General Background Information
- How old are you?
- What is your gender?
- What town/city do you live in?
- Current Schooling (Preschool/Kindergarden, Elementary (Grade 1-5), Junior High (Grade 6-8) High school (9-12), Other?
Health Habits/Behavior
- What is you opinion on fruits and vegetables?
- How many servings of fruit do you eat on a daily basis?
- How many servings of vegetables do you eat on a daily basis?
- Do you use your app when you shop for food?
- How would your rank your knowledge about healthy habits (nutrition and/or exercise)?
- 3- Extremely Knowledgable, 2- Somewhat Knowledgeable, 1- Not Knowledgeable
- If you answered, 2- Somewhat Knowledgeable, 1- Not Knowledgeable to the previous questions, would be interested in learning more?
- How (who, where) did you learn about healthy habits (nutrition and/or exercise)?
- What is your greatest health strength?
- What is your health weakness?
- How much does time management play into your your health habits and daily behavior with food and fitness?
- What do you do for fitness/physical activity (exercise, play with you friends, sports, walking)?
- How often do you engage in fitness/physical activity?
- List the top 3 foods you consume most?
- List the top 3 beverages you consume most?
- How many meals do you eat a day?
- Perceived most important meal of the day?
- How much time you spend of preparing breakfast? Lunch? Dinner? Snacks?
- Which meal do you spent longest in preparation?
- Do you buy prepackaged meals?
- Are you interested/willing to try healthier options (products)?
- Are you interested/willing to try healthier recipes?
- Describe what is a healthy lifestyle to you?
- How much does your environment (social, economical, etc) affect your healthy living decisions?
Technological Habits/Behavior
- What type of technological devices do you use frequently?
- Indicate how much time you spend a day using technological devices (tv, streaming video device, video games, computer, smart phone or device, etc)? Ranking system example: 0-2 hrs, 2-4hrs, 4-6hrs, 6 hrs or more?
- What type of devices do you own or have access to?
- Do you own your own smartphone or device? If so what is the make and model (ie iPhone 4S)
- If you answered no to the previous question, do you have access to a smartphone or device (via family, friend, work, school)? Be specific?
- Does your parent or guardian have duration limitation or content limitation in regards to smart phone usage?
- Why do you use a smart phone?
- How often do you use it? When do you use it?
- What are the top 3 most frequent tasks you use daily on the smartphone/device?
- How did you accomplish those tasks before having a smart phone/device?
- How often do you download free apps? Paid apps?
- Do you prefer using devices, individual or with a group (family and/or friends)?
- Where do you use the device most often (home, schools, car, etc)?
Survey Monkey create by Sway Harner
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