
Paige Clark
CAFS IRP.

Appendix
Questionnaire
This questionnaire is designed to examine how the media influences the formation of youth’s identity. Your willingness to complete the questions is appreciated. All responses will be anonymous and remain confidential. Once the research process has been completed, your information will be fully disposed of. Thankyou.
-
What is your gender? (please tick)
-
Male
-
Female
-
-
What is your age? (please tick)
-
12 years
-
13 years
-
14 years
-
15 years
-
16 years
-
17 years
-
18 years
-
19 years
-
20+ years
-
Which of these forms of media do you regularly interact with? (you can tick more than one)
-
Social (Facebook, Instagram)
-
TV
-
Magazines
-
Videos (eg: YouTube
-
Blogs
-
Newspapers
-
Radio
-
Approximately how many hours per day do you spend browsing the following forms of media: (Please tick one circle per item)
0 Hours
1 – 2 Hours
2 – 3 hours
3 – 4 hours
4 Hours +
Social Media (Facebook, Instagram, Snapchat)
o
o
o
o
o
TV
o
o
o
o
o
Magazines
o
o
o
o
o
Videos (eg: YouTube)
o
o
o
o
o
Blogs
o
o
o
o
o
Newspapers
o
o
o
o
o
Radio
o
o
o
o
o
-
In your opinion, does the media have a strong influence on teenagers? (please tick)
-
Yes
-
No
-
Sometimes
-
Do you aspire to be like the male and female figures that you see in the media? Please explain.
-
How would you describe physical “attractiveness” in a male versus a female? Please explain.
-
What factors have lead you to perceive this as the “ideal image?” (You can tick more than one)
-
Social Media (Facebook, Twitter ect)
-
TV
-
Magazines
-
Videos (eg: YouTube)
-
Blogs
-
Newspapers
-
Radio
-
Friends/Family
-
OTHER (please specify)
-
Have you ever felt the need to change an aspect of yourself, such as your appearance or personality, to suit the media’s “standards?” (Please tick)
-
Yes
-
No
-
If answered YES to Question 9, please state what aspects about yourself that you have changed:
-
Do you believe that the media influences the types of products that you buy? Please explain your opinion.
-
Do you regularly purchase any of the following products to help enhance your appearance? (You can tick more than one)
-
Make – up
-
Hair products
-
Expensive clothes/shoes
-
Have you ever bought any of the following products to help change your body image? (You can tick more than one)
-
Meal replacement products (shakes, bars)
-
Weight loss pills/powders
-
Weight gain pills/powders
-
Cleansing diets (juicing, detox)
-
Muscle enhancing pills/powders
-
Have you ever watched you’re eating habits in order to either loose or gain weight? (Please tick)
-
Yes
-
No
-
If answered YES to question 14, please explain why.
-
How strongly do you believe the media influences teenager’s decisions on the products they buy, their body image, self-esteem and views on plastic surgery? (Please tick one circle per item)
does not influence teenagers
Media somewhat influences teenagers
Media moderately influences teenagers
Media strongly influences teenagers
Media very strongly influences teenagers
Buying products
o
o
o
o
o
Body Image
o
o
o
o
o
Self Esteem
o
o
o
o
o
Plastic surgery
o
o
o
o
o
-
What are your views on plastic surgery?
-
How far would you go in the future to change your physical appearance? (Please explain your opinion)
Thank you for your participation!