Parents & Children

Appendix I: Parent Survey

Child’s First Name: _____________

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Your child’s elementary school provides free fresh fruits and vegetables to students as snacks – separate from the school meal (breakfast or lunch). Think about this school year and please mark one answer for each question or statement below.
	Has your child attended this school since the beginning of the current school year (2009-2010)?	1 Yes	2 No
	Does your child receive free or reduced price meals at school?	1 Yes, receives FREE meals	2 Yes, receives REDUCED PRICE meals	2 No	3 Don’t know
	What does your child usually do for breakfast on school days?	1 Eats breakfast at home	2 Brings breakfast from home	3 Eats a school breakfast	4 Eats breakfast someplace else	5 Does not eat breakfast
	What does your child usually do for lunch on school days?	1 Eats lunch at home	2 Brings lunch from home	3 Eats a school lunch	4 Eats lunch someplace else	5 Does not eat lunch
	I would like more information from my child’s school about the free fresh fruit and vegetable snack program.	1 Agree Strongly	2 Agree Somewhat	3 Disagree Somewhat	4 Disagree Strongly	5 Don’t know
	My child eats the free fruit and vegetable snacks offered at school.	1 Agree Strongly	2 Agree Somewhat	3 Disagree Somewhat	4 Disagree Strongly	5 Don’t know
	My child says he or she likes to eat the free fresh fruit and vegetable snacks offered at school.	1 Agree Strongly	2 Agree Somewhat	3 Disagree Somewhat	4 Disagree Strongly	5 Don’t know
	My child says he or she eats more fruits and vegetables on days when they are offered as a free snack at school.	1 Agree Strongly	2 Agree Somewhat	3 Disagree Somewhat	4 Disagree Strongly	5 Don’t know
	I have noticed that my child eats fewer unhealthy foods on days when fresh fruits and vegetables are offered as a free snack at school.	1 Agree Strongly	2 Agree Somewhat	3 Disagree Somewhat	4 Disagree Strongly	5 Don’t know
	My child has asked for fruits and vegetables at home more often since the free fresh fruit and vegetable snacks began being offered at school.	1 Agree Strongly	2 Agree Somewhat	3 Disagree Somewhat	4 Disagree Strongly	5 Don’t know
	The fresh fruit and vegetable snacks at school should be offered more days during the week.	1 Agree Strongly	2 Agree Somewhat	3 Disagree Somewhat	4 Disagree Strongly	5 Don’t know
	The fresh fruit and vegetable snacks at school should be offered more times each day.	1 Agree Strongly	2 Agree Somewhat	3 Disagree Somewhat	4 Disagree Strongly	5 Don’t know
	My child complains about the quality of the free fresh fruit and vegetable snacks offered at school.	1 Agree Strongly	2 Agree Somewhat	3 Disagree Somewhat	4 Disagree Strongly	5 Don’t know
	My child gets tired of the same kinds of free fresh fruit and vegetable snacks that are offered at school.	1 Agree Strongly	2 Agree Somewhat	3 Disagree Somewhat	4 Disagree Strongly	5 Don’t know
	At least once a month I encourage my child to eat the free fresh fruit and vegetable snacks offered at school.	1 Agree Strongly	2 Agree Somewhat	3 Disagree Somewhat	4 Disagree Strongly	5 Don’t know
	Overall, my opinion of the free fresh fruit and vegetable snacks is favorable.	1 Agree Strongly	2 Agree Somewhat	3 Disagree Somewhat	4 Disagree Strongly	5 Don’t know
	I would like the free fresh fruit and vegetable snack program to continue to be offered at my child’s school.	1 Agree Strongly	2 Agree Somewhat	3 Disagree Somewhat	4 Disagree Strongly	5 Don’t know
	If I could change one thing about the free fruit and vegetable snack program it would be:	(Please write in) ____________________________________________________ _________________________________________________________________

Notes: 1) Questions 5-18 to be administered only in intervention schools.