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This survey is to identify parents/caregivers to participate in a focus group to give input into finalizing a California Maternal Child and Adolescent Health MyPlate for Children. MyPlate resources are to help individuals achieve and maintain health by encouraging families to include a variety of fruits, vegetables, whole grains, lean proteins, and dairy on their family plates every day. Families are also encouraged to be physically active.

The MyPlate for Children handout we plan to focus group test is for families with children ages 2-12 years. It provides recommendations to help an average healthy child meet their daily food needs. It is presented as a handout for the parent/caregiver but encourages older children to plan and cook meals together with their family. Once finished, this MyPlate for children ages 2-12 will be available online for use by health educators and other health care professionals to provide nutrition guidance to parents and caregivers.

The MyPlate for Children is not a stand-alone intervention but is meant to be used alongside counseling. The handout to be focus group tested will be part of a new MyPlate portfolio that tailors to specific age groups and health needs.

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* 1. What is your first name, or nickname?

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* 2. What race and ethnicity(s) do you identify as?

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* 3. What are the age(s) of your children?

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* 4. Describe the race(s) and ethnicity(s) of your child/children.

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* 5. What California county do you live in? (Alameda, Sacramento, LA County... etc)

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* 6. Do you currently participate in WIC?

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* 7. Please provide us with a good email to contact you.

Thank you for taking the time to complete this survey, we will be in touch soon!
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