Survey of Food Safety and Nutrition Information Provided to Pregnant Women by Health Care Providers and WIC Educators

Survey of Food Safety and Nutrition Information Provided to Pregnant Woman by Health Care Providers and WIC Educators

Draft Survey Instrument

March 19, 2007

Screener Question

S1. On an average work day, do you provide health care or education to women who are pregnant or who are thinking about getting pregnant?

Yes  Continue to the next Section.

No  Thank you for participating in our survey. Please return the questionnaire in the envelope provided.

Survey Questions

Section A.

A1. Do you ever give your pregnant patients or clients specific nutrition advice, such as recommending or avoiding particular foods?

 Yes  Continue

 No  Go to Section B.

A2. Do you ever recommend that your patients or clients consume fish during pregnancy?

 Yes  Continue

 No  Go to Question A4.

A3. Approximately how many servings of fish per week do you recommend to your pregnant patients or clients?

A4. Do you recommend limits on either the quantity or types of fish consumed during pregnancy? Check all that apply.

 Recommend limits on certain types of fish

 Recommend limits on quantity of fish

 Recommend no limits

Section B.

B1. Are you aware of any advice about fish consumption and the risk of methyl mercury during pregnancy?

 Yes  Continue

 No  Go to section C.

B2. Do you advise your patients or clients about mercury and fish?

 Yes  Continue

 No  Go to section C.

B3. How do you give this advice to your patients or clients? Check all that apply

 In written materials, such as brochures

 In face to face discussions

 Other (specify)

B4. On a scale of 1 to 5, how important is it that you give this advice to your patients or clients?

B5. Below is a list of specific current federal recommendations for reducing the risk of methyl mercury exposure during pregnancy. For each recommendation, please rate on a scale of 1 to 5, how important it is for your patients or clients to follow the advice to ensure a healthy pregnancy.

Avoid Shark, Swordfish, King Mackerel, or Tilefish

Eat up to 12 ounces (two average meals) a week of a variety of fish and shellfish that are lower in mercury.

Eat up to six ounces (one average meal) of albacore tuna per week.

Check local advisories about the safety of fish caught by family and friends in local lakes, rivers and coastal areas.

Section C.

C1. Do you provide any advice to your pregnant patients or clients about how to avoid food related illnesses?

 Yes  continue

 No  Go to Section D.

C2. How do you give advice about avoiding food related illnesses to your patients or clients? Check all that apply

 In written materials, such as brochures

 In face to face discussions

 Other (specify)

C3. Below is a list of foods that may pose certain risks specific to pregnant women. Do you give advice to your pregnant patients or clients about avoiding any of these foods?

 Yes

 No

Raw or unpasteurized soft cheeses

Unpasteurized juice

Raw meats, like Steak tartar

Raw fish, like sushi or ceviche

Raw sprouts

Raw or undercooked eggs

Unwashed fruits and vegetables

Unheated luncheon meats or hot dogs

Pate

C4. On a scale of 1 to 5, how important is it that you give this advice to your pregnant patients or clients about avoiding these foods?

Raw or unpasteurized soft cheeses

Unpasteurized juice

Raw meats, like Steak tartar

Raw fish, like sushi or ceviche

Raw sprouts

Raw or undercooked eggs

Unwashed fruits and vegetables

Unheated luncheon meats or hot dogs

Pate

Section D.

D1. Where do you get your information about what advice to give to your pregnant patients regarding the following topics? Please select all that apply.

	Professional organization website, journal, or brochures (e.g., ACOG, AMA, etc.)	Medical journal	Professional meeting or training	Mass media (newspaper, magazine television, or radio)	Government source (federal, state or local)	Clinical experience or residency	Other. Please specify
Food safety							 _________
Nutrition							 _________
Dietary Supplements							 _________

D2. Take a look at the list below. In what format would you like to hear about new Food and Drug Administration (FDA) advisories and information for patients about food safety? (Please mark your first choice and then any other acceptable formats)

	First Choice Format for Hearing about FDA advisories	Acceptable Format for Hearing about FDA advisories	Unacceptable Format
Professional meeting			
Professional organization website or journal (Such as ACOG, AMA, etc)			
General media			
Medical journal			
FDA website			
Email listservs. Which ones?			
Brochures and other literature sent by FDA			
FDA Alerts sent by FDA			
Hospital departmental meetings			
Other. Please specify.			

D3. Take a look at the list below. In what format would like to get information from FDA to share directly with your patients? (Please mark your first choice and then any other acceptable formats)

	First Choice Format for Getting FDA Information to Share with Patients	Acceptable Format for Getting FDA Information to Share with Patients	Unacceptable Format
Patient brochures mailed to your office			
Short informational videos that can be played in your office waiting room			
Posters			
FDA website			
Other. Please specify			

 Go to Section F.

Section E.

E1. In an earlier Section, you indicated that you did not give advice to your patients concerning risks that certain foods may pose to pregnant women. Below is a list of reasons as to why you may not give this advice. On a scale of 1 to 5, how important is each of these reasons to you for not providing this type of advice?

 It is not my role to give this type of advice.

 The information is not relevant to or needed by my patients or clients.

 I don’t have enough time or resources to provide this information.

 I have not been provided enough information to give adequate advice.

 Other (specify): ___________________________________.

Section F.

F1. How would you describe your job providing health care or education to women about pregnancy? Check all that apply:

 OB/GYN

 Physicians assistant

 Nurse Practitioner

 Nurse Midwife

 WIC Educator

 Other (specify)

F2. How would you describe the environment in which you meet with your clients or patients?

 Office, clinic or hospital

 Clients’ or patients’ homes

 Other (specify) _____________________

F3. In an average week, approximately how many clients or patients do you see?

F4. Which of the following would you say is the closest description of the number of your clients or patients that are pregnant?

 Only a small portion of my clients or patients are pregnant women

 About half of my clients or patients are pregnant women

 The majority of my clients or patients are pregnant women

 All of my clients or patients are pregnant women

Thank you for your participation in this Survey. Please return the questionnaire in the envelope provided.

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