FOOD POLICY

1. Is there a policy/guidance for inclusion of “healthy” foods and beverages in the store?

◯ Yes     ◯ No

2. Is there a policy/guidance for placement and promotion of healthier items?

◯ Yes     ◯ No

3. Is there a policy/guidance for use of a labeling identification program or procedure for labeling “healthier” items?

◯ Yes     ◯ No

4. Is there a local practice to promote price adjustments and discounts for “healthier” foods and beverages?

◯ Yes     ◯ No

FOOD AVAILABILITY

5. How many varieties of whole or pre-cut fresh fruit are available?

◯ 0    ◯ 1 –2    ◯ 3–4    ◯ ≥5

6. How many varieties of pre-cut, fresh vegetables are available?

◯ 0     ◯ 1–2     ◯ 3–4     ◯ ≥5

7. How many different options of low-fat yogurt with ≤30 g sugar/serving are available?

◯ 0     ◯ 1–2     ◯ 3–4     ◯ ≥5

8. How many options of dried fruit (no added sugar) and/or canned fruit (in its own juice or water) are available?

◯ 0     ◯ 1–2     ◯ 3–4     ◯ ≥5

9. How many additional healthier, grab-n-go protein snack options (tuna, chicken, hard boiled eggs, hummus, or peanut butter) are available?

◯ 0     ◯ 1     ◯ 2     ◯ ≥3

10. Are single serving/snack pack size (1–2 oz) available for varieties of chips, pretzels, etc.?

◯ Yes     ◯ No

11. Are whole grain cereal options, ≤10 g sugar, and ≤230 mg sodium/serving available?

◯ Yes     ◯ No

12. How many healthier frozen meal entrée options ≤500 cal and ≤600 mg of sodium are available?

◯ 0     ◯ 1–2     ◯ 3–4     ◯ ≥5     ◯ N/A

13. How many grab-n-go sandwich/wraps with a lean protein source/whole grain bread/wraps are available?

◯ 0     ◯ 1–2     ◯ 3–4     ◯ ≥5

14. How many grab-n-go salads, made with leafy greens and a lean protein, are available with no dressing added or dressing on the side?

◯ 0     ◯ 1–2     ◯ 3–4     ◯ ≥5

15. How many healthier hot food entrée or sandwich options (≤500 cal, ≤40% fat, 10% sat. fat), including breakfast sandwiches, are available?

◯ 0     ◯ 1–2     ◯ 3–4     ◯ ≥5

16. How many options of low fat (1%), nonfat milk, reduced fat choc. and other dairy alternative beverages are available?

◯ 0     ◯ 1     ◯ 2     ◯ ≥3

17. How many different options of 100% fruit and vegetable juice are available?

◯ 0     ◯ 1     ◯ 2     ◯ ≥3

18. How many healthy (≤25 cal/8 oz.) bottled beverage options are available?

Do not include milk, juice, or diet soft drinks. Healthy beverages are those that have <25% of calories from (natural) sugar and has no added caloric sugar (sucrose, HFCS, etc.)

◯ 0     ◯ 1–2     ◯ 3–4     ◯ ≥5     ◯ N/A

19. How many healthy (≤25 cal/8 oz.) fountain beverage options are available? This includes water, infused water, unsweetened ice tea etc.

Do not include milk, juice, or diet soft drinks. Healthy beverages are those that have <25% of calories from (natural) sugar and has no added caloric sugar (sucrose, HFCS, etc.)

◯ 0     ◯ 1–2     ◯ 3–4     ◯ ≥5     ◯ N/A

BEHAVIORAL DESIGN

20. Is there a grab-and-go area with healthy sandwich/wraps, salad, or snack options?

◯ Yes     ◯ No     ◯ N/A—no grab-n-go

21. Are there signs, banners, displays or posters encouraging healthy food, snacks, or drink choices?

◯ Yes     ◯ No

22. At the checkout counter, are there healthier options (fresh fruit, baked chips, trail mix) available?

◯ Yes     ◯ No

23. At the checkout counter, are healthier beverages available in the beverage cooler?

◯ Yes     ◯ No     ◯ N/A—no beverage cooler

24. Are healthier beverages positioned at eye-level in the cooler?

◯ Yes     ◯ No     ◯ N/A

25. Are low-fat dairy products placed at eye level in the cooler?

◯ Yes     ◯ No     ◯ N/A

26. Are endcap displays used for promotion of nutrition initiatives (Be-FIT, Better 4 U) and healthy eating ideas?

◯ Yes     ◯ No

27. Are healthy food icons, characters/displays used throughout the venue to identify healthier food choices?

◯ Yes     ◯ No     ◯ N/A

28. Are there discounts, or specials promoting healthy food choices?

For example: combo meals or coupons advertised at the pump

◯ Yes     ◯ No