Protocol - COVID-19 Related Social Distancing Experiences

The following questions ask about your experiences with social distancing. Social distancing means keeping space between yourself and other people outside of your home.

1. In the past month, have recommendations for socially distancing caused stress for you?

[ ] A lot

[ ] Somewhat

[ ] A little

[ ] Not at all

2. Thinking about your current social habits, in the last 5 days: I have stayed home all day (aside from time spent outdoors, but never closer than 6 feet from people who are not from my home).

[ ] None of the days (0 days)

[ ] A few days (1-2 days)

[ ] Most days (3-4 days)

[ ] Every day

3. Thinking about your current social habits, in the last 5 days: I have gone to my workplace or volunteer site that is outside my home.

[ ] None of the days (0 days)

[ ] A few days (1-2 days)

[ ] Most days (3-4 days)

[ ] Every day

4. Thinking about your current social habits, in the last 5 days: I have attended social gatherings outside my home of MORE than 10 people.

[ ] None of the days (0 days)

[ ] A few days (1-2 days)

[ ] Most days (3-4 days)

[ ] Every day

5. Thinking about your current social habits, in the last 5 days: I have attended social gatherings outside my home of LESS than 10 people.

[ ] None of the days (0 days)

[ ] A few days (1-2 days)

[ ] Most days (3-4 days)

[ ] Every day

6. Thinking about your current social habits, in the last 5 days: I have gone on shopping trips or outings that were "just for fun".

[ ] None of the days (0 days)

[ ] A few days (1-2 days)

[ ] Most days (3-4 days)

[ ] Every day

7. Thinking about your current social habits, in the last 5 days: I have visited nursing homes or long-term care facilities (outside of work duties).

[ ] None of the days (0 days)

[ ] A few days (1-2 days)

[ ] Most days (3-4 days)

[ ] Every day

8. Thinking about your current social habits, in the last 5 days: I have been in close contact with someone who is in a risk group for COVID-19 (adults age 50+, people with chronic medical conditions like heart, lung, liver, or kidney disease, diabetes, high blood pressure, or a suppressed immune system). This includes someone inside or outside of your household.

[ ] None of the days (0 days)

[ ] A few days (1-2 days)

[ ] Most days (3-4 days)

[ ] Every day

[ ] I don't know

9. Thinking about these activities in the last 5 days, my social interaction with people outside my home was

[ ] A lot less than normal

[ ] Somewhat less than normal

[ ] About the same as normal

[ ] More than normal

[ ] A lot more than normal

10. Now, thinking about the COVID-19 recommendations and mandates...How often in the past month are you doing the recommended pandemic hygiene, like washing hands frequently, avoiding touching your face, covering coughs, wearing a mask, and avoiding frequently touched surfaces in public places?

[ ] All of the time

[ ] Most of the time

[ ] Sometimes

[ ] Rarely