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LCHAT Parent Role Model Survey

The purpose of this survey is to determine current healthy behavior modeling among Liberty community parents toward their children, measure community support for healthy celebrations and fundraising in schools, and determine what resources LCHAT can provide to help foster healthier lifestyles.

Your responses are anonymous and may be used in future policy changes. This should take you no more than 5-10 minutes. Your time and opinions are greatly appreciated!
1.What grade are your children in?
2.On a typical day, how many 8 oz servings of each of the following drinks do you consume?
3.How many times per week do you eat breakfast?
4.How often do you eat items like chips, candy, salted snack foods, etc. around your children?
5.How often does your family eat fast food each week (i.e. Wendy's, Chick-Fil-A, Arby's, gas stations)?
6.For what reasons do you choose fast food? Check all that apply.
7.How often do you offer sweets or your child's favorite food as a reward for good behavior?
8.On a scale from 1-5, how much of an impact do you think you have on the health behaviors of your children?
9.What kinds of ways have you been able to impact your child's eating behaviors?
10.How open are you to having monthly birthday parties in the classrooms instead of celebrating each birth date?
11.How open are you to having healthy and/or non-food fundraising alternatives for school fundraisers?
12.Do you limit the amount of screen time your children are allowed to have outside of school, such as video games, watching t.v., using social media, etc.? 
13.If you answered yes to question 12, how many hours do you limit your children to each day?
14.What resources do you utilize for nutrition information? Check all the apply.
15.Would you like resources for any of the following topics?
16.If interested, what times would you be available for meetings regarding school wellness? Check all that apply
17.Do you have any other comments or suggestions?
18.If you would like further information, to remain anonymous sign up for our emailing list at www.lchat.org OR provide your name & email and specify which team you're interested in joining: Nutrition, Physical Activity, Social Inclusion, Community Input, Communications, or the LCHAT Stakeholder's Email List.   Thank you!