We are interested in the type of beverages your child drinks and the quantity of these beverages he/she drinks.
Please answer the following questions as honestly and accurately as possible.
How often does your child drink the following beverages?
Never
Once a week
2-3 times a week
4-6 times a week
Daily
Several times a day
Water
Milk
Natural Fruit Juice (the original liquid resulting from the pressing of fruits, or the liquid resulting from the dilution with water of dehydrated natural fruit juice)
Natural Vegetable Juice (the original liquid resulting from the pressing of vegetables, or the liquid resulting from the dilution with water of dehydrated natural vegetable juice)
Sugary drinks (any nonalcoholic beverage, carbonated or noncarbonated, which is intended for human consumption and contains any added caloric sweetener. A caloric sweetener is any caloric substance suitable for human consumption that humans perceive as sweet and includes, without limitation, sucrose, fructose, glucose, fruit juice concentrate or other sugars.) For example, soda, gatorade, non-natural fruit juices.
Please indicate whether the following beverages are available in your home for your child to consume.
This beverage is NOT available
This beverage is available
Water
Milk
Natural Fruit Juice (the original liquid resulting from the pressing of fruits, or the liquid resulting from the dilution with water of dehydrated natural fruit juice)
Natural Vegetable Juice (the original liquid resulting from the pressing of vegetables, or the liquid resulting from the dilution with water of dehydrated natural vegetable juice)
Sugary drinks (any nonalcoholic beverage, carbonated or noncarbonated, which is intended for human consumption and contains any added caloric sweetener. A caloric sweetener is any caloric substance suitable for human consumption that humans perceive as sweet and includes, without limitation, sucrose, fructose, glucose, fruit juice concentrate or other sugars.) For example, soda, gatorade, non-natural fruit juices.
Please indicate whether the following beverages are available at your child's school for your child to consume.
This beverage is NOT available
This beverage is available
Water
Milk
Natural Fruit Juice (the original liquid resulting from the pressing of fruits, or the liquid resulting from the dilution with water of dehydrated natural fruit juice)
Natural Vegetable Juice (the original liquid resulting from the pressing of vegetables, or the liquid resulting from the dilution with water of dehydrated natural vegetable juice)
Sugary drinks (any nonalcoholic beverage, carbonated or noncarbonated, which is intended for human consumption and contains any added caloric sweetener. A caloric sweetener is any caloric substance suitable for human consumption that humans perceive as sweet and includes, without limitation, sucrose, fructose, glucose, fruit juice concentrate or other sugars.) For example, soda, gatorade, non-natural fruit juices.
If your child drinks sugary drinks, why do you think she/he does so? (Check all that apply)
What factors do you believe prevent your child from drinking more water? (Check all that apply)
In your opinion, what would motivate your child to drink more water and less sugary drinks?
Your answer
While at school, where do the drinks your child consumes come from? (Check all that apply)
How old is the child you answered questions about in this survey?
Your answer
What is the gender of the child you answered questions about in this survey?
What is the ethnicity of the child you answered questions about in this survey?
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