Contact: EFNEP Survey
Cornell Cooperative Extension
New York State
Name: Date:
This is a survey about ways you plan and fix foods for your family. As you read each question, think about the recent past. This is not a test. There are not any wrong answers. If you do not have children, just answer the question for yourself.
Circle the number that best describes what you do. The numbers mean:
1 - never
2 - seldom
3 - sometimes
4 - most of the time
5 - almost always
| 1. How often do you plan meals ahead of time? | 1 | 2 | 3 | 4 | 5 |
| 2. How often do you compare prices before you buy food? | 1 | 2 | 3 | 4 | 5 |
| 3. How often do you run out of food before the end of the month? | 1 | 2 | 3 | 4 | 5 |
| 4. How often do you shop with a grocery list? | 1 | 2 | 3 | 4 | 5 |
| 5. This question is about meat and dairy foods. How often do you let these foods sit out for more than two hours? | 1 | 2 | 3 | 4 | 5 |
| 6. How often do you thaw frozen foods at room temperature? | 1 | 2 | 3 | 4 | 5 |
| 7. When deciding what to feed your family, how often do you think about healthy food choices? | 1 | 2 | 3 | 4 | 5 |
| 8. How often have you prepared foods without adding salt? | 1 | 2 | 3 | 4 | 5 |
| 9. How often do you use the "Nutrition Facts" on the food label to make food choices? | 1 | 2 | 3 | 4 | 5 |
| 10. How often do your children eat something in the morning within 2 hours of waking up? | 1 | 2 | 3 | 4 | 5 |
ENTRY DATE:: January 1999
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