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2017
March
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Hello:
You are invited to participate in our survey How does nutrition affect academic. In this survey, approximately 60 people will be asked to complete a survey that asks questions about their nutritional choices. It will take approximately 5minutes to complete the questionnaire.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.
Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Nedra Joseph at 225-0-6609 or by email at the email address specified below.
Thank you very much for your time and support. Please start with the survey now by clicking on the
Continue
button below.
Please answer one of the following:
How often do you eat breakfast?
Every morning before school
-- Select --
1
2
3
Not at all
-- Select --
1
2
3
When I feel hungry
-- Select --
1
2
3
Please answer one of the following:
How often do you eat candy?
Everyday
-- Select --
1
2
3
Only on special occasions
-- Select --
1
2
3
Every chance I get
-- Select --
1
2
3
Please answer one of the following:
What types of drinks do you consume?
Water
-- Select --
1
2
3
Tea
-- Select --
1
2
3
Soda
-- Select --
1
2
3
Please answer one of the following:
How often do you each fruit and vegetables?
With every meal
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1
2
3
Once a day
-- Select --
1
2
3
Once a week
-- Select --
1
2
3
Please answer one of the following:
Do you believe fruits and vegetable can be a meal?
Agree
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1
2
3
4
Somewhat agree
-- Select --
1
2
3
4
Somewhat disagree
-- Select --
1
2
3
4
Disagree
-- Select --
1
2
3
4
Please answer one of the following
Do you believe your body needs water?
Agree
-- Select --
1
2
3
4
Somewhat agree
-- Select --
1
2
3
4
Somewhat disagree
-- Select --
1
2
3
4
Disagree
-- Select --
1
2
3
4
Please answer one of the following:
Do you belive exercise imporant for brain function?
Agree
-- Select --
1
2
3
4
Somewhat agree
-- Select --
1
2
3
4
Somewhat disagree
-- Select --
1
2
3
4
disagree
-- Select --
1
2
3
4
Please answer on of the following:
How often do you exercise?
Once a day
-- Select --
1
2
3
Two to Three days a week
-- Select --
1
2
3
Walking each day is exercise
-- Select --
1
2
3
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