36.3 Survey

OMB #: 0925-0593

OMB Expiration Date: 8/31/2014

Dietary Food Frequency SAQ, Phase 2g

OMB Specification

Dietary Food Frequency SAQ

Event Category:	Time-Based
Event:	42M, 54M
Administration:	N/A
Instrument Target:	Child
Instrument Respondent:	Primary Caregiver
Domain:	Questionnaire
Document Category:	Questionnaire
Method:	Self-Administered
Mode (for this instrument*):	In-Person, PAPI
OMB Approved Modes:	In-Person, PAPI; Phone, PAPI; Web-Based, CAI
Estimated Administration Time:	10 minutes
Multiple Child/Sibling Consideration:	Per Child
Special Considerations:	N/A
Version:	1.0
MDES Release:	4.0

*This instrument is OMB-approved for multi-mode administration but this version of the instrument is designed for administration in this/these mode(s) only.

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Dietary Food Frequency SAQ

TABLE OF CONTENTS

GENERAL PROGRAMMER INSTRUCTIONS: 1

DIETARY FOOD FREQUENCY SAQ 3

FRUITS 4

VEGETABLES 8

MEATS, FISH, AND OTHER MAIN DISHES 14

STARCHES AND GRAINS 20

DRINKS 24

OTHER DAIRY AND EGGS 29

OILS AND SPREADS 31

SWEETS AND SNACKS 33

OTHER FOODS YOUR CHILD EATS ONCE PER WEEK 36

FOR OFFICE USE ONLY 43

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Dietary Food Frequency SAQ

GENERAL PROGRAMMER INSTRUCTIONS:

WHEN PROGRAMMING INSTRUMENTS, VALIDATE FIELD LENGTHS AND TYPES AGAINST THE MDES TO ENSURE DATA COLLECTION RESPONSES DO NOT EXCEED THOSE OF THE MDES. SOME GENERAL ITEM LIMITS USED ARE AS FOLLOWS:

DATA ELEMENT FIELDS	MAXIMUM CHARACTERS PERMITTED	DATA TYPE	PROGRAMMER INSTRUCTIONS
ADDRESS AND EMAIL FIELDS	100	CHARACTER
UNIT AND PHONE FIELDS	10	CHARACTER
_OTH AND COMMENT FIELDS	255	CHARACTER	Limit text to 255 characters
FIRST NAME AND LAST NAME	30	CHARACTER	Limit text to 30 characters
ALL ID FIELDS	36	CHARACTER
ZIP CODE	5	NUMERIC
ZIP CODE LAST FOUR	4	NUMERIC
CITY	50	CHARACTER
DOB AND ALL OTHER DATE FIELDS (E.G., DT, DATE, ETC.)	10	NUMERIC CHARACTER	DISPLAY AS MM/DD/YYYY STORE AS YYYY-MM-DD HARD EDITS: MM MUST EQUAL 01 TO 12 DD MUST EQUAL 01 TO 31 YYYY MUST BE BETWEEN 1900 AND CURRENT YEAR.
TIME VARIABLES	TWO-DIGIT HOUR AND TWO-DIGIT MINUTE, AM/PM DESIGNATION	NUMERIC	HARD EDITS: HOURS MUST BE BETWEEN 00 AND 12; MINUTES MUST BE BETWEEN 00 AND 59

Instrument Guidelines for Participant and Respondent IDs:

PRENATALLY, THE P_ID IN THE MDES HEADER IS THAT OF THE PARTICIPANT (E.G. THE NON-PREGNANT WOMAN, PREGNANT WOMAN, OR THE FATHER).

POSTNATALLY, A RESPONDENT ID WILL BE USED IN ADDITION TO THE PARTICIPANT ID BECAUSE SOMEBODY OTHER THAN THE PARTICIPANT MAY BE COMPLETING THE INTERVIEW. FOR EXAMPLE, THE PARTICIPANT MAY BE THE CHILD AND THE RESPONDENT MAY BE THE MOTHER, FATHER, OR ANOTHER CAREGIVER. THEREFORE, MDES VERSION 2.2 AND ALL FUTURE VERSIONS CONTAIN A R_P_ID (RESPONDENT PARTICIPANT ID) HEADER FIELD FOR EACH POST-BIRTH INSTRUMENT. THIS WILL ALLOW ROCs TO INDICATE WHETHER THE RESPONDENT IS SOMEBODY OTHER THAN THE PARTICIPANT ABOUT WHOM THE QUESTIONS ARE BEING ASKED.

A REMINDER:

ALL RESPONDENTS MUST BE CONSENTED AND HAVE RECORDS IN THE PERSON, PARTICIPANT, PARTICIPANT_CONSENT AND LINK_PERSON_PARTICIPANT TABLES, WHICH CAN BE PRELOADED INTO EACH INSTRUMENT. ADDITIONALLY, IN POST-BIRTH QUESTIONNAIRES WHERE THERE IS THE ABILITY TO LOOP THROUGH A SET OF QUESTIONS FOR MULTIPLE CHILDREN, IT IS IMPORTANT TO CAPTURE AND STORE THE CORRECT CHILD P_ID ALONG WITH THE LOOP INFORMATION. IN THE MDES VARIABLE LABEL/DEFINITION COLUMN, THIS IS INDICATED AS FOLLOWS: EXTERNAL IDENTIFIER: PARTICIPANT ID FOR CHILD DETAIL.

DIETARY FOOD FREQUENCY SAQ

DFF01000. This questionnaire asks about the foods your child has eaten in the past month.  Put an X in the box next to your answer. If you make any changes, cross out the incorrect answer and put an X in the box next to the correct answer. 
Answer each question as best you can.  Estimate if you are not sure -- a guess is better than leaving a blank.  Use only a black ball-point pen.  Do not use a pencil or felt-tip pen.  Please do not fold, staple, or tear the pages.  

DFF02000. ​Before you begin, please fill in today’s date

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

(FFQ_DATE_MM) |___|___|

   M    M

(FFQ_DATE_DD) |___|___|

   D    D

(FFQ_DATE_YY) 20|___|___|

Y Y   Y    Y

FRUITS

FRU03000. Please check the box that best represents how often your child ate each of the foods listed, on average, in the past month.

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

FRU04000/(FFQ_FRUITS_ORANGE). Orange

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

FRU05000/(FFQ_FRUITS_GRAPEFRUIT). Grapefruit

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

FRU06000/(FFQ_FRUITS_BANANA). Banana

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

FRU07000/(FFQ_FRUITS_APPLE). Apple

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

FRU08000/(FFQ_FRUITS_APPLESAUCE). Applesauce

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

FRU09000/(FFQ_FRUITS_GRAPES). Grapes

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

FRU10000/(FFQ_FRUITS_PEACH). Peach or plum

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

FRU11000/(FFQ_FRUITS_BERRIES). Strawberries or other berries

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

FRU12000/(FFQ_FRUITS_CANTALOUPE). Cantaloupe

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

FRU13000/(FFQ_FRUITS_WATERMELON). Watermelon

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

FRU14000/(FFQ_FRUITS_PEARS). Pears

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

FRU15000/(FFQ_FRUITS_PRUNES). Raisins or prunes

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEGETABLES

VEG01000. Please check the box that best represents how often your child ate each of the foods listed, on average, in the past month.

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEG02000/(FFQ_VEG_CORN). Corn

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEG03000/(FFQ_VEG_PEAS). Peas

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEG04000/(FFQ_VEG_TOMATOES). Tomatoes

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEG05000/(FFQ_VEG_PEPPERS). Peppers (all kinds)

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEG06000/(FFQ_VEG_CARROTS). Carrots

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEG07000/(FFQ_VEG_BROCCOLI). Broccoli

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEG08000/(FFQ_VEG_GBEANS). Green beans

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEG09000/(FFQ_VEG_SPINACH). Sprinach

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEG10000/(FFQ_VEG_SQUASH). Squash (orange or winter)

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEG11000/(FFQ_VEG_FF). French fries, fried potatoes

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEG12000/(FFQ_VEG_POTATOES). Potatoes (baked, boiled, or mashed)

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​National Children’s Study, Legacy Phase (18-Month FFQ)

VEG13000/(FFQ_VEG_ONION). Onion

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEG14000/(FFQ_VEG_YAMS). Sweet potatoes or yams

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEG15000/(FFQ_VEG_CABBAGE). Cabbage, coleslaw, or cauliflower

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEG16000/(FFQ_VEG_CUCUMBERS). Cucumbers

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​National Children’s Study, Legacy Phase (18-Month FFQ)

VEG17000/(FFQ_VEG_LETTUCE). Lettuce salad

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEG18000/(FFQ_VEG_MIXED). Mixed vegetables

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEG19000/(FFQ_VEG_BEANS). Baked beans or chili beans

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

VEG20000/(FFQ_VEG_OTH_BEANS). Other dried beans, dried peas or lima bean​

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MEATS, FISH, AND OTHER MAIN DISHES

MFA00100. Please check the box that best represents how often your child ate each of the foods listed, on average, in the past month​.

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA01000/(FFQ_MAIN_PIZZA). Pizza

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA02000/(FFQ_MAIN_MAC). ​Macaroni and cheese

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA03000/(FFQ_MAIN_PB). ​Peanut butter

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA04000/(FFQ_MAIN_BURGER). Hamburger, meatballs, or meatloaf

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA05000/(FFQ_MAIN_BEEF). Beef – steak or roast

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA06000/(FFQ_MAIN_PORK). Pork – chops, roast, or ribs

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA07000/(FFQ_MAIN_HAM). ​Ham – baked or steak

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA08000/(FFQ_MAIN_COLDCUTS). ​Cold cuts  (bologna, salami, ham)

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA09000/(FFQ_MAIN_SAUSAGE). ​Sausage

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA10000/(FFQ_MAIN_BACON). Bacon

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA11000/(FFQ_MAIN_DOGS). Hot dogs

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA12000/(FFQ_MAIN_FRIED_CHICK). ​Fried chicken, chicken nuggets

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA13000/(FFQ_MAIN_CHICK_TURKEY). ​Other chicken or turkey

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA14000/(FFQ_MAIN_CAN_TUNA). ​Canned tuna

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA15000/(FFQ_MAIN_FRIED_FISH). ​Fried fish, fish sticks

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA16000/(FFQ_MAIN_OTH_FISH). ​Other fish

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA17000/(FFQ_MAIN_TOFU_BEANS). ​Tofu or soy beans

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA18000/(FFQ_MAIN_VEG_SOUP). ​Vegetable soup

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

MFA19000/(FFQ_MAIN_OTH_SOUP). Other soup

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

STARCHES AND GRAINS

SAG01000. Please check the box that best represents how often your child ate each of the foods listed, on average, in the past month.

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAG02000/(FFQ_GRAIN_PASTA). Pasta

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAG03000/(FFQ_GRAIN_WHITE_RICE). White rice

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAG04000/(FFQ_GRAIN_BWN_RICE). Brown rice

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAG05000/(FFQ_GRAIN_WHITE_BREAD). ​White bread  (slice, roll, or pita)

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAG06000/(FFQ_GRAIN_DARK_BREAD). ​Dark bread  (slice, roll, or pita)

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAG07000/(FFQ_GRAIN_CORNBREAD). ​Cornbread or tortilla

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAG08000/(FFQ_GRAIN_OATMEAL). ​Oatmeal

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAG09000/(FFQ_GRAIN_CEREAL). ​Cereal (cold)

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAG10000/(FFQ_GRAIN_DONUT). ​Donut, fried dough

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAG11000/(FFQ_GRAIN_MUFFIN). Sweet roll or muffin

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAG12000/(FFQ_GRAIN_PANCAKE). Pancake, waffle, or French toast

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAG13000/(FFQ_GRAIN_BAGEL). English muffin or bagel

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAG14000/(FFQ_GRAIN_BISCUIT). Biscuit

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

DRINKS

DRI01000. Please check the box that best represents how often your child ate each of the foods listed, on average, in the past month.

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

DRI02000/(FFQ_DRINK_MILK). ​Milk, including chocolate milk

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

DRI03000/(FFQ_DRINK_HOT_CHOC). Hot chocolate

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

DRI04000/(FFQ_DRINK_AJ). Apple juice

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

National Children’s Study, Legacy Phase (18-Month FFQ)

DRI05000/(FFQ_DRINK_GJ). Grape juice

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

National Children’s Study, Legacy Phase (18-Month FFQ)

DRI06000/(FFQ_DRINK_OJ). Orange juice

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

DRI07000/(FFQ_DRINK_PINEAPPLE). Pineapple juice

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

National Children’s Study, Legacy Phase (18-Month FFQ)

DRI08000/(FFQ_DRINK_OTH_JUICE). ​Other 100% juice

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

DRI09000/(FFQ_DRINK_FRUIT). ​Fruit drinks (Hi-C, Kool-Aid, lemonade)

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

DRI10000/(FFQ_DRINK_SODA). ​Soda (not sugar free)

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

DRI11000/(FFQ_DRINK_SF_SODA). ​Soda (sugar free)

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

DRI12000/(FFQ_DRINK _WATER). Water

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

DRI13000/(FFQ_DRINK_KIND_MILK). What kind of milk does your child usually drink?

Label	Code	Go To
Breast milk, breast fed	1	FFQ_DRINK_KIND_WATER
Breast milk, expressed	2	FFQ_DRINK_KIND_WATER
Formula made from cow’s milk	3	FFQ_DRINK_KIND_WATER
Formula made from soy milk	4	FFQ_DRINK_KIND_WATER
Whole milk	5	FFQ_DRINK_KIND_WATER
2% milk	6	FFQ_DRINK_KIND_WATER
1% milk	7	FFQ_DRINK_KIND_WATER
Skim milk	8	FFQ_DRINK_KIND_WATER
Soy milk	9	FFQ_DRINK_KIND_WATER
Not Applicable/My child does not drink milk	-7	FFQ_DRINK_KIND_WATER
Other	-5

SOURCE

Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

DRI13100/(FFQ_DRINK_KIND_MILK_OTH). Please specify: __________________________________________

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

DRI14000/(FFQ_DRINK_KIND_WATER). What kind of water does your child usually drink?

Label	Code	Go To
Tap water, not filtered	1	ODA00100
Tap water, filtered	2	ODA00100
Bottled water	3	ODA00100
Other	-5

SOURCE

​National Children’s Study, Legacy Phase (18-Month FFQ)

DRI15000/(FFQ_DRINK_KIND_WATER_OTH). Please specify: _____________________________

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

OTHER DAIRY AND EGGS

ODA00100. Please check the box that best represents how often your child ate each of the foods listed, on average, in the past month.

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

ODA01000/(FFQ_DAIRY_CHEESE). ​Cheese, plain or in sandwiches

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

ODA02000/(FFQ_DAIRY_CRM_CHEESE). ​Cream cheese

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

ODA03000/(FFQ_DAIRY_YOGURT). Yogurt

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

ODA04000/(FFQ_DAIRY_ICE_CREAM). ​Ice cream

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

ODA05000/(FFQ_DAIRY_PUDDING). Pudding

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

ODA06000/(FFQ_DAIRY_EGGS). Whole eggs

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

OILS AND SPREADS

OAS01000. Please check the box that best represents how often your child ate each of the foods listed, on average, in the past month.

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

OAS02000/(FFQ_OILS_BUTTER). ​Butter (not margarine)

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

OAS03000/(FFQ_OILS_MARG_TUB). ​Margarine (tub)

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

OAS04000/(FFQ_OILS_MARG_STICK). ​Margarine (stick)

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

OAS05000/(FFQ_OILS _MAYO). Mayonnaise

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

OAS06000/(FFQ_OILS _DRESSING). Salad dressing

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SWEETS AND SNACKS

SAS01000. Please check the box that best represents how often your child ate each of the foods listed, on average, in the past month.

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAS02000/(FFQ_SNACKS_CHIPS). ​Chips (potato, corn or others)

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAS03000/(FFQ_SNACKS_NUTS). Nuts

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAS04000/(FFQ_SNACKS_CRACKERS). Crackers

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAS05000/(FFQ_SNACKS_JELLO). ​Jello

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAS06000/(FFQ_SNACKS_COOKIES). ​Cookies or brownies

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAS07000/(FFQ_SNACKS_CAKES). Cake or cupcakes

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAS08000/(FFQ_SNACKS_PIE). Pie

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAS09000/(FFQ_SNACKS_CHOC_CANDY). Chocolate candy

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

SAS10000/(FFQ_SNACKS_OTH_CANDY). ​Other candy

Label	Code	Go To
Never	1
Less than 1 time per week	2
1 time per week	3
2-4 times per week	4
Nearly every day or every day	5
2 or more times per day	6

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

OTHER FOODS YOUR CHILD EATS ONCE PER WEEK

OFY00100. Are there any other foods not mentioned above that your child eats at least once per week?  Please write in the name of the food and check the box that best represents how often your child ate each food, on average, in the past month.

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

OFY01000.

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

(FFQ_OTHER_FOODS1_NAME) __________________________________

(FFQ_OTHER_FOODS1_FREQ)

OFY02000.

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

(FFQ_OTHER_FOODS2_NAME) ______________________________

(FFQ_OTHER_FOODS2_FREQ)

OFY03000.

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

(FFQ_OTHER_FOODS3_NAME) ________________________

(FFQ_OTHER_FOODS3_FREQ)

OFY04000.

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

(FFQ_OTHER_FOODS4_NAME) ____________________________

(FFQ_OTHER_FOODS4_FREQ) ​

OFY05000.

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

(FFQ_OTHER_FOODS5_NAME) ______________________

(FFQ_OTHER_FOODS5_FREQ)

OFY06000.

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

(FFQ_OTHER_FOODS6_NAME) _______________________

(FFQ_OTHER_FOODS6_FREQ) ​

OFY07000.

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

(FFQ_OTHER_FOODS7_NAME) ​________________________

(FFQ_OTHER_FOODS7_FREQ)

OFY08000/(FFQ_FAST_FOOD). In the past month, how often did your child eat fast foods away from home or as take-out, such as hamburgers, french fries, egg rolls, chicken nuggets, fried chicken, etc.?

Label	Code	Go To
Less than once per week	1
1 time per week	2
2 to 4 times per week	3
Nearly every day or every day	4

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)​ (modified)

OFY09000. In the past month, did you always, usually, sometimes, or seldom:

SOURCE

​National Children’s Study, Legacy Phase (18-Month FFQ)

(FFQ_WASH_HANDS) ​Wash your hands before preparing food for your family?

Label	Code	Go To
Always	1
Usually	2
Sometimes	3
Seldom	4

SOURCE

​​National Children’s Study, Legacy Phase (18-Month FFQ)

(FFQ_WASH_COUNTER) Wash the cutting board or counter before preparing food on it for your family?

Label	Code	Go To
Always	1
Usually	2
Sometimes	3
Seldom	4

SOURCE

​​National Children’s Study, Legacy Phase (18-Month FFQ)

(FFQ_WASH_FRUITS) Wash or rinse fresh fruits and vegetables 20 seconds and drain 2 minutes before preparing them for your family?

Label	Code	Go To
Always	1
Usually	2
Sometimes	3
Seldom	4

SOURCE

​National Children’s Study, Legacy Phase (18-Month FFQ)

OFY10000. In the past month, did your child eat any of the following foods that contain raw eggs:

SOURCE

​​​National Children’s Study, Legacy Phase (18-Month FFQ)

(FFQ_RAW_COOKIE) ​Raw, homemade cookie or cake batter?

Label	Code	Go To
Yes	1
No	2
Don’t know	3

SOURCE

​​National Children’s Study, Legacy Phase (18-Month FFQ)

(FFQ_RAW_EGG_FROSTING) ​Homemade frosting with raw egg?

Label	Code	Go To
Yes	1
No	2
Don’t know	3

SOURCE

​​National Children’s Study, Legacy Phase (18-Month FFQ)

(FFQ_RAW_EGG_SALAD) ​Caesar salad with raw egg?

Label	Code	Go To
Yes	1
No	2
Don’t know	3

SOURCE

​​National Children’s Study, Legacy Phase (18-Month FFQ)

(FFQ_RAW_EGG_MOUSSE) Chocolate mousse with raw egg?

Label	Code	Go To
Yes	1
No	2
Don’t know	3

SOURCE

​​National Children’s Study, Legacy Phase (18-Month FFQ)

(FFQ_RAW_EGGNOG) ​Homemade eggnog?

Label	Code	Go To
Yes	1
No	2
Don’t know	3

SOURCE

​​National Children’s Study, Legacy Phase (18-Month FFQ)

(FFQ_RAW_EGG_SHAKES) ​Shakes with raw egg?

Label	Code	Go To
Yes	1
No	2
Don’t know	3

SOURCE

​National Children’s Study, Legacy Phase (18-Month FFQ)

OFY11000. Where does your child eat, including breakfast, lunch, dinner, and snacks?  For each of these places, mark if he/she eats in these places usually, sometimes, or never.

SOURCE

​National Children’s Study, Legacy Phase (18-Month FFQ)

(FFQ_EAT_KITCHEN_TABLE) ​Kitchen table or counter

Label	Code	Go To
Usually	1
Sometimes	2
Never	3

SOURCE

​​National Children’s Study, Legacy Phase (18-Month FFQ)

(FFQ_EAT_HIGH_CHAIR) ​High chair

Label	Code	Go To
Usually	1
Sometimes	2
Never	3

SOURCE

​​National Children’s Study, Legacy Phase (18-Month FFQ)

(FFQ_EAT_DINING_TABLE) Dining room table

Label	Code	Go To
Usually	1
Sometimes	2
Never	3

SOURCE

​​National Children’s Study, Legacy Phase (18-Month FFQ)

(FFQ_EAT_FLOOR) ​On the carpet or floor anywhere in the house

Label	Code	Go To
Usually	1
Sometimes	2
Never	3

SOURCE

​​National Children’s Study, Legacy Phase (18-Month FFQ)

(FFQ_EAT_BEDROOM) Bedroom on a table or dresser

Label	Code	Go To
Usually	1
Sometimes	2
Never	3

SOURCE

​​National Children’s Study, Legacy Phase (18-Month FFQ)

(FFQ_EAT_GARAGE) ​Garage

Label	Code	Go To
Usually	1
Sometimes	2
Never	3

SOURCE

​​National Children’s Study, Legacy Phase (18-Month FFQ)

(FFQ_EAT_OUTSIDE) ​On a table or bench outside the house

Label	Code	Go To
Usually	1
Sometimes	2
Never	3

SOURCE

​​National Children’s Study, Legacy Phase (18-Month FFQ)

(FFQ_EAT_ANYWHERE) Anywhere else he or she chooses

Label	Code	Go To
Usually	1
Sometimes	2
Never	3

SOURCE

​​National Children’s Study, Legacy Phase (18-Month FFQ)

OFY12000/(FFQ_SUPPLEMENTS). Which of the following supplements was your child given at least 3 days a week during the past month?

PARTICIPANT INSTRUCTIONS

• ​Select all that apply.

Label	Code	Go To
Fluoride	1
Iron	2
Multi-vitamins	3
Other vitamins or supplements	-5
None	4

SOURCE

​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

PROGRAMMER INSTRUCTIONS

• IF FFQ_SUPPLEMENTS = -5 OR ANY COMBINATION OF 1-3 AND -5, GO TO FFQ_SUPPLEMENTS_OTH.

• IF FFQ_SUPPLEMENTS = 4, DO NOT ALLOW SELECTION OF OTHER VALUES AND GO TO FFQ_SUPP_DROPS_PILLS.

• IF FFQ_SUPPLEMENTS = ANY COMBINATION OF 1-3, GO TO FFQ_SUPP_DROPS_PILLS.

OFY13000/(FFQ_SUPPLEMENTS_OTH). ​Please specify: _______________________________

SOURCE

​​Project Viva Second-Year Questionnaire (modified from Harvard-Willett FFQ)

OFY14000/(FFQ_SUPP_DROPS_PILLS). Were any of the supplements you gave your child in the form of drops or pills?

Label	Code	Go To
Drops	1
Pills	2
Both	3

SOURCE

​National Children’s Study, Legacy Phase (18-Month FFQ)

OFY15000. ​Thank you for participating in the National Children’s Study and for taking the time to complete this survey.

FOR OFFICE USE ONLY

FOU01000/(P_ID). ​Participant ID:______________________________________________

FOU02000/(R_P_ID). Respondent ID:____________________________________

Public reporting burden for this collection of information is estimated to average 10 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. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0593*). Do not return the completed form to this address.