Starting the Conversation Nutrition and Physical Activity, Barriers, and Behaviors Questions, Ages 4–12
| Question | Response Options |
|---|---|
| Healthy eating behaviors | |
| How many servings of fruits and/or vegetables does your child eat each day? | 5 or more, 3–4, less than 3 |
| How many sugary drinks (soda, sports drinks, sweet tea, lemonade, “Kool-Aid”) and fruit juice does your child drink each day? | 1 or fewer, 2, more than 2 |
| How many snacks like cakes, cookies, ice cream, candy, and chips does your child eat each day? | 1 or fewer, 2–3, more than 3 |
| How many times a week does your child eat food purchased away from home (fast food, convenience stores, vending machines)? | 1 or fewer, 2–3, more than 3 |
| The milk that my child most often drinks is… | Skim or 1% milk, 2%, whole, none |
| Healthy eating barriers | |
| Sometimes it seems like the only way to get my child to behave is to promise candy or other food treats. | Disagree, agree a little, agree a lot |
| “Healthy foods cost too much.” | Disagree, agree a little, agree a lot |
| “My child doesn’t like healthy foods.” | Disagree, agree a little, agree a lot |
| “I find that healthy meals take too long to prepare.” | Disagree, agree a little, agree a lot |
| “My child likes to eat in front of the TV or at the computer.” | Disagree, agree a little, agree a lot |
| Readiness to change (nutrition) | |
| How do you feel about making some changes to help your child eat healthier? | I am not interested in making changes at this time. |
| I am not ready to make changes yet, but want to talk more. | |
| I am ready to make some changes now and would like help. | |
| I am already helping my child to eat healthier and don’t feel there is much more to do. | |
| Physical activity behaviors | |
| How many hours of active play does your child get every day? | More than 2, 1–2, fewer than 1 |
| How many days a week does your child play outdoors? | 5 or more, 3–4, 0–2 |
| How many hours of “screen time” (TV, video, computer games) does your child get each day? | 0–2, 3, more than 3 |
| How often is your child involved in school sports teams or community groups like basketball, swimming or step/dance? | More than once a week, once a week, rarely/never |
| How many days a week does your family or community do active things together? | More than 3, 2–3, less than 2 |
| Physical activity barriers | |
| “When my child misbehaves, I take away their outdoor/indoor play time.” | Disagree, agree a little, agree a lot |
| “It’s hard for me to find time to play outside with my child.” | Disagree, agree a little, agree a lot |
| “It takes too much time and money to have my child involved with sports programs.” | Disagree, agree a little, agree a lot |
| “My child feels that s/he will get teased when playing outside or on a team.” | Disagree, agree a little, agree a lot |
| “I feel like I’m too busy to drive my child to activities and sports.” | Disagree, agree a little, agree a lot |
| Readiness to change physical activity | |
| How do you feel about making some changes to help your child be more active? | I am not interested in making changes at this time. |
| I am not ready to make changes yet, but want to talk more. | |
| I am ready to make some changes now and would like help. | |
| I am already helping my child to be more active and don’t feel there is much more to do. |