Parent Survey

As part of my studies in the Masters in Early Childhood Education, I am conducting

a study regarding nutrition and nutritional practices. In order to gain a better
understanding of childrens food choices and preferences I wanted to gather
valuable information from the childrens families. There will be no risk to your child
during this study and participation in this survey is completely optional. There is no
compensation for the completion of this survey but it is greatly appreciated to help
me get a better understanding on this subject. The completion and submission
of this survey is your agreement to participation. Thank you to the parents
and guardians for completing the following survey regarding your childs typical
nutritional choices, preferences and practices. After each question, there is a space
to add any additional responses. If you need more room you may use the back of
the page.
1. I pack at least one serving of fruit (not including juices) in my childs
lunch:
(a) once a week
(b) twice a week
(c) 3 times a week
(d) 4 times a week
(e) everyday
(f) I do not include fruit in my childs lunch
Comments:

2. I pack at least one serving of vegetables (not including juices) in my

childs lunch:
(a) once a week
(b) twice a week
(c) 3 times a week
(d) 4 times a week
(e) everyday
(f) I do not include vegetables in my childs lunch

Comments:

3. When I pack my childs lunch, I:

(a) pack it with my childs preferences in mind only
(b) pack it with nutritional value in mind only
(c) pack it with my childs preference in mind while making sure its nutritious
Comments:

4. During the past 7 days, how many times has your child consumed
soda, or a sweetened drink:
(a) none
(b) 1-3 times in the past week
(c) 4-6 times in the past week
(d) 1-2 times a day
(e) 3 or more per day
Comments:

5. During the past 7 days, how many times has your child eaten candy
or chocolate:
(a) none
(b) 1-3 times in the past week
(c) 4-6 times in the past week
(d) 1-2 times a day
(e) 3 or more per day
Comments:

6. As a parent, what would you like to see included in the health

curriculum as it relates to nutrition and food choices [Check all that
apply]:
Nutritional Value of different food choices
Access to food, economically and geographically
Healthy Choices
Foods eaten by various cultures and in different countries
Farming of food, understanding the farm to table process
Comments:
7. In addition to understanding your childrens nutritional choices, Im
interested in learning about your family beliefs, habits, cultural
practices or other influence that shape your familys nutritional
practices.

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8. I consider myself knowledgeable when it comes to nutrition:

Strongly disagree Disagree
Strongly agree
1

Neutral

Somewhat agree

Comments:
9. I would be interested in reviewing or gaining additional knowledge
regarding nutrition:
Strongly disagree Disagree
Strongly agree
1

Neutral

Somewhat agree

Comments: