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* 1. How important is it to you to eat healthy?

* 2. What does “eating healthy” mean to you? (Check all that apply)

* 3. During the last 6 months, would you say you’re eating healthier than before?

* 4. How easy/difficult is it for you to get your 5 daily servings of fruits and vegetables as recommended by the USDA?

* 5. During the last 30 days, how often did you get your 5 daily servings of fruits and vegetables?

* 6. Check which of these you think constitutes a serving of fruits or vegetables.

* 7. Where do you usually consume fruits and/or vegetables?

* 8. Do you try to eat healthy when dining out?

* 9. Do you usually get a salad (entrée or side) when dining out?

* 10. When dining out, or at the supermarket, do you usually make use of the salad bar (if one is available)?

* 11. How easy/difficult is it to get your children to eat their vegetables?

* 12. How often do you have a fruit smoothie?

* 13. What’s your favorite way to get a serving of fruit?

* 14. Do you read nutrition information materials provided by restaurants?

* 15. Do you read the Nutrition Facts labels on grocery items?

* 16. Do you do any research on your own (magazines, Internet) on the nutritional value of foods, food brands and restaurant menus?

* 17. Have you made a conscious effort to try to “eat local” more often by buying from farmers markets, a Community Supported Agriculture (CSA) farm, or locally-grown foods in the supermarket?

* 18. Gender

* 19. Age

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