Pretest Screener (phone and mail); Pretest (phone and mail); Survey Screener (phone and mail); Phone Survey; Mail Survey

OMB No: 0910-0345 Expiration Date: xx/xx/2028

Paperwork Reduction Act Statement: The Paperwork Reduction Act of 1995 provides that an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0910-0345 and the expiration date is xx/xx/2028. The time required to complete this information collection is estimated to average 20 minutes per response, including the time for reviewing instructions and completing and reviewing the collection of information.

Send comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for reducing burden to PRAStaff@fda.hhs.gov.

2025 FSANS Food Safety Version – Pretest

This survey will be self-administrated without a moderator and will take 20 minutes.

DRAFT 8-8-25

Section I

To start off, here are some questions about food safety.

1. How common do you think it is for people in the United States to get food poisoning?

A4

1 Very common

2 Somewhat common

3 Not very common

2. How common do you think it is for people in the United States to get food poisoning because of the way food is prepared in their home?

A1

1 Very common

2 Somewhat common

3 Not very common

3. How common do you think it is for people in the United States to get food poisoning because of the way food is prepared at restaurants?

A2

1 Very common

2 Somewhat common

3 Not very common

4. Do you think certain types of people such as pregnant women, the elderly, or young children have a higher risk, lower risk, or the same risk of getting food poisoning as everyone else?

N0

1 Higher risk

2 Lower risk

3 Same risk as everyone else

4 Don't know

5. In general, how much would you trust the following people and organizations when it comes to issues related to food?

		Don't trust at all	Somewhat trust	Mostly trust	Completely trust	Don't know
a.	Q5aYour doctor or other health professionals	1	2	3	4	5
b.	Q5bGovernment health agencies such as FDA, USDA, or CDC	1	2	3	4	5
c.	Q5cFarmers	1	2	3	4	5
d.	Q5dUniversity scientists	1	2	3	4	5
e.	Q5eNews media	1	2	3	4	5
f.	Q5fFood manufacturers	1	2	3	4	5
g.	Q5gSocial media influencers	1	2	3	4	5
h.	Q5hGrocery stores	1	2	3	4	5

6. Below is a list of some ways that food may be handled. How likely are you to get sick if you ate food that was handled in each of the following ways? If you don’t prepare the food, please give your opinion. Select one for each row.

		Very unlikely to get sick	Somewhat unlikely to get sick	Neither unlikely nor likely to get sick	Somewhat likely to get sick	Very likely to get sick
a.	F10AIf you forget to wash your hands before you begin cooking.	1	2	3	4	5
b.	F10BIf you eat raw vegetables that touched raw chicken.	1	2	3	4	5
c.	F10CIf you eat chicken that is not thoroughly cooked	1	2	3	4	5
d.	F10DIf you eat chicken that was left at room temperature for more than 2 hours after it was cooked.	1	2	3	4	5

Section II

7. Which of the following have you heard of as a problem in food? Select all that apply.

F1

Salmonella

F4

Listeria

F5

Campylobacter

F6

Norovirus

F7

E. coli

F8

Vibrio

F9

Cyclospora

F9_none

None of the above

Section III

8. How likely do you think it is that the following foods contain bacteria or other germs that could make people sick? Select one for each row.

		Very unlikely	Somewhat unlikely	Neither unlikely or likely	Somewhat likely	Very likely	Don't know
a.	A5aRaw chicken	1	2	3	4	5	6
b.	A5bV1Raw beef	1	2	3	4	5	6
c.	A5Fv1Raw shellfish	1	2	3	4	5	6
d.	A5Gv1Raw fish	1	2	3	4	5	6
e.	A5Dv1Raw eggs	1	2	3	4	5	6
f.	A5Cv1Raw fruit	1	2	3	4	5	6
g.	A5Ev1Raw vegetables	1	2	3	4	5	6
h.	germ_wholelettuceUnwashed, whole heads of lettuce such as iceberg or romaine	1	2	3	4	5	6
i.	germs_cutfruitRaw fruit that you buy in the store already cut and peeled, such as a bowl of cut up melon	1	2	3	4	5	6
j.	germ_saladBagged, pre-cut lettuce or packaged, pre-cut salads	1	2	3	4	5	6

9. How likely do you think it is that the following foods contain bacteria or other germs that could make people sick? Select one for each row.

		Very unlikely	Somewhat unlikely	Neither unlikely or likely	Somewhat likely	Very likely	Don't know
a.	germs_frovegUncooked frozen packaged vegetables, such as packaged frozen spinach or peas	1	2	3	4	5	6
b.	germs_frozenfruitFrozen packaged fruit	1	2	3	4	5	6
c.	germ_flourUncooked flour	1	2	3	4	5	6
d.	germ_cookieRaw homemade cookie dough	1	2	3	4	5	6
e.	germ_doughRaw, storebought doughs (such as cookie dough or pizza dough) that are not labeled as pasteurized or safe to eat raw	1	2	3	4	5	6
f.	germ_caramelCaramel apples	1	2	3	4	5	6

The next questions are about some foods that you have eaten in the past 12 months.

10. In the past 12 months, which of the following raw or uncooked foods did you eat? Select one for each row.

		Yes	No
a.	J1ARaw clams	1	2
b.	J1BRaw oysters	1	2
c.	J1CSteak tartare or raw ground beef, such as raw kibbeh, or tiger meat	1	2
d.	J1DSushi with raw fish, ceviche, or other raw fish	1	2
e.	J1ERaw alfalfa sprouts, bean sprouts, or other raw sprouts	1	2
f.	J1Rec3Raw chicken or other raw poultry	1	2
g.	J1porkRaw pork	1	2

11. In the past 12 months, have you eaten eggs with runny yolks, soft scrambled eggs, or soft meringue?

J3

1 Yes

2 No

12. In the past 12 months, did you eat any foods that contain raw egg? Please include anything like raw homemade cookie dough or raw homemade frosting that has raw egg in it when you eat it.

J4x

1 Yes

2 No

13. In the past 12 months have you ever tasted or eaten something with uncooked flour in it, such as raw cake batter or raw cookie dough (either homemade or ready-to-bake mixes and dough)?

Tasterawflour

1 Yes

2 No

Section IV

14. In the past 12 months, did you drink any raw milk or milk that was not pasteurized? This type of milk is often sold off-the-farm or door-to-door.

J2C

1 Yes

2 No [GO TO 16]

3 Don't know [GO TO 16]

SKIP-START SB_145

{J2C} != 2 and {J2C} != 3

15. How often do you drink raw milk?

J2D

1 Less than once a year

2 A few times a year

3 Once a month

4 A few times a month

5 Once a week

6 Two to three times per week

7 Daily

SKIP-END SB_145

16. Some cheese is made from milk that is not pasteurized. It is sometimes called "raw milk" cheese or "unpasteurized cheese." In the past 12 months have you eaten any raw milk cheese?

problems_rawcheese

1 Yes [GO TO 16a]

2 No [GO TO 17]

3 Don't know [GO TO 17]

SKIP-START SB_161

{problems_rawcheese} = 1

16a. Was the raw milk cheese you ate in the past 12 months:

Q16a

1 Soft cheese (including soft, soft ripened, semi-soft cheese such as brie, camembert, and queso fresco-type cheeses)

2 Hard cheese in any form (could be shredded, sliced, or block) – such as cheddar, parmesan, Swiss, and American

3 Both hard and soft cheese

4 Don't know

SKIP-END SB_161

17. In the past 12 months, have you eaten any caramel apples?

Q17

1 Yes

2 No

17a. In the past 12 months, have you purchased any caramel apples?

Q17a

1 Yes [GO TO 17b]

2 No [GO TO 18]

SKIP-START SB_184

{Q17a} = 1

17b. Thinking about the last time you purchased caramel apples, from what type of store did you buy them?

Q17b

1 Grocery store

2 Farmer's market

3 Candy store

4 Specialty retailer

5 Some other store: Please specify

Q17b_other[__________]

5 Don't know [GO TO 17d]

SKIP-START SB_196

{Q17b} != 5

17c. The last time you purchased caramel apples, were they:

Q17c

1 In the refrigerated section when purchased

2 Frozen when purchased

3 At room temperature when purchased

4 Don't know

SKIP-END SB_196

17d. After you purchased the caramel apples, did you: Select all that apply.

Q17d_1

Eat them the same day

Q17d_2

Store in the refrigerator at home

Q17d_3

Store at room temperature at home

Q17d_4

Store in the freezer at home

Q17d_5

Don't know

SKIP-END SB_184

Section V

18. How concerned are you about each of the following? Select one for each row.

		Not at all concerned	Not very concerned	Somewhat concerned	Very concerned	Extremely concerned	Don't know
a.	concerncolorsArtificial colors in food	1	2	3	4	5	6
b.	concernartingArtificial ingredients in food	1	2	3	4	5	6
c.	concernpreservePreservatives in food	1	2	3	4	5	6
d.	concernbacteriaBacteria or other germs in food	1	2	3	4	5	6
e.	concernantibioticAntibiotics in food	1	2	3	4	5	6
f.	concernpesticidePesticides in food	1	2	3	4	5	6
g.	concernmetalHeavy metals such as lead, arsenic, cadmium, and mercury in food	1	2	3	4	5	6

18a. Have you ever heard of ultra-processed foods?

Q18a

1 Yes [GO TO 18b]

2 No [GO TO 19]

3 Don't know [GO TO 19]

SKIP-START SB_237

{Q18a} = 1

18b. Do you think about whether a food is ultra-processed when deciding whether to eat it?

Q18b

1 Yes

2 No

3 Don't know

SKIP-END SB_237

19. How often do you look at the cooking instructions for packaged frozen vegetables such as frozen spinach, peas, and corn?

Instruction_frozen

1 Every time I make them

2 Sometimes

3 Just the first time I make a new product

4 Never

5 I never prepare packaged frozen vegetables [GO TO 22]

6 Don't know

SKIP-START SB_253

{Instruction_frozen} != 5

20. In the past 12 months, how many times did you use the following packaged frozen vegetables? Select one for each row.

		Daily	Weekly	Monthly	Less than once a month	Never	Don't know
a.	Q20aFrozen spinach	1	2	3	4	5	6
b.	Q20bFrozen corn	1	2	3	4	5	6
c.	Q20cFrozen peas	1	2	3	4	5	6
d.	Q20dFrozen carrots	1	2	3	4	5	6
e.	Q20eFrozen broccoli	1	2	3	4	5	6
f.	Q20fOther frozen vegetables – Which ones?	1	2	3	4	5	6
Q20_other[__________]

21. In the past 12 months, have you ever used the following packaged frozen vegetables without first cooking or heating them? For example, did you ever add them cold or at room temperature to a salad, dip or smoothie to be eaten raw without first cooking or heating it?

		Yes, I have used this food without cooking or heating it first	No, I have not used this food without cooking or heating it first	Don't Know
a.	Q21aFrozen spinach	1	2	3
b.	Q21bFrozen corn	1	2	3
c.	Q21cFrozen peas	1	2	3
d.	Q21dFrozen carrots	1	2	3
e.	Q21eFrozen broccoli	1	2	3
f.	Q21fFrozen kale	1	2	3
g.	Q21gFrozen asparagus	1	2	3
h.	Q21hFrozen cauliflower	1	2	3
i.	Q21iOther frozen vegetables – Which ones?	1	2	3
Q21_other[__________]

SKIP-END SB_253

Section VII

The next questions are about preparing food in your household.

22. How much of your household's food shopping do you do?

shoppingfreq

1 All of the food shopping

2 Most of it

3 About half of it

4 Only a little of it

5 None of it

6 Don't know

23. How often do you prepare the main meal in your household?

D2V1

1 All or nearly all of the time

2 Only some of the time

3 Never

24. Before you begin preparing food, how often do you wash your hands with soap?

D4

1 All of the time

2 Most of the time

3 Some of the time

4 Rarely

5 Never

25. After you have cracked open raw eggs, what do you usually do?

D11

1 Continue cooking without washing hands

2 Rinse or wipe hands

3 Wash hands with soap

4 Something else. Please specify:

Please specifyD11_specify[__________]

5 Never handle raw egg

26. After handling raw meat or chicken, what do you usually do?

D12

1 Continue cooking without washing hands

2 Rinse or wipe hands

3 Wash hands with soap

4 Something else. Please specify:

Please specifyD12_specify[__________]

5 Never handle raw meat or chicken [GO TO 30]

SKIP-START SB_326

{D12} != 5

27. After cutting raw meat or chicken, what do you usually do with the cutting board or surface? Select all that apply.

D14a

Continue using it without rinsing or washing

D14b

Rinse or wipe it

D14c

Wash it with soap

D14d

Wash with bleach

D14e

Put in dishwasher

D14f

Something else. Please specify:

D14_specify[__________]D14g

Don't cut raw meat or chicken

28. How often do you wash or rinse raw chicken pieces before cooking them?

D17

1 Always

2 Often

3 Sometimes

4 Never

5 Don't cook raw chicken pieces

29. How often do you wash or rinse raw whole chickens or turkeys before cooking them?

D18

1 Always

2 Often

3 Sometimes

4 Never

5 Don't cook raw whole chicken or turkeys

SKIP-END SB_326

30. In your home, how are beef hamburgers usually served?

D9

1 Rare [GO TO 32]

2 Medium-rare

3 Medium

4 Medium-well

5 Well-done [GO TO 32]

6 Hamburgers are never served [GO TO 32]

7 Don't know [GO TO 32]

SKIP-START SB_363

{D9} != 1 and {D9} != 5 and {D9} != 6 and {D9} != 7

31. When you say beef hamburgers are usually served "medium", how would you describe the color?

D10

1 Brown all the way through

2 Still have pink in the middle

3 Don't know

SKIP-END SB_363

32. If you cook a large pot of soup, stew, or other food with meat or chicken and want to save it for the next day, when do you put the food in the refrigerator?

E1

1 Immediately [GO TO 34]

2 After first cooling it at room temperature [GO TO 33]

3 After first cooling it in cold water [GO TO 34]

4 Do not cook such foods [GO TO 34]

5 Would not refrigerate it [GO TO 34]

6 Don't know [GO TO 34]

SKIP-START SB_379

{E1} != 1 and {E1} != 3 and {E1} != 4 and {E1} != 5 and {E1} != 6

33. For about how long would you let it cool at room temperature?

E2

1 Less than two hours

2 Two hours or more

3 Don't know

SKIP-END SB_379

34. After handling raw fish, what do you usually do?

D13

1 Continue cooking without washing hands

2 Rinse or wipe hands

3 Wash hands with soap

4 Something else. Please specify:

Please specifyD13_specify[__________]

5 Never handle raw fish [GO TO 36]

SKIP-START SB_398

{D13} != 5

35. After cutting raw fish or shellfish, what do you do with the cutting board or surface? Select all that apply.

D15a

Continue using it without rinsing or washing

D15b

Rinse or wipe it

D15c

Wash it with soap

D15d

Wash with bleach

D15e

Put in dishwasher

D15f

Something else. Please specify:

Please specify:D15_specify[__________]D15g

Don't cut raw fish or shellfish

SKIP-END SB_398

36. Do you have a food thermometer, such as a meat thermometer?

H6

1 Yes [GO TO 37]

2 No [GO TO 38]

3 Don't know [GO TO 38]

SKIP-START SB_421

{H6} != 2 and {H6} != 3

37. Over the past 12 months, how often did you use a food thermometer to test for doneness when you prepare the following foods? Select one for each row.

		Always use a food thermometer	Often use a food thermometer	Sometimes use a food thermometer	Never use a food thermometer	Did not cook the food in the past 12 months
1.	H8aBeef, lamb, or pork roasts	1	2	3	4	5
2.	thermwholechickenWhole chickens or turkeys	1	2	3	4	5
3.	H8bChicken parts such as breasts or legs	1	2	3	4	5
4.	H8cBaked egg dishes such as quiche, custard, or bread pudding	1	2	3	4	5
5.	H8dHamburgers made from beef	1	2	3	4	5
6.	thermfrozenFrozen food such as meals, entrees, and burritos	1	2	3	4	5

SKIP-END SB_421

38. When preparing uncooked rice, how often do you rinse it with water before cooking?

Riceprep

1 Always

2 Often

3 Sometimes

4 Rarely

5 Never

6 Don't prepare rice

39. Do you ever buy bagged lettuce, or bagged salad marked "prewashed" or "ready to eat"?

E9V2

1 Yes [GO TO 40]

2 No [GO TO 41]

3 Don't know [GO TO 41]

SKIP-START SB_450

{E9V2} = 1

40. Do you usually wash or rinse bagged lettuce that is marked "prewashed" or "ready to eat" or do you eat it as is from the bag?

E10V2

1 Wash or rinse

2 Eat as is without washing

3 It depends (i.e., product type, how it looks, how it smells)

4 Don't know

SKIP-END SB_450

41. Do you ever buy whole avocados?

E11V2

1 Yes [GO TO 42]

2 No [GO TO 44]

3 Don't know [GO TO 44]

SKIP-START SB_466

{E11V2} = 1

42. Do you usually wash or rinse avocados before you prepare or eat them?

E12V2

1 Yes [GO TO 43]

2 No [GO TO 44]

3 Don't know [GO TO 44]

SKIP-START SB_475

{E12V2} = 1

43. What methods do you use to wash or rinse avocados? Select all that apply.

E13V2a

Rub them under running water, with a brush, cloth or my hands

E13V2b

Hold under running water, without rubbing them

E13V2c

Soak them in a container of water

E13V2d

Use a cleaner to wash them. Please specify:

E13V2_specify[__________]

SKIP-END SB_475

SKIP-END SB_466 SKIP-START SB_488

1=1

44. Do you ever buy whole cantaloupe or any whole melons?

E14V2

1 Yes [GO TO 45]

2 No [GO TO 47]

3 Don't know [GO TO 47]

SKIP-END SB_488 SKIP-START SB_497

{E14V2} = 1

45. Do you usually wash or rinse cantaloupe or other melons before you prepare or cut it?

E15V2

1 Yes

2 No

3 Don't know

SKIP-START SB_506

{E15V2} = 1

46. Do you use any of these methods to wash or rinse cantaloupe or other melons? Select all that apply.

E16V2a

Rub them under running water, with a brush, cloth or my hands

E16V2b

Hold under running water, without rubbing them

E16V2c

Soak them in a container of water

E16V2d

Use a cleaner to wash them. Please specify:

E16V2_specify[__________]

SKIP-END SB_506

SKIP-END SB_497

Section VIII

SKIP-START SB_520

1=1

The next questions are about fish and shellfish consumption.

47. About how often do you eat fish or shellfish? Please also include any food that has fish or shellfish in it such as sandwiches, soups, or salads.

Q47

1 Once per day or more frequently

2 5 to 6 times per week

3 2 to 4 times per week

4 1 to 3 times per month

5 Less than once per month

6 A few times a year

7 Not in the last 12 months

8 Never

SKIP-END SB_520

48. How important is each of the following for determining how often you eat fish and shellfish?

		Not at all important	Not very important	Somewhat important	Very important	Extremely Important
a.	Q48aTaste or family preference	1	2	3	4	5
b.	Q48bFood allergies to fish and/or shellfish (myself or family)	1	2	3	4	5
c.	Q48cCost of fish and shellfish	1	2	3	4	5
d.	Q48dConfidence in ability to prepare fish and shellfish	1	2	3	4	5
e.	Q48eTime to shop or prepare for fish and shellfish	1	2	3	4	5
f.	Q48fHealth benefits of fish and shellfish	1	2	3	4	5
g.	Q48gHealth concerns related to fish	1	2	3	4	5
h.	Q48hAdvice from FDA, CDC, or your local state health department	1	2	3	4	5
i.	Q48iOther. Please specify.	1	2	3	4	5
Q48_other[__________]

49. What are the health benefits related to eating fish and shellfish? Select all that apply.

Q49a

Good source of healthy fats (omega -3s)

Q49b

Good source of protein

Q49c

Good source of iron

Q49d

Good source of iodine

Q49e

Good source of vitamin D

Q49f

Good for children’s brain development

Q49g

Supports brain health

Q49h

Promotes bone health – decreases the risk for hip fractures

Q49i

Helps with weight managementQ49j

Heart health benefits

Q49k

Decreases the risk for colon and rectal cancer

Q49k1

I have not heard about health benefits from fish and shellfish

Q49l

None of the above

50. Have you heard about the following health concerns related to eating some fish and shellfish? Select all that apply.

Q50a

Mercury

Q50b

Chemical pollutants (like (dioxins, PCBs, PFAS, and PFOS)

Q50c

Arsenic

Q50d

Harmful bacteria

Q50e

Parasites

Q50f

Scombrotoxin (histamine) formation

Q50g1

I have not heard about health concerns from fish and shellfish

Q50g

None of the above

51. Which of the following fish have high mercury levels? Select all that apply.

Q51a

King mackerel

Q51b

Marlin

Q51c

Orange roughy

Q51d

Shark

Q51e

Swordfish

Q51f

Tilefish from the Gulf of Mexico

Q51g

Tuna, albacore/white tuna, canned

Q51h

Tuna, yellowfin

Q51i

Tuna, canned light (includes skipjack)

Q51j

Tuna, bigeye

Q51k

Salmon

Q51l

Shrimp

Q51m

Catfish

Q51n

Tilapia

Q51o

Cod

Q51p

Don't know

Q51q

None of the above

52. Have you heard of any particular groups of people who are advised not to eat too much fish that are higher in mercury?

Q52

1 Yes [GO TO 53]

2 No [GO TO 54]

SKIP-START SB_607

{Q52} = 1

53. Which of the following groups of people are advised not to eat too much fish that are higher in mercury? Select all that apply.

Q53a

Pregnant women or women who might become pregnant

Q53b

Breastfeeding women

Q53c

Babies and toddlers

Q53d

School-aged children

Q53e

Older adults

Q53f

No particular group

Q53g

Don't know

SKIP-END SB_607

Section IX

The next questions are for statistical purposes.

54. Have you ever worked in any of the following industries? Select one for each row.

		Yes	No
a.	work_foodmanuFood manufacturing	1	2
b.	work_farmFarming	1	2
c.	work_foodserviceRestaurant or other food service	1	2
d.	work_healthcareHealth care	1	2
e.	work_publichealthPublic health	1	2

55. Do you have or have you ever had a ServSafe or other similar safe food handling certification?

Servedafe

1 Yes

2 No

3 Don't know

56. Would you say your health in general is:

V11

1 Excellent

2 Very good

3 Good

4 Fair

5 Poor

6 Don't know

57. Do you have any current food allergies or do you suspect you have a food allergy?

M1

1 Yes

2 No [GO TO 59]

SKIP-START SB_656

{M1} != 2

58. Has a medical doctor diagnosed your condition as a food allergy?

M7

1 Yes

2 No

SKIP-END SB_656

59. In the past 12 months, did you get sick from eating spoiled or unsafe food? Don’t include allergies to food.

N4V1

1 Yes

2 No

3 Don't know

60. Has a medical doctor or health care professional ever diagnosed you as having any of the following: hypertension or high blood pressure, diabetes, heart disease, respiratory diseases, kidney disease, autoimmune disorder, cancer, or another condition that could compromise your immune system?

Q60

1 Yes

2 No

3 Don't know

61. How tall are you without shoes?

V9_ft

[__________]

ft

V9_in

[__________]

Inch

OR

V9_m

[__________]

m

V9_cm

[__________]

cm

V9_DN

Don't know

62. How much do you weigh without clothes or shoes?

Enter weight in pounds V10_lbs

[__________]

lbs

OR

Enter weight in kilogramsV10_kg

[__________]

kg

V10_DN

Don't know

63. How many total people, including yourself, currently live in your household at least 50% of the time? Please include unrelated individuals (such as roommates), and also include those now away traveling, away at school, or in a hospital.

Enter number: P3

[__________]

Total people

SKIP-START SB_716

{P3} > 1

63a. Including yourself, how many of the people are:

	Number of people
Children 2 years and younger	Number of peopleQ63a_numppl[__________]
Children 3 to 5 years old	Number of peopleQ63b_numppl[__________]
Children 6 to 17 years old	Number of peopleQ63c_numppl[__________]
Adults 18 to 59 years old	Number of peopleQ63d_numppl[__________]
Adults 60 years or older	Number of peopleQ63e_numppl[__________]

SKIP-START SB_732

{Q63a_numppl} > 0 or {Q63b_numppl} > 0 or {Q63c_numppl} > 0

[Program Note: If no children living in your household, Go to 66]

64. Are you the parent or primary caregiver to any of the children under the age of 18 in your household?

primarycaregiver

1 Yes

2 No

65. In the past 12 months, have you or anyone living in your household received benefits from the Women, Infants and Children (WIC) program?

WIC12m

1 Yes

2 No

3 Don't know

SKIP-END SB_732

SKIP-END SB_716

66. In the past 12 months, have you or anyone living in your household received Supplemental Nutrition Assistance Program (SNAP) or food stamp benefits?

SNAP12m

1 Yes

2 No

3 Don't know

67. Are you:

Q67_gender

1 Female

2 Male

68. In what year were you born?

Enter year:P5[__________]

69. Do you...

hometype

1 Own your home,

2 Rent your home, or

3 Have some other arrangement?

70. What language or languages do you usually speak at home? Select all that apply.

P8a_ENG

English

P8a_SP

Spanish

P8a_OTH

Other language(s)? Please specify

P8a_specify[__________]

71. What is your race and/or ethnicity? Select all that apply and enter additional details in the spaces below.

P95

American Indian or Alaska Native

P95_1

Other, please specify.

P95_other[__________]

P93

Asian – Provide details below.

P93_1

Chinese

P93_2

Asian Indian

P93_3

Filipino

P93_4

Vietnamese

P93_5

Korean

P93_6

Japanese

P93_7

Other, please specify.

P93_other[__________]

P92

Black or African American – Provide details below.

P92_1

African American

P92_2

Jamaican

P92_3

Haitian

P92_4

Nigerian

P92_5

Ethiopian

P92_6

Somali

P92_7

Other, please specify.

P92_other[__________]

Q71_hisp

Hispanic or Latino – Provide details below.

Q71_hisp_1

Mexican

Q71_hisp_2

Puerto Rican

Q71_hisp_3

Salvadoran

Q71_hisp_4

Cuban

Q71_hisp_5

Dominican

Q71_hisp_6

Guatemalan

Q71_hisp_7

Other, please specify.

Q71_hisp_other[__________]

Q71_east

Middle Eastern or North African – Provide details below.

Q71_east_1

Lebanese

Q71_east_2

Iranian

Q71_east_3

Egyptian

Q71_east_4

Syrian

Q71_east_5

Iraqi

Q71_east_6

Israeli

Q71_east_7

Other, please specify.

Q71_east_other[__________]

P94

Native Hawaiian or Pacific Islander – Provide details below.

P94_1

Native Hawaiian

P94_2

Samoan

P94_3

Chamorro

P94_4

Tongan

P94_5

Fijian

P94_6

Marshallese

P94_7

Other, please specify.

P94_other[__________]

P91

White – Provide details below.

P91_1

English

P91_2

German

P91_3

Irish

P91_4

Italian

P91_5

Polish

P91_6

Scottish

P91_7

Other, please specify.

P91_other[__________]

72. What is the last grade or year of school that you have completed?

P10

1 Less than high school degree

2 High school graduate or GED

3 1 – 3 years college/some college

4 College graduate – Bachelors’ degree or equivalent

5 Postgraduate, master’s degree, doctorate, law degree, other professional degree

73. What was your total household income before taxes during the past 12 months?

Include ALL income sources for everyone living in your household:

• Employment income: Wages, salary, tips, bonuses, commissions • Business income: Self-employment earnings, partnerships, S-Corporation distributions • Retirement income: Traditional pensions, 401(k)/403(b)/457 withdrawals, IRA distributions • Government benefits: Social Security, unemployment benefits, disability payments • Investment income: Interest, dividends, capital gains, rental property income • Other income: Alimony, child support, gifts, or any other regular income

P14

1 Less than $25,000

2 $25,000 to 34,999

3 $35,000 to $49,999

4 $50,000 to $74,999

5 $75,000 to $99,999

6 $100,000 to $149,999

7 $150,000 to $199,999

8 $200,000 or more

9 Don’t know

10 Prefer not to answer

74. We appreciate your taking the time to participate in our study. Is there anything you’d like to add?

Response:qcomm[__________]

Thank you

Thank you for completing our survey.

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