OMB Control No.: 0584-0524
Expiration Date: 02/28/2026
OMB BURDEN STATEMENT: Public reporting burden for this collection is estimated to average 24 minutes per submission, including reviewing the screener and privacy act statement, reviewing instructions, gathering and maintaining the data needed, completing the form, and reviewing the collection of information. Comments on the burden or content of this instrument may be sent to U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, 1320 Braddock Place, 5th Floor, Alexandria, VA 22306 ATTN: PRA (0584-0524). You are not required to respond to the collection unless the OMB control number and expiration date displayed on page 1 are current and valid. (See 5 C.F.R. 1320.5(b)(2)(i).)
ATTACHMENT A-1: Survey (English)
USDA CNPP Brand Health 2023 Baseline
SCREEN 1: LANGUAGE PREFERENCE
You can take this survey in English or Spanish. Which would you prefer?
Ud. puede completar esta encuesta en Ingles o en Español, cual prefiere?
English/Ingles
Español/Spanish
Neither/Ninguno TERMINATE
SCREEN 2: PRIVACY ACT STATEMENT
Legal Authority: USDA is authorized to collect this information under 42 USC 12651d (b)(13), (14), and (c)(11).
Purpose: This information will be used to inform an awareness campaign to increase familiarity with and eventual interest in participation in USDA programs.
Routine Use: Information may be disclosed for any use permitted under law. Information will only be used in aggregate without personally identifiable information, and is thus not subject to the Privacy Act.
Disclosure: All information collected will be collected privately and only reported anonymously, without any association with your information or personal information. Any information which would permit identification of the individual will be safeguarded and will be used only by persons engaged in and for the purpose of the survey, except as otherwise required by law.
Participation in this research is voluntary and there are no penalties for refusing to answer any question. However, your cooperation in obtaining this much needed information is extremely important in order to ensure the completeness of the results.
To continue, click NEXT.
SCREEN 3: CONSENT FORM
You are being invited to participate in a research study on behalf of the United States Department of Agriculture (USDA) Center of Nutrition Policy and Promotion to inform a National Outreach Campaign. If you agree to take part in this study, you will be asked to complete an online survey. This survey will take you approximately 24 minutes to complete.
You may not directly benefit from this research; however, we hope that your participation in the study may help USDA determine how to best communicate with the general public about specific programs.
You agree to ask questions about the study if you don't understand something. If you have questions once the study is over, you can contact Glynis Donaldson at 703-842-0200.
I
Agree
I
Do Not Agree
IF CLICKS ‘I DO NOT AGREE’, TERMINATE. MUST CLICK ‘I AGREE’ TO CONTINUE.
SCREEN 4: OMB BURDEN STATEMENT
OMB
BURDEN STATEMENT:
Public reporting burden for this collection is estimated to average
24 minutes per submission, including reviewing the screener and
privacy act statement, reviewing instructions, gathering and
maintaining the data needed, completing the form, and reviewing the
collection of information. Comments on the burden or content of this
instrument may be sent to U.S. Department of Agriculture, Food and
Nutrition Service, Office of Policy Support, 1320 Braddock Place, 5th
Floor, Alexandria, VA 22306 ATTN: PRA (0584-0524). You are not
required to respond to the collection unless the OMB control number
and expiration date are current and valid. (See 5 C.F.R.
1320.5(b)(2)(i).). The OMB control number is 0584-0524 with the
expiration date of 02/28/2026.
To continue, click NEXT.
SCREENING: initial questions about respondent demographics
The first few questions are to learn a little bit about you.
Are you: Mark all that apply.
Female
Male
Transgender, non-binary, or another gender
Prefer not to say EXCLUSIVE
In what year were you born? Please type in the 4-digit year.
________ TERMINATE AFTER 2005 (under 18)
In which state do you live?
[PULL-DOWN MENU; SET QUOTAS BY 4-WAY REGION OVERALL]
IF (Q04=ALABAMA OR NEBRASKA) AND (Q03=AFTER 2004; under 19 years old), TERMINATE.
In what type of community do you live?
Urban, which is inside a city
Suburban, which is just outside of a city
Small town or rural, which is farther outside of a city, like in the country
SHOW Q06 & Q07 ON SAME SCREEN
Are you Hispanic, Latino/Latina, or of Spanish descent?
1 Yes
2 No
3 Prefer not to say
To be sure we have a representative sample, which of the following categories describes your ethnic background/race? Please select all that apply.
White/Caucasian
Black/African American
Asian
Native Hawaiian or other Pacific Islander
American Indian or Alaska Native
Other
Prefer not to say EXCLUSIVE
ASK Q08-Q11 AMONG HISPANIC AUDIENCE ONLY; Q06=1
ACCULTURATION WILL BE DETERMINED USING Q08+Q09+Q10
Q08-Q10 USES A POINTS SYSTEM; POINTS ARE LISTED NEXT TO RESPONSES BELOW IN BRACKETS
ACCULTURATION LEVELS ARE AS FOLLOWS:
|
Q08-10 POINTS TOTAL |
UNACCULTURATED |
11-15 |
BI-CULTURAL |
6-10 |
ACCULTURATED |
1-5 |
[ASK HISPANIC AUDIENCE ONLY, Q06=1] What language do you usually speak at home?
[ALTERNATE 1 TO 5 AND 5 TO 1, ANCHOR OTHER]
Only Spanish [5 POINTS]
Mostly Spanish [4 POINTS]
Spanish and English equally [3 POINTS]
Mostly English [2 POINTS]
Only English [1 POINT]
Other [0 POINTS]
[ASK HISPANIC AUDIENCE ONLY, Q06=1] Thinking of your media habits, including television, the internet, social media, radio, and print newspapers and magazines, would you say you use…
[ALTERNATE 1 TO 5 AND 5 TO 1, ANCHOR OTHER]
Only Spanish-language media [5 POINTS]
Mostly Spanish-language media [4 POINTS]
Spanish- and English-language media equally [3 POINTS]
Mostly English-language media [2 POINTS]
Only English-language media [1 POINT]
Other [0 POINTS]
[ASK HISPANIC AUDIENCE ONLY, Q06=1] Thinking about your overall cultural identification, would you say you feel…?
ALTERNATE SHOWING 1 TO 5, 5 TO 1
Much closer to the Hispanic/Latino culture [5 POINTS]
Somewhat closer to the Hispanic/Latino culture [4 POINTS]
Equally close to both Hispanic/Latino and U.S. cultures [3 POINTS]
Somewhat closer to the U.S. culture [2 POINTS]
Much closer to the U.S. culture [1 POINT]
[ASK HISPANIC AUDIENCE ONLY, Q06=1] Which of the following locations are you, your family, and/or your ancestors from? Please select all that apply.
Antigua and Barbuda
Argentina
Bahamas
Barbados
Belize
Bolivia
Chile
Colombia
Costa Rica
Cuba
Dominica
Dominican Republic
Ecuador
El Salvador
Grenada
Guatemala
Guyana
Haiti
Honduras
Jamaica
Mexico
Nicaragua
Panama
Paraguay
Peru
Puerto Rico
Saint Lucia
Saint Vincent and the Grenadines
Spain
Suriname
Trinidad and Tobago
Uruguay
United States
Venezuela
Other, specify ________
RESUME ASKING ALL
How many people live with you regularly and make up your “household,” including yourself? Your household is everyone who lives in your home (including children) and shares income and household expenses (bills, food, etc.). Your household may include people who are related to you and people who are not.
_____ Please enter the number of people in your household, including yourself
[NUMERIC 1-99; REQUIRED]
What was your approximate annual household income for 2022, before taxes, from all sources? This includes salaries, Social Security, pension, interest, and investment earnings.
Under $30,000
$30,000 to just below $35,000
$35,000 to just below $40,000
$40,000 to just below $45,000
$45,000 to just below $55,000
$55,000 to just below $65,000
$65,000 to just below $75,000
$75,000 to just below $85,000
More than $85,000
CODE AS “LOW INCOME” IF MEETS ANY OF THE FOLLOWING REQUIREMENTS:
If Q12=1 and Q13=1
If Q12=2 and Q13 =1, 2
If Q12=3 and Q13 =1, 2, 3
If Q12=4 and Q13 =1, 2, 3, 4
If Q12=5 and Q13 =1, 2, 3, 4, 5
If Q12=6 and Q13 =1, 2, 3, 4, 5, 6
If Q12=7 and Q13 =1, 2, 3, 4, 5, 6, 7
If Q12=8 and Q13 =1, 2, 3, 4, 5, 6, 7, 8
IF DOES NOT FALL INTO THIS DEFINITION, CODE AS MIDDLE/HIGHER INCOME.
BRAND FUNNELS: questions to gauge the brand health of MyPlate and its peer set
Note: Q14-Q18 comprise the brand funnels for MyPlate and its peer set.
What programs or organizations can you think of that communicate about healthy food choices? PROGRAM 5 OPEN END BOXES. REQUIRED. INCLUDE OPTION FOR “Not sure”
Thinking specifically about government programs, what government programs can you think of that communicate about healthy food choices? If any of your responses to the previous question are government programs, please provide them again here. PROGRAM 5 OPEN END BOXES. REQUIRED. INCLUDE OPTION FOR “Not sure”
Now,
please indicate if you have ever heard of any of the following.
Please
select all that you have heard
of.
RANDOMIZE.
SPLIT
SAMPLE: HALF SEE PROGRAM NAME & LOGO, HALF SEE PROGRAM NAME
ALONE
MyPlate
[ENGLISH VERSION; SHOW IF Q01=1:]
[SPANISH VERSION; SHOW IF Q01=2:]
Text4Baby
Fuel Up/Fuel Up to Play60
Move Your Way
The Nutrition Facts Label
The Heart Truth/National Red Dress Day
DASH Eating Plan
Let’s Move
Team Nutrition
“SNAP” or the Supplemental Nutritional Assistance Program. It is sometimes referred to and formerly known as “Food Stamps”
“WIC” or the Special Supplemental Nutrition Program for Women, Infants, and Children
None of these EXCLUSIVE; ANCHOR
How
familiar
are you with each of the following?
SHOW
PROGRAMS AWARE; SELECTED IN Q16
Very familiar
Somewhat familiar
Not too familiar
Not familiar at all/I only know the name
Never heard of [PROGRAMMER NOTE: IF BRAND SELECTED IN Q21, FLAG AS CHEATER FOR REVIEW]
How
favorable
is your opinion of each of the following?
SHOW
PROGRAMS FAMILIAR; SELECTED 1-3 IN Q17
Very favorable
Somewhat favorable
Neutral/no opinion
Somewhat unfavorable
Very unfavorable
Not sure
Do you currently participate in or get services from any of the following? Select all that apply.
SHOW ORGANIZATIONS FAMILIAR EXCEPT MYPLATE; SELECTED 1-3 IN Q17.
INCLUDE OPTION FOR “None of these”
PROGRAMMING: CODE AUDIENCES
WIC/SNAP PARTICIPANT: SELECTED WIC OR SNAP IN Q19
WIC/SNAP ELIGIBLE: (LOW INCOME IN Q12/Q13) AND (DID NOT SELECT WIC OR SNAP IN Q19)
OTHER: ALL OTHERS
ASK Q20 OF 3 RANDOM PROGRAMS SELECTED 1-3 IN Q17. ALWAYS ASK MYPLATE IF SELECTED 1-3 IN Q17.
How well do each of the descriptions below describe [INSERT PROGRAM]?
Describes very well
Describes somewhat/to some extent
Neutral/not sure
Does not describe well
Does not describe at all
RANDOMIZE
Accessible
Convenient
Easy to use
Educational
For someone like me
Inclusive
Relevant to my culture
Trustworthy
Well-respected
Helps me stay healthy
Offers information relevant to my dietary needs
Helps me find affordable ways to eat healthy
Useful
Informative
MYPLATE BRAND: questions to gain insight into sentiments towards the MyPlate brand
SPLIT SAMPLE; ASK IF DID NOT GET MYPLATE LOGO IN Q16
Before today, had you seen this picture?
[ENGLISH VERSION; SHOW IF Q01=1:]
[SPANISH VERSION; SHOW IF Q01=2:]
Yes
No
Not sure
RESUME ASKING ALL
What words or phrases would you use to describe this image? Please type in your answers. SHOW MYPLATE LOGO (ENGLISH VERSION IF Q01=1; SPANISH VERSION IF Q01=2). PROGRAM 10 OPEN END BOXES. REQUIRED. INCLUDE OPTION FOR “Not sure”
[ASK IF SEEN LOGO; Q21=1] And where had you seen this logo before? Select all that apply.
RANDOMIZE
At school or as part of a class/seminar
Through a government program (e.g., WIC, SNAP, etc.)
Through my doctor or another healthcare professional
A nutrition app or tool
On social media
An online advertisement
Through a workplace wellness program
At my grocery store
On food labels
On materials my child received from school/at my child’s school
Other, specify _______ ANCHOR
Not sure EXCLUSIVE; ANCHOR
ASK Q24-Q27 IF FAMILIAR WITH MYPLATE; SELECTED 1-3 IN Q17
You mentioned you have heard of MyPlate. How likely are you to do each of the following in the next 3 months?
Very likely
Somewhat likely
Neutral/not sure
Not very likely
Not likely at all
RANDOMIZE
Visit the MyPlate website, MyPlate.gov
Follow MyPlate on social media
Use MyPlate to find recipes
Use MyPlate to seek information about healthy eating
Use MyPlate to find affordable ways to eat healthy
What makes you say you are [Q24a=1,2: likely to visit / Q24a=3: neutral or not sure about visiting / Q24a=4,5: not likely to visit] the MyPlate website in the next 3 months? OPEN END; REQUIRED; CHECK FOR CHEATERS
Here are some statements about MyPlate. For each, please indicate how convincing it is as a reason to visit the MyPlate website, MyPlate.gov.
Very convincing
Somewhat convincing
Neutral
Not too convincing
Not convincing at all
Not sure
RANDOMIZE
MyPlate helps people learn how to eat healthy
MyPlate provides guidance for portion sizes
MyPlate provides information about the five food groups
MyPlate offers tips for buying and preparing healthy food on a budget
MyPlate provides healthy recipes and ideas
MyPlate has videos and resources that show you how to make healthy changes
MyPlate helps you find savings on groceries in your area
MyPlate helps you find ways to make healthy meals for the whole family
MyPlate offers healthy eating recommendations based on scientific research
MyPlate is a program offered by the US Department of Agriculture, or USDA
MyPlate provides tips and ideas for making small changes to be healthier
MyPlate promotes long-term healthy eating habits
MyPlate promotes ways to live a longer, more active life
MyPlate provides information that is relevant to my lifestyle
MyPlate provides information that is relevant to my culture
In your opinion, what could MyPlate.gov do to become a more valuable resource for individuals looking to improve what they eat? OPEN END; REQUIRED; INCLUDE OPTION FOR “Not sure”
RESUME ASKING ALL
In general, how motivated are you to eat healthy foods?
Very motivated
Somewhat motivated
Neither motivated nor unmotivated
Not motivated
In the past year, have you…
Yes
No
Not sure
RANDOMIZE
Consulted with a primary care physician/nurse practitioner about your diet
Begun a new diet to lose weight
Continued a diet to lose or maintain weight
Started a new fitness regimen
Kept a regular fitness regimen
Searched for information about healthy eating
Worked toward specific goals to improve your health
How much do you agree or disagree with each of the following statements?
Agree strongly
Agree somewhat
Neutral
Disagree somewhat
Disagree strongly
Not sure
RANDOMIZE
It is more expensive to buy healthy foods
I often eat fast food because it is cheap and easy to get
I often struggle with craving unhealthy foods
I no longer buy certain foods because the price has gone up
My loved ones often prefer to eat unhealthy meals
It is generally difficult for me to prepare healthy foods
Food labels are difficult to understand
I am not always sure what is considered the right amount of food to eat
I am not always sure how much of each food group to eat at each meal
It is difficult for me to find healthy foods near me
I don’t have time to prepare or eat healthy meals
DEMOGRAPHICS: questions about respondent demographics
Now just a few final questions for statistical purposes...
What is the highest level of education you completed?
Less than high school
High school
Associate’s degree
Bachelor's degree
Advanced degree (Masters, PhD, MD, JD, etc.)
Not sure/Prefer not to say
What is your marital status? Are you…
Married
Unmarried but living with partner
Single
Separated
Divorced
Widowed
Other
Prefer not to say
What is your current employment status?
Employed full-time
Employed part-time
Self-employed
Student
Homemaker
Retired
Unemployed, looking for work
Other
Not sure
Are you the parent/guardian of any children under age 18?
Yes
No
Prefer not to say
You’ve completed all the questions and your answers have been submitted. You may now close the survey window. Thank you for your participation.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Liana Gainsboro |
File Modified | 0000-00-00 |
File Created | 2023-12-12 |