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8 the environment for a child’s dietary intake.
Age: 18 to 19 years 20 to 24 years 25 to 29 years 30 to 34 years 35 to
39 years 40 to 44 years 45 to 49 years 50 years & above. N/A Yes
6
Gender: male female other
Income: <$25,000 $25,000-$50,000 $50,000-$75,000 $75,000-$100,000 4
No REFERENCES
>$100,000 N/A
2 1. Savage JS, Fisher JO, Birch LL. Parental influence on eating behavior:
Highest level of education: some high school no diploma high school or Conception to adolescence. The Journal of Law, Medicine & Ethics.
equivalent (GED) undergraduate degree. graduate degree or higher 2007;35(1):22-34.
0
education none of the above 25 – 29 30 – 34 35 – 39 40 – 44 45 – 49
Diet restrictions: vegan vegetarian pescatarian gluten-free lactose-free
other none
Age Group (Years) 2. Bergmeier HJ, Skouteris H, Haycraft E, Haines J, Hooley M. Reported
and observed controlling feeding practices predict child eating behavior
Number of children: one two three four five six or more after 12 months. J Nutr. 2015;145(6):1311-1316.
Please read each statement and circle yes or no If this represents you and your Answered Yes: My Child Eats More When I Feed Him/Her
child 3. Rollins BY, Loken E, Savage JS, Birch LL. Maternal controlling feeding
I encourage my children to explore new foods: Yes No 0%
practices and girls’ inhibitory control interact to predict changes in BMI
I like my child to make his/her own food choices: Yes No 10% and eating in the absence of hunger from 5 to 7 y. Am J Clin Nutr.
My child lets me know me when he/she is hungry: Yes No
2014;99(2):249-257.
32% one
I have a set routine for meals (i.e, meals are at a certain time): Yes No
4. Couch SC, Glanz K, Zhou C, Sallis JF, Saelens BE. Home food
I encourage my child to try something on his/her own before I help: Yes two environment in relation to children’s diet quality and weight status.
No three Journal of the Academy of Nutrition andtetics. 2014;114(10):1579. e1.
I try not to change the rules at home very often: Yes No
four
My child has 4-9 servings of fruits and vegetables a day: Yes No
five
Half of my child’s plate is filled with fruits and vegetables: Yes No
I have a hard time enforcing rules with my child: Yes No 58%
My child eats a variety of foods: Yes No
My child understands that certain foods (i.e., cake) cannot be eaten all the
time: Yes No