Parents & Children

Appendix I: Parent Survey

For parents of students in non-FFVP schools an abbreviated version of this survey will be used that includes only questions 1, 2, 3, and 18. We have included a Spanish translation of this instrument which will be used as needed.

PARENT SURVEY – FFVP SCHOOL Child’s First Name: ____________________

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB number. The valid OMB control number for this information collection is 0584-xxxx. The time required to complete this information collection is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Food and Nutrition Service, Office of Research and Analysis, 3101 Park Center Drive, Alexandria, VA 22302.

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 (except for the last question where more than one answer can be given).
	My child likes to eat the free fresh fruit and vegetable snacks offered at school.	1 Rarely or never	2 Some of the time	3 Most of the time	4 All of the time	5 Don’t know or not applicable
	My child eats more fruits and vegetables since they have been offered as a free snack at school.	1 Rarely or never	2 Some of the time	3 Most of the time	4 All of the time	5 Don’t know or not applicable
	My child complains about the quality of the free fresh fruit and vegetable snacks offered at school.	1 Rarely or never	2 Some of the time	3 Most of the time	4 All of the time	5 Don’t know or not applicable
	My child gets tired of the same kinds of free fresh fruit and vegetable snacks that are offered at school.	1 Rarely or never	2 Some of the time	3 Most of the time	4 All of the time	5 Don’t know or not applicable
	My child eats fewer unhealthy foods on days when fresh fruits and vegetables are offered as a free snack at school.	1 Rarely or never	2 Some of the time	3 Most of the time	4 All of the time	5 Don’t know or not applicable
	My child has asked for fruits and vegetables at home more often since they have been offered as a free snack at school.	1 Rarely or never	2 Some of the time	3 Most of the time	4 All of the time	5 Don’t know or not applicable
	I encourage my child to eat the free fresh fruit and vegetable snacks offered at school.	1 Rarely or never	2 Some of the time	3 Most of the time	4 All of the time	5 Don’t know or not applicable

	I don’t like it when teachers take time from class to give out the free fresh fruit and vegetable snacks to children.	1 Agree Strongly	2 Agree Somewhat	3 Disagree Somewhat	4 Disagree Strongly	5 Don’t know or not applicable
	The fresh fruit and vegetable snacks at school should be offered more frequently.	1 Agree Strongly	2 Agree Somewhat	3 Disagree Somewhat	4 Disagree Strongly	5 Don’t know or not applicable
	Overall, I think the free fresh fruit and vegetable snack program is good.	1 Agree Strongly	2 Agree Somewhat	3 Disagree Somewhat	4 Disagree Strongly	5 Don’t know or not applicable
	If I could change one thing about the free fruit and vegetable snack program it would be:	(Please write in)

	Has your child attended this school since the beginning of the current school year (2010-2011)?	1 Yes	2 No
	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
	Does your child receive free or reduced price meals at school?	1 Yes, receives FREE meals	2 Yes, receives REDUCED PRICE meals	3 No	4 Don’t know
	Is your child Hispanic or Latino?	1 Yes	2 No
	How would you describe your child? Please mark all that apply.	1 American Indian or Alaska Native	2 Asian	3 Black or African American	4 Native Hawaiian or Other Pacific Islander	5 White

THANK YOU FOR COMPLETING THIS SURVEY!