OMB
Approval No. 0584-0580 Approval
Expires: 05/31/2016
APPENDIX P.1
WIC ITFPS-2 Participant Interview
13 Month - ENGLISH
SOCIODEMOGRAPHICS AND BACKGROUND
Respondent still Caregiver?
1, 3, 5, 7, 9, 11, 13, 15, 18, 24
SD12. (1 mo.: Before we go any further/ All other: Before we begin today), I need to ask whether you are still {CHILD's} caregiver. [Source: New Development]
Yes 01
No 02
(If no, go to a)
a. Does {CHILD} still live with you?
Yes 01
No 02
b. (If a is Yes): Can you please tell me who in your household is now {CHILD's} caregiver? Can I speak with that person?
Name of New Caregiver______________________________________________
c. (If a is No): Can you please tell me who is caring for {CHILD} now, and how I could reach that person?
Name of New Caregiver______________________________________________
Phone of New Caregiver______________________________________________
Address of New Caregiver____________________________________________
Relation of New Caregiver to Child_____________________________________
OK, I’m going to start by asking you some questions about yourself and your household.
Marital status
Baseline, 13
SD14. Are you married, separated, divorced, widowed, or never married? [Source: WIC IFPS-1]
Married 01
Separated 02
Divorced 03
Widowed 04
Never Married 05
Don’t know 98
Refused 99
Currently pregnant/due date
7, 13, 18
SD16. Are you currently pregnant? [Source: New Development]
Yes 01
No 02
Don’t know 98
Refused 99
SD17. (If yes) When is your baby due? [Source: FDA IFPS-2]
Month [January – Dec.]
Day [1-31]
{Year – autofill for next occurrence of the month}
Household size
Enrollment, 7, 13, 24
SD18. How many people live in your household? By household I mean people who live together and share living expenses. Please include yourself in this count, and (If PN enrollment: please add 1 to the total for your pregnancy, too/If postnatal enrollment or 7, 13, or 24 months: If you are pregnant right now please add 1 to the total for your pregnancy. [Source: FITS 2002, modified]
Number of people in household [number]
Household income
Enrollment, 7, 13, 24
SD19. During [PREVIOUS MONTH], what was your household income before taxes? Please include any income in the past month from you, your family members who live with you, and any other people who live with you and share living expenses with you [Source: WIC IFPS-1, modified]
$500 or less 01
$501-$1000 02
$1001-$1500 03
$1501-$2000 04
$2001-$2500 05
$2501-$3000 06
$3001-$3500 07
$3501-$4000 08
$4001-$4500 09
$4501-$5000 10
$5001+ 11
Don’t know 98
Refused 99
Presence of infant's father
Baseline, 13
SD20. [PN: Is the father of your unborn child/1, 3, 13: Is {CHILD’s} father] living in your household? [Source: WIC IFPS-1, modified]
Yes 01
No 02
Don’t know 98
Refused 99
Receipt of public assistance
Baseline, 13
SD21. Are you or your family currently receiving any of the following: [Source: WIC IFPS-1; modified]
a. Supplemental nutrition assistance benefits, sometimes called SNAP or Food Stamps?
Yes 01
No 02
Don’t know 98
b. Temporary assistance to needy families, sometimes called TANF or welfare?
Yes 01
No 02
Don’t know 98
c. Are you receiving Medicaid or [state specific name for medicaid]?
Yes 01
No 02
Don’t know 98
d. Are any children in your household receiving free or reduced price meals from the National School Lunch or School Breakfast Program, or the Summer Foods Program?
Yes 01
No 02
Don’t know 98
6-Item Food Security
Enrollment, 24 bonus module
These next questions are about the food eaten in your household in the last 12 months, since (current month) of last year and whether you were able to afford the food you need.
SD36. I’m going to read you several statements that people have made about their food situation. For these statements, please tell me whether the statement was often true, sometimes true, or never true for your household in the last 12 months—that is, since last (name of current month). [Source: USDA food security 6-item]
The first statement is, “The food that (I/we) bought just didn’t last, and (I/we) didn’t have money to get more.” Was that often, sometimes, or never true for your household in the last 12 months?
Often true 01
Sometimes true 02
Never true 03
Don’t know 98
Refused 99
SD37. “We couldn’t afford to eat balanced meals.” Was that often, sometimes, or never true for your household in the last 12 months?
Often true 01
Sometimes true 02
Never true 03
Don’t know 98
Refused 99
SD38. In the last 12 months, since last (name of current month), did you or other adults in your household ever cut the size of your meals or skip meals because there wasn't enough money for food?
Yes 01
No 02 (skip SD38a)
Don’t Know 98 (skip SD38a)
a. [if yes to SD38, ask] How often did this happen—almost every month, some months but not every month, or in only 1 or 2 months?
Almost every month 01
Some months but not every month 02
Only 1 or 2 months 03
Don’t know 98
SD39. In the last 12 months, did you ever eat less than you felt you should because there wasn't enough money for food?
Yes 01
No 02
Don’t Know 98
SD40. In the last 12 months, were you ever hungry but didn't eat because there wasn't enough money for food?
Yes 01
No 02
Don’t Know 98
Next I’d like to ask you some questions about WIC
Continuation/discontinuation of WIC participation (timing, reasons, location)
1, 3, 5, 7, 9, 11, 13, 15, 18, 24
SD31. Are you currently getting WIC food or checks for yourself or {CHILD}? [Source: FDA IFPS-2; modified]
Yes 01
No 02
(if no for the first time go to SD34, if no previously go to next applicable module)
SD32. The last time we talked with you, you were going to WIC at [fill in location]. Do you still go there, or do you go to a new location? [Source: FDA IFPS-2 modified]
Yes, still that location 01
No, new location 02
SD33. (If SD32 is no) Please tell me where you go now
Record location _______________________________________
Ask SD34 and SD35 only if SD31 is 'no'
SD34. How old was {CHILD} when you stopped going to WIC? [Source: LA WIC Survey; modified]
Age [weeks/months]
SD35. I'm going to read some reasons why you might have stopped going to WIC. Please tell me if each one is a reason you stopped going to WIC: [Source: LA WIC Survey; modified]
You no longer qualify for WIC 01
It was inconvenient for you 02
You no longer need WIC 03
Other reason (record response) 04
WIC PROGRAM AWARENESS, SATISFACTION, UTILIZATION
Perceptions of Impact of Nutrition Education
3, 13, 24
Administer WC20 only if respondent indicated in SD31 that they are still on WIC. If not on WIC, skip to WC21.
WC20. Your WIC benefits include both education and food. Which is more important to you—the food you get from WIC, the education you get from WIC, or are they equally important? [Source: New Development]
Food is more important 01
Education is more important 02
They are equally important 03
Don’t know 98
Refused 99
If no longer on WIC, say: I’d like to ask you about how you used WIC education.
WC21. Have you changed how you feed yourself or your family because of something you learned at WIC? [Source: New Development]
Yes 01
No 02
Don’t Know 98
WC22. (If YES to WC21) What is the most important change you have made based on education you received from WIC? (Open-ended; Interviewer record response) [Source: New Development]
I/we eat more fruits and vegetables 01
I/we eat more whole grains 02
I/we drink more reduced fat/low-fat/non-fat milk 03
I am breastfeeding/breastfed 04
I know how to prepare formula/feed the right amount of formula 05
We have more family meals/eat together 06
We don’t watch TV when eating meals 07
We drink/buy fewer sugar sweetened beverages 08
I/we offer the right amount of foods (portion) 09
I know how to choose more healthy foods for myself/my family 10
Other (specify____________________________________) 11
Don’t know 98
Refused 99
CURRENT FEEDING PRACTICES
AMPM Module (Asking child’s food intake in past 24 hours)
24-HR Recall for Food Intake
1, 3, 5, 7, 9, 11, 13, 15, 18, 24
Nutrition intake
Number of breastmilk/formula feedings per day
Type of formula used
Adherence to formula dilution instructions
Use/timing of supplemental formula for breastfeeding mothers
Addition of anything other than human milk/formula to child’s bottle
Specific food item intake
Use of jarred baby foods
Meal and snack pattern
Eating locations (eating on the go)
Use of dietary supplements for infants (direct administration)
Current feeding choice
1, 3, 5, 7, 9, 11, 13
CF1. Are you currently feeding {CHILD} breastmilk either from your breast or from a bottle, formula, (1-5 months: or both) (7-13 months: both, or neither)? [Source: New Development]
Only breastmilk 01
Only formula 02
Both breastmilk and formula 03
Neither breastmilk nor formula 04
IF CF1 = 02, SKIP TO CF19
IF CF1 = 04, AND CF30 NOT ADMINISTERED AT A PREVIOUS INTERVIEW, GO TO CF30.
IF CF1 = 04, AND CF30 ADMINISTERED AT A PREVIOUS INTERVIEW, GO TO CF34.
Breastfeeding Module (Asked only if mother currently feeding breastmilk, based on CF1)
Questions CF6 – CF18
You said that you are currently feeding {CHILD} breastmilk. I’d like to ask you some questions about that now.
Use of breast pump
1, 3, 5, 7, 9, 11, 13
CF6. Some mothers are able to pump breastmilk and others are not. Are you currently pumping breastmilk?
Interviewer: code yes if mother is pumping at all, even if infrequently.
Yes 01
No 02
Refused 99
If CF6 is NO, skip to CF18
Time of day of pumping
1, 3, 5, 7, 9, 11, 13
Ask only if currently pumping breastmilk in CF6
CF12. Now I’d like to ask you about the times of day when you usually pump. [Source: New Development]
a. When you pump, how often do you pump in the morning, before noon? Would you say usually, sometimes, or never?
Usually 01
Sometimes 02
Never 03
Don’t know 98
Refused 99
b. When you pump, how often do you pump mid-day, from noon to 5pm? Would you say usually, sometimes, or never?
Usually 01
Sometimes 02
Never 03
Don’t know 98
Refused 99
c. When you pump, how often to you pump in the evening or night time, after 5pm? Would you say usually, sometimes, or never?
Usually 01
Sometimes 02
Never 03
Don’t know 98
Refused 99
Frequency of pumping
1, 3, 5, 7, 9, 11, 13
Ask only if currently pumping breastmilk in CF6
CF11. Thinking about the past two weeks, how many times did you pump milk? (Interviewer allow open-ended, calculate numbers for response if needed, and confirm with respondent)[Source: FDA IFPS-2, modified]
Times pumped [times]
Storage practices for pumped/expressed human milk
1, 3, 5, 7, 9, 11, 13
Ask only if currently pumping breastmilk in CF6
CF16. In the last month, how long was your pumped milk usually stored in the refrigerator? [Source: FDA IFPS-2, modified]
I do not store milk in a refrigerator 01
1 day or less 02
2 to 3 days 03
4 to 5 days 04
6 to 8 days 05
More than 8 days 06
CF17. How long is your frozen milk usually stored? [Source: FDA IFPS-2]
Only include 4 months or more after the 5 month interview
I do not freeze my milk 01
Less than 1 week 02
1 to 4 weeks 03
1 to 3 months 04
4 months or more 05
How is breastmilk feeding schedule determined (time schedule, child seems hungry, mixed)
1, 3, 5, 7, 9, 11, 13
CF18. Do you breastfeed or feed {CHILD} breastmilk from a bottle on a regular schedule, or when [HE/SHE] cries or seems hungry? [Source: IFPS-1, modified]
Schedule 01
Cries or seems hungry 02
Both on a schedule and when baby cries or seems hungry 03
IF CF1 = 01 SKIP TO CF52
Formula Feeding Module (Asked only if mother currently formula feeding)
Questions CF19 – CF27
You said that you are currently feeding {CHILD} formula. I’d like to ask you some questions about that.
Who provided formula
1, 3, 5, 7, 9, 11, 13
CF19. Where do you get the formula that you use to feed {CHILD}? Do you get it from WIC, from somewhere else, or both WIC and somewhere else? [Source: New Development]
WIC 01
Somewhere else 02
Both WIC and somewhere else 03
CF20. (If indicated in CF19 getting formula from WIC) Is the amount of formula that you get from WIC to help feed {CHILD} more than you usually need, less than you usually need, or about right? [Source: PHFE WIC Survey 2010, modified]
More 01
Less 02
About right 03
Don’t know 98
Refused 99
Reasons for formula use
1, 3, 5, 7, 9, 11, 13 (ask for the last time at the interview where mom indicates she has completely stopped breastfeeding)
CF21. There are many reasons for using formula. Please tell me if any of the following are reasons why you feed your baby formula? [Source: FDA IFPS-2, modified]
If not currently breastfeeding at all (CF1) and never tried to breastfeed (HF10, CF29), skip to h.
Ask (a) only in months 1, 3, 5
a. My baby had trouble sucking or latching on to the breast
Yes 01
No 02
b. My baby lost interest in nursing or began to stop nursing by him or herself
Yes 01
No 02
c. Breastmilk alone did not satisfy my baby
Yes 01
No 02
d. I thought that my baby was not gaining enough weight
Yes 01
No 02
e. I didn’t have enough breastmilk
Yes 01
No 02
f. Breastfeeding was too painful
Yes 01
No 02
g. I wanted my baby to have both formula and breastmilk.
Yes 01
No 02
Ask h-n if mother is either exclusively formula feeding or feeding both breastmilk and formula
h. I chose not to breastfeed
Yes 01
No 02
i. My baby was sick and could not breastfeed
Yes 01
No 02
j. I was sick or had to take medicine
Yes 01
No 02
k. Breastfeeding seemed too inconvenient
Yes 01
No 02
l. I could not or did not want to pump
Yes 01
No 02
m. I wanted or needed someone else to feed my baby
Yes 01
No 02
n. For another reason
Yes (specify______________________________________) 01
No 02
If not adhering to formula dilution instructions, why? Prescribed by Dr., nutritionist?
1, 3, 5, 7, 9, 11, 13
CF22. In the past month, did you ever mix the formula with extra water to make it last longer? [Source: IFPS-1]
Yes 01
No 02
If CF22 = NO, skip to CF24.
CF23. (If yes to CF22) Who told you to prepare the formula this way? [Source: New Development]
Doctor 01
Someone who works at the WIC office or clinic 02
Another health care provider 03
Friend 04
Family member 05
Other 06
No one told me 07
CF24. In the past month, did you ever mix the formula with less water than directed in order to concentrate it or make it stronger? [Source: IFPS-1, modified]
Yes 01
No 02
Not applicable – use ready-to-feed 03
If CF24 = NO, skip to CF27.
CF25. (If yes to CF24) Who told you to prepare the formula this way? [Source: New Development]
Doctor 01
Someone who works at the WIC office or clinic 02
Another health care provider 03
Friend 04
Family member 05
Other 06
No one told me 07
How is formula feeding schedule determined (set, on demand, mixed)
1, 3, 5, 7, 9, 11, 13
CF27. Do you feed {CHILD} formula on a regular schedule or when [HE/SHE] cries or seems hungry? [Source: IFPS-1]
Schedule 01
Cries or seems hungry 02
Both on a schedule and when baby cries or seems hungry 03
Move to Partial Breastfeeding
Timing of move to partial breastfeeding
(any time 1-13)
Ask of all women who indicated fully BF in CF1. Once answered affirmatively, drop from subsequent interviews.
CF52. Has {CHILD} ever been fed infant formula, even just one time? Do not count while you were in the hospital after {CHILD’s} birth.
Yes 01 (go to CF53)
No 02 (go to CF32)
Don’t know 03
Refused 04
Ask of fully BF women who answered yes to CF52, partially BF women (based on CF1), and fully formula feeding women (based in CF1) who indicated that they ever breastfed in CF29 or HF10. Ask once, first time formula feeding indicated in CF1 or CF52, then drop from subsequent interviews.
CF53. How old was {CHILD} the first time [HE/SHE] was fed infant formula? Do not count while you were in the hospital after {CHILD’S} birth.
Age [days/weeks/months]
Don’t know 98
Refused 99
Asked of all partially BF women and all fully formula feeding women who ever breastfed based on CF29 or HF10. Ask until an age, don’t know, or refused is given in response, then drop from subsequent interviews.
CF28. How old was {CHILD} when [HE/SHE] was first fed formula every day? [Source: FITS 2002, modified]
Age [days/weeks/months]
Child is not fed formula every day 97
Don’t Know 98
Refused 99
Breastfeeding Cessation Module: (asked once first time mother indicates not currently feeding breastmilk in CF1)
Questions CF30 – CF31
Timing of cessation of breastfeeding
(any time 1-13)
Ask at first interview when mother says she is not feeding breastmilk, if she indicated breastfeeding on previous interviews or if she answered ‘yes’ to ever breastfed or tried to breastfeed
CF30. How old was {CHILD} when you completely stopped breastfeeding or feeding [HIM/HER] breastmilk from a bottle? [Source: IFPS-1, modified]
Age [days/weeks/months]
Reasons for cessation of breastfeeding
(any time 1-13)
CF31. There are many reasons mothers stop breastfeeding. Please tell me if any of the following reasons helped you to decide to stop breastfeeding {CHILD}? [Source: FDA IFPS-2, modified]
Do not ask (a) if interview is 5 months or later
a. My baby had trouble sucking or latching on
Yes 01
No 02
b. My baby began to bite
Yes 01
No 02
c. My baby lost interest in nursing or began to stop nursing by him or herself
Yes 01
No 02
d. Breastmilk alone did not satisfy my baby
Yes 01
No 02
e. I thought that my baby was not gaining enough weight
Yes 01
No 02
f. I didn’t have enough milk
Yes 01
No 02
g. Breastfeeding was too painful
Yes 01
No 02
h. I was sick or had to take medicine
Yes 01
No 02
i. Breastfeeding was too inconvenient
Yes 01
No 02
j. I wanted or needed someone else to feed my baby
Yes 01
No 02
k. I did not want to breastfeed in public
Yes 01
No 02
l. Another reason (specify ________________________________)
Yes 01
No 02
Time to cessation of bottle feeding
7, 9, 11, 13, 15, 18, 24 (ask until affirmative, then stop asking)
CF34. Is {CHILD} still drinking anything from a bottle? [Source: New Development]
Yes 01
No 02
CF35. (If no, ask:) How old was {CHILD} when he/she stopped using a bottle? [Source: New Development]
Age [weeks/months/years]
Supplemental Foods Initiation (asked all interviews 1-24 until all endorsed)
Fed other than breastmilk or formula
1, 3, 5, 7, 9, 11, 13, 15, 18, 24
Ask CF32 at every interview until mother answers yes, then drop from later interviews and go straight to CF33.
CF32. Has {CHILD} been given anything to eat or drink besides formula or breastmilk? [Source: WIC IFPS-1, modified]
Yes 01
No 02
Time to introduction of supplemental foods
1, 3, 5, 7, 9, 11, 13, 15, 18, 24
Only ask CF33 if CF32 = YES now or at a previous interview
Next I’m going to ask you some questions about when you first started feeding {CHILD} different types of foods.
Ask each food until answer is affirmative, then stop asking that food in subsequent interviews
CF33. For each of the following, please tell me if {CHILD} has been given this food or drink, and if so, how old {CHILD} was when he/she first had that food. [Sources: FITS 2008; IFPS-1; WHO Toolkit 1996]
a. Has [HE/SHE] been given plain bottled or tap water?
Yes 01
No 02
b. (If yes) How old was {CHILD} when [HE/SHE] was first fed plain bottled or tap water?
Age [weeks/months]
Don’t know 98
Refused 99
c. Has [HE/SHE] been given soda or soft drinks?
Yes 01
No 02
d. (If yes) How old was {CHILD} when [HE/SHE] was first fed soda or soft drinks?
Age [weeks/months]
Don’t know 98
Refused 99
e. Has [HE/SHE] been given other sweetened beverages (such as Kool Aid, Hi-C, Fruit Punch, sweetened juice, sweetened or flavored water, Gatorade, or sweet tea)?
Yes 01
No 02
f. (If yes) How old was {CHILD} when [HE/SHE] was first fed other sweetened beverages?
Age [weeks/months]
Don’t know 98
Refused 99
g. Has [HE/SHE] been given 100% fruit juice such as apple juice, orange juice, or other types of 100% juice. Do not include fruit-flavored drinks with added sugar or fruit juice you made at home and added sugar to?
Yes 01
No 02
h. (If yes) How old was {CHILD} when [HE/SHE] was first fed 100% fruit juice?
Age [weeks/months]
Don’t know 98
Refused 99
i. Has [HE/SHE] been given other drinks and liquids, including teas and broths?
Yes 01
No 02
j. (If yes) How old was {CHILD} when [HE/SHE] was first fed Other drinks and liquids, including teas and broths?
Age [weeks/months]
Don’t know 98
Refused 99
k. Has [HE/SHE] been given Cow’s milk, including whole milk, 2%, 1%, or skim? Please include milk you add to other foods such as cereal.
Yes 01
No 02
l. (If yes) How old was {CHILD} when [HE/SHE] was first fed cow’s milk?
Age [weeks/months]
Don’t know 98
Refused 99
m. Has [HE/SHE] been given dairy products other than cow’s milk including cheese, yogurt, or goat’s milk? Please include any dairy products other than cow’s milk that you add to other foods.
Yes 01
No 02
n. (If yes) How old was {CHILD} when [HE/SHE] was first fed dairy products other than cow’s milk?
Age [weeks/months]
Don’t know 98
Refused 99
o. Has [HE/SHE] been given baby cereal, either with a spoon or by adding it to a bottle of breastmilk or formula?
Yes 01
No 02
p. (If yes) How old was {CHILD} when [HE/SHE] was first fed baby cereal?
Age [weeks/months]
Don’t know 98
Refused 99
q. Has [HE/SHE] been given other cereal besides baby cereal?
Yes 01
No 02
r. (If yes) How old was {CHILD} when [HE/SHE] was first fed other cereal besides baby cereal?
Age [weeks/months]
Don’t know 98
Refused 99
s. Has [HE/SHE] been given eggs?
Yes 01
No 02
t. (If yes) How old was {CHILD} when [HE/SHE] was first fed eggs?
Age [weeks/months]
Don’t know 98
Refused 99
u. Has [HE/SHE] been given fruit, including baby food or regular fruit?
Yes 01
No 02
v. (If yes) How old was {CHILD} when [HE/SHE] was first fed fruit?
Age [weeks/months]
Don’t know 98
Refused 99
w. Has [HE/SHE] been given vegetables, including baby food or regular vegetables?
Yes 01
No 02
x. (If yes) How old was {CHILD} when [HE/SHE] was first fed vegetables?
Age [weeks/months]
Don’t know 98
Refused 99
y. Has [HE/SHE] been given beans, such as black beans, pinto beans, or chick peas?
Yes 01
No 02
z. (If yes) How old was {CHILD} when [HE/SHE] was first fed beans?
Age [weeks/months]
Don’t know 98
Refused 99
aa. Has [HE/SHE] been given peanut butter
Yes 01
No 02
bb. (If yes) How old was {CHILD} when [HE/SHE] was first fed peanut butter?
Age [weeks/months]
Don’t know 98
Refused 99
cc. Has [HE/SHE] been given meats,, chicken, or fish, including baby food and baby food combination dinners containing these foods?
Yes 01
No 02
dd. (If yes) How old was {CHILD} when [HE/SHE] was first fed meat, chicken, or fish?
Age [weeks/months]
Don’t know 98
Refused 99
ee. Has [HE/SHE] been given salty snacks, such as chips, pretzels, crackers, or other snack foods including baby snacks?
Yes 01
No 02
ff. (If yes) How old was {CHILD} when [HE/SHE] was first fed salty snacks?
Age [weeks/months]
Don’t know 98
Refused 99
gg. Has [HE/SHE] been given sweets, such as cake, cookies, candy, or jam
Yes 01
No 02
hh. (If yes) How old was {CHILD} when [HE/SHE] was first fed sweets?
Age [weeks/months]
Don’t know 98
Refused 99
Next I’m going to ask you some questions about the types of food you buy or make for {CHILD}, how you prepare those foods and feed them to {CHILD}, and what foods you get through WIC.
Source of baby food (homemade or purchased; if purchased, was it all with WIC vouchers or some purchased without WIC vouchers)
7, 9, 11, 13
CF37. For each food category I read to you, please tell me about how much of the food fed to your baby over the past 7 days was store-bought baby food in a jar or container. Baby foods in a jar or container are those sold especially for babies. Foods that are not baby foods in a jar or container include fresh fruit, fruit juices other than those especially sold for babies, foods you prepare especially for the baby, and table food. [Source: FDA IFPS-2, modified]
a. Fruit and vegetable juice
All store-bought baby food 01
Mostly store-bought baby food 02
Some store-bought baby food 03
No store-bought baby food 04
Not fed this food in past 7 days 05
b. Fruit
All store-bought baby food 01
Mostly store-bought baby food 02
Some store-bought baby food 03
No store-bought baby food 04
Not fed this food in past 7 days 05
c. Vegetables
All store-bought baby food 01
Mostly store-bought baby food 02
Some store-bought baby food 03
No store-bought baby food 04
Not fed this food in past 7 days 05
d. Meat, such as beef and chicken
All store-bought baby food 01
Mostly store-bought baby food 02
Some store-bought baby food 03
No store-bought baby food 04
Not fed this food in past 7 days 05
d. Combination dinners
All store-bought baby food 01
Mostly store-bought baby food 02
Some store-bought baby food 03
No store-bought baby food 04
Not fed this food in past 7 days 05
CF38. [If all, mostly or some store-bought baby food indicated above, then ask:] Was all of the store-bought baby food in jars or containers bought with WIC checks, only some with WIC checks, or none with WIC checks? [Source: New Development]
All with WIC checks 01
Some with WIC checks 02
None with WIC checks 03
Don’t know 98
Refused 99
Methods and frequency of methods used to prepare child foods
7, 9, 11, 13
CF39. [If mostly, some, or no store-bought baby food fed in past 7 days from above, ask:] I’m going to read you some ways people prepare homemade food for babies. For each one, please tell me if you do this to make food for {CHILD}. [Source: New Development]
a. Puree, such as in a blender or food processor
Yes 01
No 02
b. Mash, such as with a fork or spoon
Yes 01
No 02
c. Chop or dice
Yes 01
No 02
d. Chew foods yourself before giving to [HIM/HER]
Yes 01
No 02
e. Is there any other way you make food for {CHILD}?
Yes (specify _____________________________) 01
No 02
Method of feeding child (spoon, infant feeder, bottle/modified bottle, etc.)
*3, 5, 7, 9, 11, 13, 15
*only ask if indicated that child is eating solid foods (something other than formula or BM)
CF40. In the past 7 days, have you given {CHILD} any foods with a spoon? [Source: IFPS-1, modified]
Yes 01
No 02
CF41. In the past 7 days, have you given {CHILD} any foods with an infant feeder or with a bottle that has an extra large nipple hole? [Source: IFPS-1, modified]
Yes 01
No 02
Infant/child food package – does child eat foods from WIC food package?
7, 13, 15, 18, 24
For 13, 15, 18, 24 mo:
CF43. Which of the following WIC foods does {CHILD} eat? Does [HE/SHE] eat: [Source: FITS 2008, modified]
a. Breakfast cereal, either hot or cold from WIC
Yes 01
No 02
Don’t Know 98
b. Cheese from WIC
Yes 01
No 02
Don’t Know 98
c. Eggs from WIC
Yes 01
No 02
Don’t Know 98
d Does {CHILD} eat fruits from WIC
Yes 01
No 02
Don’t Know 98
e. 100% juice from WIC
Yes 01
No 02
Don’t Know 98
f. Milk from WIC, including cow’s milk, soy milk, or other milk
Yes 01
No 02
Don’t Know 98
g. Peanut butter from WIC
Yes 01
No 02
Don’t Know 98
h. Does {CHILD} eat vegetables from WIC
Yes 01
No 02
Don’t Know 98
i. Whole grain bread or other whole grains, such as brown rice, bulgur, barley, or tortillas from WIC
Yes 01
No 02
Don’t Know 98
j. Does {CHILD} eat other food from WIC (specify ________________________________________)
Yes 01
No 02
Don’t Know 98
Child use of cup (with/without assistance), spoon, sippy cup
9, 13, 18
CF44. During the past 7 days, did {CHILD} ever drink from a cup that was held by someone else? [Source: WIC IFPS-1]
Yes 01
No 02
Don’t know 98
Refused 99
CF45. Does {CHILD} feed [HIM/HERSELF] with a spoon without spilling much? [Source: FITS 2002]
Yes 01
No 02
Don’t know 98
Refused 99
CF46. Does {CHILD} drink from a sippy cup without help? (IF ASKED: a sippy cup is a cup with a plastic cover that has a spout) [Source: FITS 2002]
Yes 01
No 02
Don’t know 98
Refused 99
CF47. Does [HE/SHE] drink from a regular cup without help—that is a cup without a lid? [Source: FITS 2002]
Yes 01
No 02
Don’t know 98
Refused 99
Self-feeding during mealtimes
9, 11, 13 – discontinue after answer is affirmative
CF48. Does {CHILD} feed [HIM/HERSELF] any foods? That is, does {CHILD} pick up these foods and put them in [his/her] mouth without any help? [Source: IFPS-1, modified]
Yes 01
No 02
Don’t know 98
Refused 99
MATERNAL HEALTH AND LIFESTYLE
Now I’d like to change topics and ask you some questions about your health, and about work, school, and child care.
Maternal weight
1, 3, 13, 24
MH13. Right now, about how much do you weigh, without shoes? [Source: PHFE WIC Postpartum Questionnaire 2010]
Pounds [number]
Educational status
3, 7, 13, 18, 24
SD27. As of today, are you in school or college? [Source: WIC IFPS-1]
Yes 01
No 02
Current employment status
3, 7, 13, 18, 24
SD29. Are you currently working for pay full time, part time, or not at all? [Source: LA WIC Survey]
Full time (35 hours or more) 01
Part time 02
Not at all 03
Ask SD30 first time answer to SD 27 or SD29 is ‘yes’ then discontinue
SD30. How old was {CHILD} when you started going to school or working? [Source: New Development]
Age [weeks, months]
Ever used regular non-maternal child care?
3, 7, 13, 24 (once answered affirmative, stop asking for subsequent interviews)
The next few questions are about childcare. By childcare, we mean any kind of arrangement where someone other than you or {CHILD’S} other parent takes care of {CHILD} on a regular basis, while you go to work or school.
Please include care provided by a relative or non-relative, either in your home or someone else’s home, as well as in a childcare center or family daycare home. Do not include care provided by you or {CHILD’S} other parent. [Source: PHFE WIC Survey 2010 modified]
MH18. Have you ever used a regular childcare arrangement for {CHILD}?
Yes 01
No 02
When did child first start non-maternal child care?
3, 7, 13, 24 (asked only if ever used is yes, then stop asking once answered)
MH19. At what age did {CHILD} first start a regular childcare arrangement? [Source: New Development]
Age [months]
Current use of non-maternal child care (and what kind)
3, 7, 13, 24
MH20. Which type of regular childcare arrangement are you currently using the most for {CHILD}? [Source: PHFE WIC Survey 2011, modified]
A child care center 01
A family daycare home 02
Early Head Start 03
Someone cares for {CHILD} in their home 04
Someone cares for {CHILD} in your home 05
Some other kind of childcare 06
Not currently using childcare 07
Contact info for child care (for CACFP status)
3, 7, 13, 24
MH21. (If center or family daycare from MH20) Can we get the official name and address of the childcare? We won’t contact them without your permission, we just need it to for our records. [Source: New Development]
Name ___________________________________________________
Address _________________________________________________
Who provides food to child care location (provided by mother, or by facility)
3, 7, 13, 24
Ask only if indicated current child care use in MH20
MH23. Who provides most of the food {CHILD} eats at childcare – the child care provider, you, or is the food divided about equally between you and the childcare provider? [Source: PHFE WIC Survey 2011]
Child care provider 01
Parent 02
Equally divided 03
If child care provides food, program timing for transition to supplemental foods
7, 13
Ask only if MH23 indicates child care provides food
13 mo:
MH25. (If the child care provider supplies food) At what age does the child care provider start giving table foods? [Source: New Development]
Age [weeks/months]
MH26. (If the child care provider supplies food) At what age does the child care provider start giving cow’s milk? [Source: New Development]
Age [weeks/months]
EXPERIENCE, KNOWLEDGE, ADVICE, BELIEFS
Next I’m going to ask you some questions about your beliefs about feeding babies and toddlers.
Maternal knowledge, attitudes, and beliefs about nutrition (religious or ethical/lifestyle such as Kashrut, Halal, Vegetarian/Vegan
13
KA9. Do you have any religious or lifestyle beliefs, such as Halal, keeping Kosher or being Vegetarian orVegan, that influence how you feed {CHILD}? [Source: New Development]
Yes 01
No 02
Don’t Know 98
KA10. (If yes) What are those beliefs? [Source: New Development]
Halal 01
Kosher 02
Vegetarian 03
Vegan 04
Other (specify ____________________) 05
Caregiver understanding of infant nonverbal satiety cues and crying; toddler satiety cues.
3, 13, 24
13 and 24 months:
KA27. I’m going to read you some statements about when {CHILD} is hungry or full. Please tell me how much you agree or disagree with these statements. [Source: First Steps Survey, modified]
a. My child knows when he or she is full. Would you say that you [Interviewer read options]:
Strongly agree 01
Agree 02
Neither agree nor disagree 03
Disagree 04
Strongly disagree 05
b. I let my child decide how much to eat. Would you say that you [Interviewer read options]:
Strongly agree 01
Agree 02
Neither agree nor disagree 03
Disagree 04
Strongly disagree 05
Perceptions of infant/toddler size and role in feeding decisions
3, 13, 24
At 3, 13, 24:
KA29. Does your child’s weight influence your decisions about how and what to feed {HIM/HER]? [Source: New Development]
Yes 01
No 02
Don’t know 98
CHILD HEALTH, BEHAVIOR, AND CHILD REARING
Finally, I’m going to ask you some questions about your child’s health and behavior.
Health status/conditions
Actions to rectify health conditions
1, 3, 5, 7, 9, 11, 13, 15, 18, 24
CH2. Has the doctor told you that {CHILD} has any long-term medical problems or conditions that may affect what or how [HE/SHE] eats? [Source: FITS 2008, modified]
(Interviewer, if necessary add) These medical problems or conditions may be things like food allergies, diabetes, metabolic disorders such as PKU or galactosemia, gastrointestinal problems such as gastric reflux, other problems like cleft palate or other mouth or facial conditions – any long-term problems that affect the baby’s ability to eat and swallow.
Yes 01
No 02
Don’t Know 98
(If yes) What medical problem or condition does {CHILD} have?
Specify ______________________________________________
CH3. (If yes to health status/conditions in CH2): What are you currently doing to treat this medical problem? [Source: New Development] (Open-ended, Interviewer check all that apply)
Taking her/him to the doctor for treatment 01
Treating him/her at home with medicine 02
Treating him/her at home with something other than
medicine (such as herbal remedies, special teas, or other
forms of treatment) 03
Changing his/her diet 04
Other 04
Don’t Know 98
Refused 99
Child physical activity indoors
5, 13, 15, 24
At 13, 15, 24 only:
CH6. I am going to read you a list of activities you or someone in your home may have done with {CHILD} in the past week. How often did you or someone in your home do: [Source: MacDonald & Parke, 1986, modified]
a. Wrestling. This is when someone gently and playfully pushes the child around on the ground or a bed, and the child playfully pushes back. In the past week, how often did you or someone in your home wrestle with {CHILD}?
Every day 01
Several times a week 02
Once a week 03
Not at all 04
Don’t Know 98
Refused 99
b. Tumbling. This is when a child rolls around, does somersaults, or climbs over things. In the past week, how often did you or someone in your home play tumbling with {CHILD}?
Every day 01
Several times a week 02
Once a week 03
Not at all 04
Don’t Know 98
Refused 99
c. Playing chase. This is when someone playfully runs or crawls after a child. In the past week, how often did you or someone in your home play chase with {CHILD}?
Every day 01
Several times a week 02
Once a week 03
Not at all 04
Don’t Know 98
Refused 99
d. Playing ball. This includes placing a ball in front of a child so he has to go after it by crawling, walking, or grabbing. In the past week, how often have you or someone in your home played ball with {CHILD}?
Every day 01
Several times a week 02
Once a week 03
Not at all 04
Don’t Know 98
Refused 99
PARTICIPANT CONTACT INFORMATION UPDATE
Thank you for taking the time to speak with me today. Because we’ll be calling you again for your next interview (EN: in a couple of weeks / all other times: when your child is {AGE – next interview}), I’d like to be sure we have all the right ways to contact you.
CM1. Is your full name still {NAME}?
Yes 01
No 02
(If no, go to a)
a. Can you please tell me what your full legal name is now?
_____________________________________________
Ask only if still on WIC:
CM2. {If have WIC ID on file: We have your WIC ID as {FILL}, is that correct?/If don’t have WIC ID on file: Do you know what your current WIC ID is?}
WIC ID is the same (fill below) 01
New WIC ID (specify below) 02
Don’t know WIC ID 98
Refused WIC ID 99
WIC ID___________________________________
CM3. I reached you today at {FILL #}. Will that still be the best number to call you at for your next interview?
Yes (if yes, go to b) 01
No (if no, go to a) 02
a. What is the best number to call you at for your next interview?
Number (specify ---/---/----)
NO PHONE (go to CM4) 97
Is that number home, work, cell, or something else?
Home 01
Work 02
Cell 03
Other (specify__________________) 04
b. Is there another number we could try in case we have trouble reaching you?
Number (specify ---/---/----)
Is that number home, work, cell, or something else?
Home 01
Work 02
Cell 03
Other (specify__________________) 04
We’d like to keep in touch with you even if we can’t get you by phone or your phone number changes, so I’m going to ask you about a few additional ways we might be able to contact you.
CM4. If have email on file: We have your email address as {FILL}, is that correct?/If no email: Do you have an email address we could use to contact you if necessary?
Email is the same (fill below) 01
New Email (specify below) 02
Don’t know Email 98
Refused Email 99
Email___________________________________
CM5. If mailing address on file: We have your current mailing address as {FILL}. Is that correct? If no mailing address on file: Can I get a mailing address we could use to contact you if necessary?
Address is the same (fill below) 01
New address (specify below) 02
Don’t know/don’t have address 98
Refused address 99
a. Can you please tell me what your current mailing address is?
Street/Apt#________________________________________
City______________________________________________
State_____________________________________________
ZIP______________________________________________
b. (If CM3a is 97 – no phone): Earlier you indicated that you do not have a phone. Since we need to speak with you by phone we will mail you a study phone. You will receive the phone before your next interview. The package will contain instructions on how to use the phone. Should we mail the phone to the mailing address you just provided?
Address is the same (fill below) 01
New address (specify below) 02
Don’t know/don’t have address 98
Refused address 99
Can you please provide the address where the phone should be mailed?
Street/Apt#________________________________________
City______________________________________________
State_____________________________________________
ZIP______________________________________________
CM6. [Social Media – will develop question when procedure is finalized]
CM7. (If contacts on file: Earlier you provided the names and contact information for two people who would always know how to find you. Can I read that information back to you and check that it’s still up to date?/If no contacts on file: Just in case we can’t get in touch with you using the information you just gave me, I’d like to ask you for the names and contact information for two people who would always know how to find you.
Person #1 (If contacts on file, read fill info and correct as needed)
Name
Who is this person to you?
Phone
Address
Person #2 (If contacts on file, read fill info and correct as needed)
Name
Who is this person to you?
Phone
Address
Ask at 7, 13, 24 months only if core sample, and no longer in WIC. Ask once and then confirm at interview prior to when the next height/weight measure is needed:
CM9. As we mentioned when you first joined the study, we’d like to get information from {CHILD}’s doctor, and you gave us permission to do that. Can I please have the name of your child’s doctor, the doctor’s phone number if you have it, and the city and state where the doctor’s office is?
Doctor’s name
Location
Phone
Child hasn’t seen a doctor 97
Don’t know 98
Refused 99
If CM9 = 97, 98, 99 refer case for home health service.
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 0584-0580. The time required to complete this
information collection is estimated to average 31 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.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Nancy Weinfield |
| File Modified | 0000-00-00 |
| File Created | 2021-01-29 |