This survey is for research purposes and will remain anonymous. Your participation is voluntary and any question on the survey may be skipped. For questions about the survey, contact Natalie Wickenheisser at 203-376-4721 or Hannah Malian at 908-310-4818.
Male
Female
What is your ethnicity? (select all that apply)
Black or African American
Latinx, or Spanish origin
American Indian and Alaska native
Asian
Native Hawaiian and Other Pacific Islander
White
Other
Black or African American
Latinx, or Spanish origin
American Indian and Alaska native
Asian
Native Hawaiian and Other Pacific Islander
White
Other
Food Security Questions Please answer the following questions (1-4) as they relate to you BEFORE the COVID-19 outbreak and stay at home order impacted you and your family.
1) How often were the following statements true for you or other members in your household in the last 6 months (before the COVID-19 or coronavirus outbreak began) ?
a) The food that I/we bought just didn't last, and I/we didn't have money to get more.
Often true
Sometimes true
Never true
Often true
Sometimes true
Never true
b) I/we couldn't afford to eat balanced meals.
Often true
Sometimes true
Never true
Often true
Sometimes true
Never true
2) In the 6 months (before COVID-19) , did you (or other adults in your household) ever cut the size of your meals or skip meals because there wasn't enough money for food?
Yes
No
If you said YES to 2, how often did this happen?
Almost every month
Some months but not every month
In 1 or 2 months
Don't know
Almost every month
Some months but not every month
In 1 or 2 months
Don't know
3) In the last 6 months (before COVID-19) , did you ever eat less than you felt you should because there wasn't enough money to buy food?
Yes
No
Don't know
4) In the last 6 months (before COVID-19), were you ever hungry but didn't eat because you couldn't afford enough food?
Yes
No
Don't know
Questions about Food
1) How many servings of fruits, vegetables, or beans did you eat per day?
0
1
2
3
4
5 or more
2) How many of your meals did you cook at home (INCLUDE when you eat leftovers you have cooked but DO NOT INCLUDE ready made foods such as cereal or frozen meals)?
A few of my meals (Between 0 and 7 meals per week)
Some of my meals (Between 7 and 14 meals per week)
Most of my meals (Between 14 and 21 meals per week)
A few of my meals (Between 0 and 7 meals per week)
Some of my meals (Between 7 and 14 meals per week)
Most of my meals (Between 14 and 21 meals per week)
3) Do you feel like you were eating healthy in general?
None of the time
Not very often
Sometimes
Most of the time
All the time
None of the time
Not very often
Sometimes
Most of the time
All the time
Which sources do you rely on most for medical information in general, when you aren't sick? (choose all that apply)
Doctor or healthcare professional
TV news
TV shows
Social Media (Facebook, Instagram, Twitter)
Online
Newspaper
Radio or Podcasts
Scientific or medical journals
Word of mouth (friends, family, neighbors, co-workers)
Mail
Other (movies, articles, etc.)
Doctor or healthcare professional
TV news
TV shows
Social Media (Facebook, Instagram, Twitter)
Online
Newspaper
Radio or Podcasts
Scientific or medical journals
Word of mouth (friends, family, neighbors, co-workers)
Mail
Other (movies, articles, etc.)
COVID-19 (Coronavirus) Questions COVID-19 (Coronavirus) Food Security Questions
1) How often were the following statements true for you or other members in your household in the past 2 weeks?
a) The food that I/we bought just didn't last, and I/we didn't have money to get more.
Often true
Sometimes true
Never true
Often true
Sometimes true
Never true
b) I/we couldn't afford to eat balanced meals.
Often true
Sometimes true
Never true
Often true
Sometimes true
Never true
2) In the past 2 weeks, have you (or other adults in your household) ever cut the size of your meals or skip meals because there wasn't enough money for food?
Yes
No
If you said YES to 2, how often did this happen?
Almost every month
Some months but not every month
In 1 or 2 months
Don't know
Almost every month
Some months but not every month
In 1 or 2 months
Don't know
3) In the past 2 weeks have you ever eaten less than you felt you should because there wasn't enough money to buy food?
Yes
No
Don't know
4) In the past 2 weeks, were you ever hungry but didn't eat because you couldn't afford enough food?
Yes
No
Don't know
1) In the past 2 weeks, how many servings of fruits, vegetables, or beans did you eat per day?
0
1
2
3
4
5 or more
2) In the past 2 weeks, how many of your meals did you cook at home (INCLUDE when you eat leftovers you have cooked but DO NOT INCLUDE ready made foods such as cereal or frozen meals)?
A few of my meals (Between 0 and 7 meals per week)
Some of my meals (Between 7 and 14 meals per week)
Most of my meals (Between 14 and 21 meals per week)
A few of my meals (Between 0 and 7 meals per week)
Some of my meals (Between 7 and 14 meals per week)
Most of my meals (Between 14 and 21 meals per week)
3) In the past 2 weeks, do you feel like you were eating healthy in general?
None of the time
Not very often
Sometimes
Most of the time
All the time
None of the time
Not very often
Sometimes
Most of the time
All the time
How has the COVID-19 (coronavirus) outbreak and stay at home order affected you and your family? Check all that apply.
Which sources do you rely on most for information about COVID-19? (choose all that apply)
Doctor or healthcare professional
TV news
TV shows
Social Media (Facebook, Instagram, Twitter)
Online
Newspaper
Radio or Podcasts
Scientific or medical journals
Word of mouth (friends, family, neighbors, co-workers)
Other (movies, articles, etc.) provide space for free text
Not applicable
Doctor or healthcare professional
TV news
TV shows
Social Media (Facebook, Instagram, Twitter)
Online
Newspaper
Radio or Podcasts
Scientific or medical journals
Word of mouth (friends, family, neighbors, co-workers)
Other (movies, articles, etc.) provide space for free text
Not applicable
Please answer the following questions in relation to your experience DURING the COVID-19 outbreak in the past two weeks:
Please select an option based on the following statement:
Strongly Disagree Disagree Neutral Agree Strongly Agree Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
The following questions are about challenges you may have faced in transportation.
Did you ever find it difficult to come to the Duke Outpatient Clinic for a Fresh Produce Program Distribution?
Yes No I have not been to a Fresh Produce Program distribution Yes
No
I have not been to a Fresh Produce Program distribution
Did you ever find it difficult to come to the Duke Outpatient Clinic to get food from the Fresh Produce Program distributions?
Have you ever had any type of food delivered to you, such as through a program like Meals on Wheels?
Yes No
Have you ever had fruits and vegetables (produce) delivered to you before?
Yes
No
How interested are you in continuing to receive this temporary produce delivery service if the service remained free?
Not at all interested
Slightly interested
Moderately interested
Very interested
Extremely Interested
Not at all interested
Slightly interested
Moderately interested
Very interested
Extremely Interested
Overall, how easy has it been to understand home food delivery or store pickup options?
Very hard
Somewhat hard
Neither hard nor easy
Somewhat easy
Very easy
Not applicable, (I have not tried to use these services).
Very hard
Somewhat hard
Neither hard nor easy
Somewhat easy
Very easy
Not applicable, (I have not tried to use these services).