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pdfOMB CONTROL NO.:
0503-0024
EXPIRATION DATE:
04/30/2023
Handout 1
StartSimpleQuizFinal
What is your eating style?
Start MyPlate quiz
OMB BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control
number. The valid OMB control number for this information collection is 0503-0024 and the expiration date is 04/30/2023. The time required to complete this information collection is estimated at 10 minutes per initial screening for
non-qualifying participants, 15 minutes per initial screening for qualifying participants, 10 minutes per attendance for non-focus group participants, and 2.5 hours per attendance for focus group participants, 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: U.S. Department of Agriculture, Food and Nutrition Services, Braddock Metro Center II, 1320 Braddock Place, Alexandria, VA 22314, ATTN: PRA
(0503-0024). Do not return the completed form to this address.
Welcome to the Start Simple
with MyPlate quiz
What’s your name?
Previous Question
What are your top 3 healthy eating goals?
To be healthier overall
Get to a healthy weight
Maintain a healthy weight
Increase my energy
Feel better about myself
Reduce stress
Help get my family on track with
healthy eating
Other
Continue
4% Complete
Previous Question
Which of the following, if any, are
preventing you from eating healthy?
Select all that apply
Costs too much
Taste and flavor
Takes too much time
Inconvenient
Others in the household do not
want to
No support system (someone to help
me stay on track)
I’m not sure how to
None of the above
Continue
8% Complete
Previous Question
How familiar are you with MyPlate?
Very familiar
Somewhat familiar
Not too familiar
Continue
12% Complete
Not familiar at all
Previous Question
Is this your first time visiting MyPlate.gov?
Yes
No
Continue
16% Complete
Not Sure
Previous Question
Now let’s look into what you’re currently eating.
How often do you eat from the Fruit Group?
i
The Fruit Group includes any fruit (fresh, frozen, canned, dried) and 100% fruit juice.
Never/Rarely
0-1 day per week
Occasionally
2-3 days per week
Continue
20% Complete
Often/Always
3+ days per week
Previous Question
How often do you drink 100% fruit juice?
i
100% fruit juice contains no added sugar or artificial flavors.
Never/Rarely
0-1 day per week
Occasionally
2-3 days per week
Continue
24% Complete
Often/Always
3+ days per week
Previous Question
How often do you eat from the Vegetable Group?
Never/Rarely
0-1 day per week
Occasionally
2-3 days per week
Continue
28% Complete
Often/Always
3+ days per week
Previous Question
How often do you eat dark green vegetables?
i
Broccoli, greens (collards, mustard green, turnip greens, kale), spinach, and raw leafy greens
(romaine, watercress, dark green leafy lettuce, endive, escarole) count as a dark green vegetable.
Never/Rarely
0-1 day per week
Occasionally
2-3 days per week
Continue
32% Complete
Often/Always
3+ days per week
Previous Question
How often do you eat red & orange vegetables?
i
Tomatoes, bell peppers, carrots, pumpkins, sweet potato, and winter squash (acorn, butternut,
hubbard) count as red & orange vegetables.
Never/Rarely
0-1 day per week
Occasionally
2-3 days per week
Continue
36% Complete
Often/Always
3+ days per week
Previous Question
How often do you eat beans & peas?
i
Beans & peas include dry and canned beans and peas (such as black, garbanzo, kidney, pinto,
or soy beans, lentils or black-eyed peas or split peas).
Never/Rarely
0-1 day per week
Occasionally
2-3 days per week
Continue
40% Complete
Often/Always
3+ days per week
Previous Question
How often do you eat from the Grains Group?
i
Any food made from wheat, rice, oats, cornmeal, barley, or another cereal grain is a grain
product. Bread, pasta, breakfast cereals, grits, and tortillas are examples of grain products.
Foods such as popcorn, rice, and oatmeal are also included in the Grains Group.
Never/Rarely
0-1 day per week
Occasionally
2-3 days per week
Continue
44% Complete
Often/Always
3+ days per week
Previous Question
How often do you eat whole grains?
i
Examples of whole grains include whole-wheat flour, bulgur (cracked wheat), oatmeal, whole
cornmeal, whole-wheat breads, whole-wheat pastas, and brown rice.
Never/Rarely
0-1 day per week
Occasionally
2-3 days per week
Continue
48% Complete
Often/Always
3+ days per week
Previous Question
How often do you eat from the Protein Foods Group?
i
The Protein Foods Group includes meats, poultry, seafood, eggs, nuts and seeds, beans
and peas.
Never/Rarely
0-1 day per week
Occasionally
2-3 days per week
Continue
52% Complete
Often/Always
3+ days per week
Previous Question
How often do you eat seafood?
i
Seafood includes both fish and shellfish (shrimp, crab, lobster, crayfish, clams, scallops,
oysters, and mussels.)
Never/Rarely
0-1 day per week
Occasionally
2-3 days per week
Continue
56% Complete
Often/Always
3+ days per week
Previous Question
How often do you eat from the Dairy Group?
i
The Dairy Group includes milk, yogurt, cheese, and calcium-fortified soy milk. Foods made from
milk that have little to no calcium, such as cream cheese, cream, and butter, are not part of the
Dairy Group.
Never/Rarely
0-1 day per week
Occasionally
2-3 days per week
Continue
60% Complete
Often/Always
3+ days per week
Previous Question
How often do you drink fat-free (skim) or
low-fat milk?
Never/Rarely
0-1 day per week
Occasionally
2-3 days per week
Continue
64% Complete
Often/Always
3+ days per week
Previous Question
How often do you drink soymilk or another
calcium-fortified plant-based milk?
Never/Rarely
0-1 day per week
Occasionally
2-3 days per week
Continue
68% Complete
Often/Always
3+ days per week
Previous Question
How often do you shop for groceries?
Never/Rarely
0-1 day per week
Occasionally
2-3 days per week
Continue
72% Complete
Often/Always
3+ days per week
Previous Question
How often do you plan your meals?
Never/Rarely
0-1 day per week
Occasionally
2-3 days per week
Continue
76% Complete
Often/Always
3+ days per week
Previous Question
How often do you dine out or order takeout/delivery?
Never/Rarely
0-1 day per week
Occasionally
2-3 days per week
Continue
80% Complete
Often/Always
3+ days per week
Previous Question
How often do you cook meals at home?
Never/Rarely
0-1 day per week
Occasionally
2-3 days per week
Continue
84% Complete
Often/Always
3+ days per week
Previous Question
What would you like to learn more about?
Select all that apply
Healthy recipes
Healthy snack ideas
Healthy eating on a budget
Meal planning
Food preparation
Portion control
Grocery shopping tips
Setting goals
Continue
88% Complete
Previous Question
Would you like to receive tips to help you meet your goals?
Yes, daily
Yes, weekly
Yes, monthly
Continue
92% Complete
Not right now
Previous Question
Would you be interested in learning more about sodium
(salt), saturated fats, added sugars, and oils?
Yes
Not right now
Continue
96% Complete
Previous Question
Please share other resource topics related to healthy
eating that may be of interest to you.
Complete quiz
100% Complete
File Type | application/pdf |
File Modified | 2020-07-22 |
File Created | 2020-05-07 |