Current State of Health Among Persons with Intellectual Disability Current State of Health Among Persons with Intellectual DisabilityWe would like to know more about your current state of health. This survey will ask you about your health behaviours and desired Special Olympics Healthy Athlete programming.Name (Optional) First Last How old are you? (example: if you are 18 years old, write 18)What is your current living situation?I live on my own and support myselfI live on my own and get support from a friend, family member or support workerI live in a group homeI live with my family and/or friendsThe following question is about your gender. What is your gender?MaleFemaleOtherRefuse to answerI don't knowIf other, please tell us your gender (optional): The next questions are about your health.In general, would you say your health is…?ExcellentVery goodGoodFairPoorRefuse to answerI don't knowOur mental health is how we think, feel and act each day. In general, would you say your mental health is…?ExcellentVery goodGoodFairPoorRefuse to answerI don't knowThe next questions are about your height and weight.How tall are you without shoes on (feet and inches, example: if you're 5ft 11in tall, write 5ft 11in)? How much do you weigh in pounds (lbs, example if you weigh 120lbs, write 120lbs)? Do you consider yourself…?OverweightUnderweightJust about rightRefuse to answerI don't knowThe following questions are about health conditions.Have you been diagnosed with any of the following conditions? Please check all that apply. Fibromyalgia Arthritis Back problems Osteoporosis High blood pressure High cholesterol Heart disease Stroke Diabetes Cancer Alzheimer’s Disease or dementia Chronic fatigue Depression, bipolar disorder, mania Anxiety disorder, phobia, obsessive-compulsive disorder or panic disorder Do you have any difficulty seeing (even when wearing glasses or contact lenses)?NoSometimesOftenAlwaysDo you have any difficulty hearing (even when using a hearing aid)?NoSometimesOftenAlwaysDo you have any difficulty walking, using stairs, using your hands or fingers or doing other physical activities?NoSometimesOftenAlwaysDo you have any emotional, psychological or mental health conditions?YesNoI'm not sureDo you wear glasses or contact lenses to improve your vision?NoSometimesOftenAlwaysThe following questions will ask you about sleepHow long do you usually spend sleeping each night (in hours, example: if you sleep 8hrs a night, write 8hrs) How often do you have trouble going to sleep or staying asleep?NeverRarelySometimesMost of the timeAll of the timeI don't knowHow often do you find it difficult to stay awake when you want to?NeverRarelySometimesMost of the timeAll of the timeI don't knowThese next questions are about the foods you eat and drink.Do you know what Canada's Food Guide is?YesNoDo you understand Canada's Food Guide?Yes, Canada’s Food Guide is easy to understandI have an idea but I’m still confused on how to achieve the recommendationsNo, Canada’s Food Guide is hard to understandI haven't used Canada's Food GuideCan you afford to buy healthy foods (fruits and vegetables, whole grains, lean meat) from the grocery store?YesNoI don't knowIn the last month, did you eat dark green vegetables such as broccoli, green beans, peas, green peppers, or spinach?YesNoI don't knowThe following questions are about smoking.In the past 30 days, did you smoke any cigarettes?YesNoI don't knowIn the past 30 days, did you use an e-cigarette or vaping device?YesNoI don't knowThe following questions are about physical activities done in the last 7 days.In the last 7 days, did you do any physical activities such as walking, cycling or sports that made you sweat and breathe harder?YesNoI don't knowIn the last 7 days, how many hours did you spend doing activities that made you sweat and breathe harder? How much time PER DAY do you spend watching television, using a computer, tablet, or phone or an electronic device with a screen?2 hours or less per dayMore than 2 hours but less than 4 hours4 hours to less than 6 hours6 hours to less than 8 hours8 hours or more per dayI don't knowThe following questions are about mental health and your social relationshipsOver the last two weeks, have you felt down, depressed or hopeless?YesNoI don't knowDo you know what resources are available to you when/if you are feeling down, depressed or hopeless?YesNoI don't knowDo you have a friend, family member or close relationship that you can talk to when you feel sad?YesNoI don't knowThe following questions will ask you about what health programs at Special Olympics Ontario. We want to know what health programs are going to be the most useful for you. Are you a Special Olympics Ontario athlete?YesNoHave you returned to Special Olympics programs after the COVID-19 pandemic?(Required)YesNoWhat has it been like returning to Special Olympics programs?Practices and games feel easier than before the pandemicPractices and games feel the same as before the pandemicPractices and games feel harder than before the pandemicPlease tell us more about why you haven't returned to Special Olympics programs: I am looking for more opportunities to receive healthcare.(Required)YesNoI don't knowI would like opportunities to receive a Healthy Athletes screening near me.(Required)YesNoI don't knowI would like to attend workshops and presentations that teach me more about health and wellness behaviours such as healthy eating and maintaining positive mental health.(Required)YesNoI don't knowPlease select the Healthy Athletes screenings that are most valuable to you (select all that apply)(Required) Special Smiles (dental and oral health) Opening Eyes (eye health) FunFitness (fitness and physiotherapy) MedFest (general check-ups) FitFeet (feet health) Health Promotion (health, wellness, healthy eating, sun safety, sexual health) Please select each type of healthcare provider that you’ve visited in the last 6 months.(Required) Dentist (teeth) Optometrist (eyes) Physiotherapist (fitness) Doctor Podiatrist/Chiropodist (feet health) Public Health Nurse (sexual health, vaccinations) I have not visited any of these healthcare providers Please tell us more about your current health needs and desires. Select all that apply.(Required) I’d like to know more about how to keep my teeth healthy and clean I’d like to know more about how to keep my eyes healthy and clean I’d like to know more about stretching and flexibility exercises I’d like a check-up from a doctor who knows how to support me I’d like to know more about how to keep my feet healthy I want more information about healthy eating, sleep, and physical activity I do not have any current health needs The following questions will help us learn a little bit more about youWhich of the following best describes you?AsianBlackHispanic or LatinoIndigenousWhite or CaucasianMultiple ethnic groupsPrefer not to answerWhich of the following best describes you?Heterosexual (straight)GayLesbianBisexualOtherPrefer not to answerIf other, please tell us:
