Compendium of Surveys (to assess fruit and vegetable consumption)

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This is a form about what you did this morning and yesterday. There are23 questions. It is not a test so there are no right or wrong answers. Theimportant thing is that you answer the questions truthfully and try yourhardest to remember what you did and what you had to eat and drink.Here is an example:2. Did you have anything to eat ordrink at home this morning?NoYesWhat did you have to eat or drink?.........................................................................................................................................................................................Write downEVERYTHINGyou canremember!3. How did you travel to school this morning?If you didn’t have anything to eat or drink at home this morning, youshould put a tick in the box that says ‘No’. You should then follow thearrow to the next question.If you did have something to eat or drink at home this morning you shouldput a tick in the box that says ‘Yes’. You should then follow the arrow tothe box with the blank lines and write down everything you had to eat anddrink. It is important that you try hard to remember exactly what youhad to eat and drink and that you write down everything. Once you aresure that you have remembered everything you should follow the arrow tothe next question.All your answers are a secret between you and the people helping you fillout the form. Nobody else will see your answers. Please don’t talk toanyone else while you are filling in the form and try not to let anyone elsesee what you put down.If there is anything you don’t understand or any words that you are notsure about then make sure you ask. There is no rush so you can take aslong as you like.DILQ 9-11 years 32
What did you do this morning?1. Did you watch television at home this morning?NoYes(Put a tick in the correct box)2. Did you have anything to eat ordrink at home this morning?NoYesWhat did you have to eat or....................................................................................................................................................Write downEVERYTHINGyou canremember!3. How did you travel to school this morning?walk cycle by bus by carDILQ 9-11 years 33
Page 3 and 4: COMPENDIUM OF SURVEYS..............
Page 5 and 6: FRUIT AND VEGETABLE TOOLS
Page 7 and 8: BRFSS items and most of these crite
Page 9 and 10: Food Behavior Checklist - Food Stam
Page 11 and 12: Fruit and Vegetable ChecklistFull s
Page 13 and 14: NCI All Day Screener 13
Page 15 and 16: NCI By Meal Screener (Thompson, et
Page 17 and 18: 4a. Each time you ate these potatoe
Page 19 and 20: LUNCHTIME AND AFTERNOON8. Think abo
Page 21 and 22: 11. Think about all the foods you a
Page 23 and 24: Fruit and Vegetable Module (BRFSS)T
Page 25 and 26: The three consumption questions fro
Page 27 and 28: The Day in the Life Questionnaire (
Page 29 and 30: DILQ for 7-9 years 29
Page 31: Day in the Life Questionnaire (9-11
Page 35 and 36: What did you do yesterday?6. Did yo
Page 37 and 38: 12. Did you have anything to eat or
Page 39 and 40: 19. Did you have anything to eat or
Page 41 and 42: California Healthy Kids Survey (CHK
Page 43 and 44: Youth Risk Behavior Survey (YRBS)Fr
Page 45 and 46: Food Recognition Form (Cullen, et a
Page 47 and 48: OtherButter Margarine Jam or Je
Page 49 and 50: 4. Apples?Includeapplesauce.5. 100%
Page 51 and 52: 7. Other100%juice?Include100% grape
Page 53 and 54: 10.Grapes?“What is (yourchild’s
Page 55 and 56: 13.Strawberries?14.Pineapple?“Wha
Page 57 and 58: 18. Baked,mashed orboiledpotatoes?N
Page 59 and 60: Food Frequency Questionnaire 59
Page 61 and 62: 25. GreenPeas?26.Broccoli?“What i
Page 63 and 64: 29. Beans?like bakedor refriedbeans
Page 65 and 66: Availability Survey - Fruit, Juice
Page 67 and 68: School and Idea Resource KitTarget
Page 69 and 70: ReferencesBaranowski T, Davis M, Re
Page 71 and 72: We want to know what you think will
Page 73 and 74: We want to know what you think abou
Page 75 and 76: We want to know what you think abou
Page 77 and 78: fruits or vegetables that were prev
Page 79 and 80: Student identification number______
Page 81 and 82: 7. For breakfast, I think I can…I
Page 83 and 84:
Network Youth Survey and Network Hi
Page 85 and 86:
Additional informationNetwork Youth
Page 87 and 88:
Write your Identification Number he
Page 89 and 90:
5. Yesterday, did you eat any hot o
Page 91 and 92:
O Yes, I drank regular (not diet) s
Page 93 and 94:
Thank youNetwork Youth Survey 93
Page 95 and 96:
Instrucciones: Esta es una encuesta
Page 97 and 98:
8. ¿Comiste fruta ayer? Incluye fr
Page 99 and 100:
O ViernesO SábadoO Domingo15. ¿De
Page 101 and 102:
Page 103 and 104:
5. Yesterday, did you eat any hot o
Page 105 and 106:
O4 or more times per day12. During
Page 107 and 108:
18. Yesterday, did you eat breakfas
Page 109 and 110:
Questions 32-33 These questions mea
Page 111 and 112:
Page 113 and 114:
The questions in this next section
Page 115 and 116:
The questions in this next section
Page 117 and 118:
Now we want to know how active you
Page 119 and 120:
In this section, we want you to tel
Page 121 and 122:
Food Preferences SurveyTarget behav
Page 123 and 124:
How much do you like these fruits a
Page 125 and 126:
Food Security SurveysTarget behavio
Page 127 and 128:
Food-Security/Hunger Core Module3-S
Page 129 and 130:
[IF CHILDREN UNDER 18 IN HOUSEHOLD,
Page 131 and 132:
12. In the last 12 months, did (you
Page 133 and 134:
California Women’s Health Survey
Page 135 and 136:
10. In the past 12 months, were you
Page 137 and 138:
Short Form of the 12-month Food Sec
Page 139 and 140:
ReferencesRussell, S. 2004. Validit
Page 141 and 142:
Hawthorne Unified School District (
Page 143 and 144:
Full survey available from http://t
Page 145 and 146:
Social Norms (Baranowski, et al.)Wh
Page 147 and 148:
Outcome Expectations for Eating FVs
Page 149 and 150:
Self-Efficacy Surveys for ChildrenT
Page 151 and 152:
Exámen de Eficacia Propia-Comiendo
Page 153 and 154:
Self-Efficacy Survey - Eating FVs (
Page 155 and 156:
PHYSICAL ACTIVITY TOOLSPhysical Act
Page 157 and 158:
PAR: Men ages 18 to 69; college stu
Page 159 and 160:
7-Day Physical Activity Recall (Sal
Page 161 and 162:
Physical Activity Surveys for Child
Page 163 and 164:
4. On an average school day, how ma
Page 165 and 166:
Physical Activity Preferences Surve
Page 167 and 168:
Self-Efficacy for Physical Activity
Page 169 and 170:
Social Support From Family & Friend
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Compendium of Surveys (to assess fruit and vegetable consumption)

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