Data Collection Instrument Please enable JavaScript in your browser to complete this form. - Step 1 of 4Data collection instrumentThank you for consenting to take part in this study, “The perceived effectiveness of sugar tax to change human behavior in Gauteng.” Participation in this study is entirely voluntary. You are free to exit the study anytime without facing any repercussions. However, l do recommend and encourage that you complete the interview questionnaire. No identify or any other personal information will be collected during the study. All responses will be captured and saved directly into a secure server. This information will not be used for any other purpose except for the purposes of completing this study and it will be destroyed after five years. The research questionnaire will take you about 10 to 15 minutes to complete.Section A1.1 Do you consent to participate in this study free of charge? *Select OptionYesNo1.2 Are you 18 years or older? *Select OptionYesNo1.3 Are you a resident of Gauteng province? *Select OptionYesNoNB: If there is at least one NO on section A, please do not proceed with the questionnaire.NextSection B2.1 Are you male or female? *Select OptionMaleFemale2.2 What is your age range? *Select Option1. 18 – 35 (young)2. 36 – 49 (middle aged)3. 50 – 65 (late middle aged)4. 66 and over (old aged)2.3 What is your educational level *Select OptionNot educatedMatricDiplomaDegreePostgraduate Degree2.4 What is your household income per month (before tax)? (Socio Economic Measure) *Select Option1. 0 – R4 5002. R4 501 – R69 999.993. R70 000.00 and above2.5 What is your employment status *Select Option1. Not working2. Working full time3. Working part time4. Retired2.6 What is your ethnicity? *Select Option1. Asian/Indian2. Black African3. Caucasian4. Mixed race5.OtherNextSection C3.1 Do you know anything about Health Promotion Levy or sugar tax in South Africa? *Select OptionYesNo3.2 How did you know about Health Promotion Levy or sugar tax in South Africa? *Select Option1. Television (Advertisements, News)2. Radio3. Internet including social media4. Friends5. N/A3.3 How has your SSB consumption changed since 01 April 2018 to date? *Select Option1. Increased2. Decreased3. Did not change3.4 What has influenced your change in SSB consumption more? *Select Option1. Price increase (as a result of sugar tax)2. Unhealthy3. Weight loss4. Diagonised with Non-Communicable Disease(s) e.g. BP5. Health promotion awareness campaigns3.5 If your disposal income increases, how will that affect your SSB consumption? *Select Option1. Increase2. Decrease3. No effect3.6 Have you substituted SSBs with other healthier options like water, milk, fruit juices? *Select OptionYesNo3.7 How often do you used to consume SSBs before 1 April 2018 over 2 days? *Select Option1. At least once a day2. 4 – 6 times a week3. 1 – 3 times a week4. Less than once a week5. Never3.8 How often do you consume SSBs after 1 April 2018 over 2 days? *Select Option1. At least once a day2. 4 – 6 times a week3. 1 – 3 times a week4. Less than once a week5. NeverNextSection DAwareness programmes do perceive human beings to change their consumption behaviour from sugar sweetened beverages. On a scale of 1 to 5. 1 being extremely unlikely and 5 being extremely unlikely. How likely are the following actions in effectively reducing the consumption of sugar sweetened beverages? 4.1 Placing SSBs price stickers clearly show the amount of sugar tax included in the overall price. *Select Option1 = Highly unlikely2 = Unlikely3 = Neutral4 = Likely5 = Highly likely4.2 Ban on advertisements of sweetened beverages during the hours when the highest number of children and teenagers are watching *Select Option1 = Highly unlikely2 = Unlikely3 = Neutral4 = Likely5 = Highly likely4.3 Placing information about the content of sweetened beverages on the packaging of sweetened beverages using a big font *Select Option1 = Highly unlikely2 = Unlikely3 = Neutral4 = Likely5 = Highly likely4.4 Placing the information about the content of sugars using graphics on the packaging of the sweetened beverages *Select Option1 = Highly unlikely2 = Unlikely3 = Neutral4 = Likely5 = Highly likely4.5 Placing information about the health effects of sugar consumption on the packaging of beverages *Select Option1 = Highly unlikely2 = Unlikely3 = Neutral4 = Likely5 = Highly likely4.6 Requirement to provide information concerning the content of sugar in the product when running an advertisement *Select Option1 = Highly unlikely2 = Unlikely3 = Neutral4 = Likely5 = Highly likely4.7 The need to provide information about the health effects of sugar consumption in graphic form when running advertisements *Select Option1 = Highly unlikely2 = Unlikely3 = Neutral4 = Likely5 = Highly likely Submit
