1. PERS Fruit and Veggie Challenge Survey Instructions

We are interested to learn more about your current fruit and vegetable consumption and the availability of fruits and vegetables to you. The project partners will use this information to evaluate the success of this program and to design additional nutrition education materials and programs in the future.

We would like to invite you to take a survey. It will take you about 5-10 minutes to complete this survey. Your identity will not be revealed in the survey results. Only group comparisons will be made and reported in summary form. Your participation is entirely voluntary, and you may withdraw from participation any time. If you have any questions about the survey or would like a copy of the summarized results, please contact Julie Garden-Robinson at 701-231-7187 or email julie.garden-robinson@ndsu.edu. If you have questions about the rights of human research subjects, you should contact the NDSU IRB office, (701)231-8908.

At the end of the survey, click "DONE."

Thank you for participating in this program!

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* 1. In the past month, how often did you drink fruit juices such as orange, grapefruit , or tomato? (Mark one)

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* 2. In the past month, not counting juice, how often did you eat fruit? (Mark one)

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* 3. In the past month, how often did you eat green salad? (Mark one)

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* 4. In the past month, how often did you eat potatoes NOT including french fries, fried potatoes, or potato chips? (Mark one)

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* 5. In the past month, how often did you eat carrots? (Mark one)

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* 6. Not counting carrots, potatoes, or salad, how many servings of vegetables do you usually eat?

Example: A serving of vegetables at both lunch and dinner would be two servings.

One serving is 1/2 cup cut-up fresh, frozen or canned vegetables, 3/4 cup 100% juice, or 1 cup leafy greens.

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* 7. Think about your previous answers. On average, about how many TOTAL servings of FRUITS AND VEGETABLES do you consume daily?

(One serving is 1/2 cup cut-up fresh, frozen or canned fruits or vegetables, 3/4 cup 100% juice, 1 cup leafy greens, 1 medium piece of fruit, 1/4 cup dried fruit)

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* 8. About how long have you been eating this number of daily servings of fruits and vegetables?

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* 9. Are you trying to eat at least 5 servings of fruits and vegetables each day?

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* 10. How confident are you that you can eat at least 5 servings of fruits and vegetables each day?

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* 11. Following is a list of what some people consider to be barriers to eating fruits and vegetables. Please rate the following items as to how much of a barrier each item is for you on a scale of 1 to 5, with 1 being not a barrier at all and 5 being a high barrier.

  Not a barrier High barrier
Cost of fresh fruits and vegetables.
Few fresh fruits and vegetables available in grocery stores.
Few canned fruits and vegetables available in grocery stores.
Few frozen fruits and vegetables available in grocery stores.
Lack of variety of fruits and vegetables in restaurants.
Lack of variety of fruits and vegetables at grocery stores.
Lack of variety of fruits and vegetables at worksite.
Poor quality of fresh fruits in restaurants.
Poor quality of fresh fruits in grocery stores.
Poor quality of fresh fruits at worksite.
Do not like the taste of fruits.
Do not like the taste of vegetables.
Lack of time to prepare at home.

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* 12. How are fruits and vegetables available to you at your workplace? (Mark all that apply)

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* 13. Which of these describes what happens at your office at "break time"? (Mark all that apply)

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* 14. What types of snacks do you typically keep at your desk/work area? (Mark all that apply)

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* 15. How often do you buy candy bars, chips, pretzels and similar foods (NOT including soda pop) from vending machines at work? (Mark one)

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* 16. Please indicate your gender.

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* 17. Are you:

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* 18. What is your age?

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