shoulder, collar bone or arm) which causes shortening of half-span, failure to straighten arm fully or to secure the tape between the fingers. If so, make the measurements using the right arm: indicate so on the measurement form and reverse the instructions below as appropriate (all the instructions are written for left arm).

2. The measurement should be made with the respondent standing (preferably) or sitting upright on a chair without arms. Position the respondent with their back to a clear length of wall or a door (this helps line up the arm in a horizontal position).

3. Locate the edge of the right collar bone (in the sternal notch) with the arm in a horizontal portion.

4. Position the respondent - standing up straight, looking straight ahead with the shoulders relaxed, horizontally level and square with the rest of the body. Unless they are wearing flat, soft shoes or it is very difficult for them to do so, ask the respondent to remove their shoes (s/he will need to do this to be weighed.).

5. Insert the stop between the middle and ring finger of the respondent's left hand.

6. Ask the respondent to extend their arm.

7. Support the respondent's wrist with your right wrist.

8. Check that the arm is horizontal and in line with the shoulders. (If the respondent cannot fully straighten their arm, move your supporting right hand in to the respondent's elbow and support at that point whilst also holding the tape measure against the arm).

9. Take the tape measure in your left hand and extend the tape to the point described in (3).

10. Ask the subject to extend their arm as fully as possible. Check quickly that

a) the arm is flat, (b) the wrist remains straight.

11. Read the tape (to nearest m) and tell the respondent to relax.

12. Record the value immediately in the space on the questionnaire. Code as recorded -

for example 76.5 cm is coded as 765 and 80.8 cm is coded 808.

13. Repeat the measurement from stages 6 to 12.

NB Care must be taken that the arm is straight and in line with the shoulders when the tape is read. If the arm swings behind the shoulders, or the wrist is extended, the measurement will be too high. If the arm swings forward, or the wrist is flexed, the measurement will be too low.

FRIDGE TEMPERATURE

1. Remove the thermometer from its' insulating case.

2. Place it on the top shelf of the fridge. Avoid putting it inside the door or in the base of the fridge as these spots are usually the warmest. Do not rest the thermometer on any frozen food which is defrosting in the fridge.

3. Make sure the door is shut properly and avoid letting the respondent open the fridge door too often. This will affect the temperature in the fridge cavity.

4. Leave the thermometer in until you are about to leave.

5. Have either your questionnaire or a sheet of paper handy to note down the temperature before you remove the thermometer.

6. The thermometer scale is a little confusing.

Zero degrees centigrade is in the centre. To the left of 0, temperatures are minus i.e. less than zero. To the right they are positive i.e. above zero. Ideally the fridge temperature should be around 5 degrees centigrade. If you have any problems reading the scale mark with a pencil where the central column of blue liquid ends and we will read it off at HCE.

AFTER YOU HAVE COMPLETED THE OBJECTIVE MEASURES MAKE SURE YOU HAVE COLLECTED ALL THE EQUIPMENT AND COMPLETED QUESTIONNAIRE ETC.

FOOD DIARY MANUAL

DESIGN

The diary is in two main parts - Part One looks at the respondents eating habits and Part Two at their food shopping behaviour. From this we hope to get information on what people eat, how often and in what quantity along with where they shop, what they buy and spend.

SECTION ONE - EATING HABITS

This part of the diary combines a food frequency questionnaire (FFQ) with some more straightforward questions on buying, preparing and cooking behaviour.

The FFQ looks like this -

At the top of the page is a list of codes the respondents can use to describe how often they eat a particular food - never, rarely, one or more times a month, week or day. The codes have been chosen to simplify writing down the various possible answers. The instructions for choosing the correct code are given on page 3 of the diary.___________________________________________________________________________

HOW TO ANSWER

NEVER RARELY TIMES A TIMES A TIMES AMONTH WEEK DAY

N R 1 1 12 M 2 W 2 D3 3 3 etc....

____________________________________________________________________________

Then respondents are prompted for how often they eat the categories of food listed on the page -

"About how often do you eat these foods ?"

Category of food How often (using a code Column for peopleFood name from the panel above) to make any changes

necessary to the FFQCerealsMuesli .......... ____________

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Boiled rice .......... ____________

Pasta .......... ____________

In some cases there are two columns for frequency - this occurs when there are seasonal foods included in the list i.e. foods which are eaten in very different quantities according to the time of year - ice cream, salad veg, seasonal fruits etc. In this case we need the respondent to fill in answers for both columns :

___________________________________________________________________________HOW TO ANSWER

NEVER RARELY TIMES A TIMES A TIMES AMONTH WEEK DAY

N R 1 1 12 M 2 W 2 D3 3 3

____________________________________________________________________________

"About how often do you eat these foods ?"

Category of food How often How often Comments in summer in winter

Fruits and VegNew potatoes .......... ..........

____________

Lettuce .......... ..........____________

Peaches (fresh).......... ..........____________

_____________________________________________________________________________

This kind of questionnaire will be unfamiliar to most people - for this reason we need you to take the respondent through as much of the FFQ as possible so that we get accurate, complete information.

PROCEDURE

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1. We will identify those people qualifying for a diary here at HCE. All these people should have a pink contact sheet. When you have finished the lap top interview explain to them that we would like to find out more about what they eat and where they buy it from. If necessary mention to them :

a) We are not the 'food police' - the information they give is not going to be treated judgementally, there are no right or wrong answers involved. All information will be confidential like their questionnaire responses. In particular they shouldn't worry about how many sweets or how much alcohol they report.b) No-one has done a study which looks at what people eat as they get older or why they eat they way they do. We hope to use the information we get from their answers to improve things like food labelling, portion sizes, shopping facilities, transport etc. Their answers are therefore very important.

c) The FFQ should not take more than about twenty minutes to complete. The shopping diary can be filled in at a leisurely pace over the space of several days.

d) We are entering the names of all those who complete a diary into prize draws. Prizes are being donated by various companies like Boots, Sainsburys, Tesco and Asda. A draw will take place every 12 weeks of the study.

2. If the respondent agrees to complete a diary, fill in their respondent ID from your contact sheet on the front page of the diary before attempting to start filling it in.

3. Read through the instructions on page three with the respondent whilst you show them how the diary is set out.

4. Go through the example with them to make sure they understand the different codes and then move onto the first page of the FFQ.

5. Read out the question "About how often do you think you eat these foods?"

6. Read out the first food - "How often do you think you eat porridge in summer?"

7. If the respondent is vague, remind them that we just want a general idea and then prompt them - "Would you say it's never, rarely, once a month, twice a week ...?"

8. Most people will say that 'it varies' - we expect this, try to get at the average number of times they eat the food.

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9. Once you have established what the frequency of eating the food is show the respondent how you have written this in code in the column for frequency e.g. 1W.

10. Go through at least a couple of the FFQ sections of the questionnaire with the respondent until they are familiar with what to write and which column to write it in. Try to include at least one section with seasonal foods in. Reassure them that if they have any problems they can call the office and we will try to help. It might help if they just do the FFQ on 'gut reaction' - it can be one of those things where the more you think about it the more complicated it gets!

BUYING AND COOKING HABITS

In between the sections of FFQ are more general questions which look at what people buy, how they prepare and cook it. These are coded like much of the first questionnaire interview and should be familiar to you. E.g. :

Q4. Which of the following do you usually spread on bread ? (Please circle the number beside the answer which applies to you)

1 Butter2 Soft margarine3 Hard (block) margarine4 Low fat spread5 Dripping or lard6 Nothing7 Something else (please name) _____________________

It would be helpful if you could go through the first section of these questions to familiarise the respondent.

1. Read out the question - emphasise that we are interested in what they usually eat, buy, use etc. If they say that 'it varies' what do they use most often. If they insist that they use a variety of spreads, milks etc equally get them to write what they use in the 'other' or 'something else' line and we will sort out the coding later. E.g. :

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You have read out the question on fats (above). The respondent says that they use both butter and soft marge equally circle '7' and write in 'butter and marge' or '1 and 2'. Show the respondent how you have tackled this.

2. I have tried to give examples for some of the products listed e.g. reduced fat cheeses. If you find that the respondent is unfamiliar with the product it is unlikely that they use it. However, I can give you extra examples if you find you need them. I am sure that as most of you are food shoppers you will have ideas of your own.

SECTION TWO

This is the shopping and eating questionnaire. We have a general picture from the first section of what kinds of foods people eat, this section looks at where these foods are bought and what meals they might be included in. We have picked a four day period for them to record details of because we doubt that people will fill in any more than this. Because people tend to eat or shop differently on different days of the week, we would like to get details of two weekend days and two weekdays. If possible this is what the respondent should aim to cover but if they do give us four week days or any other combination their information is still valid.

PROCEDURE

1. Explain to the respondent that you would like to leave the rest of the diary with them to fill in. It asks them details of what they ate and bought over a four day period.

2. Tell the respondent that they can pick any four days they wish to record - they don't have to be consecutive or even in the same week but we would like them to try to choose two weekdays and two weekend days. This will give us a better picture of the variety of their eating and shopping habits (this will be especially important for our rural sample where we may well have people who are still working full time).

3. Turn to the example on page 27. Go through how this has been filled in with them.

* Firstly fill in the ID number, day and date in the top left hand corner. These are vitally important - if we can't tell what day it is or when the information was recorded we can't analyse the data properly.

* The first meal is the initial one they had after they got out of bed. We want a basic idea of what they ate and drank for that meal, what time they ate it, what they spent if they ate it outside their home, where they

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ate (e.g. home, office canteen, MacDonalds etc) and whether they ate it alone or in company.

* The columns across are for any other meals and snacks eaten that day. For instance if after a 1st meal of tea and toast at 7 am they had tea and biscuits at 10.30 am even though this isn't a meat and two veg type 'meal' it still counts as an eating occasion. Emphasise to the respondent that they must include these snacks or 'meals' which are drinks only e.g. Cup-a-Soup for lunch or a whisky before bed.

4. If necessary get the respondent to practice on a piece of paper until you are happy they know what they are doing.

5. The next part is a shopping diary. Again it is vitally important that the respondent fills in the day and date first. Point this out to them.

6. Get the respondent to think about which kind of shops they use - look at their 1st food choice questionnaire to prompt them if necessary. Not all our food is bought from food shops - we use chemists, newsagents, farms etc.

7. Go through the example on page 29 with them.

* Column 1 - Which type of shop do they use ? If it is a major food shop e.g. Kwik Save or Marks and Spencer the name is important as well as the type of shop as they aim at very different segments of the market. Tell the respondent that if they are in doubt to include both the name and type of shop they used.

* Column 2 - Where is it ? Is the shop a local one or do they have to travel elsewhere to use it. The simplest way of answering this would be for the respondent to make a note of which area the shop is in e.g. Sainsburys in Beeston, Asda in Newark, Tesco in central Nottingham.

* Column 3 - What did you buy ? Here we do not need fine detail - we are more interested in what types of product they buy (including brand if possible) rather than things like weight or quantity. For example from Tesco in Nottingham they might buy Weetabix, bread, marge, milk, cheese and oil. Heavier things they buy from a local corner shop - potatoes, canned peas and cauliflower.

We are only interested in food items not sundries - remind the respondent not to include things like washing up liquid, toilet rolls, washing powder, shampoo etc.

* Cost - If possible we would like the respondent to attach receipts but these will undoubtedly be few and far between. Instead and approximate cost will do - remind respondents to subtract money spent in the

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shop on non-food items from the total.

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COLLECTING DIARIES

All interviewers from the ESRC and MAFF projects will be responsible for follow up interviews as well as some of the initial interviews. The same person will also collect in the diaries of those people to be followed up.

This is a good opportunity for us to check the quality of the data we are getting and avoid having partially or incorrectly completed questionnaires sent in. Your job of checking the diaries is therefore very important. You can begin this when you make the appointment for the follow up.

* Remind the respondent of the diary they were given to fill in.

* Ask them if they had any problems with it. If they had difficulties try to resolve these over the telephone with help from HCE staff if neccesary rather than trying to sort them out during your visit.

* Ask if they would mind if you came to collect the diary from them and had a half hour chat about it.

Once the respondent has agreed to the follow up you will need to be systematic in how you check the information in the diary. These rules are designed to help.

1. Make sure that the ID number has been filled in on the front page and the first page of the diary. If these are missing fill them in from your contact sheet.

2. Check that the diary is based on the respondents answers and not those of someone else. Whilst respondents may have help with reading the questionnaire and filling it in they cannot delegate it entirely to another person.

3. Check the food frequency sections first. If these are largely blank ask the respondent if they had trouble filling then in. It may be that they have trouble reading or writing on the questionnaire and need some help. Unless they are adamant that they do not want to be bothered filling the rest of it in try to persuade them to fill it in with you.

4. Then check the figures which have been noted for frequency - how realistic are they ? If someone has put an unusually high or low frequency please check with the respondent that this is what they meant to write. Amend the entries as necessary.

5. Turn to the shopping section - make sure that the day and date are filled in for each day unless no shopping was done on that day.

6. Make sure that all the relevant sections have been completed.

7. Remind the respondent to complete their entry form.

What happens if .....

1. The respondent starts filling in a day in the shopping diary and forgets to complete that day Get them to put a line through what they have done for that day. We can't use partially filled in days. Ask them to attach a piece of paper to the back of the diary and fill in a new day of their choice. Give the respondent an SAE to send the completed diary back to us unless it is convenient for you to call back and collect it on your way to another appointment.

2. None or very little of the questionnaire has been completedAsk the respondent if they had problems filling it in. Would they like you to go through it with them ? Offer as much help as is practicable. If they are fed up filling it in remind them that they can take their time filling it in and leave an SAE if necessary. Remind them there is something in it for them if they finish the diary.

3. The completed diary is illegibleAsk the respondent if they had enough space to write in comfortably. Could you just clarify what some of their answers are?

4. The respondent cannot read and/or writeAsk if there is someone who could help them to fill it in. We can check their purchases with them by telephone if only a small number are involved.

5. The respondent's eyesight is particularly poorAgain ask if there is someone who could help read or fill in the diary with them. If necessary we could produce a limited number of large size diaries.

6. The answers look rather strange Assess whether the respondent has understood the coding system - 'I notice you have put that you have 'x' 6 times a day - is that right ?' If they have misunderstood the way the coding is done please go through it again with them. We have to check just to be on the safe side - it may be that we just have people with odd eating habits.

7. The diary has been filled in by someone other than the respondentExplain to the respondent that we cannot use information which is about someone other than themselves. The respondent has been specifically selected for a diary because they have certain characteristics in terms of age, sex, social class, marital status etc. If we cannot collect information on them it affects the quality of our results overall.

8. The respondent has mislaid the diaryOffer them a replacement. Please remember to write their ID number on the front page first.

9. The respondent has run out of room to record what they ate or boughtIf the reverse side of the page in question is blank, ask the respondont to write PTO and finish filling in their details there. Please make sure that it is clear which day/ meal/ shop they are including details for. If there is no blank page ask the respondent to make notes on a sheet of paper and attach it to the diary. The day, date, meals/shops MUST be included.

CODING THE DIARIES

The same person responsible for collecting the diaries will also have to code the responses.

This is done in one of two ways :

Coding Food Frequency Sections

Look at the column for frequency of eating - you will give it a score which is either a decimal or a whole number. The rules for coding these sections are fairly simple.

Frequency Code Used Score

Never N 0

Rarely R 0

Once a month 1M 0.25

Twice a month 2M 0.5

Three times a month 3M 0.75

Once a week 1W 1

Twice a week 2W 2

Three times a week 3W 3

Four times a week 4W 4

Five times a week 5W 5

Six times a week 6W 6

Once a day 1D 7

Twice a day 2D 14

Three times a day 3D 21

Four times a day 4D 28

Five times a day 5D 35

Six times a day 6D 42 and so on in multiples of seven.....

You have assessed the frequency of eating these foods using this system. Now we also need a system for assessing the variety of someone's diet. This again is quite simple.

Look at Pages 10 and 11 in the diary - these cover "Dairy products and Eggs" and "Confectionery and Jams". The diary products category covers 11 different types of food - regular cheese, cottage cheese, cream, yoghurt, ice cream, liquid milk, dried milk, custard, fried eggs, boiled/poached eggs, scrambled egg / omelette. How many of these has the respondent said they eat ? Anything from once a month upwards counts as a yes. Write down the number eaten by the respondent in red by the category title.

E.g. -Dairy Products and Eggs Comments

Regular cheese 1W ____________Cottage cheese N ____________Cream 1W ____________Yoghurt 5W ____________Ice cream summer 3W ____________

winter N ____________Liquid milk 2D ____________Dried milk N ____________Custard R ____________Fried egg N ____________Boiled egg/poached egg 2W ____________Scrambled egg/omelette 1M ____________

The first four here are straightforward - 3 yes and 1 no. Because ice cream is a seasonal food it has two lines for the possible frequency of eating - one for summer and one for winter. So long as the respondent eats ice cream in one of those seasons count it as a yes. In this case the respondent would be given a point for ice cream out of a possible two. The mark is for whether they eat it rather than for how much. For sections like seasonal vegetables please add up the variety score for each column (summer and winter) rather than the section as a whole.

Multiple Choice

These are the sections of questions which come in between the food frequency questionnaires.Most of these should be very straightforward as they are already pre-coded. In these cases you will code according to which number has been circled. E.g.

What type of bread do you use ? (Please circle the number which applies to you)

1 Wholemeal or granary bread2 White bread3 White bread with added bran e.g. Mighty White4 Brown bread5 Continental breads e.g. french stick, rye bread, pumpernickel, pitta6 Other bread (please name)7 Don't eat bread

Multiple Choice - Not Pre-coded

Other multiple choice questions have not been given a numerical coding in the diary. In these cases the simplest approach is to use the same kind of rules as we used in the initial questionnaire.

Do you have milk (circle one for each)in your tea? Yes No Don't drink teain your coffee? Yes No Don't drink

In the initial questionnaire we had the coding scheme '0' for No; '1' for Yes. This will be continued for this type of question. Any answer which is 'not applicable'/ 'don't eat' / 'don't drink' etc will be coded as '7'; answers left blank should be coded as '9' - missing data.

Other questions in the same vein are Q1. page 14 and Q1. page 19.

If you eat the following meats how would you usually cook them ? (please circle one for each food)Steak Fried Grilled/Baked Microwaved

Don't eatChops Fried Grilled/Baked Microwaved

Don't eat

In this case the best way to approach it is to code the 'not applicable'/ 'don't eat' etc as 7 to be consistent with other sections. The other answers are then coded according to their order i.e. Fried is the first option, therefore it is coded as '1'; grilled and baked as '2' and microwaved as '3'.

Do you add salt to the cooking water when boiling the following foods ? (Please circle one answer for each)

Code 1 Code 2 Code 3 Code 7 Code 8Vegetables Always Sometimes Never Don't boil

Don't eatPasta/rice Always Sometimes Never Don't boil

Don't eat

In cases like this one where there are two categories for answers which are not applicable code the first as '7' in the usual way and the second as '8'. Examples of codings are attached on page 52-55. We will also

do training sessions on coding.

Post-coded questions

Various other questions will need to be post coded e.g. for the types of milk added to cereals (page 7). We will draw up a list for these at a later stage and post code. Just leave them blank initially.

Numerical Answers

Another type of question is the 'how much?' e.g. how many spoons of sugar or sweetener are used in coffee, tea etc. Just code these as the number written down by the respondent. If they say they use a teaspoon round this up to a whole number.

The coding of shopping diaries will be conducted at HCE.

Examples

About how often do you usually eat these foods ?

Cereals VARIETY = 4 CommentsFREQUENCY

Porridge/oatmeal(cooked) summer ....N.... ___________0

Porridge/oatmeal (cooked) winter ....R....0

Muesli . ...R.....____________ 0

Other breakfast cereal ...3W... ____________ 3

Bread roll ...2D.... ____________ 14

Boiled rice ...2W... ____________ 2

Pasta ...3W... ____________ 3(spaghetti, macaroni etc, not tinned)_____________________________________________________________________

Q1. What types of breakfast cereal do you usually eat ? Please write in the name(s). If you do not eat breakfast cereals write 'none'.shreddies, bran flakes, corn flakes & shredded wheat (POSTCODED)

Q2. How many slices of bread do you usually eat ? Remember to include bread you use for sandwiches and for toast. If you do not eat bread write 'none'. _______2________ slices per day OR _______14______ slices per week (CODE PER WEEK = 14)

Q3. What type of bread do you usually use ? (Please circle the number beside the answer that applies to you)

1 Wholemeal or granary bread2 White bread3 White bread with added bran e.g. "Mighty White"4 Brown bread5 Continental breads e.g. french stick, rye bread, pumpernickel, pitta6 Other bread (please name)____________________7 Don't eat bread

(CODE = 1)

Q1. Do you have milk :(circle one for each)

CODE AS

in your tea ? Yes No Don't drink tea1

in your coffee ? Yes No Don't drink coffee1

in your cocoa ? Yes No Don't drink cocoa7

in other hot drinks ? Yes No Don't drink 7 (e.g. Horlicks)

Q2. What type of milk do you usually add to tea/coffee/cocoa etc?(Whole, skimmed, raw, semi-skimmed, enriched etc). If you don't add milk to these drinks or don't drink these drinks write 'none'.

Type of milk ...........SEMI-SKIMMED....................................(POSTCODED)

Q3. How many teaspoons of sugar or other sweetener do you have in

(Circle one for each)tea ? 0 1 2 3 4 5 6 Don't drink (0)

coffee ? 0 1 2 3 4 5 6 Don't drink (0)

cocoa ? 0 1 2 3 4 5 6 Don't drink (2)

hot chocolate ? 0 1 2 3 4 5 6 Don't drink(7)

Q4. If you eat the following meats how would you usually cook them ?(Please circle one for each food)

Steak Fried Grilled/baked Microwaved Don't eat (2)Chops Fried Grilled/baked Microwaved Don't eat (2)Sausages Fried Grilled/baked Microwaved Don't eat (3)Bacon Fried Grilled/baked Microwaved Don't eat (1)

Q5. When you eat ice cream what type is it usually ? (Please circle one number)

1 Regular ice cream (full fat)2 Low calorie/ reduced fat ice cream e.g. 'Too good to be true'3 Other (please name)...................................................4 More than one type (please specify which numbers) .1 AND 2..5 Do not eat ice cream6 Don't know/ can't remember

(CODE AS 4)

Q6. Do you buy any of the following products ?

Please enter number 1-5 in the space provided

1 Always or nearly always2 Sometimes3 Rarely4 Never5 Don't eat

Low fat mince (may be marked 'Superlean', 'Lean', 'Extra lean') ....1...... (1)

Low fat sausages .......2...... (2)

Low fat burgers ......5...... (5)

About how often do you usually eat these foods?

Seasonal Vegetables Summer F Winter F Comments

Broccoli ..1W...... 1 ..1W... 1 ____________

Cauliflower ....R...... 0 ..1W.. 1 ____________(fresh/frozen)

Onion ..3W.... 3 ..3W... 3 ____________

Tomato ...2D..... 14 ..1D.... 7 ____________

Lettuce ....1D.... 7 ...5W.. 5 ____________

Cucumber ....1D...... 7 ..1M.. 0.25 ____________

Celery ....3W.... 3 ..5W... 5 ____________ Capsicum .....3W... 3 ..3M... 0.75 ____________(red/green/yellow pepper)

Mushrooms ...4W... 4 ...2W.. 2 ____________

VARIETY = 8 FOR SUMMER AND 9 FOR WINTER

Q1. Do you add salt to the cooking water when boiling the following foods?(Please circle one answer for each)

Vegetables Always Sometimes Never Don't boil Don't eat (7)Pasta/rice Always Sometimes Never Don't boil Don't eat (2)

Q2. Do you add anything other than salt to the cooking water when cooking vegetables ? (If yes, write in what you add. If no, write 'nothing')______BICARBONATE OF SODA__________________ POSTCODED

FOLLOW-UP INTERVIEW MANUAL

The follow-up interview is designed to get at some of the reasons why our respondents make particular choices about the food they buy and eat. As this is the last part of the study and respondents have already completed a questionnaire and a diary, it is important that the interview is kept to around half an hour in length to avoid demanding too much of the respondent. As a result, much of the follow up interview consists of pre-coded questions, the coding of which will be very similar to the first questionnaire.

What you need to take with you

Lap top computerPaper follow-up questionnaires ManualShowcards numbered 1 - 7 (includes two A2 size picture boards)Spare DiariesPen / pencilIdentity BadgeMap of NottinghamRespondent's contact sheet

Design of the Follow-up Questionnaire

1. Food Labelling Nineteen questions look at whether respondents use food labels to make choices about food and how much of the label they actually understand. Several questions require you to use a mock-up food label.

2. Dietary Change One question on their view of their current eating habits.

3. Health Beliefs Sixteen statements are used to assess the respondents health beliefs and how much they think food is important for good health.

4. Influences on Choice Ten statements assess which factors influence choice of food and how much weight is given to each.

5. Relative Risk Respondents are asked to rank a series of risk factors related to food.

6. Resistance to Change Past research has suggested that older people are inflexible in their

eating habits. This series of 13 statements aims to find out what respondents believe about experimenting with new foods. 7. Sources of Information Two questions examine the sources used by respondents to get information on food and which they consider reliable. In addition various statements look at the relative influence of family and experts.

8. Good and Bad Foods Respondents are shown a series of pictures of foods and asked which they consider to be 'good' and 'bad' for health as opposed to those that they actually use.

9. The Influence of Food on Health A series of twenty statements looks at the respondents personal beliefs about the influence of nutrition on their health, the beliefs of their family and the influences of labels & advertising .10. Brand ImageUsing pictures again, respondents are asked 4 questions about various qualities of the foods mentioned to them.

11. Locus of ControlTen statements look at what respondents believe about food and whether these beliefs are their own or come from advice given by others.

12. Market SegmentationRespondents are asked to identify the qualities and characteristics of a list of 9 food retailers.

STARTING THE INTERVIEW

All those respondents who are to be followed up will have a green contact sheet which Jennifer will give you. Your contact with the respondent will initially be by telephone. Two weeks after the diary has been given to the respondent you will need to get in touch. The way in which you approach the respondent is extremely important as we do not want to lose too many people through refusals at this final stage.

i) Mention who you are and that you are calling in connection with our projectii) Thank them for agreeing to take a diary and ask them if they have had any problems filling it in.iii) If the respondent is in difficulty follow the instructions given on page 47.iv) If the respondent has completed the diary ask them if they would mind you coming to collect it from them. Mention that you would like to ask them a few questions regarding the diary and that this should take no longer than half an hour.v) If the respondent is agreeable, thank them and make the appointment.

COLLECTING AND CODING THE DIARIES

Details of these are covered on pages 47-55 of the manual. Please check the instructions again before you attend your appointment.

CONDUCTING THE INTERVIEW

Once the diary has been completed and checked start the interview with the respondent.

Q1. In this question we are interested in whether respondents look at food labels in the shop whilst deciding what to buy. Code as 'no' if they only read the label after they have bought the product. Be careful to distinguish from people who have never noticed food labels and those who are aware of them but choose not to use them. Probe as necessary here.

Q2. This question relates to particular ingredients or nutrients in food such as additives, preservatives, monosodium glutamate, salt etc.If the respondent is unsure prompt them by re-phrasing the question e.g. "Is there anything you want to make sure isn't in the food before you buy it?" but do not mention the names of ingredients they might avoid. Code as appropriate.

Q3. Enter details in the text field and this will be post coded later.

Q4. As with Q2 if the respondent is unsure prompt them - "Is there anything you like to make sure is in the food you buy?". Avoid mentioning particular nutrients/ ingredients such as fibre, calcium etc. Code as appropriate.

Q5. Enter details in the text field and these will be post coded later.

Q6. Read out the question and then offer the possible answers to the respondent as a running prompt. Code as appropriate. If you think a show card would help please ask and we will make one up for you.

Q7- 13. Show the respondent the mock up food label. Give the respondent a few minutes to look at the information on it. Should they have poor eyesight read out the information on the label that is referred to in the question. If they still have difficulty with this question skip this section and code all responses as '9'.

Q7. Sell by date is the date used to tell both manufacturers and shoppers when the product should be kept on the shelf until. It is not an indicator of when the food goes off and food is still safe to eat. Only code as 'correct' if the respondent is able to tell you that it shows when the product should be displayed until.

Q8. Use by date tells the consumer when the product should be eaten by. After this date the eating quality of the product will decrease and for some foods such as meat, their microbiological safety is questionable. Code as 'correct' if the respondent mentions that it helps decide whether food is safe to eat, needs to be disposed of etc.

Q9. List of ingredients - the ingredients are listed by weight in descending order. In other words the label shows that sugar is the main ingredient by weight, whilst citric acid is present in the least quantity. Code as correct if the respondent mentions either of these possibilities.

Q10. Saturates - a type of fat, usually of animal origin. These are the fats which are most responsible for blocking arteries and causing heart disease. Code as 'correct' if the respondent mentions either that this is a type of fat, or a type of fat bad for health.

Q11. Kilocalories - measure of energy value of the product. Code as correct if the respondent mentions that it shows how fattening the product is/ how many calories there are in it etc.

Q12. Grammes and milligrammes are both units of weight.

Q13. Recommended Daily Allowance. This is the amount that nutritionists

suggest most people should eat of a particular nutrient per day. In order to help consumers decide whether the product is a good source of a nutrient the nutrition label often shows the percentage of the RDA supplied by the product.

Q14-18. In the following five questions we are aiming to find out whether the information available to older people is limited because they are not able to read the information properly. This may be the fault of the manufacturer (information is crammed into too small a space) or due to the fact that the respondent has poor sight but does not wear reading glasses, for example, when they are shopping.

Q14. Code as appropriate

Q15. "Poor eyesight" means any impairment of vision whether it is correctable (short or long sightedness) or more severe (full or partial blindness).

Q16. Visual aids may be glasses, contact lenses, monocle or magnifying glass. Those who are completely blind and use braille or have someone to read labels to them should skip to Question 19.

Q17. Only code this as yes if the respondent actually uses their visual aid while they are shopping, reading labels, hunting for money etc. Taking a pair of spectacles with them is not a 'yes' unless they put them on !

Q18. Make a note of any reasons offered e.g. glasses not strong enough, forgets them etc and we will post code this later.

Q19. Read out the run up to the questions and then read out each alternative carefully to the respondent. If the respondent is unsure, prompt them with the alternatives to their answer "Would you say price is not so important or very important?" "What score would you give it between 1 and 6?". If the respondent is adamant that they are not involved in buying food code all answers as '7'.


Q21. In this question we are aiming to detect whether our respondents have absorbed the healthy eating messages which have been put out in the past few years. If possible try to avoid making this sound like a test of their knowledge - we want their opinion. If necessary probe to get an answer by reading the list of possible answers out after each question "Do you think we should be eating more or less red meat?". If the respondent still cannot decide code as 7.

Q22. Read out each of the statements slowly and carefully to the respondent. Give them time to consider their answer and if necessary

prompt them with the possible responses open to them. "Do you think that is true or untrue?". Only code the response as unsure or don't know if the respondent still cannot make a decision after you have prompted them.

Q23. Once you have introduced the question read out each of the possible answers to the respondent. Then read the statements in turn. Prompt the respondent - "Would you say this is very important, quite important, fairly unimportant or unimportant in determining what you eat / buy?". If they have no feelings either way code as '3'.If the question is inappropriate e.g. the respondent has no spouse or no children, code as '7'.If you think a showcard would help please let us know and we will make one up for you.

Q24. Hand the card to the respondent and explain what you would like them to do. If they are unsure of your instructions give them a scenario to help - "If you were buying some food which of these would you be most worried about ?" or "Which of these do you think is the greatest risk to people eating food in this country?" If the respondent is not worried about any of the items mentioned on the list code as '6'.Please read out the list slowly as a running prompt to anyone with poor sight.

Q25. Hand the card of possible responses to the respondent. Read out each of the statements carefully and wait for their answer. If necessary prompt them - "Would you say you strongly agree, agree, strongly disagree, etc....". Code as appropriate.

Q26. Hand the card of possible responses to the respondent. Then read out each section of the question. If necessary prompt the respondent "How reliable do you think they are ?" and run through the alternatives. Code as appropriate.

Q27. Read through the list as a running prompt "Have you been given advice about food or diet from ...?" and code as appropriate.

Q28-30. Show the respondent the food pictures. Give them a little time to look them over. Ask the respondent to read out the numbers of the foods they think apply when you ask them the questions. Read out the questions in turn and then note down the numbers mentioned.

Q31. Hand the showcard used for Q25 to the respondent again. Tell them that you are going to follow the same procedure with them calling out their opinion once you have asked the question. Again, if necessary use the list of possible answers as a running prompt if necessary.

Q32-36. Lay out the labels on a flat surface - floor, table etc. Give the

respondent a chance to look at them and then ask each question in turn. Get the respondent to quote you the number(s) of the labels in their answer. If the respondent has very poor eyesight or is blind, try to read out the possible answers. If this proves unsuccessful skip this questions and code all the entries as '9'.

You may need to re-phrase the questions to get at the opinions of the respondents. Try these if necessary :

Q32. - Which product would they buy if saving money was their only consideration

Q33. - By value for money we mean the best quality for the best price e.g. HP baked beans but taste just as good as Heinz but cost less.

Q34. - Which product is best in terms of taste, texture, colour etc.

Q35. - Which costs the most

Q36. - If they were out shopping, which would they buy most often. If the respondent does not do the food shopping, code as '10'.

Q37. Hand the showcard used for Q25 and Q31 to the respondent again. Explain that you will be using the same procedure as before and that you would like them to listen to the statements and give their opinion. Read out each statement slowly and carefully then wait for their answer. If the respondent needs to be prompted use the list of possible answers as a running prompt. Only code the answer as 'don't know' if you cannot get a decision from the respondent after prompting them.

Q38-43. Follow a similar procedure to Questions 32-36 when dealing with the names of shops. Lay out the numbered cards, giving the respondents a chance to look them over. Then ask each question in turn. Follow the same procedure if the respondent has poor eyesight.

Again you may find that you need to re-phrase various questions to get answers from the respondent. If this proves necessary try these -

Q38. - Which shop(s) sell(s) the most cut price foods / has the most bargains / keeps their prices down ?

Q39. - If the respondent wanted to be able to buy all their food shopping for the week in one shop which shop(s) do they think they could get it all from.

Q40. - Which shop(s) would they visit if they wanted to get good quality food e.g. fresh vegetables, good quality meat, top brands etc.

Q41. - Which shop(s) sell(s) food at the highest prices?

Q42. - Which shops are within easy travelling distance from their home i.e. that they could walk/catch a bus or drive to easily.

Q43. - In a typical month which shops would they use to buy food from ?

Q46. - Which shops have they never used to buy their food from ?

Q47. - Enter the details in the text field and these will be post-coded later. If necessary probe for answers - "Is the shop too far away, too expensive, doesn't stock all you need etc?"

APPENDIX I

SCRIPT SHEET

If the respondent answers introduce yourself as follows :

"I am ... from Nottingham University Medical School. This is my identification badge (show badge). We sent you a letter like this recently about our research project. We are doing a study about food and health in later life and are particularly keen to talk to people over 55 living in (study area name Nottingham/Lincolnshire etc).

Before I start I'd like to explain that we chose your name purely at random from your GP's list. Anything you told me would be treated in the strictest confidence. It will not be possible to identify anyone taking part in the study individually and nothing you say would be passed on to anyone outside our small team. The aim is to find out what kinds of food people eat and why. It will take about an hour and participation is completely voluntary. Would it be okay to ask you a few questions ?"

If the respondent says no to the interview code the contact sheet as refusal with the reason for refusal.

If yes explain to the respondent

"We are using computers like this one (show lap top) to record the information you give us. This is to save us time and also to avoid making the interview too long for you. I do need to plug it in somewhere in your house to get it working. Would that be alright? We will pay for the electricity it uses."

If the respondent refuses an interview at this stage code the contact sheet as a refusal with the reason for refusal.

If the respondent is agreeable commence the interview and make a note of the time it started on the contact sheet.

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APPENDIX II

CONTACT SHEET

UNIQUE NO unique no ~NAME title ~ first ~ sur ~ADDRESS road ~

district ~notts and postcode ~

DOB dob ~GP gp name ~ gp code ~RESPONDENT LETTER SENTDATE OF INTERVIEWTELEPHONE NUMBERMAP REFERENCE

CONTACT OUTCOME : ______

Interview refused at interviewer approach - 3*Interview discontinued (e.g. respondents ill) - 4Failed Cape Score - 5Successful interview - 6Died between 1/1/95 and interview - 7Not found - 8Died prior to sample data 1/1/95 - 9

* REASON FOR REFUSAL __________________________________

__________________________________________________________________________

TIME INTERVIEW STARTED ________________

TIME INTERVIEW ENDED __________________

DURATION (IN MINUTES) __________________

DATES OF VISITS TO CONTACT :1. ___________________2. ___________________3. ___________________

64

DIARY CONTACT SHEET

UNIQUE NO unique ~NAME title ~ first ~ sur ~ADDRESS road ~


DOB dob ~GP gp name ~ gp code ~DATE DIARY OFFEREDDATE DIARY COLLECTEDTELEPHONE NUMBERMAP REFERENCE


Refused diary - 24*Diary incomplete - 25


__________________________________________________________________________


NB It would be helpful to know if the diary was refused because of:respondents inability to read Englishrespondents inability to write Englishrespondent can neither read nor write EnglishInability to write because of disablement e.g. stroke, arthritis etcNever learned to read/write etc...

65

FOLLOW - UP INTERVIEW

UNIQUE NO unique no ~NAME title ~ first ~ sur ~ADDRESS road ~


DOB dob ~GP gp name ~ gp code ~DIARY TO COLLECT AT FOLLOW- UPDATE OF FOLLOW UP INTERVIEWTELEPHONE NUMBERMAP REFERENCE


Refused follow-up interview * - 15Died after initial interview but before follow-up - 17Follow up interview abandoned - 28Moved into institution prior to follow up but after first interview - 10Not found at follow up - 21


__________________________________________________________________________


Documents

THE CONSTRUCTION OF FOOD CHOICE IN LATER LIFE · Web viewthe construction of food choice in later life. interviewer manual. departments of health care for the elderly, social studies