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8/1/07 Questionnaire: Family CONSUMER BEHAVIOR – CBQ Target Group: Family Questionnaire BOX NEW 1A NEW CHECK ITEM: IF ONE PERSON FAMILY, GO TO CBQ.020. OTHERWISE, CONTINUE. CBQ.010 Is anyone in this family on any kind of diet, either to lose weight or for some other health-related reason? HELP SCREEN: Examples of special diets include diet for weight loss, low carbohydrate, high protein, Atkins, to lower cholesterol, gluten-free, low sodium, diabetic diet, etc. YES .................
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    8/1/07  Questionnaire: Family CONSUMER BEHAVIOR – CBQ  Target Group: Family Questionnaire  BOX NEW 1ANEW CHECK ITEM: IF ONE PERSON FAMILY, GO TO CBQ.020.OTHERWISE, CONTINUE.CBQ.010  Is anyone in this family on any kind of diet, either to lose weight or for some other health-related reason? HELP SCREEN: Examples of special diets include diet for weight loss, low carbohydrate, high protein, Atkins, to lowercholesterol, gluten-free, low sodium, diabetic diet, etc.YES ............................................................... 1  NO................................................................. 2  REFUSED ..................................................... 7  DON'T KNOW ............................................... 9  CBQ.020  The next questions ask how often {your family has/you have} certain types of food available at home.How often {does your family/do you} have fruits available at home? This includes fresh, dried, canned andfrozen fruits. Would you say always, most of the time, sometimes, rarely, or never?HAND CARD CBQ1ALWAYS ...................................................... 1  MOST OF THE TIME ................................... 2  SOMETIMES ................................................ 3  RARELY ....................................................... 4  NEVER ......................................................... 5  REFUSED ..................................................... 7  DON'T KNOW ............................................... 9  CBQ.030  How often {does your family/do you} have any of these dark green vegetables available at home? Thisincludes fresh, dried, canned, and frozen vegetables. [Would you say always, most of the time, sometimes,rarely, or never?]HAND CARD CBQ2 and HAND CARD CBQ3.INTERVIEWER INSTRUCTION: DO NOT INCLUDE ICEBERG, BUTTERHEAD, BOSTON, AND MANOALETTUCEALWAYS ...................................................... 1  MOST OF THE TIME ................................... 2  SOMETIMES ................................................ 3  RARELY ....................................................... 4  NEVER ......................................................... 5  REFUSED ..................................................... 7  DON'T KNOW ............................................... 9     CBQ.040 How often {does your family/do you} have salty snacks such as chips and crackers available at home? Donot include nuts. [Would you say always, most of the time, sometimes, rarely, or never?]HAND CARD CBQ3ALWAYS ...................................................... 1  MOST OF THE TIME ................................... 2  SOMETIMES ................................................ 3  RARELY ....................................................... 4  NEVER ......................................................... 5  REFUSED ..................................................... 7  DON'T KNOW ............................................... 9  CBQ.050  How often {does your family/do you} have 1% fat, skim or fat-free milk available at home? Please do notinclude 2% milk. [Would you say always, most of the time, sometimes, rarely, or never?]HAND CARD CBQ3INTERVIEWER INSTRUCTION: DO NOT INCLUDE SOY MILKALWAYS ...................................................... 1  MOST OF THE TIME ................................... 2  SOMETIMES ................................................ 3  RARELY ....................................................... 4  NEVER ......................................................... 5  REFUSED ..................................................... 7  DON'T KNOW ............................................... 9  CBQ.060  How often {does your family/do you} have soft drinks, fruit-flavored drinks, or fruit punch available athome? Please do not include diet drinks, 100 percent juice or sports drinks. [Would you say always, most ofthe time, sometimes, rarely, or never?]HAND CARD CBQ3ALWAYS ...................................................... 1  MOST OF THE TIME ................................... 2  SOMETIMES ................................................ 3  RARELY ....................................................... 4  NEVER ......................................................... 5  REFUSED ..................................................... 7  DON'T KNOW ............................................... 9     CBQ.070 The next questions are about how much money {your family spends/you spend} on food. First I’ll ask youQ/U about money spent at supermarkets or grocery stores. Then we will talk about money spent at other typesof stores.During the past 30 days , how much money {did your family/did you} spend at supermarkets or grocerystores ? Please include purchases made with food stamps. (You can tell me per week or per month.)INTERVIEWER: ENTER “0” IF SP SAYS NO MONEY WAS SPENT.$ |___|___|___|___|___|___|___|___|___|NO MONEY SPENT ...................................... 0 (CBQ.100)  REFUSED ..................................................... 7 (CBQ.100)  DON'T KNOW ............................................... 9 (CBQ.100)  ENTER UNITWEEK............................................................ 1  MONTH ......................................................... 2  REFUSED ..................................................... 7  DON'T KNOW ............................................... 9  CBQ.080  Was any of this money spent on nonfood items such as cleaning or paper products, pet food, cigarettes oralcoholic beverages?YES ............................................................... 1  NO................................................................. 2 (CBQ.100)  REFUSED ..................................................... 7 (CBQ.100)  DON'T KNOW ............................................... 9 (CBQ.100)  CBQ.090 About how much money was spent on nonfood items? (You can tell me per week or per month.)Q/U$ |___|___|___|___|___|___|___|___|___|HARD EDIT: AMOUNT CANNOT BE MORE THANTHE AMOUNT ENTERED ON CBQ.070.REFUSED ..................................................... 7  DON'T KNOW ............................................... 9  ENTER UNITWEEK............................................................ 1  MONTH ......................................................... 2  REFUSED ..................................................... 7  DON'T KNOW ............................................... 9     CBQ.100  During the past 30 days , {did your family/did you} spend money on food at stores other than grocerystores? Here are some examples of stores where you might buy food. Please do not include stores that youhave already told me about.HAND CARD CBQ4YES ............................................................... 1  NO................................................................. 2 (CBQ.120)  REFUSED ..................................................... 7 (CBQ.120)  DON'T KNOW ............................................... 9 (CBQ.120)  CBQ.110About how much money {did your family/did you} spend on food at these types of stores? (Please do notQ/U include any stores you have already told me about.) (You can tell me per week or per month.)INTERVIEWER: ENTER “0” IF SP SAYS NO MONEY WAS SPENT.HAND CARD CBQ4$ |___|___|___|___|___|___|___|___|___|REFUSED ..................................................... 7  DON'T KNOW ............................................... 9  ENTER UNITWEEK............................................................ 1  MONTH ......................................................... 2  REFUSED ..................................................... 7  DON'T KNOW ............................................... 9  CBQ.120 During the past 30 days , how much money {did your family/did you} spend on eating out ? Please includeQ/Umoney spent in cafeterias at work or at school or on vending machines, for all family members . (You cantell me per week or per month.)INTERVIEWER INSTRUCTION: IF RESPONDENT KNOWS ONLY AMOUNT FOR SELF, CODE DK.INTERVIEWER: ENTER “0” IF SP SAYS NO MONEY WAS SPENT.$ |___|___|___|___|___|___|___|___|___|REFUSED ..................................................... 7  DON'T KNOW ............................................... 9  ENTER UNITWEEK............................................................ 1  MONTH ......................................................... 2  REFUSED ..................................................... 7  DON'T KNOW ............................................... 9 
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