Appendix A Hispanic Study English Questionnaire

Appendix A

Comparing Nutrition Knowledge, Attitude and Behavior among

English-dominant Hispanics, Spanish-dominant Hispanics, and Other Consumers

QUESTIONNAIRE

[RECORD LANGUAGE USED IN THE QUESTIONNAIRE: ENGLISH OR SPANISH]

Form Approved: OMB No. 0910-xxxx

Expiration Date: xx/xx/201x

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A. knowledge, attitude and behavior toward nutrition and health

A1

Think about shopping for food products at the store. On a scale of 1 to 5 where 1 is not important at all and 5 very important, how important to you is each of the factors listed below? [RANDOM ORDER]

1 2 3 4 5 Don’t know (DK)

a. taste

b. price

c. brand

d. healthiness or nutritional qualities

e. convenience

A2

How much do you agree or disagree with each of the following statements? [RANDOM ORDER]

Strongly agree Somewhat agree Somewhat disagree Strongly disagree DK

1. If I get the right amount of exercise, I can greatly reduce my chance of getting heart disease.

2. Some people are born to be fat and some thin; there is not much one can do to change this.

3. I generally know which fast food items have more calories and which have fewer calories.

4. To lose weight, one must give up some of his or her favorite foods.

5. There are so many recommendations about healthy ways to eat; it is hard for me to know what to believe.

6. If I eat a healthy diet I can greatly reduce my chance of getting heart disease.

7. If I eat a healthy diet I can greatly reduce my chance of getting cancer.

8. I generally know which menu items in a restaurant have more calories and which have fewer calories.

A3

Compared to what you believe is healthy, do you think your diet is too low, too high, or about right in [RANDOM ORDER]

Too low Too high About right DK

1. calories

2. fiber

3. sugar

4. fat

5. cholesterol

6. carbohydrates

A4

Have you tried to limit any of the following things in your diet in the past 30 days? [RANDOM ORDER]

Yes No DK

1. calories

2. fat

3. sodium

4. sugar

5. cholesterol

6. carbohydrates

A5

The next questions ask about different kinds of fat in foods we eat. Have you ever heard of the following types of fat? [RANDOM ORDER]

Yes No DK

1. trans fat or trans fatty acid

2. saturated fat

3. omega 3 fatty acid

A6 [IF ANSWER TO AN ITEM IS YES, ASK A6 FOR THE SAME ITEM; KEEP SAME ORDER AS IN A5]

As far as you know, does [insert fat] raise the risk of heart disease, lower the risk of heart disease, or have no effect on the risk of heart disease, or don’t you know?

Raises the risk of heart disease

lowers the risk of heart disease

has no effect on the risk of heart disease

DK

A7

If one wants to lose weight, which is more important, [RANDOM ORDER] eating less fat or eating fewer calories?

Less fat Less calories DK

A8

Have you taken a multi-vitamin or multi-mineral supplement in the past 12 months, that is, since (month) 2010? [THESE PRODUCTS ARE THINGS LIKE ONE-A-DAY, MEGA-VITAMIN, CENTRUM A-TO-ZINC, AND OTHER PRODUCTS THAT CONTAIN A VARIETY OF DIFFERENT VITAMINS, MINERALS, AND MAY ALSO CONTAIN OTHER THINGS AS WELL.]

Yes No DK

A9

In the past 12 months, have you taken a specialized or single-ingredient vitamin or mineral supplement such as Vitamin C, Vitamin E, iron, or calcium?

Yes No DK

A10

Have you taken any kind of herbs, botanicals, or other dietary supplements in the past 12 months, that is, since (month) 2011? These products are things like garlic pills, echinacea, ginkgo, glucosamine, St. John's wort, amino acids, or fish oil.

Yes No DK

A11 [IF ANY OF A8, A9, A10 = YES]

Before you try a dietary supplement for the first time, do you usually, sometimes, hardly ever, or do you never look for information about the supplement?

Usually sometimes hardly ever never DK

A12 [IF A11 IS NOT HARDLY EVER OR NEVER]

How much information about a dietary supplement product do you get from each of the following sources? [KEEP a-b AS FIRST TWO ITEMS AND ROTATE items c – h]

A lot of information A little of information No information DK

a. a medical doctor, physician's assistant, registered nurse, or dietitian

b. an alternative medicine practitioner like a nutrition therapist or a herbal therapist

[ALSO INCLUDES: PRACTITIONER/THERAPIST

OF ACUPUNCTURE, BIOFEEDBACK,

CHIROPRACTIC, CHELATION THERAPY,

ENERGY HEALING/REIKI, FOLK MEDICINE,

HEPNOSIS, HERBAL THERAPY, HOMEOPATHY,

MASSAGE, NATUROPATHY, NUTRITION

THERAPY, OSTEOPATHY.]

c. family or friends

d. a sales person at a store

e. newspapers, magazines, books, or medical articles

f. television or radio

g. the Internet

h. product labels

A13 [IF ANY OF A8, A9, A10 = YES]

As far as you know, does the government set manufacturing standards for dietary supplements?

Yes No DK

A14 [IF ANY OF A8, A9, A10 = YES]

As far as you know, does the government approve dietary supplements before they are marketed to consumers?

Yes No DK

B. health literacy, and use and understanding of food labels and label information

[SHOW THE NUTRITION FACTS LABEL]

B1

Please look at this label as long as you like. The next six questions will be about this label. If you eat the entire container, how many calories will you eat?

__________ calories

B2

If you are allowed to eat 60 g of carbohydrates as a snack, how much of this product could you have?

__________

B3

Suppose your doctor advises to reduce the amount of saturated fat in your diet. You usually have 42 g of saturated fat each day, which includes 1 serving of this product. If you stop eating this product, how many grams of saturated fat would you be consuming each day?

__________ grams

B4

If you usually eat 2,500 calories in a day, what percentage of your daily value of calories will you be eating if you eat one serving of product?

__________ percent

B5

Pretend that you are allergic to the following substances: penicillin, peanuts, latex gloves, and bee stings. Is it safe for you to eat this product?

Yes No DK

B6 [IF B5 = NO]

Why is it not safe for you to eat this product?

_______________________

[B7-B12: AT EACH QUESTION, SHOW THE SAME LABEL AS IN B1]

B7

How often do you use the information on the serving size on a food label?

Always most of the time sometimes rarely never DK

B8

How about the information on the percent daily value?

Always most of the time sometimes rarely never DK

B9

Now think about the serving size information on a food label. What does serving size mean to you? Please check all that apply. You can also fill in your answer, if it is not listed. [RANDOM ORDER, EXCEPT ITEM D]

1. the amount of a food that people should eat

2. the amount of a food that people usually eat

3. something that makes it easier to compare foods

4. Other ___________________

B10

Next, look at the label and focus on the “total fat” line. There is a 20% under “% Daily Value.” What does the “20%” mean to you? [RANDOM ORDER, EXCEPT ITEM F]

1. The product has 20% of the minimum amount of total fat that a person should eat in a day

2. 20% of the weight of this product is total fat

3. The product has 20% of maximum amount of total fat that a person should eat in a day

4. A person should get 20% of calories from total fat in a day

5. The product has 20% of the total fat that a person should eat in a day

6. Other _____________________

B11

When you buy a food product for the first time, how often do you read the label, like the one you see here, to find out how much it has in things like calories, fat, sodium, or vitamins?

Regularly Occasionally Hardly ever Never DK

B12

People tell us they use food labels in many different ways. When you read food labels, either in the store or at home, how often, if at all, do you use the labels in the following ways? [RANDOM ORDER]

Often Sometimes Rarely Never DK

a. To help you decide which brand of a particular food item to buy

b. To figure out how much of the food product you or your family should eat

c. To compare different food items with each other

d. To see if something said in advertising or on the package is actually true

e. To get a general idea of the nutritional content of the food

f. To see how high or low the food is in things like calories, salt, vitamins, or fat

g. To help you in meal planning

h. To see if there is an ingredient that you or someone in your family should avoid

B13

Food packages sometimes have statements on the front of the package that describe the amount of certain nutrients in the product, such as “low fat,” “high fiber” or “cholesterol-free.” When it is available, how often do you use this information on certain nutrients when deciding to buy a food product?

Often Sometimes Rarely Never DK

B14

About how many of the food labels that use statements like “low fat,” “high fiber” or “cholesterol free” to describe the amount of certain nutrients, do you believe are accurate?

Just about all of them Most of them Only some of them

Almost none of them DK

B15

How much do you agree with each of the following statements? Please select one for each statement. [RANDOM ORDER]

Strongly agree Somewhat agree Somewhat disagree Strongly disagree DK

1. I feel confident that I know how to use food labels to choose a nutritious diet

2. The nutrition information on food labels is hard to interpret

3. Reading food labels takes more time than I can spare

4. I would like to learn more about how to use food labels to choose a nutritious diet

5. Using food labels to choose foods would be better than just relying on my own knowledge about what is in them

B16 [Latino Panelists only]

Of Hispanic/Latino and American food, do you usually eat

1. Mainly Hispanic/Latino foods

2. Mostly Hispanic/Latino foods and some American food

3. Equal amounts of both Hispanic/Latino and American foods

4. Mostly American foods and some Hispanic/Latino foods

5. Mainly American foods

B17. [ALL respondents]

How often do you or your family usually go out to eat at or bring home ready-to-eat foods from

Less than 1-2 times per week 3-4 times per week 5 or more times per week Never DK

1. Relatives’ or Friends’ homes

2. Fast food restaurants (including Chinese and Latino food)

3. Sit down restaurants (with table service)

4. Buffet restaurants (including Chinese buffet)

5. Pick-up-and-take-home restaurants

6. Grocery stores (hot or cold ready-to-eat food from store)

7. Cafeterias (school or work)

8. Vending machines

9. On-street vendors (including trucks, carts, wagons)

10. Other (for example quick marts and bakeries)

B18 [IF B17b = YES]

Do you remember seeing at fast-food restaurants the numbers of calories for different foods and drinks? This information may be shown behind the cashier.

Yes No DK

B19 [IF B18 = YES]

Have you ever decided on what to order at fast-food restaurants because you saw the numbers of calories for different foods and drinks?

Yes No DK

B20 [IF B17c = YES]

Do you remember seeing at the sit-down restaurant information on how many calories each food or drink has? This information may be shown on the menu or on napkins and placemats.

Yes No DK

B21 [IF B20 = YES]

Have you ever decided on what to order at sit-down restaurants because you saw the numbers of calories for different foods and drinks?

Yes No DK

C. Degree of acculturation

[LATINO PANELISTS ONLY]

C1

In general, what language(s) do you read and speak?

Only Spanish Spanish better than English Both equally

English better than Spanish Only English DK

C2

What language(s) do you usually speak at home?

Only Spanish Spanish better than English Both equally

English better than Spanish Only English DK

C3

In which language(s) do you usually think?

Only Spanish Spanish better than English Both equally

English better than Spanish Only English DK

C4

What language(s) do you usually speak with your friends?

Only Spanish Spanish better than English Both equally

English better than Spanish Only English DK

C5

Which of the following best describes your Hispanic/Latino heritage? (Check one)

Dominican or Dominican descent

Central American or Central American descent

Cuban or Cuban descent

Mexican or Mexican descent

Puerto - Rican or Puerto Rican descent

South American or South American descent

More than one heritage

Other

DK or Prefer not to answer

D. health status and demographic characteristics

D1

Would you say your health in general is …

Excellent Very good Good Fair Poor DK

D2

Have you been told by a doctor or other healthcare professional that you have any of these health problems? Check all that apply. [RAMDOM ORDER]

1. cancer

2. diabetes

3. heart disease

4. hypertension or high blood pressure

5. high cholesterol

6. obesity or overweight

7. osteoporosis or bone problem

8. stroke

D3

Are these health problems of concern to you? Check all that apply. [RAMDOM ORDER]

9. cancer

10. diabetes

11. heart disease

12. hypertension or high blood pressure

13. high cholesterol

14. obesity or overweight

15. osteoporosis or bone problem

16. stroke

D4

Do you consider yourself to be …

Overweight Underweight About the right weight DK

D5

Have you been told by a doctor or other healthcare professional that you are overweight?

Yes No DK

D6 [IF (D4= OVER- OR UNDERWEIGHT) OR D5=YES]

Are you concerned about your being over/underweight?

Yes No DK

D7 [IF D6=YES]

Are you very concerned or somewhat concerned about your being over/underweight?

Very concerned somewhat concerned DK

D8

Are you taking any action about your weight?

Yes No DK

D9

The next two questions may seem a bit personal, but we need this information because our research is about nutrition and health. How tall are you without shoes?

____ feet _____ inches (or _______ cm) Prefer not to answer

D10

How much do you weigh without shoes?

_____ pounds (or ______ kg) Prefer not to answer

END OF QUESTIONNAIRE

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