Survey Series on People and their Communities - Community Engagement
For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
Table of Contents
- Respondent confirmation (RC)
- Household members and geographic region 1 (DEM)
- Household members and geographic region 2 (TST)
- Household members and geographic region 3 (SDC)
- Gender (GDR)
- Main activity (MAC)
- Participation in groups 1 (CER)
- Participation in groups 2 (GRP)
- Sense of belonging (SBL)
- Trust in people (PCT)
- Trust in different groups of people (TIP)
- Confidence in institutions (CII)
- Marital status (MS)
- Sexual orientation (SOR)
- Education (ED)
- Long-term conditions (LTC)
- Indigenous identity (ABM)
- Sociodemographic characteristics (PG)
- Contact information (UCE)
Respondent confirmation (RC)
Respondent confirmation (RC) - Question identifier:RC_R01
The following questions are for [NAME_OR_EMAIL].
Household members and geographic region 1 (DEM)
Household members and geographic region 1 (DEM) - Question identifier:DEM_Q05
Including yourself, how many people live in your household?
Number of people
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20 or more
Household members and geographic region 2 (TST)
Household members and geographic region 2 (TST) - Question identifier:TST_Q11
Are there any children under the age of 18 in your household?
- 1: Yes, under the age of 5
- 2: Yes, aged 5 to 11
- 3: Yes, aged 12 to 17
- 4: No
Household members and geographic region 3 (SDC)
Household members and geographic region 3 (SDC) - Question identifier:SDC_Q01A
Is your postal code [POSTAL CODE]?
- 1: Yes
- 2: No
Household members and geographic region 3 (SDC) - Question identifier:SDC_Q01B
What is your postal code?
Long Answer Length = 7
Gender (GDR)
Gender (GDR) - Question identifier:GDR_Q10
What is your gender?
- 1: Male
- 2: Female
- 3: Or please specify
Main activity (MAC)
Main activity (MAC) - Question identifier:MAC_Q05
Last week, was your main activity working at a paid job or business, looking for paid work, going to school, caring for children, household work, retired or something else?
- 01: Working at a paid job or business
- 02: Vacation from paid work
- 03: Looking for paid work
- 04: Going to school, including vacation from school
- 05: Caring for children
- 06: Household work
- 07: Retired
- 08: Maternity, paternity or parental leave
- 09: Long term illness
- 10: Volunteering
- 11: Care-giving other than for children
- 12: Other
Participation in groups 1 (CER)
Participation in groups 1 (CER) - Question identifier:CER_R10
The next questions are about formal and informal groups, organizations or associations to which you may belong.
Participation in groups 1 (CER) - Question identifier:CER_Q10
In the past 12 months, were you a member or participant in the following groups, organizations or associations? These could be formally organized groups or just groups of people who get together regularly to do an activity or talk about things.
- 01: Sports or recreational organization (e.g., hockey league, health club or golf club)
- 02: Cultural, educational or hobby organization ( e.g., theatre group, book club or bridge club)
- 03: Union or professional association
- 04: Political party or group
- 05: Religious-affiliated group (Exclude regular attendance at your place of worship.)
- 06: School group, neighbourhood, civic or community association (e.g., parent-teacher association (PTA), alumni association, block parents or neighbourhood watch)
- 07: Humanitarian or charitable organization or service club (e.g., Meals on Wheels, United Way, UNICEF, Heart and Stroke Foundation, Distress Centre, Rotary Club, Red Cross)
- 08: Seniors' group (e.g., seniors' club, recreational association or resource centre)
- 09: Youth organization (e.g., Scouts, Guides, Big Brothers or Big Sisters, YMCA or YWCA)
- 10: Immigrant or ethnic association or club
- 11: Environmental group (e.g., in the areas of conservation, ecology, the environment or animal rights)
- 12: Other type of group, organization or association
- 13: Not a member or participant in any groups, organizations or associations
Participation in groups 1 (CER) - Question identifier:CER_Q20
What are the reasons you were not a member or participant in any groups, organizations or associations?
- 01: Lack of interest, motivation or self confidence
- 02: Don't know what groups, organizations or associations are available in your community
- 03: Financial reasons (e.g., cannot afford it, too expensive)
- 04: Location or transportation problems (e.g., not available in your area, location is inconvenient or not on a public transportation route, no access to vehicle)
- 05: Not offered in your language of choice
- 06: Lack of time (e.g., because of work, school or family responsibilities)
- 07: Requires too much of a commitment
- 08: Health, medical issues or disability
- 09: No Internet subscription or Internet is not available in your area and participation is only accessible online
- 10: To reduce COVID-19 exposure risk
- 11: Some other reason
Participation in groups 2 (GRP)
Participation in groups 2 (GRP) - Question identifier:GRP_R40
You mentioned having participated in the following groups, organizations or associations in the past 12 months:
[List of groups, organizations or associations selected in question 6]
Participation in groups 2 (GRP) - Question identifier:GRP_Q40
On average, how often did you participate in group activities and meetings on the Internet?
- 1: At least once a week
- 2: A few times a month
- 3: Once a month
- 4: Three or four times a year
- 5: Once or twice a year
- 6: Not in the past year
- 7: Never
Participation in groups 2 (GRP) - Question identifier:GRP_Q45
On average, how often did you participate in group activities and meetings in person?
- 1: At least once a week
- 2: A few times a month
- 3: Once a month
- 4: Three or four times a year
- 5: Once or twice a year
- 6: Not in the past year
- 7: Never
Participation in groups 2 (GRP) - Question identifier:GRP_Q50
To what extent do you agree or disagree with the following statement?
My participation in groups, organizations or associations has a positive impact on my well-being.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 6: Not applicable
Participation in groups 2 (GRP) - Question identifier:GRP_Q55
Because of the COVID-19 pandemic, how has your level of participation in groups, organizations or associations changed?
- 1: It has increased
- 2: It has decreased
- 3: It has stayed the same
Sense of belonging (SBL)
Sense of belonging (SBL) - Question identifier:SBL_Q100
How would you describe your sense of belonging to your local community?
- 1: Very strong
- 2: Somewhat strong
- 3: Somewhat weak
- 4: Very weak
- 5: No opinion
Sense of belonging (SBL) - Question identifier:SBL_Q400
How would you describe your sense of belonging to Canada?
- 1: Very strong
- 2: Somewhat strong
- 3: Somewhat weak
- 4: Very weak
- 5: No opinion
Trust in people (PCT)
Trust in people (PCT) - Question identifier:PCT_Q10
Generally speaking, would you say that most people can be trusted or that you cannot be too careful in dealing with people?
- 1: Most people can be trusted
- 2: You cannot be too careful in dealing with people
Trust in different groups of people (TIP)
Trust in different groups of people (TIP) - Question identifier:TIP_Q10
Using a scale of 1 to 5, where 1 means "Cannot be trusted at all" and 5 means "Can be trusted completely", what is your level of trust in each of the following groups of people?
People in your family
- 1: 1 - Cannot be trusted at all
- 2: 2
- 3: 3
- 4: 4
- 5: 5 - Can be trusted completely
Trust in different groups of people (TIP) - Question identifier:TIP_Q15
Using a scale of 1 to 5, where 1 means "Cannot be trusted at all" and 5 means "Can be trusted completely", what is your level of trust in each of the following groups of people?
People in your neighbourhood
- 1: 1 - Cannot be trusted at all
- 2: 2
- 3: 3
- 4: 4
- 5: 5 - Can be trusted completely
Trust in different groups of people (TIP) - Question identifier:TIP_Q20
Using a scale of 1 to 5, where 1 means "Cannot be trusted at all" and 5 means "Can be trusted completely", what is your level of trust in each of the following groups of people?
People you work with
- 1: 1 - Cannot be trusted at all
- 2: 2
- 3: 3
- 4: 4
- 5: 5 - Can be trusted completely
Trust in different groups of people (TIP) - Question identifier:TIP_Q21
Using a scale of 1 to 5, where 1 means "Cannot be trusted at all" and 5 means "Can be trusted completely", what is your level of trust in each of the following groups of people?
People you go to school with
- 1: 1 - Cannot be trusted at all
- 2: 2
- 3: 3
- 4: 4
- 5: 5 - Can be trusted completely
Trust in different groups of people (TIP) - Question identifier:TIP_Q22
Using a scale of 1 to 5, where 1 means "Cannot be trusted at all" and 5 means "Can be trusted completely", what is your level of trust in each of the following groups of people?
People who speak a different language than you
- 1: 1 - Cannot be trusted at all
- 2: 2
- 3: 3
- 4: 4
- 5: 5 - Can be trusted completely
Trust in different groups of people (TIP) - Question identifier:TIP_Q23
Using a scale of 1 to 5, where 1 means "Cannot be trusted at all" and 5 means "Can be trusted completely", what is your level of trust in each of the following groups of people?
People with a different religion than you
- 1: 1 - Cannot be trusted at all
- 2: 2
- 3: 3
- 4: 4
- 5: 5 - Can be trusted completely
Trust in different groups of people (TIP) - Question identifier:TIP_Q24
Using a scale of 1 to 5, where 1 means "Cannot be trusted at all" and 5 means "Can be trusted completely", what is your level of trust in each of the following groups of people?
People with a different ethnic or cultural background than you
- 1: 1 - Cannot be trusted at all
- 2: 2
- 3: 3
- 4: 4
- 5: 5 - Can be trusted completely
Trust in different groups of people (TIP) - Question identifier:TIP_Q25
Using a scale of 1 to 5, where 1 means "Cannot be trusted at all" and 5 means "Can be trusted completely", what is your level of trust in each of the following groups of people?
Strangers
- 1: 1 - Cannot be trusted at all
- 2: 2
- 3: 3
- 4: 4
- 5: 5 - Can be trusted completely
Confidence in institutions (CII)
Confidence in institutions (CII) - Question identifier:CII_R10
Using a scale of 1 to 5 where 1 means "No confidence at all" and 5 means "A great deal of confidence", please answer the following questions.
Confidence in institutions (CII) - Question identifier:CII_Q10
How much confidence do you have in the following institutions?
The police
- 1: 1 - No confidence at all
- 2: 2
- 3: 3
- 4: 4
- 5: 5 - A great deal of confidence
Confidence in institutions (CII) - Question identifier:CII_Q15
How much confidence do you have in the following institutions?
The justice system and courts
- 1: 1 - No confidence at all
- 2: 2
- 3: 3
- 4: 4
- 5: 5 - A great deal of confidence
Confidence in institutions (CII) - Question identifier:CII_Q30
How much confidence do you have in the following institutions?
The school system
- 1: 1 - No confidence at all
- 2: 2
- 3: 3
- 4: 4
- 5: 5 - A great deal of confidence
Confidence in institutions (CII) - Question identifier:CII_Q40
How much confidence do you have in the following institutions?
The Federal Parliament
- 1: 1 - No confidence at all
- 2: 2
- 3: 3
- 4: 4
- 5: 5 - A great deal of confidence
Confidence in institutions (CII) - Question identifier:CII_Q45
How much confidence do you have in the following institutions?
Banks
- 1: 1 - No confidence at all
- 2: 2
- 3: 3
- 4: 4
- 5: 5 - A great deal of confidence
Confidence in institutions (CII) - Question identifier:CII_Q50
How much confidence do you have in the following institutions?
Major corporations
- 1: 1 - No confidence at all
- 2: 2
- 3: 3
- 4: 4
- 5: 5 - A great deal of confidence
Confidence in institutions (CII) - Question identifier:CII_Q55
How much confidence do you have in the following institutions?
Local merchants and business people
- 1: 1 - No confidence at all
- 2: 2
- 3: 3
- 4: 4
- 5: 5 - A great deal of confidence
Confidence in institutions (CII) - Question identifier:CII_Q60
How much confidence do you have in the following institutions?
The Canadian media
- 1: 1 - No confidence at all
- 2: 2
- 3: 3
- 4: 4
- 5: 5 - A great deal of confidence
Marital status (MS)
Marital status (MS) - Question identifier:MS_Q01
What is your marital status?
- 1: Married (For Quebec residents only, select the "Married" category if your marital status is "civil union".)
- 2: Living common law (Common law refers to two people who live together as a couple but who are not married, regardless of the duration of the relationship.)
- 3: Never married and not living common law
- 4: Separated and not living common law
- 5: Divorced and not living common law
- 6: Widowed and not living common law
Sexual orientation (SOR)
Sexual orientation (SOR) - Question identifier:SOR_Q01
What is your sexual orientation?
- 1: Heterosexual
- 2: Lesbian or gay
- 3: Bisexual
- 4: Or please specify
Education (ED)
Education (ED) - Question identifier:ED_Q05
What is the highest certificate, diploma or degree that you have completed?
- 1: Less than high school diploma or its equivalent
- 2: High school diploma or a high school equivalency certificate
- 3: Trades certificate or diploma
- 4: College, CEGEP or other non-university certificate or diploma (other than trades certificates or diplomas)
- 5: University certificate or diploma below the bachelor's level
- 6: Bachelor's degree (e.g., B.A., B.A. (Hons), B.Sc., B.Ed., LL.B.)
- 7: University certificate, diploma or degree above the bachelor's level
Long-term conditions (LTC)
Long-term conditions (LTC) - Question identifier:LTC_R05
The following questions are about any long-term conditions you may have.
Long-term conditions (LTC) - Question identifier:LTC_Q05
Do you have any of the following difficulties?
- 1: Difficulty seeing even when wearing glasses or contact lenses
- 2: Difficulty hearing even when using a hearing aid or cochlear implant
- 3: Difficulty walking, using stairs, using your hands or fingers or doing other physical activities
- 4: Difficulty learning, remembering or concentrating
- 5: Emotional, psychological or mental health conditions (e.g., anxiety, depression, bipolar disorder, substance abuse, anorexia)
- 6: Other health problem or long-term condition that has lasted or is expected to last for six or more months
- 7: I do not have any difficulty or long-term condition that has lasted or is expected to last for six or more months
Long-term conditions (LTC) - Question identifier:LTC_Q10
Do you identify as a person with a disability?
- 1: Yes
- 2: No
Indigenous identity (ABM)
Indigenous identity (ABM) - Question identifier:ABM_Q01
Are you First Nations, Métis or Inuk (Inuit)?
- 1: No, not First Nations, Métis, or Inuk (Inuit)
- 2: Yes, First Nations (North American Indian)
- 3: Yes, Métis
- 4: Yes, Inuk (Inuit)
Sociodemographic characteristics (PG)
Sociodemographic characteristics (PG) - Question identifier:PG_Q05
The following question collects information in accordance with the Employment Equity Act and its Regulations and Guidelines to support programs that promote equal opportunity for everyone to share in the social, cultural, and economic life of Canada.
- 01: White
- 02: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
- 03: Chinese
- 04: Black
- 05: Filipino
- 06: Arab
- 07: Latin American
- 08: Southeast Asian (e.g., Vietnamese, Cambodian, Laotian, Thai)
- 09: West Asian (e.g., Iranian, Afghan)
- 10: Korean
- 11: Japanese
- 12: Other
Contact information (UCE)
Contact information (UCE) - Question identifier:UCE_R05
Thank you for completing the Community Engagement survey.
This is the first of four surveys in the Survey Series on People and their Communities. By participating in this survey series, you will provide important information about the social and cultural environment of individuals and families in Canada. Results from the surveys will help decision makers develop programs and policies to better serve all Canadians.
Contact information (UCE) - Question identifier:UCE_Q05A
Please provide the following information so we can contact you by email or telephone to participate in the upcoming surveys in this series.
Email address
Long Answer Length = 64
Contact information (UCE) - Question identifier:UCE_Q05B
Please provide the following information so we can contact you by email or telephone to participate in the upcoming surveys in this series.
Phone number
Long Answer Length = 10
Contact information (UCE) - Question identifier:UCE_R10
Thank you. We will contact you soon. Press the Next button to continue.
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