Thank you for participating in this survey. Purchase Area Health Connections (PAHC) has developed a Childhood Obesity Prevention Action Team (COPAT). This team is comprised of members from schools across the region, health clinics, community college, university, hospitals, public health, parks and recreation and other non-profit organizations. COPAT is working to develop a childhood obesity toolkit that can be used in our community to address the childhood obesity epidemic.

        · Due to the high rate of obesity, this generation may be the first in U.S. history to not outlive their parents.

        · Students who are obese are more likely than non-obese children to have lower academic scores, lower self-esteem, and more hospital stays.

        · If current U.S. trends continue, more than 57 percent of today’s youth will be obese at age 35.

Survey participation is voluntary. Since we are not collecting individually identifiable data, it has been determined that survey participation is exempt from IRB standards. Aggregated results of this and other surveys will be shared broadly to inform our project and community. Should you have any questions about this survey, please contact our data analyst, Kaitlyn Krolikowski, at 270-444-9625 x191. Thanks again for your participation!

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* 1. What program or school does your child(ren) attend?

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* 2. What is your child(ren)'s age?

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* 3. Is your child(ren) male or female?

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* 4. Does your child(ren)'s teacher regularly spend time teaching health topics?

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* 5. If yes, can you tell us what health topics are covered?

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* 6. Does your child(ren) participate in structured physical activity time at school, i.e. recess, PE, brain breaks?

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* 7. Have you ever received information about "healthy eating habits" from your child(ren)'s school, physician, or other resources?

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* 8. Do you feel like information regarding healthy eating habits is clear, useful, and applies to your family?

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* 9. Do you feel like your child(ren) has a healthy diet?

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* 10. Does your child(ren) have  a primary care physician?

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* 11. Does your child(ren) receive a annual well-child physical or exam?

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* 12. Has your physician expressed concerns about your child(ren)'s weight?

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* 13. Do you have concerns about you child(ren)'s weight?

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* 14. Does your child(ren) participate in any organized sport or other activity outside of school?

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* 15. How many fruits and/or vegetables does your child(ren) eat a day?

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* 16. Are your aware of proper serving sizes for your child(ren)'s age?

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* 17. Does your household limit the amount of screen time for your child(ren)?

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* 18. Does your family regularly eat dinner together?

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* 19. Does your child(ren) regularly eat meals in front of a screen?

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* 20. Are you currently looking for information for your family on health topics or healthy eating?

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* 21. If yes, what type of information are you looking for, i.e. physical activity, nutrition?

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* 22. Do you consider childhood obesity to be a problem in your community?

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* 23. If you believe childhood obesity is a problem in your community, is there anything your child school or health organization could do to better address obesity in your community?

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* 24. What resources are you aware of that are available in your community in regards to childhood obesity, i.e. pick your own produce farms, nutrition classes, physical activity clubs?

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* 25. VOLUNTARY INFORMATION

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