Appendix H Demographic Questionnaire_03172021

Appendix H: Demographic Questionnaire

1. In what month and year were you born? _________________ __________________

month year

2. What is the highest level of school education you have completed?

Less than high school diploma

High school diploma

Some college courses, no degree

Associate’s degree

Bachelor’s degree

Graduate degree

3. Are you male or female?

Male

Female

4. Are you of Hispanic, Latino, or Spanish origin?

Yes

No

5. What is your race (choose all that apply)?

White

Black or African American

American Indian or Alaska Native

Asian

Native Hawaiian or Other Pacific Islander

Other: _____________________

6. Did you or anyone in your household receive WIC benefits in the past 30 days? WIC is short for the Special Supplemental Food Program for Women, Infants, and Children. This program provides food assistance and nutritional screening to low-income pregnant and postpartum women and their infants, as well as to low-income children up to age 5.

Yes

No

7. Did you or anyone in your household get SNAP or government assistance for food purchases in the past 30 days? SNAP stands for Supplemental Nutrition Assistance Program and was formerly known as the Food Stamp Program. SNAP benefits are provided on a food stamp benefit card/EBT card.

Yes

No

8. How long have you been using a smartphone? (Check one of the following)

Less than 1 year (STOP RECRUITMENT)

1 year or more but less than 2 years

2 years or more

9. How often do you use a smartphone in a week? (Check one of the following)

Everyday

5-6 days

3-4 days

1-2 days

Less than 1 day

10. Have you ever used a map on the smartphone?

Yes

No

11. List up to three things you do most often on your smartphone, for example, making a phone call.

1. _________________________________

2. _________________________________

3. _________________________________