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Surveys
2015
August
B
Behavioral Outcomes Evaluation
Behavioral Outcomes Evaluation
Behavioral Outcomes Evaluation
0%
Exit Survey
1. In the last 3 days, how many days did you track calorie intake?
1 day
2 days
3 days
2. In the last 24 hours, how many servings of fruit did you consume?
1-2 servings
3-4 servings
5-6 servings
7-8 servings
9-10 servings
3. In the last 24 hours, how many servings of vegetables did you consume?
1-2 servings
3-4 servings
5-6 servings
7-8 servings
9-10 servings
4. In the last 3 days, how many meals did you prepare at home?
1-3 meals
4-6 meals
7-9 meals
10+ meals
5. In the last week, how often did you eat breakfast?
Rarely (0-2 days)
Sometimes (3-4 days)
Most of the time (5-6 days)
Always (all 7 days)
6. In the last 24 hours, how many glasses of water did you drink?
1
2
3
4
5
6
7
8
More than 8
7. In the last 3 days, did you choose to replace unhealthy snacks with healthier options?
Yes
No
I Don't Know
8. In the last week, did you buy fresh, frozen, or canned fruits and/or vegetables?
Yes
No
9. In the last week, how often were you conscious of portion sizes while eating?
Never
Rarely
Sometimes
Often
Always
10. In the last week, how many days did you exercise for 30 minutes or more (in addition to daily routine)?
1-2 days
3-4 days
5-7 days
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