Appendix A
FDA Food Safety Survey
DRAFT 6 13 14
NOTES: 1. HP2010/HP2020 QUESTIONS ARE MARKED HP 2. TRACKING ITEMS FROM 1988, 1993, 1998, 2001, 2006, 2010 ARE MARKED (TR88, TR93, TR98, TR01, TR06, TR10) 3. “V” DENOTES A VERSIONED QUESTION 4. RESPONSES IN ALL CAPITAL LETTERS ARE NOT READ TO RESPONDENT 5. CATI PROGRAMMER ENSURE ALL LISTS APPEAR ON A SINGLE PAGE |
|
CONVERSION. Refusal conversion
1 = Yes
2 = No
CALL_ATTEMPTS. Number of calls made to contact respondent
1 = Yes
2 = No
AREA. Area Code
ZIP. Zip Code
STATE. State
DATE. Date of Interview
PHONE. Type of phone reached
1=Landline
2=Cell phone
LANG. Language used for survey administration
EN = English
ES =
Spanish
VRN. Survey version
1= Version 1
2 = Version
2
FINALWT: Final weight without non-response adjustment (weighting scheme used for previous Food Safety Surveys)
FINALWT_NR: Non-response adjusted final weight
INTRODUCTION:
Hello, I'm ________________ with Ipsos. I am calling on behalf of the United States Food and Drug Administration, the FDA. We’re not selling anything. We’re doing a study about food. Have I reached you on a landline phone or a cell phone?
[IF LANDLINE]
SCR1. May I speak to the member of your household who is aged 18 or over and has had the most RECENT birthday? Would that be you?
[IF SCR2:1, REINTRODUCE; IF SCR2:2, ASK FOR THE FIRST NAME OF THE ELIGIBLE RESPONDENT FOR CALL-BACK PURPOSE. REINTRODUCE AS NECESSARY.]
SCR2. May I speak with a member of the household who is at least 18 years old and has the most recent birthday?
Yes
No/Not available
(IF NOT AVAILABLE, ASK FOR THE FIRST NAME OF THE ELIGIBLE RESPONDENT FOR CALL-BACK PURPOSE. REINTRODUCE AS NECESSARY.)
[ONLY respondents reached via a cell number]
SCR4. Are you at least 18 years old or under 18?
Yes, 18+ years old
No, under 18
[IF SCR4:1; CONTINUE, OTHERWISE TERMINATE]
FIRST QUESTION SCRIPTED
[ASK SCR0 OF ALL RESPONDENTS]
SCR0. INTERVIEWER DO NOT READ. Is respondent on cell phone or landline?
Landline phone
Cell phone
INTERVIEWER WARNING: YOU HAVE SELECTED [INSERT SCR0 RESPONSE]. IS THIS CORRECT?
YES
NO
[IF NO GO BACK TO SCR0 AND ENTER CORRECT RESPONSE]
SCR3. This call may be monitored for quality control purposes. Your answers to this survey are voluntary and will be kept confidential. The survey will take about 15 minutes.
[ONLY respondents reached via a landline number]
SCR3a. For personal calls, do you only use a landline phone at your household, or do you also have cell phone service on which I could have reached you?
Landline only
Cell phone also
[SCR5 ON ONLY RESPONDENTS REACHED VIA A CELL NUMBER]
SCR5. For personal calls, do you only use a cell phone, or do you also have regular landline phone at your household on which I could have reached you?
Cell phone only
Landline also
This call may be monitored for quality control purposes. Your answers to this survey are voluntary and will be kept secure to the extent provided by law. The survey will take about 15 minutes.
(INTERVIEWER: CODE SEX WITHOUT ASKING)
Sb4. Male
Female
Not Sure
[ALL RESPONDENTS] GO TO SURVEY.
A1. TR98,
TR01, TR06, TR10
To
start off, I would like to ask, how
common do you think it is for people in the United States to get food
poisoning because of the way food is prepared in their home? Would
you say that it is…
1. very common,
2. somewhat common, or
3. not very common?
8. DON’T KNOW
9. REFUSED
A2. TR98,
TR01, TR06, TR10
How common do you think it is for people in the
United States to get food poisoning from restaurant food? Would you
say that it is…
1. more common than from food prepared at home,
2. less common than food prepared at home, or
3. about the same as food prepared at home?
8. DON’T KNOW
9. REFUSED
A4. TR01,
TR98, TR06, TR10
Do you think contamination of food by
micro-organisms, such as germs, is a serious food safety problem,
somewhat of a problem, or not a food safety problem at all?
1. SERIOUS FOOD SAFETY PROBLEM
2. SOMEWHAT OF A FOOD SAFETY PROBLEM
3. NOT A FOOD SAFETY PROBLEM AT ALL
8. DON’T KNOW
9. REFUSED
A5. TR98,
TR01, TR06, TR10
How likely do you think it is that the
following foods contain germs or other micro-organisms that could
make you sick? Please use any number between 1 and 5, where 1 is “not
at all likely” and 5 is “very likely.”
A5A. TR06,
TR10
Raw chicken — how likely is it that raw chicken has
germs that could make you sick? Remember that 1 is “not at all
likely” and 5 is “very likely.”
1. (NOT AT ALL LIKELY) 2 3 4 5(VERY LIKELY)
8. DON’T KNOW
9. REFUSED
(ROTATE A5BV1 – A5DV1)
A5BV1. How about raw beef? IF NECESSARY: How likely is it that raw beef has germs that could make you sick? Remember that 1 is “not at all likely” and 5 is “very likely.”
1. (NOT AT ALL LIKELY) 2 3 4 5(VERY LIKELY)
8. DON’T KNOW
9. REFUSED
A5CV1. How about raw fruits? IF NECESSARY: How likely is it that raw fruits have germs that could make you sick? Remember that 1 is “not at all likely” and 5 is “very likely.”
1. (NOT AT ALL LIKELY) 2 3 4 5(VERY LIKELY)
8 DON’T KNOW
9 REFUSED
A5DV1. How about raw eggs? IF NECESSARY: We are only talking about unpasteurized eggs. IF NECESSARY: How likely is it that raw eggs have germs that could make you sick?
1. (NOT AT ALL LIKELY) 2 3 4 5(VERY LIKELY)
8. DON’T KNOW
9. REFUSED
(ROTATE A5EV2 – A5GV2)
A5EV2. How about raw vegetables? IF NECESSARY: How likely is it that raw vegetables have germs that could make you sick? Remember that 1 is “not at all likely” and 5 is “very likely.”
1. (NOT AT ALL LIKELY) 2 3 4 5(VERY LIKELY)
8. DON’T KNOW
9. REFUSED
A5FV2. How about raw shellfish? (DO NOT READ: SHELLFISH INCLUDES CLAMS, OYSTERS, SHRIMP.) IF NECESSARY: How likely is it that raw shellfish has germs that could make you sick? Remember that 1 is not at all likely and 5 is very likely.
1. (NOT AT ALL LIKELY) 2 3 4 5(VERY LIKELY)
8. DON’T KNOW
9. REFUSED
A5GV2. How about foods that contain raw fish, like ceviche (se-VEE-chay) or sushi? IF NECESSARY How likely is it that raw fish has germs that could make you sick? Remember that 1 is not at all likely and 5 is very likely.
1. (NOT AT ALL LIKELY) 2 3 4 5(VERY LIKELY)
8. DON’T KNOW
9. REFUSED
Now, I have some questions about cooking at home.
D1. TR93-TR10
Where
you live, do you have a refrigerator and either a stove or microwave?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
[IF D1=2 OR 8 OR 9, GO TO E20V1 or E9V2]
D2. TR93-TR10
How
often do you prepare the main meal in your household? Do you prepare
the main meal...
1. All or nearly all of the time,
2. Only some of the time, or
3. Never?
8. DON’T KNOW
9. REFUSED
D4. HP
Before you begin preparing food, how often do you wash your
hands with soap?
1. All of the time
2. Most of the time
3. Some of the time, or
4. Rarely
8. DON’T KNOW
9. REFUSED
[IF D2 = 3 OR 8 OR 9 GO TO D9]
D5. TR98,
TR01, TR06, TR10
[IF D2 = 1 or 2, THEN D5]
Do you ever
prepare fish or shellfish?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
D6. TR98,
TR01, TR06, TR10
[IF D5=1]
Do you ever prepare meals where
you begin with raw fish or shellfish? (INTERVIEWER: CLARIFY IF
NECESSARY: Do not include canned fish, frozen fish sticks, frozen
fish dinners, and other pre-cooked items. INTERVIEWER NOTE: ALL
CANNED ITEMS ARE COOKED. CRAB MEAT IS SOLD ONLY COOKED (EXCEPT LIVE
CRABS)) (IF FROZEN, CLARIFY: Is that frozen raw or frozen cooked?)
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
D6a. NEW [IF D6=1]
How many days per week do you prepare meals where you begin with raw fish?
RECORD ANSWER AS 1 to 7
88. LESS THAN ONCE PER WEEK
98. DON’T KNOW
99. REFUSED
D7. TR98,
TR01, TR06, TR10
[IF D2= 1 or 2, THEN D7]
Do you ever
prepare meat or chicken?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
D8. TR98,
TR01, TR06, TR10
[ASK IF D7= 1]]
Do you ever prepare meals
where you begin with raw meat or chicken? (NOTE: FROZEN MEAT IS FINE
AS LONG AS IT IS FROZEN RAW.)
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
D8a. NEW [IF D8=1]
How many days per week do you prepare meals where you begin with raw meat or chicken?
RECORD ANSWER AS 1 to 7
88. LESS THAN ONCE PER WEEK
98. DON’T KNOW
99. REFUSED
D9. HP
(THIS QUESTION IS NO LONGER VERSIONED. ALL RESPONDENTS SHOULD GET
IT.)
In your home, are hamburgers usually served rare, medium,
or well done?
[CLARIFY: IF DIFFERENT WAYS FOR DIFFERENT PEOPLE:
What is the rarest degree of doneness hamburgers are served?]
1. RARE, (GO TO D11)
2. MEDIUM (GO TO D10)
3. WELL DONE (GO TO D11)
4. MEDIUM RARE (GO TO D10) [DO NOT READ]
5. MEDIUM WELL (GO TO D10) [DO NOT READ]
6. HAMBURGERS ARE NEVER SERVED (GO TO D11) [DO NOT READ]
8. DON’T KNOW (GO TO D11)
9. REFUSED (GO TO D11)
D10. HP
[ASK IF D9 = 2, 4, or 5]
When you say hamburgers are usually
served “medium / medium well / medium rare” (HAVE THE
ANSWER FROM PREVIOUS QUESTION POP UP) do you mean they are...
1. brown all the way through, or
2. still have some pink in the middle?
8. DON’T KNOW
9. REFUSED
(ROTATE D11, D12, D13.)
(NON-COOKS, D2 =3 or 8 or 9, GO to D17)
D11. HP
[ASK IF D2 = 1 or 2]
After you have cracked open raw eggs, do
you usually continue cooking, or do you first rinse your hands with
water, or wipe them, or wash them with soap? IF NECESSARY TO CLARIFY
“CONTINUE COOKING”: Touching anything besides the eggs,
such as cookware, bottles of seasoning, or other ingredients.
1. CONTINUE COOKING
2. RINSE OR WIPE HANDS
3. WASH WITH SOAP
4. NEVER HANDLE RAW EGGS
8. DON’T KNOW
9. REFUSED
D12. HP
[ASK IF D8 = 1]
After handling raw meat or chicken, do you
usually continue cooking, or do you first rinse your hands with
water, or wipe them, or wash them with soap? WASH WITH WATER IS CODED
WITH RINSE. IF NECESSARY TO CLARIFY “CONTINUE COOKING”:
You touch anything besides the meat, such as cookware, bottles of
seasoning, or other ingredients.
1. CONTINUE COOKING
2. RINSE OR WIPE HANDS
3. WASH WITH SOAP
4. DON’T HANDLE RAW MEAT OR CHICKEN
8. DON’T KNOW
9. REFUSED
D13. HP
[ASK IF D6 = 1]
After handling raw fish, do you usually continue
cooking, or do you first rinse your hands with water, or wipe them,
or wash them with soap. IF NECESSARY TO CLARIFY “CONTINUE
COOKING”: You touch anything besides the fish, such as
cookware, bottles of seasoning, or other ingredients.
1. CONTINUE COOKING
2. RINSE OR WIPE HANDS
3. WASH WITH SOAP
4. NEVER HANDLE RAW FISH
8. DON’T KNOW
9. REFUSED
D14. HP
[IF D8 = 1]
After you have used a cutting board or other
surface for cutting raw meat or chicken, do you use it as it is for
other food to be eaten raw for the same meal, or do you first rinse
it, or wipe it, or wash it with soap? Interviewer
note: “put it in the dishwasher” should be coded as “wash
with soap.” WASH WITH WATER IS CODED AS RINSE.
1. USE AS IT IS
2. RINSE OR WIPE IT
3. WASH WITH SOAP
4. WASH WITH BLEACH/ DISINFECTANT
5. USE A DIFFERENT BOARD
6. DON’T CUT RAW MEAT OR POULTRY
7. OTHER
98. DON’T KNOW
99. REFUSED
(Raw fish and raw meat cooks)
D15. HP
[ASK IF D6 = 1 and D8=1]
After cutting raw fish or shellfish,
what do you do with the cutting board or surface? IF NECESSARY: Do
you use it as it is for cutting food to be eaten raw for the same
meal, or do you first rinse it, wipe it, or wash it with soap?
Interviewer
note: “put it in the dishwasher” should be coded as “wash
with soap.” WASH WITH WATER IS CODED AS RINSE.
1. USE AS IT IS
2. RINSE OR WIPE IT
3. WASH WITH SOAP
4. WASH WITH BLEACH/ DISINFECTANT
5. USE A DIFFERENT BOARD
6. DON’T CUT RAW FISH OR SHELLFISH
7. OTHER
98. DON’T KNOW
99. REFUSED
(Raw fish cooks who are not raw meat cooks)
D16. HP
[ASK IF D6 = 1 and D8 = 2, DK, or REF]
After you have used a
cutting board or other surface for cutting raw fish or shellfish, do
you use it as it is for other food to be eaten raw for the same meal,
or do you first rinse it, wipe it, or wash it with soap?
Interviewer note: “put it in the dishwasher” should be
coded as “wash with soap.” WASH WITH WATER IS CODED AS
RINSE.
1. USE AS IT IS
2. RINSE OR WIPE IT
3. WASH WITH SOAP
4. WASH WITH BLEACH/ DISINFECTANT
5. USE A DIFFERENT BOARD
6. DON’T CUT RAW FISH OR SHELLFISH
7. OTHER.
98. DON’T KNOW
99. REFUSED
D19V1. NEW [IF D8=1]
Thinking back do you generally wash or clean small cuts of raw poultry before cooking them? [IF NEEDED: Examples of small cuts of poultry include breasts, thighs, wings?] Would you say…..
No, you don’t wash or clean small cuts of raw poultry
You wash them with water only
You wash them in the sink with water and either salt/lime/vinegar, or lemon juice.
You rinse the poultry with boiling water.
Parboil, or
Do you use some other method? What? _______________
DON’T KNOW
REFUSED
D20V1. NEW
Do you regularly use a kitchen sponge for things like washing dishes or wiping counters?
1. YES
2. NO
8 DON’T KNOW
9. REFUSED
D21V1. NEW
How often do you usually replace your kitchen sponge? Would you say…
Daily
Weekly
A few times a month
Monthly, or
Less often than once a month?
98. DON’T KNOW
99. REFUSED
D22V1. NEW
Do you ever sanitize your kitchen sponge?
1. YES
2. NO
8 DON’T KNOW
9. REFUSED
D23V1. NEW [IF D25V1=1]
How do you usually sanitize your kitchen sponge? Do you… (ROTATE ANSWERS)
D23V1a. Microwave it? (YES/NO/DON’T KNOW/REFUSED)
D23V1b. Run it through the dishwasher? (YES/NO/DON’T KNOW/REFUSED)
D23V1c. Put bleach on it? (YES/NO/DON’T KNOW/REFUSED)
D23V1d. Rinse it out in hot water? (YES/NO/DON’T KNOW/REFUSED)
D23V1e. Rise it out in cold water?, or (YES/NO/DON’T KNOW/REFUSED)
D23V1f. Do you use some other method? (YES/NO/DON’T KNOW/REFUSED)
D23V1FOTR. Please specify ________.
D24V1. NEW [IFD25V1=1]
How often do you usually sanitize your kitchen sponge? Would you say…
Daily
Weekly
A few times a month
Monthly, or
Less often than once a month?
98. DON’T KNOW
99. REFUSED
D25V1. NEW [IF D8=1]
After preparing raw meat or chicken, which of the following do you use to clean counter tops? Do you use…
1. a Dish cloth(YES/NO/DON’T KNOW/REFUSED)
2. Sponge (YES/NO/DON’T KNOW/REFUSED)
3. Paper towel (YES/NO/DON’T KNOW/REFUSED)
4. Sanitizer wipes (YES/NO/DON’T KNOW/REFUSED)
5. Plain water (YES/NO/DON’T KNOW/REFUSED)
6. Hot soapy water (YES/NO/DON’T KNOW/REFUSED)
7. Bleach (YES/NO/DON’T KNOW/REFUSED)
8. Kitchen cleaner/sanitizing spays (YES/NO/DON’T KNOW/REFUSED)
9. Other, please specify (YES/NO/DON’T KNOW/REFUSED)
D26 V1. [IF D25v1=1]
What do you usually do with the dish cloth after you finish cleaning the counter (IF NEEDED, AFTER PREPARING RAW MEAT OR CHICKEN). Do you…
1. Use again for other tasks such as drying dishes
2. Rinse it out in water
3. Wash in hot soapy water
4. Launder in the washing machine
5. Wash in the dishwasher
6. Throw away
7. or,something else?
8. DON’T KNOW
9. REFUSED
D27V1. Which of the following do you use for drying your hands in the kitchen? (YES/NO/DN/REFSUED for each)
1. A towel that is only used for drying hands
2. The same towel that is used to dry dishes or for other tasks
3. A fresh paper towel
4. A paper towel that is also used to dry dishes or other tasks
5. Your apron
6. Other.
D28V1. NEW [IF D25v1=1or D27v1=2]
How often do you use a new or freshly washed dish cloth? Would you say…
1. Daily
2. A couple of times each week
3. Weekly
4. Monthly,
5. or, Less than once a month
8. DON’T KNOW
9. REFUSED
D29V1. NEW
Do you have any pets in your household?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
D30V1. NEW [IF D27=1]
What type of pets do you have? Do you have a…(ASK HOW MANY FOR EACH – ENTER THE NUMBER. ENTER 0 (ZERO) IF NONE)
D28a. Dog
D28b.Cat
D28c. Bird
D28d. Rabbit
D28e. Reptile or amphibian such as a snake, turtle or lizard or a frog.
D28f. Other pet.
D31V1. NEW [IF D28b >0]
Do you keep your cat(s) inside at all times, outside at all times, or does your cat(s) go both inside and outside? (IF CAT ONLY GOES ON SCREENED-IN PORCH CODE AS INSIDE)
INSIDE ONLY
OUTSIDE ONLY
INSIDE AND OUTSIDE
8. DON’T KNOW
9. REFUSED
D32V1. NEW [IF D28b>0]
Do you always wash your hands after cleaning the cat litter box?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
D33V1. NEW [IF D27V1=1]
When you are preparing food, is your pet(s) allowed to be in the kitchen?
YES
NO
ONLY SOME PETS
8. DON’T KNOW
9. REFUSED
D34V1. NEW [IF D27V1=1]
Are your pet(s) allowed on the kitchen counter?
1. YES
2. NO
3. ONLY SOME PETS
8. DON’T KNOW
9. REFUSED
D35V1. NEW [IF D32V1=2]
Do your pet(s) ever get on the kitchen counter?
1. YES
2. NO
3. ONLY SOME PETS
8. DON’T KNOW
9. REFUSED
E1.
HP [ASK IF D7 = 1]
If you cook a large pot of soup, stew, or
other food with meat or chicken and want to save it for the next day,
when do you put the food in the refrigerator? Would it be...(CLARIFY:
IF A NUMBER OF METHODS ARE USED THAT INCLUDE COOLING IT TO ROOM
TEMPERATURE THEN MARK ROOM TEMPERATURE)
1. Immediately
2. After first cooling it at room temperature, or
3. After first cooling it in cold water?
4. DO NOT COOK SUCH FOODS [DO NOT READ]
5. WOULD NOT REFRIGERATE IT [DO NOT READ]
8. DON’T KNOW
9. REFUSED
E2. HP
[ASK IF E1 = 2]
For about how long would you let it cool at room
temperature?
1. LESS THAN TWO HOURS [DO NOT READ]
2. TWO HOURS OR MORE / ABOUT 2 HOURS [DO NOT READ]
8. DON’T KNOW [DO NOT READ]
9. REFUSED [DO NOT READ]
(Fish cooks who also cook meat)
E3. HP
[IF D5 = 1 AND D7 = 1]
How about if the soup or stew contains
fish or shellfish instead of meat or chicken. If you want to save it
for the next day, when do you put the food in the refrigerator? Would
it be....(CLARIFY: IF A NUMBER OF METHODS ARE USED THAT INCLUDE
COOLING IT TO ROOM TEMPERATURE THEN MARK ROOM TEMPERATURE)
1. Immediately
2. After first cooling it at room temperature, or
3. After first cooling it in cold water?
4. DO NOT COOK SUCH FOODS [DO NOT READ]
5. WOULD NOT REFRIGERATE IT [DO NOT READ]
8. DON’T KNOW [DO NOT READ]
9. REFUSED [DO NOT READ]
(Fish cooks who do not cook meat)
E4. HP
[IF D5 = 1 AND D7 = 2, DK, or REF]
If you cook a large pot of
soup, stew, or other food with fish or shellfish and want to save it
for the next day, when do you put the food in the refrigerator? Would
it be....(CLARIFY: IF A NUMBER OF METHODS ARE USED THAT INCLUDE
COOLING IT TO ROOM TEMPERATURE THEN MARK ROOM TEMPERATURE)
1. Immediately
2. After first cooling it at room temperature, or
3. After first cooling it in cold water?
4. DO NOT COOK SUCH FOODS [DO NOT READ]
5. WOULD NOT REFRIGERATE IT [DO NOT READ]
8. DON’T KNOW [DO NOT READ]
9. REFUSED [DO NOT READ]
E5. HP
[ASK IF E3=2 or E4 = 2]
For about how long would you let it cool
at room temperature?
1. LESS THAN TWO HOURS [DO NOT READ]
2. TWO HOURS OR MORE [DO NOT READ]
8. DON’T KNOW [DO NOT READ]
9. REFUSED [DO NOT READ]
E5bV2. NEW [ASK IF D7 = 1]
After you cook a whole turkey, how long do you usually let it sit out at room temperature before you eat it?
_____________MINUTES
_____________HOURS
_____________DAYS
4. DON’T COOK WHOLE TURKEY
8. DON’T KNOW [DO NOT READ]
9. REFUSED [DO NOT READ]
E5cV2. NEW [ASK IF E5bV2= 1,2,8,9]
After cooking a whole turkey, how long would you let it sit out at room temperature before putting it, including any leftovers, in the refrigerator?
_____________MINUTES
_____________HOURS
_____________DAYS
4. DON’T COOK WHOLE TURKEY
8. DON’T KNOW [DO NOT READ]
9. REFUSED [DO NOT READ]
E6V1. TR01,
TR06, TR10
Have you grilled meat, poultry, or fish outside in
the past year?
1. YES
2. NOT SURE (GO TO E9V1 or E14V2)
8. DON’T KNOW (GO TO E9V1 or E14V2)
9. REFUSED (GO TO E9V1 or E14V2)
E7V1. TR01,
TR06, TR10 [IF E6V1=1]
After the food is cooked, what do you
usually use to carry it from the grill to the place where it will be
eaten? Do you use... IF RESPONDENT GIVES MORE THAN ONE ANSWER OR SAYS
“IT DEPENDS,” PROBE: What do you do most of the time? IF
RESPONDENT SAYS “CLEAN PLATE,” ASK: “Is it the same
plate that you used to carry the food to the grill or a different
plate?]
1. The plate or pan you used to carry the food to the grill
2. A different plate or pan, or do you usually
3. Serve directly from the grill to individual plates?
4. OTHER
8. DON’T KNOW
9. REFUSED
E8V1.
TR01, TR06, TR10 [IF E7V1=1]
Do you use the plate or pan as it
is, or do you first wipe it, or rinse it, or wash it with soap?
USE AS IS
WIPE OR RINSE IT
WASH WITH SOAP (OR BLEACH)
4. NOT SURE
8. DON’T KNOW
9. REFUSED
E22V1. NEW
Think about when you usually go grocery shopping, on average how long is it between when you pay for the food and when you put the food that needs to be refrigerated in the refrigerator? Would you say…
Less than half an hour,
Between half an hour and an hour,
Between an hour and two hours, or
Longer than two hours?
DON’T KNOW
REFUSED
E23V1. NEW
When you shop for groceries, how often do you bring your own bags to carry the food home? Would you say…
All of the time
Most of the time
Some of the time,
Or Never?
DON’T KNOW
REFUSED
E24V1. NEW [IF E23V1 < 4]
How often do you wash reusable grocery bags? Would you say….
Every time you use them
Once in a while, or do you
Never wash them?
DON’T KNOW
REFUSED
E9V2. TR06,
TR10 (modified)
Do you ever buy bagged, precut leafy greens such
as lettuce or spinach? IF NECESSARY: WE ARE TALKING ABOUT BAGGED
SALAD
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
E10V2. TR06,
TR10 [IF E9V2 = 1]
Do you usually wash or rinse bagged, precut
lettuce before you eat it?
1. YES
2. NO
3. IT DEPENDS (IE. PRODUCT TYPE, HOW IT LOOKS, HOW IT SMELLS)
8. DON’T KNOW
9. REFUSED
E10V2A. TR06
, TR10
Of all the bags of precut lettuce available at the store,
about how many of them contain lettuce that has already been washed?
Would you say…
1. All of them
2. Most of them
3. Some of them, or
4. None of them
8. DON’T KNOW
9. REFUSED
E10V2B. NEW [IF E10V2=1]
Why do you wash bagged, precut lettuce? Would you say…
E10V2B1. To remove dirt? (YES/NO/DON’T KNOW/REFUSED)
E10V2B2. To remove germs such as E. coli and Salmonella? (YES/NO/DON’T KNOW/REFUSED)
E10V2B3. To remove pesticides? (YES/NO/DON’T KNOW/REFUSED)
E10V2B4. Or, for some other reason? (YES/NO/DON’T KNOW/REFUSED)
E11V2. TR06,
TR10 (MODIFIED)
Do you ever buy whole avocados?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
E12V2. TR01,
TR06, TR10 (MODIFIED)
[IF E11V2=1]
Do you usually wash or
rinse avocados before you prepare or eat them?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
E12aV2. NEW [IF E12V2=1]
Why do you wash avocados?
E12aV2_1. To remove dirt? (YES/NO/DON’T KNOW/REFUSED)
E12aV2_2. To remove germs such as E. coli and Salmonella? (YES/NO/DON’T KNOW/REFUSED)
E12aV2_3. To remove pesticides? (YES/NO/DON’T KNOW/REFUSED)
E12aV2_4. Or, for some other reason? (YES/NO/DON’T KNOW/REFUSED)
E13V2. TR06
[IF E12V2=1, TR10] (MODIFIED)
What methods do you use to wash or
rinse avocados? Do you…NOTE: IF SAY THEY USE A COLANDER,
“Using your colander, do you (READ THE ANSWERS AGAIN]
E13V2_1. Rub them under running water, with a brush, cloth or your hands? (YES/NO/DON’T KNOW/REFUSED)
E13V2_2. Hold under running water, without rubbing them? (YES/NO/DON’T KNOW/REFUSED)
E13V2_3. Soak them in a container of water? or (YES/NO/DON’T KNOW/REFUSED)
E13V2_4. Use a cleaner to wash them? (YES/NO/DON’T KNOW/REFUSED)
E13V2a. NEW [IF E12V2=1]
Do you ever eat the avocado skin?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
E14V2. TR06,
TR10
Do you ever buy whole cantaloupe?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
E15V2. TR01,
TR06, TR10 [IF E14V2=1]
Do you usually wash or rinse cantaloupe
before you prepare or cut it?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
E15aV2. NEW [IF E15V2=1]
Why do you wash cantaloupe?
E15aV2_1. To remove dirt? (YES/NO/DON’T KNOW/REFUSED)
E15aV2_2. To remove germs such as E. coli and Salmonella? (YES/NO/DON’T KNOW/REFUSED)
E15aV2_3. To remove pesticides? (YES/NO/DON’T KNOW/REFUSED)
E10aV2_4. Or, for some other reason? (YES/NO/DON’T KNOW/REFUSED)
E16V2. TR06,
TR10 [IF
E15V2=1]
Do you use any of these methods to wash or rinse
cantaloupe? Please choose one or more. Do you…
E16V2_1. Rub them under running water, with a brush, cloth or your hands? (YES/NO/DON’T KNOW/REFUSED)
E16V2_2. Hold under running water, without rubbing them? (YES/NO/DON’T KNOW/REFUSED)
E16V2_3. Soak them in a container of water? or (YES/NO/DON’T KNOW/REFUSED)
E16V2_4. Use a cleaner to wash them? (YES/NO/DON’T KNOW/REFUSED)
F1. TR93,
TR98, TR01, TR06, TR10
Have you ever heard of Salmonella (sal -
mon - ELL - la) as a problem in food? [NOTE: IF THE RESPONDENT HAS
HEARD OF SALMONELLA, BUT NOT AS A PROBLEM IN FOOD, CODE AS “NO”]
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
F2. TR93,
TR98, TR01, TR06, TR10 (Ask all as in 2001 or only if heard of
Salmonella?)
How do you think a food can be made safe if it has
salmonella (sal - mon - ELL - la) in it? Would you say by….)
F2_1. Cooking it? (YES/NO/DON’T KNOW/REFUSED)
F2_2. Washing it? (YES/NO/DON’T KNOW/REFUSED)
F2_3. Freezing it? (YES/NO/DON’T KNOW/REFUSED)
F2_4. Adding vinegar or lemon juice? (YES/NO/DON’T KNOW/REFUSED) or
F2_5. Would you say the food cannot be made safe (YES/NO/DON’T KNOW/REFUSED)
[ROTATE F4 – F9b, but F9 and F9a need to be kept together]
F4. TR01,
TR06, TR10
[Have you ever heard of] Listeria (lis - TEER - ee -
ah) as a problem in food? [NOTE: IF THE RESPONDENT HAS HEARD OF
LISTERIA, BUT NOT AS A PROBLEM IN FOOD, CODE AS “NO”]
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
F5. Tr93,
TR98, TR01, TR06, TR10
[Have you ever heard of] Campylobacter
(KAM - pee - low - BACK - ter) as a problem in food? [NOTE: IF THE
RESPONDENT HAS HEARD OF CAMPYLOBACTER, BUT NOT AS A PROBLEM IN FOOD,
CODE AS “NO”]
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
F6. TR93,
TR98, TR01, TR06, TR10
[Have you ever heard of] Vibrio
(VIB-bree-oh) as a problem in food? ?[NOTE: IF THE RESPONDENT HAS
HEARD OF VIBRIO, BUT NOT AS A PROBLEM IN FOOD, CODE AS “NO”]
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
F7. TR93,
TR98, TR01, TR06, TR10
[Have you ever heard of ] E. Coli as a
problem in food? [NOTE: IF THE RESPONDENT HAS HEARD OF E.COLI, BUT
NOT AS A PROBLEM IN FOOD, CODE AS “NO”]
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
F8. TR93,
TR98, TR01, TR06, TR10
[Have you ever heard of] Hepatitis A as a
problem in food? ?[NOTE: IF THE RESPONDENT HAS HEARD OF HEPATITIS A,
BUT NOT AS A PROBLEM IN FOOD, CODE AS “NO”]
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
F8a. NEW
[Have you ever heard of] Trichinella as a problem in food? ?[NOTE: IF THE RESPONDENT HAS HEARD OF TRICHINELLA , BUT NOT AS A PROBLEM IN FOOD, CODE AS “NO”]
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
F9 NEW
[Have you heard of] Toxoplasma as a problem in food? This is also sometimes called Toxoplasmosis or T. gondii [NOTE: IF THE RESPONDENT HAS HEARD OF TOXOPLASMA, BUT NOT AS A PROBLEM IN FOOD, CODE AS “NO”]
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
F9a. NEW
[IF F9=1]
How do
you think a food can be made safe if it has Toxoplasma in it? Would
you say by…
F9a_1. Cooking it? (YES/NO/DON’T KNOW/REFUSED)
F9b_2. Washing it? (YES/NO/DON’T KNOW/REFUSED)
F9c_3. Freezing it? (YES/NO/DON’T KNOW/REFUSED)
F9d_4. Adding vinegar or lemon juice? (YES/NO/DON’T KNOW/REFUSED) or
F9e_5. Would you say the food cannot be made safe (YES/NO/DON’T KNOW/REFUSED)
F9b. NEW
Have you heard of Norovirus (also called Norwalk virus) as a problem in food? NOTE: IF THE RESPONDENT HAS HEARD OF NOROVIRUS, BUT NOT AS A PROBLEM IN FOOD, CODE AS “NO”]
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
F10A. TR98
, TR01, TR06, TR10
Now, I’m going to read a list of some
ways that food may be handled. For each, please tell me how likely it
is that you would get sick if you ate food that was handled that way.
Please use any number between 1 and 5, where 1 is “not at all
likely” and 5 is “very likely.” (IF RESPONDENT SAYS
THEY DON’T PREPARE THE FOOD, ASK THEM FOR THEIR OPINION.)
F10AV1. If you forget to wash your hands before preparing food, how likely are you to get sick? Where 1 is “not at all likely” and 5 is “very likely.”
F10AV2. If you forget to wash your hands before you begin cooking, how likely are you to get sick? Where 1 is “not at all likely” and 5 is “very likely.”
F10B. If vegetables you will eat raw happen to touch raw meat or chicken, how likely are you to get sick? IF NECESSARY: Where 1 is not at all likely and 5 is very likely.
F10C. If you eat meat or chicken that is not thoroughly cooked, how likely are you to get sick? IF NECESSARY: Where 1 is not at all likely and 5 is very likely.
F10D. TR06,
TR10
If you happen to leave a meat or chicken stew or a
casserole out of the refrigerator for 2 to 5 hours after it has
finished cooking, and eat it, how likely are you to get sick? IF
NECESSARY: Where 1 is not at all likely and 5 is very likely.
F10F. TR10
If
you eat a food that has been recalled, how likely are you to get
sick? IF NECESSARY: Where 1 is not at all likely and 5 is very
likely.
F10GV1. New
If you forget to wash your hands after cleaning out a cat litter box before you prepare food, how likely are you to get sick? IF NECESSARY: Where 1 is not at all likely and 5 is very likely.
F10HV1. New
If you forget to wash your hands after gardening before you begin to prepare food, how likely are you to get sick? IF NECESSARY: Where 1 is not at all likely and 5 is very likely.
SECTION H. THERMOMETERS
NOTE: THE REFRIGERATOR THEMOMETER QUESTIONS ARE MODIFIED FROM 2001
H2. TR01
modified, TR06, TR10 modified to add note.
Does your
refrigerator have a built-in thermometer
that tells you the temperature in degrees Fahrenheit? We are not
talking about the dial that you adjust to change the temperature.
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
H2A. TR01
modified, TR06, TR10[IF H2 =2, 8, or 9]
Have you put a
thermometer in your refrigerator so you can tell the temperature?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
H2B. NEW
What temperature, in degrees Fahrenheit, should you try to keep you refrigerator set at?
[RANGE FOR FAHRENHEIT: 0 - 100]
[RANGE FOR CELSIUS: 0 - 20]
[RESPONDENT ANSWERS IN CELSIUS, PLEASE REPORT IN CELSIUS]
1. RESPONDENT ANSWERS IN FAHRENHEIT
2. RESPONDENT ANSWERS IN CELSIUS
8. DON’T KNOW
9. REFUSED
H2B1. __________ DEGREES FARENHEIT [PLEASE HAVE FARENHEIT COME UP FIRST IN THE CATI PROGRAM]
H2B2. __________ DEGREES CELSIUS
H3. TR06,
TR10 [IF H2=1 OR H2a=1]
[RANGE FOR FAHRENHEIT: 0 - 100]
[RANGE
FOR CELSIUS: 0 - 20]
What is the temperature, in degrees
Fahrenheit, of your refrigerator now? [RESPONDENT ANSWERS IN CELSIUS,
PLEASE REPORT IN CELSIUS]
1. RESPONDENT ANSWERS IN FAHRENHEIT
2. RESPONDENT ANSWERS IN CELSIUS
8. DON’T KNOW
9. REFUSED
H3A. Make a note if the respondent says that he or she is chekcing the actual temperature.
h3F. __________
Degrees FARENHEIT
[PLEASE HAVE FARENHEIT COME UP FIRST IN THE CATI PROGRAM]
H3C. __________ Degrees CELSIUS
H5. TR06,
TR10 (modified)
How
important do you think it is to use a food
thermometer for checking the doneness of hamburgers? Would you say…
1. Very important
2. Somewhat important, or
3. Not important at all
8. DON’T KNOW
9. REFUSED
H6. TR98,
TR01, TR06, TR10
Do you have a food thermometer, such as a meat
thermometer?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
H7. NEW [IF H6=2]
Why don’t you have a food thermometer? Would you say because…(ROTATE RESPONSES)
H7_1. It is too expensive? (YES/NO/DON’T KNOW/REFUSED)
H7_2. You never thought to get one? (YES/NO/DON’T KNOW/REFUSED)
H7_3. You have not gotten around to getting one? (YES/NO/DON’T KNOW/REFUSED)
H7_4. You don’t know of a good place to get one? (YES/NO/DON’T KNOW/REFUSED)
H7_5. You can’t find the kind you like? (YES/NO/DON’T KNOW/REFUSED)
H7_6. You don’t need one? (YES/NO/DON’T KNOW/REFUSED)
H7_7. Yours broke? (YES/NO/DON’T KNOW/REFUSED)
H7_8. It was not in your kitchen when you were growing up? (YES/NO/DON’T KNOW/REFUSED)
H7_9. Or, some other reason? (YES/NO/DON’T KNOW/REFUSED)
[IF D8= 1 and H6=1, THEN H8A andH8B]
Thinking of your usual habits over the past year, when you prepare the following foods, how often do you use a thermometer?
H8A. HP
For
roasts, or other large pieces of meat—how often do you use a
thermometer when you cook roasts. Would you say... [CLARIFY IF
NECESSARY: SHOULD NOT INCLUDE TURKEYS or CHICKENS]
1. Always
2. Often
3. Sometimes, or
4. Never
5. (DO NOT READ) NEVER COOK THE FOOD
8. DON’T KNOW
9. REFUSED
[IF H6=2,8,9 and D8=1 OR H8A=4, 8, or 9] (NOTE: We only want people who cook meat but don’t often or sometimes use a thermometer when cooking roasts)
H8A1V1. NEW
How do you know when your roast is done? Would you say… [ROTATE] (YES/NO/DON’T KNOW/REFUSED FOR EACH)
H8A1a. You can tell when your roast is done by the amount of time it has been cooking?
H8A1b. You can tell when it is done by touching it?
H8A1c. You can tell when it is done by tasting it?
H8A1d. You can tell when it is done by looking at it?
H8A1e. You can tell when it is done by cutting into it?
H8A1f. You only cook roasts with built-in/pop-up thermometers?
H8A1g. or, you can tell by some other reason?
[IF D8= 1 and H6=1]
H8B. HP
How
about chicken parts, such as breasts or legs—how often do you
use a thermometer when you cook chicken parts? [Would you say...]
1. Always
2. Often
3. Sometimes, or
4. Never
5. (DO NOT READ) NEVER COOK THE FOOD
8. DON’T KNOW
9. REFUSED
[IF H6=2,8,9 and D8=1 OR IF H8B=4, 8, or 9] (NOTE: We only want people who cook meat but don’t often or sometimes use a thermometer when cooking chicken parts.)
H8B1V1. NEW
How do you know when your chicken parts are done? Would you say… [ROTATE] (YES/NO/DON’T KNOW/REFUSED FOR EACH)
H8B1a. You can tell when your chicken parts are done by the amount of time it has been cooking?
H8B1b. You can tell when it is done by touching it?
H8B1c. You can tell when it is done by tasting it?
H8B1d. You can tell when it is done by looking at it?
H8B1e. You can tell when it is done by cutting into it?
H8B1f. I can tell when it is done when the juices run clear,
H8B1g. or, you can tell by some other reason?
[IF D2[V]=1, 2 and H6=1, THEN H8C]
H8C. TR01,
TR06, TR10
How about baked egg dishes such as quiche (KEESH),
custard, or bread pudding, —how often do you use a thermometer
when you cook baked egg dishes?
2. Often
3. Sometimes, or
4. Never
5. (DO NOT READ) NEVER COOK THE FOOD
8. DON’T KNOW
9. REFUSED
H8D. HP
TR98, TR01, TR06 [IF D8= 1 and H6=1 THEN H8D]
How about
hamburgers—-How often do you use a thermometer when you cook or
grill hamburgers? [Would you say..] TURKEY BURGERS ARE INCLUDED IF
RESPONDENT VOLUNTEERS; DO NOT PROBE FOR TURKEY BURGERS. DO NOT
INCLUDE VEGGIE BURGERS.
1. Always
2. Often
3. Sometimes, or
4. Never
5. NEVER COOK THE FOOD (DO NOT READ)
8. DON’T KNOW
9. REFUSED
[IF H6=2,8,9 and D8=1 OR IF H8B=4, 8, or 9] (NOTE: We only want people who cook meat but don’t often or sometimes use a thermometer when cooking hamburgers.)
H8D1V1. NEW
How do you know when your hamburgers are done? Would you say…… [ROTATE] (YES/NO/DON’T KNOW/REFUSED FOR EACH)
H8D1a. You can tell when your hamburgers are done by the amount of time they have been cooking?
H8D1b. You can tell when it is done by touching it?
H8D1c. You can tell when it is done by tasting it?
H8D1d. You can tell when it is done by looking at it?
H8D1e. You can tell when it is done by cutting into it?
H8D1f. I can tell when it is done when the juices run clear,
H8D1g. or, you can tell by some other reason?
H8E. NEW [IF H6=1]
How about for frozen food entrees, like frozen pizzas, pot pies, and TV dinners that you heat in the microwave? —-How often do you use a thermometer when you heat frozen food entrees in the microwave? [Would you say…
1. Always
2. Often
3. Sometimes, or
4. Never
5. NEVER COOK THE FOOD (DO NOT READ)
8. DON’T KNOW
9. REFUSED
J1. HP,
TR98, TR01, TR06, TR10 J1A-J1J
In the past 12 months, which of
the following raw foods did you eat? [READ LIST]
J1A. Raw clams?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
J1B. Raw oysters? [NOTE: STEAMED OYSTERS ARE COOKED.]
J1C. Steak tartare (TAR-TAR), or raw hamburger meat?
J1D. Sushi with raw fish, ceviche (se - VEE - chay), or other raw fish? [DO NOT INCLUDE PICKELED FISH, SMOKED FISH, OR LOX]
J1E. Raw alfalfa sprouts, bean sprouts, or other sprouts?
J1F. Did you eat any other raw meat, poultry or fish? If yes, what? [ACCEPT MULTIPLES IF YES. “NO” SHOULD BE SINGLE RESPONSE]
J1F1. YES — RAW MUSSELS
J1F2. YES — RAW SHRIMP
J1F3. YES — RAW POULTRY [NOTE: IF THE RESPONDENT SAYS RAW POULTRY, PLEASE CONFIRM THAT THE RESPONDENT ATE POULTRY “RAW.”]
J1F4. YES — RAW CRAB
J1F5. YES — OTHER
J1F6. NO
J1F8. DON’T KNOW
J1F9. REFUSED
J2. NEW
In the past 12 months have you eaten any cheese that was made from milk that was not pasteurized? This type of cheese is sometimes called “raw milk” cheese?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
[IF J2=1]
J21. NEW
Thinking of the most recent time you had raw milk cheese, was this cheese a “hard” cheese such as cheddar or a “soft” cheese such as brie?
HARD
SOFT
DON’T KNOW
REFUSED
J2A. TR06,
TR10
In the past 12 months, have you eaten queso
fresco, queso blanco, or similar cheeses?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
J2B. TR06, TR10 [IF J2A=1]
From where did you get these cheeses?
J2B1. GROCERY STORE
J2B2. FARMERS MARKET
J2B3. LATIN OR SPANISH MARKET
J2B4. RESTAURANT
J2B5. I MADE IT AT HOME
J2B6. IT WAS MADE BY FRIENDS/FAMILY
J2B7. OTHER (SPECIFY: __________)
J2B8. DON’T KNOW
J2B9. REFUSED
J2C. TR10
In
the past 12 months, did you drink any raw milk or milk that was not
pasteurized? This type of milk is often sold off-the-farm or
door-to-door.
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
NEW [IF J2C=1]
J2D. How often do you drink raw milk? Would you say…
Less than once a year.
A few times a year.
Once a month
A few times a month
Once a week
Two to three times per week
Or, Daily?
DON’T KNOW
REFUSED
J3. TR01,
TR06, TR10
In the past 12 months, have you eaten eggs with runny
yolks, soft scrambled eggs, or soft meringue (MER-ANG)? SOFT MERINGUE
IS THE TYPE USED TO TOP SOME PIES; IN CONTRAST, HARD MERINGUE IS USED
FOR SHELLS TO HOLD FRUIT, PUDDING, MERINGUE COOKIES, OR OTHER
DESSERTS. DO NOT INCLUDE HARD MERINGUE.
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
J4. HP
TR
98, TR01,
TR06, TR10
In the past 12 months, did you eat any of the
following foods that contain raw eggs? [IF NECESSARY: WE MEAN FOODS
THAT CONTAIN RAW EGG WHEN YOU EAT THEM, NOT FOODS MADE WITH A RAW EGG
THAT IS COOKED BEFORE EATEN] [READ LIST] [NOTE: YOU DO NOT NEED TO
READ THE INTRODUCTION TO THE QUESTION FOR EVERY FOOD. ONLY REPEAT AS
NECESSARY.]
J4A. [IF
NECESSARY. IN THE PAST 12 MONTHS DID YOU EAT?]
Raw, homemade
cookie or cake batter?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
J4B. [IF
NECESSARY. IN THE PAST 12 MONTHS DID YOU EAT?]
Homemade frosting
with raw egg?
J4C. [IF
NECESSARY. IN THE PAST 12 MONTHS DID YOU EAT?]
Caesar salad
dressing with raw egg?
J4D. [IF
NECESSARY. IN THE PAST 12 MONTHS DID YOU EAT?]
Chocolate mousse
with raw egg?
J4E. [IF
NECESSARY. IN THE PAST 12 MONTHS DID YOU EAT?]
Homemade eggnog
with raw egg?
J4F. [IF
NECESSARY. IN THE PAST 12 MONTHS DID YOU EAT?]
Homemade ice
cream with raw egg?
J4G. [IF
NECESSARY. IN THE PAST 12 MONTHS DID YOU EAT?]
Shakes with raw
egg?
J4H. Any other food with raw egg?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
J4I. [IF
J4H=1] [ACCEPT MULTIPLES]
What raw food would that be?
J4I1. Mayonnaise made with raw egg
J4I2. Raw eggs by themselves
J4I3. OTHER
J4I4. DON’T KNOW
J4I5. REFUSED
J5. NEW [IF ANSWER YES TO ANY OF THE RAW EGG QUESTIONS. IF YES TO MULTIPLE RAW EGG QUESTIONS, PLEASE ASK THIS FOR EACH ONE.]
“Was the XXXX [FILL IN WITH FOOD MADE FROM RAW EGG] made from pasteurized eggs? (YES/NO/SOMETIMES/DON’T KNOW/REFUSED)
K6V1. TR06,
TR10
In the past 12 months, have you eaten any fish or
shellfish? We are talking about all fish and shellfish including tuna
fish, fish sticks, and shrimp that you may have eaten.
1. Yes (GO TO K8V1)
2. No (GO TO K7V1)
8. DON’T KNOW (GO TO K9V1)
9. REFUSED (GO TO K9V1)
K8AV1. NEW
On
average, how often do you eat fish or shellfish? You may answer in
times per week or times per month.
1. _____TIMES PER WEEK (K8AV1_1)
2. ______TIMES PER MONTH (K8AV1_2)
3. LESS THAN ONCE A MONTH
8. DON’T KNOW
9. REFUSED
K8V1. TR06,
TR10
In the past month, did you eat any recreationally caught
fish? We mean fish that you or others caught from lakes,
rivers, or coastal areas.
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
K9V1. TR06,
TR10
Have you heard about any health benefits from eating fish
and shellfish?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
K11V1. TR06,
TR10
Have you heard about any health concerns with eating fish
and shellfish?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
K16. TR01,
TR06
Have
you heard anything about mercury as a problem in some fish?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
K17. TR01,
TR06, TR10
[IF K16=1]
What kinds of fish have mercury
problems? [ACCEPT MULTIPLES. NOTE: IF RESPONDENT SAYS “BIG
FISH,” PROBE: Any specific fish? IN THE CASE OF A GENERAL
RESPONSE OF “TUNA,” ASK THE RESPONDENT: Any specific type
of tuna? Such as tuna steaks or canned tuna or both?] [DO NOT READ
LIST] [PROBE: Anything else?]
K17A. SWORD FISH [DO NOT READ]
K17B SHARK [DO NOT READ]
K17C. KING MACKEREL [DO NOT READ]
K17D. TILEFISH [DO NOT READ]
K17E. TUNA STEAKS [DO NOT READ]
K17F. ANY GENERAL MENTION OF TUNA [DO NOT READ]
K17G. GENERAL CANNED TUNA [DO NOT READ]
K17H. ALBACORE OR CHUNK WHITE CANNED TUNA FISH [DO NOT READ]
K17I. ANY GENERAL MENTION OF SALMON BUT NOT FARM RAISED [DO NOT READ]
K17J. FARM RAISED SALMON [DO NOT READ]
K17K. ANY FARM RAISED FISH [DO NOT READ]
K17L. RAW FISH (CEVICHE) [DO NOT READ]
K17M. RAW SHELLFISH (OYSTERS, CLAMS) [DO NOT READ]
K17N. BIG FISH, UNSPECIFIED, FISH HIGH ON FOOD CHAIN [DO NOT READ]
K17O. OTHER OR UNSPECFIED FISH [DO NOT READ]
K17P. RECREATIONAL CAUGHT FISH (FROM LAKES AND RIVERS) [DO NOT READ]
K17Q. DON’T KNOW
K17R. REFUSED
K17S. FISH FROM A SPECIFIC REGION
K17T. FISH FROM A SPECIFIC LAKE, RIVER, OR STREAM
K18. TR01,
TR06, TR10 [IF K16=1]
Have you heard of any particular group of
people who are advised to be especially careful not to eat too much
fish that might have mercury?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
K18A. [IF K18 = 1] Which group? MARK ALL THAT APPLY. DO NOT PROBE.
K18A1. NOT HEARD OF A PARTICULAR GROUP [DO NOT READ]
K18A2. PREGNANT WOMEN OR WOMEN WHO MIGHT BECOME PREGNANT [DO NOT READ]
K18A3. NURSING MOTHERS [DO NOT READ]
K18A4. YOUNG CHILDREN [DO NOT READ]
K18A5. ELDERLY [DO NOT READ]
K18A6. COMPROMISED IMMUNE SYSTEM [DO NOT READ]
K18A7. OTHER RESPONSE [DO NOT READ] [SPECIFY: ________________________]
K18A8. NO PARTICULAR GROUP IS AT HIGHER RISK [DO NOT READ]
K18A9. DON’T KNOW
K18A10. REFUSED
K19V1. TR01, TR06, (modified to add “raw”)
Have you heard or read about any possible health problems related to eating “raw” sprouts, such as alfalfa or bean sprouts?
1. YES
2. NO
3. NOT SURE
8. DON’T KNOW
9. REFUSED
[IF K19V1=1]
K20V1. TR01, TR06,
Do you recall what you heard about eating sprouts? [ACCEPT MULTIPLES]
K20V1a. DO NOT EAT RAW
K20V1b. COOK BEFORE EATING
K20V1c. RAW SPROUTS MAY CONTAIN HARMFUL GERMS (INCLUDE ANY MENTION OF E. COLI OR SALMONELLA OR LISTERIA)
K20V1d. COULD MAKE YOU SICK (INCLUDE – CAUSE AN OUTBREAK)
K20V1e. OTHER, SPECIFY
K20V1f. RECALLS NO ADVICE
K20V1g. DON’T KNOW
K20V1h. REFUSED
K21V1. NEW
[IF K19V1=1]
Have
you heard of any particular group of people who are advised to be
especially careful not to eat raw sprouts?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
K22V1. NEW [IF K19V1 = 1] Which group? MARK ALL THAT APPLY. DO NOT PROBE.
K22A1. NOT HEARD OF A PARTICULAR GROUP [DO NOT READ]
K22A2. PREGNANT WOMEN OR WOMEN WHO MIGHT BECOME PREGNANT [DO NOT READ]
K22A3. NURSING MOTHERS [DO NOT READ]
K22A4. YOUNG CHILDREN [DO NOT READ]
K22A5. ELDERLY [DO NOT READ]
K22A6. COMPROMISED IMMUNE SYSTEM [DO NOT READ]
K22A7. OTHER RESPONSE [DO NOT READ] [SPECIFY: ________________________]
K22A8. NO PARTICULAR GROUP IS AT HIGHER RISK [DO NOT READ]
K22A9. DON’T KNOW
K22A10. REFUSED
SECTION L METHODS OF PRODUCING AND PROCESSING FOODS
NOTE: May add questions about locally grown foods.
Next, I would like to ask your opinion about some ways food can be grown or processed.
[RANDOMIZE (L1&2 TOGETHER, L3& L4 TOGETHER, L5)]
L1V2. TR01, TR06 (Slightly modified for correctness.)
As you may know, some fruits and vegetables are produced by organic methods.
Using a 10-point scale, how well informed would you say you are about organically grown fruits and vegetables, if one means you are not at all informed about organically grown fruits and vegetables and ten means you are very well informed?
1 (NOT AT ALL INFORMED) 2 3 4 5 6 7 8 9 10 (VERY WELL INFORMED)
98. DON'T KNOW
99. REFUSED
L2V2. TR01, TR06
Do you buy organically grown fruits or vegetables?
1. YES
2. NO
3. SOMETIMES
8. DON'T KNOW
9. REFUSED
L3V2. TR01, TR06
Using a 10-point scale, how well informed would you say you are about irradiated [e-RAY-dee-A-ted] foods? (OPTIONAL: one means you are not at all informed about irradiated foods and ten means you are very well informed)
1 (NOT AT ALL INFORMED) 2 3 4 5 6 7 8 9 10 (VERY WELL INFORMED)
98. DON'T KNOW
99. REFUSED
L4V2. TR06
Have you seen any food labels indicating that the product was irradiated [e-RAY-dee-A-ted]?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
L4AV2. NEW.
Would you purchase foods that you knew had been irradiated?
1. YES
2. MAYBE
2. NO
8. DON’T KNOW
9. REFUSED
L5V2. TR01, TR06 (MODIFIED TO ADD “GMOs”)
Some food products are being developed with the help of new scientific techniques. The general area is called "biotechnology" or "bioengineered foods" and includes tools such as genetic engineering. Sometimes these new foods are called “genetically modified” foods or GMOs. Using a 10-point scale, how well informed would you say you are about biotechnology? (OPTIONAL: if one means you are not at all informed about biotechnology and ten means you are very well informed.)
1 (NOT AT ALL INFORMED) 2 3 4 5 6 7 8 9 10 (VERY WELL INFORMED)
98. DON'T KNOW
99. REFUSED
L5aV2. NEW
Do you look for labels on foods you buy that tell you whether it is GMO free?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
[ASK L6 TO L17 SERIES IN SAME ORDER AS L1, L3, AND L5]
[IF L1= 1 - 2, SKIP L6 – L9]
L6V2. TR01, TR06
Do you think that organically grown fruits and vegetables are more likely or less likely to have harmful
germs than those grown without using organic methods, or are they the same?
1. MORE LIKELY
2. LESS LIKELY
3. SAME
8. DON'T KNOW
9. REFUSED
L7V2. TR01, TR06
Do you think that organically grown fruits and vegetables are more likely or less likely to cause long term health problems than those grown without using organic methods, or are they the same?
1. MORE LIKELY
2. LESS LIKELY
3. SAME
8. DON'T KNOW
9. REFUSED
L8V2. TR01, TR06
How about the environment? Do you think that organically grown fruits and vegetables are more safe or less safe for the environment, or are they the same as those grown without using organic methods?
1. MORE SAFE
2. LESS SAFE
3. SAME
8. DON'T KNOW
9. REFUSED
L9V2. TR01, TR06
How about nutrition? Do you think that organically grown fruits and vegetables are more nutritious or less nutritious than those grown without using organic methods, or are they the same?
1. MORE NUTRITIOUS
2. LESS NUTRITIOUS
3. SAME
8. DON'T KNOW
9. REFUSED
[IF L3 = 1 - 2, SKIP L10 - L13]
L10V2.TR01, TR06
Do you think that irradiated fresh foods are more likely or less likely to have harmful germs than non-irradiated foods, or are they the same?
1. MORE LIKELY
2. LESS LIKELY
3. SAME
8. DON'T KNOW
9. REFUSED
L11V2.TR01, TR06
Do you think that irradiated fresh foods are more likely or less likely to cause long term health problems than non-irradiated foods, or are they the same?
1. MORE LIKELY
2. LESS LIKELY
3. SAME
8. DON'T KNOW
9. REFUSED
L12V2.TR01, TR06
How about the environment? Do you think that irradiated fresh foods are more safe or less safe for the environment, or are they the same as non-irradiated foods?
1. MORE SAFE
2. LESS SAFE
3. SAME
8. DON'T KNOW
9. REFUSED
L13V2.TR01, TR06
How about nutrition? Do you think that irradiated fresh foods are more nutritious or less nutritious than non-irradiated foods, or are they the same?
1. MORE NUTRITIOUS
2. LESS NUTRITIOUS
3. SAME
8. DON'T KNOW
9. REFUSED
[IF L5 = 1 OR 2, SKIP L14-L17]
L14V2.TR01, TR06
Do you think that bioengineered foods, GMOs, are more likely or less likely to have harmful germs than foods produced without bioengineering, or are they the same? (IF RESPONDENT ASKS WHETHER YOU ARE TALKING ABOUT GENETICALLY MODIFIED ORGANISMS OR FOODS, THE ANSWER IS “EITHER ONE”.)
1. MORE LIKELY
2. LESS LIKELY
3. SAME
8. DON'T KNOW
9. REFUSED
L15V2.TR01, TR06
Do you think that bioengineered foods, GMOs, are more likely or less likely to cause long term health problems than foods produced without bioengineering, or are they the same?
1. MORE LIKELY
2. LESS LIKELY
3. SAME
8. DON'T KNOW
9. REFUSED
L16V2.TR01, TR06
How about the environment? Do you think that bioengineered foods, GMOs, are more safe or less safe for the environment, or are they the same as foods produced without bioengineering?
1. MORE SAFE
2. LESS SAFE
3. SAME
8. DON'T KNOW
9. REFUSED
L17V2.TR01, TR06
How about nutrition? Do you think that bioengineered foods, GMOs, are more nutritious or less nutritious than foods produced without bioengineering, or are they the same?
1. MORE NUTRITIOUS
2. LESS NUTRITIOUS
3. SAME
8. DON'T KNOW
9. REFUSED
SECTION S. MICROWAVE SAFETY
This section is TR10
S0AV1. The next few questions ask about frozen food entrees, like frozen pizzas, pot pies, and TV dinners. How often do you prepare frozen food entrees in the microwave? Would you say…?
1. DAILY
2. WEEKLY
3. MONTHLY
4. LESS THAN ONCE A MONTH
5. NEVER [SKIP TO S3V1]
8. DON’T KNOW [SKIP TO S3V1]
9. REFUSED [SKIP TO S3V1]
S1V1. How often do you follow the instructions for frozen food entrees for heating them in the microwave? Would you say…?
1. ALWAYS
2. OFTEN
3. SOMETIMES, OR
4. NEVER
8. DON’T KNOW
9. REFUSED
S1aV1. NEW
When the instructions say to let food sit for a certain amount of time after it’s cooked in the microwave, do you typically…
Ignore them because you can handle the hot dish
Ignore them because you are in a hurry to eat your meal
Wait the time so you can handle it without burning your hands
Wait the time to let it finish cooking?
OTHER.
8. DON’T KNOW
9. REFUSED
S0V1. Now I’m going to read you a statement. Please tell me whether you believe the statement is “True” or “False.” If I do not follow the cooking instructions when preparing frozen food entrees containing meat or poultry, I could get sick.
1. TRUE
2. FALSE
8. DON’T KNOW
9. REFUSED
S2V1. Do you know the wattage of your microwave?
1. YES
2. NO
3. I DO NOT OWN A MICROWAVE
8. DON’T KNOW
9. REFUSED
S2aV1 [IF S2V1=2,8,9] NEW
Do you know how to find the wattage of your microwave?
1. YES
2. NO
3. I DO NOT OWN A MICROWAVE
8. DON’T KNOW
9. REFUSED
S3V1. Of all the frozen food entrees containing meat or poultry, about how many of them contain meat or poultry that is already precooked? Would you say…?
1. All of them
2. Most of them
3. Some of them
4. None of them
5. DO NOT BUY
8. DON’T KNOW
NEW SECTION O. MECHANICALLY TENDERIZED BEEF
ENTIRE SECTION IS NEW
O1V2. Have you heard of mechanically tenderized beef or steak? It is sometimes called needle tenderized beef.
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
O2V2. Have you ever bought beef that was labeled as mechanically tenderized or needle tenderized?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
O3V2. Would you say that mechanically tenderized beef is more likely, less likely, or has about the same likelihood of being contaminated with germs such as E. Coli as compared to regular beef?
More likely to be contaminated
Less likely
About the same
DON’T KNOW
REFUSED
O4V2. [If O2V2=1]
Do you do any of the following things when preparing mechanically tenderized beef (YES/NO)
Be sure to cook until the meat is well-done.
Use a food thermometer (IF YES)
What temperature do you cook it to?
Let the meet rest (sit without cutting) for 3 minutes after is it cooked.
SECTION M. FOOD ALLERGIES
This section has been modified from 2001. Unless otherwise marked, questions are based on 2001 FSS and are TR06, TR10
M1. HP
Now,
[PAUSE] I’d like to ask if you have any current food allergies,
or do you suspect you have a food allergy? [IF NEEDED: Do not count
allergies you used to have but outgrew or were desensitized to].
[MARK YES IF RESPONDENT THINKS HE/SHE HAS A FOOD ALLERGY. IT IS NOT
NECESSARY TO HAVE BEEN DIAGNOSED BY A DOCTOR. DO NOT COUNT ALLERGIES
THAT OTHER HOUSEHOLD MEMBERS HAVE.]
1. YES
2. NO OR NOT AWARE OF
3. SOMEONE IN HOUSEHOLD DIED FROM FOOD ALLERGY (DIED: I’m very sorry to hear that. I won’t be asking questions about that. PROCEED TO N0)
8. DON’T KNOW
9. REFUSED
M4. [IF M1 = 1, ELSE GO TO N0.]
What foods or food ingredients are you allergic to? I am going to read you a list. Please answer yes or no for each food category.
M4A. Are you allergic to any milk or dairy?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
M4B. What about eggs?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
M4c. Any type of fish or shellfish?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
M4D1. [IF
M4C=1, ELSE GO TO M4G1]
What type(s) of fish or shell fish are
you allergic to?
Are you allergic to fish that have fins
such as salmon, tuna, or cod?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
M4D2. [IF
M4C= 1, Else go to M4G1]
Are you allergic to shellfish? [IF
NECESSARY: For example, shrimp, crabs, lobster, crayfish, crawfish,
prawn, clams, oysters, scallops, mussels, squid, or snails]
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
M4E. [IF
M4d2=1, ELSE GO TO M4G1]
What type of shellfish are you allergic
to? [DON’T READ, JUST CODE RESPONSE] [ACCEPT MULTIPLES]
M4E1. CRUSTACEANS (FOR EXAMPLE, SHRIMP, CRABS, LOBSTER, CRAYFISH, CRAWFISH, PRAWN)
M4E2. MOLLUSKS (FOR EXAMPLE, CLAMS, OYSTERS, SCALLOPS, MUSSELS, SQUID, SNAILS, CONCHES, OCTOPUS)
M4E3. OTHER
M4E4. DON’T KNOW
M4E5. REFUSED
[NEW STAND ALONE 2015]
M4G1. Are you allergic to peanuts?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
[NEW STAND ALONE 2015]
M4G1a. Are you allergic to tree nuts (IF NECESSARY: For example, almonds, cashews, pecans, walnuts, or brazil nuts] [DO NOT INCLUDE COCONUT – SEE BELOW FOR COCONUT]?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
[NEW STAND ALONE 2015]
M4G1b. Are you allergic to sesame seeds?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
[REVISED 2015]
M4g. Other than peanuts, tree nuts, and sesame seeds, are you allergic to any other type of nuts or seeds?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
M4H. [IF
M4G = 1, ELSE GO TO M4I]
What type of nuts or seeds are you
allergic to? [DON’T READ LIST] [ACCEPT MULTIPLES]
M4H1. [REVISED TO M4G1]
M4H2. TREE NUTS (FOR EXAMPLE, ALMONDS, CASHEWS, PECANS, WALNUTS, BRAZIL NUTS)[DO NOT INCLUDE COCONUT – SEE M4H4A FOR COCONUT][ALSO REVISED TO NEW STAND ALONE DIRECT M4G1A]
M4H3. [REVISED TO M4G1B]
M4H4. MUSTARD SEEDS
M4H4A. COCONUT
M4H4B. PINE NUTS
M4H5. OTHER SEEDS (SUCH AS SUNFLOWER, POPPY OR CARAWAY SEEDS)
M4H6. OTHER NUTS
M4H7. DON’T KNOW
M4H8. REFUSED
M4i. Are you allergic to wheat, gluten, corn, or other grains? (IF NECESSARY, which ones are you allergic to? Accept multiples.)
M4i1. YES—-WHEAT
M4i2. YES—-GLUTEN
M4i3. YES—-CORN
M4i4. YES—OTHER GRAINS
M4i5. NOT ALLERGIC TO WHEAT, CORN, GRAINS [DO NOT SELECT IF YES TO ANY M4I1-M4I4.]
M4i6. DON’T KNOW
M4i7. REFUSED
M4j. Are you allergic to any fruits or vegetables?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
M4K. [IF
M4J = 1, ELSE GO TO M4L1]
What type of fruits or vegetables are
you allergic to? [ACCEPT MULTIPLES] [DON’T READ LIST]
M4K1. AVOCADO, KIWI, BANANA, CHESTNUT
M4K2. STRAWBERRY, CHERRY, PEACH, PEAR, PLUM, APPLE (ROSACEAE FAMILY)
M4K3. CELERY
M4K4. MUSTARD
M4K5. CORN
M4K6. OTHER FRUIT
M4K7. OTHER VEGETABLE
M4K8. DON’T KNOW
M4K9. REFUSED
[NEW STAND ALONE DIRECT 2015, PREVIOUSLY M4M5]
M4L1. Are you allergic to soy?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
[REVISED 2015]
M4l2. Other than soy, are you allergic to any other kind of beans or legumes [LE-GOOMS]?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
M4M. [IF
M4L2 = 1, ELSE GO TO M4N]
What kind of beans or legumes are you
allergic to? [DON’T READ LIST] [ACCEPT MULTIPLES]
M4M1. ALL BEANS
M4M2. ALL LEGUMES
M4M3. LENTILS
M4M4. PEAS
M4M5. [REMOVED - REVISED TO M4L1]
M4M6. [REMOVED - REVISED TO M4G1]
M4M7. OTHER
M4M8. DON’T KNOW
M4M9. REFUSED
M4n. Are you allergic to any other foods?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
M4O. [IF
M4N=1, ELSE GO TO M5]
What else are you allergic to? [DON’T
READ LIST] [ACCEPT MULTIPLES]
M4O1. CHOCOLATE
M4O2. SULFITES
M4O3. SPICES
M4O4. FOOD COLORS
M4O5. OTHER FOOD ADDITIVE: (SUCH AS ASPARTAME, NITRITE, OLESTRA)
M4O6. OTHER
M4O7. DON’T KNOW
M4O8. REFUSED
M5. How old were you when you first realized or suspected, or were told that you had a food allergy? [TO ANY FOOD. IF RESPONDENT SAYS DIFFERENT TIMES FOR DIFFERENT FOODS, ASK FOR THE FIRST KNOWN/SUSPECTED FOOD ALLERGY.]
1. LESS THAN ONE YEAR OLD
2. ONE - 2 YEARS OLD
3. 3 TO 5 YEARS OLD
4. 6 TO 9 YEARS OLD
5. 10 TO 14 YEARS OLD
6. 15 TO 19 YEARS OLD
7. 20 - 24 YEARS OLD
8. 25 - 29YEARS OLD
9. 30 – 39 YEARS OLD
10. 40 – 49 YEARS OLD
11. 50 YEARS OR OLDER
98. DON’T KNOW
99. REFUSED
M6. HP
What
kinds of reactions have you had to the food(s) you are allergic to?
Please respond with yes or no to each item I read. [IF NECESSARY:
This is for all of the foods you are allergic to. [INCLUDE REACTIONS
FROM JUST TOUCHING THE FOOD] [REPEAT THE QUESTION AS NEEDED.]
M6A. Skin reaction, such as hives, itching, or redness [IF NECESSARY: AS A REACTION TO FOOD]
M6B. Swelling of face [IF NECESSARY: AS A REACTION TO FOOD]
M6C. Itchy lips or mouth, itchy throat [IF NECESSARY: AS A REACTION TO FOOD]
M6D. Throat tightness [IF NECESSARY: AS A REACTION TO FOOD]
M6E. Wheezing [IF NECESSARY: AS A REACTION TO FOOD]
M6F. Trouble breathing, shortness of breath, or coughing (IF NECESSARY: AS A REACTION TO FOOD]
M6G. Nasal congestion [IF NECESSARY: AS A REACTION TO FOOD]
M6H. Stomach pain or abdominal cramping [IF NECESSARY: AS A REACTION TO FOOD]
M6I. Vomiting or nausea [IF NECESSARY: AS A REACTION TO FOOD]
M6J. Diarrhea [IF NECESSARY: AS A REACTION TO FOOD]
M6K. Headache [IF NECESSARY: AS A REACTION TO FOOD]
M6L. Dizziness [IF NECESSARY: AS A REACTION TO FOOD]
M6M. Anaphylactic [ANA-FA-LAK-TIC] Shock [IF NECESSARY: Dangerous drop in blood pressure or near death experience] [IF NECESSARY: AS A REACTION TO FOOD]
[NOT HP]
M6N. Paleness or blueness of the skin
M6P. Weak pulse or large drop in blood pressure
M6N. Did you have any other types of reactions?
1. YES
2. NO (GO TO M7)
8. DON’T KNOW
9. REFUSED
M6NA. [IF
M6N = 1, ELSE GO TO M60]
What type of reaction did you have?
M6NA1. EDEMA/SWELLING (UNSPECIFIED)
M6NA2. LETHARGY/DROWSINESS
M6NA3. JOINT/MUSCLE PAIN OR WEAKNESS
M6NA4. CHEST PAIN
M6NA5. INCREASED HEART RATE
M6NA6. SNEEZING
M6NA7. SWELLING OF TONGUE/THROAT/MOUTH
M6NA8. SWELLING OF HANDS/FEET/LEGS
M6NA9. CONSTIPATION
M6NA10. SWELLING OF EYES
M6NA11. GAS/BLOATING
M6NA12. ITCHY EYES
M6NA13. NONE/NOTHING
M6NA14. OTHER (SPECIFY: ____________________)
M6NA15. DON’T KNOW
M6NA16. REFUSED.
M6O. HP
Has
never had a reaction to the food(s).
1. YES
M7.
HP
Has a medical doctor diagnosed your condition as a food
allergy?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
[NEW 2015]
M7A [IF M7=1, ELSE GO TO M9]
What type of medical doctor diagnosed the condition as a food allergy? Was it a(an) … [READ EACH OPTION FROM M7A1 THRU M7A6]
M7a1 Allergist,
1. YES [CATI PROGRAMMER USE SAME RESPONSE OPTIONS THRU M7a6]
2. NO
8. DON’T KNOW
9. REFUSED
M7a2 Family Physician,
M7a3 Pediatrician,
M7a4 Gastroenterologist
M7a5 Emergency physician,
M7a6 Any other type of doctor (SPECIFY: ________________________)
M8. How did the doctor make the diagnosis of a food allergy. [MARK ALL THAT APPLY. DO NOT READ RESPONSES IF RESPONDENT CAN ANSWER IMMEDIATELY WITHOUT THEM.] [CATI PROGRAMMER ENSURE OPTIONS M8A THRU M8K SHOW ON ONE PAGE]
M8A. SKIN TEST/ PIN PRICK/ SKIN SCRATCH TEST
M8B. RAST OR CAP-RAST OR BLOOD TEST
M8C. FOOD ELIMINATION
M8D. ORAL FOOD CHALLENGE
M8E. ON THE BASIS OF HISTORY [FOR EXAMPLE, DESCRIPTION OF THE FOOD(S) EATEN AND REACTIONS]
M8I. PHYSICAL EXAMINATION OF SYMPTOMS
M8J. ALLERGY SHOTS
M8K. ALLERGY TEST (UNSPECIFIED)
M8F. OTHER (SPECIFY:________________)
M8G. DON’T KNOW
M8H. REFUSED
M9. HP
When
was the last time you had an allergic reaction to food, or had
symptoms you thought were caused by an allergic reaction to food?
[PROBE: IF THE RESPONDENT DOES NOT REMEMBER A SPECIFIC INSTANCE OR
DOES NOT REMEMBER THE DATE, ASK “Do you think it was more than
a year ago, more than 5 years ago?” TRY TO GET RESPONSE INTO A
CATEGORY. IF RESPONDENT HAS A NON-FOOD REACTION, DO NOT COUNT IT]
1. LESS THAN ONE MONTH
2. ONE - 2 MONTHS
3. 3 - 6 MONTHS
4. 7 - 11 MONTHS
5. 1 - 2 YEARS
6. 3 - 5 YEARS
7. 6 - 9 YEARS
8. 10 – 14 YEARS
9. 15 – 19 YEARS
10. 20 YEARS OR MORE
11. NEVER
98. DON’T KNOW/ NOT SURE
99. REFUSED
M10. [IF
M9 = 1, 2, 3, 4, 5, OR 6, ELSE GO TO M11]
How many total food
allergic reactions have you had in the past 5 years? [INCLUDE
REACTIONS TO ALL FOODS]
___________ [NUMBER OF REACTIONS; ALLOW RANGE: 0-20]
98. DON’T KNOW
99. REFUSED
M11.
Have
you been prescribed an epinephrine [EP - eh - NEF - rin] kit, such as
EpiPen® for food allergies? (CLARIFY: THE QUESTION ASKS ABOUT
HAVING A PRESCRIPTION, NOT ABOUT FILLING THE PRESCRIPTION. IF THE
DOCTOR TOLD THEM TO GET EPINEPHRINE FOR FOOD ALLERGIES THEN MARK
“YES”)
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
M12. HP
[IF M9 = 1, 2, 3, 4, 5, OR 6, ELSE GO TO M18]
Now, I just want to talk about your most recent food reaction. Was epinephrine [EP - eh - NEF - rin] used to treat this most recent reaction? [IT DOES NOT HAVE TO BE THE ALLERGIC PERSON’S EPI KIT - WE ARE INTERESTED IN ANY SOURCE OF EPINEPHRINE (AMBULANCE CREW, HOSPITAL, ER, ANOTHER’S KIT, ETC)]
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
M13. HP
Were you treated in a hospital or doctor’s office for
this reaction? Which?
1. YES, HOSPITAL
2. YES, DOCTOR’S OFFICE
3. BOTH – HOSPITAL AND DOCTOR’S OFFICE
4. NO
8. DON’T KNOW
9. REFUSED
M14. HP
Did you have to stay overnight in the hospital?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
M15. Thinking about the food that caused the reaction we were just talking about, was it [READ LIST]:
1. A packaged food eaten without further preparation, such as milk or cookies,
2. A prepared packaged food from a mix, such as cake mix.
3. A prepared food cooked or made at a home, restaurant, or other such place, or [COUNT ALL FOOD THAT HAS TO BE PREPARED IN ANY WAY. FOR EXAMPLE, A PIECE OF FISH OR SHRIMP COUNTS AS A PREPARED FOOD BECAUSE IT HAS TO BE COOKED.]
4. A food that did not come in a package and was not prepared, such as a piece of fruit?
8. DON’T KNOW
9. REFUSED
M16. [IF
M15 = 1 OR 2, ELSE SEE M17]
Was the packaged food...?
1. A simple one made from one main ingredient and only a few additions, such as milk or peanut butter, or
2. A complex one made from several ingredients, such as cookies, snack food, or ice cream?
8. DON’T KNOW
9. REFUSED
M17. [IF
M15 = 2 OR 3, ELSE GO TO M18]
Was the food prepared...?
1. At home
2. At the home of a friend or relative, or
3. In a restaurant, grocery store, bakery, or other such place?
8. DON’T KNOW
9. REFUSED
M18. How often do you read the ingredient lists on food packages to see if the food you are allergic to is in it?
1. Always
2. Sometimes
3. Rarely
4. Never
5. Only if the food is new to me.
8. DON’T KNOW
9. REFUSED
M20. TR01
In the past year, have you bought for yourself or eaten a
packaged food that you didn’t know contained the food you are
allergic to?
2. Maybe
3. No
8. DON’T KNOW
9. REFUSED
M21.
[IF M20 = 1 OR 2,
ELSE GO TO M22]
Did this food cause you to have an allergic
reaction?
Yes
Maybe
3. No
8. DON’T KNOW
9. REFUSED
[TR 01, (M13b)]
M22. Some people who manage allergies say that they have problems using food labels to make safe food choices. Thinking of your own food allergy, how serious a problem is each of the following in choosing safe food for you?
M22b. Some ingredients lists are so long that it is hard to find the ingredient you are concerned about. For managing your allergy, how much of a problem is that? Would you say a…
Very serious problem
A serious problem
A minor problem
Or not a problem at all
NOT RELAVANT TO MY ALLERGY
8. DON’T KNOW
9 REFUSED
M22c. Different words for the food a person is allergic to are used on different food products. For managing
your allergy would you say that is a (IF RESPONDENT NEEDS AN EXAMPLE: for example, using the terms whey or casein (kay seen)
for milk.)
Very serious problem
A serious problem
A minor problem,
Or not a problem at all?
NOT RELEVANT TO MY ALLERGY
8. DON'T KNOW
9. REFUSED
M22d. Food labels do not always alert people that new ingredients have been added to a food, although they
are stated in the ingredient list. For managing your allergy, how serious a problem is that?
[INTERVIEWER NOTE: IF ASKED OR RESPONDENT SEEMS CONFUSED, SAY: BY ALERT
PEOPLE, I MEAN PUT A STATEMENT ON THE FRONT THAT LETS YOU KNOW THE
RECIPE HAS CHANGED, SUCH AS NEW TASTE OR IMPROVED.
Very serious problem
A serious problem
A minor problem,
Or not a problem at all?
NOT RELEVANT TO MY ALLERGY
8. DON'T KNOW
9. REFUSED
M22e. Some ingredient lists give a general name for an ingredient without specifying the source, such as
natural flavors, spices, vegetable oil, or modified starch. For managing your allergy,
how serious a problem is that? Would you say it’s a:
Very serious problem
A serious problem
A minor problem,
Or not a problem at all?
NOT RELEVANT TO MY ALLERGY
8. DON'T KNOW
9. REFUSED
[NEW 2015]
M23a. Some food labels have statements on them such as may contain or made on the same equipment as the food you are allergic to. Statements like these are called Advisory Statements. Have you ever seen Advisory Statements on a food label? You can answer ‘yes,’ ‘not sure,’ or ‘no.’ [CATI PROGRAMMER AND INTERVIEWER PLEASE EMPHASIZE THE BOLDED ITALICIZED PHRASES]
1. YES
2. MAYBE/NOT SURE
3. NO [SKIP TO M23C]
8. DON’T KNOW
9. REFUSED
M23b. Have you ever eaten a food product that had an advisory statement on the label saying that the food may contain an ingredient you are allergic to? [CATI PROGRAMMER AND INTERVIEWER PLEASE EMPHASIZE BOLDED ITALICIZED WORDS]
YES [SKIP TO M23d]
MAYBE /NOT SURE
3. NO
8. DON’T KNOW
9. REFUSED
M23c. Would you eat a food product that had an advisory statement on the label saying that the food may contain an ingredient you are allergic to? [CATI PROGRAMMER AND INTERVIEWER PLEASE EMPHASIZE BOLDED ITALICIZED WORDS]
1. YES
2. MAYBE/NOT SURE
3. NO
8. DON’T KNOW
9. REFUSED
[SKIP IF M23A=3]
M23d. Have you ever eaten a food product that had an advisory statement on the label saying that the food was made on equipment that also processes products containing the food you are allergic to? [CATI PROGRAMMER AND INTERVIEWER PLEASE EMPHASIZE BOLDED ITALICIZED WORDS]
1. YES [SKIP TO M23f]
2. MAYBE/NOT SURE
3. NO
8. DON’T KNOW
9. REFUSED
M23e. Would you eat a food product that had this advisory statement on the label? [IF NEEDED: The food was made on equipment that also processes products containing the food you are allergic to; CATI PROGRAMMER AND INTERVIEWER PLEASE EMPHASIZE THE ITALICIZED STATEMENT]
1. YES
2. MAYBE/NOT SURE
3. NO
8. DON’T KNOW
9. REFUSED
[SKIP IF M23A=3]
M23f. Have you ever experienced an allergic reaction to a food that had an advisory statement on it?
1. YES
2. MAYBE/NOT SURE
3. NO
8. DON’T KNOW
9. REFUSED
M24a. Would you eat a food product that contains trace amounts of a food that you are allergic to if you could be assured that the amount of the allergen present in the food is only capable of triggering a mild allergic reaction, such as tingly lips or an itchy throat?
1. YES
2. MAYBE /NOT SURE
3. NO
8. DON’T KNOW
9. REFUSED
M24b. What if you could be assured that the trace amount of allergen in the food was not capable of triggering any allergic reaction? Would you eat the food product? [CATI PROGRAMMER AND INTERVIEWER PLEASE EMPHASIZE THE ITALICIZED STATEMENT]
1. YES
2. MAYBE/NOT SURE
3. NO
8. DON’T KNOW
9. REFUSED
M24c. Have you ever heard about the concept of threshold levels with regard to food allergies?
1. YES
2. MAYBE/NOT SURE
3. NO
8. DON’T KNOW
9. REFUSED
M24d. Do you think there can be a level of allergen in a food below which an allergic person would not have a reaction?
1. YES
2. MAYBE /NOT SURE
3. NO
8. DON’T KNOW
9. REFUSED
M24f. Have you ever experienced an allergic reaction to a food that you thought had only trace amounts of allergen in it?
1. YES [GO TO M24g]
2. MAYBE/NOT SURE [GO TO M24g]
3. NO [GO TO M24h]
8. DON’T KNOW
9. REFUSED
M24g. What level of allergic reaction have you had or do you think you had to a food that contained trace amounts of the food you are allergic to in it?
No reaction
Very mild reaction such as tingly lips or itchy throat
Medium level reaction such as throat tightening, shortness of breath, or hives
Severe reaction such as anaphylactic shock
8. DON’T KNOW
9. REFUSED
M24h. What level of allergic reaction do you think you would have to a food that contained trace amounts of the food you are allergic to in it?
1. No reaction
2. Very mild reaction such as tingly lips or itchy throat
3. Medium level reaction such as throat tightening, shortness of breath, or hives
4. Severe reaction such as anaphylactic shock
8. DON’T KNOW
9. REFUSED
N0. TR98
, TR10
Now I have a few questions about your health and
experience with food poisoning. Of the following two statements,
which one is closer to your view... (READ CODES 1 - 2) (ROTATE)
(PROBE IF NECESSARY: Do you think that certain types of people have a
higher risk of getting food poisoning, or do you think that all types
of people have about the same, risk?)
1. Certain types of people
have a higher risk of getting food poisoning. (GO TO N0a)
OR
2. All types of people have about the same risk of getting food poisoning. (GO TO N1)
3. IT DEPENDS – CERTAIN TYPES OF PEOPLE ARE AT HIGHER RISK FOR SOME TYPES OF FOOD POISONING (GO TO N0a)
8. DON’T KNOW (GO TO N1)
9. REFUSED (GO TO N1)
[SELECT OPTION 3 IF REPONDENT MENTIONS THAT SOME PEOPLE ARE AT HIGHER RISK FOR SOME TYPES OF FOOD POISIONING. IF RESPONDENT SAYS IT DEPENDS WITHOUT CLARIFYING, THEN SELECT DON’T KNOW (OPTION 8).]
N0A. TR98,
TR10[IF N0 = 1 or 3.]
What types of people do you think are more likely to get food
poisoning? (PROBE
ONCE ONLY): Any other? (DO NOT READ
RESPONSES; ACCEPT MULTIPLE RESPONSES)
N0A1. INFANTS
N0A2. CHILDREN
N0A3. PREGNANT WOMEN
N0A4. ELDERLY PEOPLE
N0A5. PEOPLE WITH CERTAIN ILLNESSES
N0A6. IMMUNOCOMPROMISED
N0A7. CARELESS PEOPLE/PEOPLE WITH POOR FOOD HANDLING PRACTICES
N0A8. PEOPLE WHO EAT RISKY FOODS
N0A9. TEEN/YOUNG ADULTS.
N0A10. OTHER (SPECIFY:___________________________.)
N0A11. DON’T KNOW
N0A12. REFUSAL
N1. Modified
TR01, TR06, TR10
Have you been told by a doctor that you have
either diabetes or reduced gastric acidity [a-SID-a-tee]?
1. YES, HAVE A CONDITION
2. NO, DO NOT HAVE A CONDITION
8. DON’T KNOW
9. REFUSED
N2.
Modified TR01, TR06, TR10
I am going to read a list of health
conditions. I don’t need to know which condition you have, only
whether you have been told by a doctor that you have any of the
following conditions: liver disease, currently receiving chemotherapy
or radiation therapy, HIV, AIDS, organ transplant, or a weakened
immune system.
1. YES, HAVE A CONDITION
2. NO, DO NOT HAVE A CONDITION
8. DON’T KNOW
9. REFUSED
N2a. NEW
Do you take any prescription medications?
1. YES
2. NO (Go To N3.)
8. DON’T KNOW
9. REFUSED
NEW [If N2a =1]
N2a1. We are interested in knowing only about certain medications. Do you take:
Any drugs to treat rheumatoid arthritis, ankylosing spondylitis, psoriasis, crohn’s disease, or ulceratrive colitis?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
N2a2. Any type of cancer chemotherapy drug? (YES/NO/DN/REF)
N2a3. Any type methotrexate used to treat cancer and other autoimmune diseases? (YES/NO/DN/REF)
N2a4. Any type of systemic corticosteroid or prednisone used to treat inflammatory conditions, cancer, or to prevent organ transplant rejection? (YES/NO/DN/REF)
N2a5. NEW
Because of a health or physical problem, do you have ANY difficulty eating, like holding a fork, cutting food, or drinking from a glass?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
N3. TR93,
TR98, TR01, TR06, TR10 –slightly modified.
In the past
month, have you or has anyone in your household had any kind of
sickness that you thought might have been caused by eating spoiled or
unsafe food? Don’t include allergies or intolerances
to food.
1. YES
2. NO
3. SOMEONE IN HOUSEHOLD DIED FROM FOODBORNE ILLNESS. READ: I’m very sorry to hear that. I won’t be asking questions about that. I just have a few more before the interview is over (GO TO SECTION P)
8. DON’T KNOW
9. REFUSED
N4. [IF
N3 = 2,8,9]
TR93, TR98, TR01, TR06, TR10
How about in the
past year? Have you or has anyone in your household had any kind of
sickness that you thought might have been caused by eating spoiled or
unsafe food?
1. YES
2. NO (Go to Section P)
3. SOMEONE IN HOUSEHOLD DIED FROM FOODBORNE ILLNESS. READ: I’m very sorry to hear that. I won’t be asking questions about that. I just have a few more before the interview is over (GO TO SECTION P)
8. DON’T KNOW (GO TO SECTION P)
9. REFUSED (GO TO SECTION P)
N5. If
N3 or N4=1
TR93, TR98, TR01, TR06 , TR10
Was it you or
someone else in your household who became sick?
1. RESPONDENT
2. ANOTHER HOUSEHOLD MEMBER (GO TO SECTION P)
3. BOTH (ASK SUBSEQUENT QUESTIONS ABOUT THE RESPONDENT)
4. SOMEONE IN HOUSEHOLD DIED FROM FOODBORNE ILLNESS. READ: I’m very sorry to hear that. I won’t be asking questions about that. I just have a few more before the interview is over (GO TO SECTION P)
8. DON’T KNOW (GO TO SECTION P)
9. REFUSED (GO TO SECTION P)
N7. TR01
TR06, TR10[IF N5 = 1,3]
How soon after eating this food did you
become sick? Would you say it was within days, hours, or minutes from
eating the food or don’t you know? [RECORD ANSWER]
1. DAYS
2. HOURS
3. MINUTES
8. DON’T KNOW
9. REFUSED
[IF N7 = DAYS]
N7DAY. How many days after eating the food did you become sick? [RANGE 1-21]
1. NEXT DAY
________ [REPORT WHOLE NUMBER]
96. IMMEDIATELY
98. DON’T KNOW
99. REFUSED
[IF N7 = HOURS]
N7HR. How many hours after eating the food did you become sick? [RANGE 1-72]
________ [REPORT WHOLE NUMBER]
96. IMMEDIATELY
98. DON’T KNOW
99. REFUSED
[IF N7 = MINUTES]
N7MIN. How many minutes after eating the food did you become sick? [RANGE 1- 90]
________ [REPORT WHOLE NUMBER]
96. IMMEDIATELY
98. DON’T KNOW
99. REFUSED
N8. TR93,
TR01, TR10
Did anyone report this illness?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
N8A. TR01,
TR06,TR10 [IF N8 = 1]
Who did you report it to? [ALLOW MULITPLE
RESPONSES]
N8A1. A DOCTOR
N8A2. A HOSPITAL EMERGENCY ROOM
N8A3. THE LOCAL HEALTH DEPARTMENT
N8A4. GOVERNMENT AGENCY
N8A5. OTHER (SPECIFY: _________________)
N8A6. DON’T KNOW
N8A7. REFUSED
N8B. TR01,
TR06, TR10 [IF N8A4 = 1]
Which government agency did you report
it to? [ALLOW MULITPLE RESPONSES]
N8B1. FDA
N8B2. USDA
N8B3. OTHER
N8B4. UNSPECIFIED GOVT AGENCY
N8B5. LOCAL HEALTH DEPARTMENT
N8B6. DON’T KNOW
N8B7. REFUSED
N9. TR93,
TR01, TR06, TR10
Did see a doctor for this illness?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
N10.
TR93, TR01, TR06, TR10 [IF N9 = 1]
Did a doctor say it was food
poisoning or foodborne illness?
1. YES
2. SAID IT MIGHT BE; POSSIBLY
3. NO
8. DON’T KNOW
9. REFUSED
N11.
TR93, TR01, TR06, TR10
[IF N9 = 1]
Did a doctor or other
health professional take a stool sample or a blood sample?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
N12. NEW [IF N9=1]
Did the doctor give you the results of the lab test?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
N13. NEW [If N12=1]
Did the lab test say that you had an infection?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
N14. NEW [IF N13=1]
Do you remember the what the name of the bacteria or infection was?
RECORD ANSWER
[PROG.:V2. ONLY respondents reached via a landline number]
V2. Now, I have a few questions for statistical purposes. Are there any telephone numbers in addition to [the telephone number being called] in your home that you receive calls on? Please exclude cell phone numbers or numbers used only for fax or computer.
Yes
No
DK/NS
RF
[IF V2=YES GO TO V2a
IF V2=( (No, DK/NS, OR RF) AND If SCR3a=”cell also,” )GO TO V4a. OTHERWISE, SKIP TO V3]
[PROG. ASK V2a: ASK V2a. to ONLY respondents reached via a landline number]
V2a. Is this/Are these number(s) for …
Home use
Business and home use
Business use only
DK/NS
RF
[PROG. V4a : ASK IF SCR5=’landline also,’ OR IF V2=’no/dk/ns/rf AND ROUTED TO V4A]
V4a. Of all the telephone calls that you or your household receive, are all or almost all calls received on cell phones, some received on cell phones and some on regular phones, or very few or none received on cell phones?
All or almost all calls received on cell phones
Some received on cell phones and some on regular phones
Very few or none on cell phones
DK/NS
RF
V4b. Thinking just about the landline home phone, not your cell phone, if that telephone rang and someone was home, under normal circumstances, how likely would it be answered? Would you say extremely likely the landline would be answered, very likely, somewhat likely, somewhat unlikely or not at all likely the landline would be answer?
Extremely likely that landline would be answered
Very likely that landline would be answered
Somewhat likely that landline would be answered
Somewhat unlikely that landline would be answered
Very unlikely that landline would be answered
Not at all likely that landline would be answered
DK/NS
RF
P2. What is the zip code where you live?
V3. How many adults, age 18 and older, including yourself live in your household?
NUMBER: ____________ (RANGE: 1-15)
DK/NS
RF
P3. TR01,
TR06, TR10
How many total people, including yourself, live in
your household? (Range = 1-97)
IF P3 > or = 10 RECHECK
THE QUESTION.
[INCLUDE: FOSTER CHILDREN, ROOMMATES OR
HOUSEMATES, AND PEOPLE STAYING HERE LAST NIGHT WHO HAVE NOT PERMENANT
PLACE TO STAY. THIS INCLUDES PEOPLE LIVING HERE MOST OF THE TIME WHLE
WORKING, EVEN IF THEY HAVE ANOTHER PLACE TO LIVE. DO NOT INCLUDE:
COLLEGE STUDENTS LIVING AWAY WHILE ATTENDING COLLEGE, PEOPLE IN A
CORRECTIONAL FACTILITY, NURSING HOME OR MENTAL HOSPITAL LAST NIGHT,
ARMED FORCES PERSONNEL LIVING SOMEWHERE ELSE, PEPOLE WHO LIVE OR STAY
AT ANOTHER PLACE MOST OF THE TIME.]
_____NUMBER
98. DON’T KNOW
99. REFUSED
P3B. Confirm number for P3.
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
P4. [ASK
IF P3 IS GREATER THAN 1, else skip to P5]
How many of these
people [in your household] are...
P4A.
TR01, TR06, TT10
Children younger than five years old?
_____ (Range = 0 to 20)
98. DON’T KNOW
99. REFUSED
[IF P4A > or = 10 CONFIRM ANSWER]
P4B. TR01,
TR06, TR10
Children between 5 and 18 years?
______ (Range = 0 to 20)
98. DON’T KNOW
99. REFUSED
[IF P4B > or = 10 CONFIRM ANSWER]
P4C.
TR01, TR06, TR10
Adults 60 years of age or older?
_______ (Range = 0 to 20)
98. DON’T KNOW
99. REFUSED
[IF P4C > or = 10 CONFIRM ANSWER]
IF SUM P4A TO P4C >P3, READ FOLLOWING AND GO THROUGH P3 TO P4C SEQUENCE AGAIN:
P4A1. Confirm Number for P4a.
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
P4B1. Confirm Number for P4b.
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
P4C1. Confirm Number for P4c.
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
The numbers are greater than the total number of people living in the household. Let’s go back and refigure those numbers.
P5. TR88,
TR93, TR98, TR01, TR06, TR10
What year were you born?
___________ (RANGE: 1900-1987)
8888 DON’T KNOW
9999. REFUSED
P7. TR06,
TR10 [DON’T ASK IF S4b= 1 and P3 = 1]
Is anyone in your
household pregnant?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
P7A. [IF
P7 =1 and if S4b=2]
Are you pregnant or is it someone else?
1. RESPONDENT PREGNANT
2. SOMEONE ELSE
8. DON’T KNOW
9. REFUSED
P8. TR93,
TR98, TR01, TR06, TR10
Are you Hispanic or Latino?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
P8a. NEW [IF P8=1]
Do you usually speak English, Spanish, or some other language at home?
ENGLISH
SPANISH
OTHER LANGUAGE
8. DON’T KNOW
9. REFUSED
P9. TR88,
TR93, TR98, TR01, TR06, TR10
What is your race? Please select
one or more. Are you...MARK ALL THAT APPLY [Read list P9A to P9E if
needed. Don’t read other categories.]
P9A. WHITE
P9B. BLACK OR AFRICAN AMERICAN
P9C. ASIAN
P9D. NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER
P9E. AMERICAN INDIAN OR ALASKA NATIVE?
P9I. DON’T KNOW
P9J. REFUSED
P9a. NEW.
Were you born in the United State or in another country?
UNITED STATES
ANOTHER COUNTRY
DON’T KNOW
REFUSED
[IF P9a=2]
P9a1. NEW
How old were you when you moved to the United States?
P10. TR88,
TR93, TR98, TR01, TR06, TR10
What is the last grade or year of
school that you have completed? [READ LIST IF NECESSARY]
1. LESS THAN HIGH SCHOOL DEGREE
2. 12 YEARS (HIGH SCHOOL GRADUATE OR GED)
3. 13-15 YEARS (1-3 YEARS COLLEGE (SOME COLLEGE))
4. 16 YEARS (COLLEGE GRADUATE (BACHELOR DEGREE OR EQUIVALENT))
5. (>16 YEARS) POSTGRADUATE, MASTER’S DEGREE, DOCTORATE, LAW DEGREE, OTHER PROFESSIONAL DEGREE [CLARIFY: THIS INCLUDES PEOPLE WORKING ON A GRADUATE DEGREE]
8. DON’T KNOW
9. REFUSED
P11. TR06,
TR10
What is your current working status? Are you…
1. WORKING FULL-TIME FOR PAY
2. WORKING PART-TIME FOR PAY
3. EMPLOYED, BUT TEMPORARILY NOT WORKING (IF NECESSARY: LONG TERM LEAVE)
4. LOOKING FOR WORK
5. WORKING, BUT NOT FOR PAY
6. NOT WORKING AT A JOB OR BUSINESS AND NOT LOOKING FOR WORK/ RETIRED/ [DON”T READ: HOMEMAKER/ FULL TIME STUDENT]
8. DON’T KNOW
9. REFUSED
P13. TR06,
TR10
Now, thinking of your households’ total income from
all sources before taxes, did your household earn $20,000 or more
last year?
1. YES
2. NO
8. DON’T KNOW
9. REFUSED
P14. TR98,
TR01, TR06, TR10
[IF P13 = 1]
Which of the following
categories best describes your total household income before taxes?
Please, stop me when I read your category.
1. $20,000 - $30,000
2. $30,000 - $40,000
3. $40,000 - $50,000
4. $50,000 - $60,000
5. $60,000 - $70,000
6. $70,000 - $80,000
7. $80,000 - $90,000
8. $90,000 - $100,000
10. More than $150,000
98. DON’T KNOW
99. REFUSED
Thank you much for your cooperation. We appreciate your taking the time to participate in our study. Those are all of the questions I have.
| File Type | application/msword |
| File Title | Food Safety Survey 2000-2001 |
| Author | Preferred Customer |
| Last Modified By | Lando, Amy |
| File Modified | 2014-11-25 |
| File Created | 2014-11-25 |