questionnaire – Omega Psi Phi Fraternity, Inc.

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Well Prepared Program - Pre/Post Evaluation Questionnaire - Parents

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Well Prepared Program - Pre/Post Evaluation Questionnaire - Parents

Please answer a few preliminary demographic questions prior to beginning the questionnaire
Chapter
Select the chapter that requested you to complete this questionnaire.
1. What is your age?*
- A. 25-34
- B. 35-44
- C. 45-54
- D. 55 or older
2. Do you identify as?*
- A. Male
- B. Female
- C. Prefer not to answer
3. What is your ethnicity?*
- A. American Indian or Alaska Native
- B. Asian
- C. Black or African American
- D. Hispanic or Latino
- E. Native Hawaiian or Other Pacific Islander
- F. Caucasian
4. What city and state do you live in
City State / Province / Region Country
5. Obesity during childhood can affect a child’s*
- A. Immediate health
- B. Future health as an adult
- C. Mental health
- D. All of the above
6. BMI or Body Mass Index determined by your health care provider is calculated the same for adults and children*
- A. True
- B. False
7. Are you comfortable with having a discussion with your doctor about your child’s BMI?*
- A. Yes
- B. No
If no, please explain why (BMI discussion with Doctor)
8. As a parent and caregiver what you say can have which effect on your child’s eating behaviors*
- A. Help
- B. Hinder
- C. Both
9. What are the recommended servings of fruits and vegetable for your child per day?*
- A. 2
- B. 3
- C. 4
- D. 5
10. A portion and a serving are not the same*
- A. True
- B. False
11. Snacks should be a part of your child’s eating pattern*
- A. True
- B. False
12. Energy drinks are recommended for pediatric athletes*
- A. True
- B. False
13. Shopping healthy on a budget cannot be done in small chain stores such as (Dollar General, Family Dollar, Dollar Tree)*
- A. True
- B. False
14. Increasing the amount of screen time for your child is associated with an increased risk of negative health impacts even if the child is physically active*
- A. True
- B. False
15. The American Academy of Pediatrics recommends that children ages 6-12 should sleep how many hours a day*
- A. 5-6
- B. 7-8
- C. 9-12

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