DHF Cafe Grant Survey | DHF Learning

Cafe Grant Survey

Please fill out this survey to provide us with valuable input on what this grant could be used for to help offer more healthy food and beverage offerings at our Springfield terminal. The Department of Health and Senior Services (DHSS), and Bureau of Community Health and Wellness (CHW) is partnering with Driver Health & Fitness with a grant opportunity to enhance the availability of healthy food and beverage options within our worksite for the benefit of our drivers and associates.

1. Please read the following statements. Select the statement that best describes your current intake of 100 % juices and fresh, frozen and/or dried fruits and vegetables. A serving is a ½ cup or 1 medium piece of fresh and frozen fruits and vegetables, 6 oz of 100% juice and ¼ cup of dried fruits or vegetables.

I don’t eat fruits or vegetables regularly now, and I don’t plan to start in the near future.

I don’t eat fruits and vegetables regularly, but I’ve been thinking about starting.

I’m eating some fruits and vegetables every day (total of 2 servings or less)

I’ve been eating fruits and vegetables every day (total of 3 or more servings), for the last 1-6 months.

I’ve been eating 5 or more servings of fruits and vegetables every day, for more than 6 months.

2. Please read the following statements. Select the statement that best describes your current intake of low-fat foods.

I don’t worry about the fat content of the food I eat, and I don’t plan to in the near future.

I eat high-fat foods daily, but I’ve been thinking about trying to reduce my intake

I limit my intake of high-fat foods to 1-3 times per week.

I eat high-fat foods less than 1 time per week and have been for the past 1-6 months.

I eat high-fat foods less than once a week and have been for more than 6 months..

3. Please read the following statements. Select the statement that best describes your current intake of whole-grain foods. The serving size for whole grains is 1 ounce (1 slice of bread, 1 ounce of cereal, ½ cup of cooked rice or pasta).

I don’t cook, eat or purchase whole grain foods now and I don’t plan to start in the near future.

I don’t cook, eat or purchase whole-grain foods regularly, but I’ve been thinking about starting.

I’m cooking, eating or purchasing whole-grain foods 3-4 times a week.

I’ve been cooking, eating or purchasing whole-grain foods every day, for the past 1-6 months.

I’ve been cooking, eating or purchasing at least 3 servings of whole-grain foods every day, for more than 6 months.

4. Please read the following statements. Select the statement that best describes your current intake of low-fat dairy products (or dairy alternatives) such as milk, yogurt, cheese, and fortified soy beverages.

I don’t eat low-fat dairy products now, and I don’t plan to start in the near future.

I don’t eat low-fat dairy product now, but I’ve been thinking about starting

I’m eating some low-fat dairy products every day (once a day)

I’m eating 2-3 servings of low-fat dairy products a day for the past 1-6 months.

I’m eating 2-3 servings of low-fat dairy products a day for more than 6 months.

5. Please read the following statements. Select the statement that best describes your current intake of non-fried protein foods, such as seafood, lean meats and poultry, eggs, legumes (beans and peas), nuts, seeds, and soy products, daily.

I don’t eat lean, non-fried protein now, and I don’t plan to start in the near future.

I don’t eat lean, non-fried protein now, but I’ve been thinking about starting

I’m eating some lean, non-fried protein every day (once a day)

I’m eating 2-3 servings of lean, non-fried protein a day for the past 1-6 months.

I’m eating 2-3 servings of lean, non-fried protein a day for more than 6 months.

6. Please read the following statements. Select the statement that best describes your current intake of sodium including meals which have <= 800 mg of sodium, entrees containing <=600 mg of sodium, and side items which contain <=230 mg of sodium.

I don’t limit my sodium intake now, and I don’t plan to start in the near future.

I don’t limit my sodium intake now, but I’ve been thinking about starting

I’m limiting my sodium intake every day (once a day)

I’m limiting my sodium intake 2-3 times a day for the past 1-6 months.

I’m limiting my sodium intake 2-3 times a day for more than 6 months.

7. Please read the following statements. Select the statement that best describes your current intake of water, low-calorie beverages containing <= 40 calories per 8 fluid ounces, and low-fat milk and soy beverages with no added sugars.

I don’t drink any low-calorie beverages now, and I don’t plan to start in the near future.

I don’t drink any low-calorie beverages now, but I’ve been thinking about starting.

I’m drinking low-calorie beverages every day (once or twice a day)

I’m drinking low-calorie beverages 3 or more times a day for the past 1-6 months.

I’m drinking low-calorie beverages 3 or more times a day for more than 6 months.

8. Please read the following statements. Select the statement that best describes how often you use calorie and nutrition information when making your food and beverage choices.

I don’t use calorie and nutrition information now, and I don’t plan to start in the near future.

I don’t use calorie and nutrition information now, but I’ve been thinking about starting.

I use calorie and nutrition information daily (once a day)

I use calorie and nutrition information 2-3 times per day for the past 1-6 months.

I use calorie and nutrition information 2-3 times per day for more than 6 months.

On a scale of 1-5 with ‘1’ being a very low interest and ‘5’ being a very high interest rate your interest in the following nutrition options.

a. Attending regular presentations on nutrition topics

b. Receiving regular nutritious eating tips via email

c. Having access to internet resources on nutrition and healthful eating

d. Getting recipes and meal ideas

e. Getting information on existing food and nutrition related groups in your area

f. Healthful eating reminders and information in the cafeteria

g. Labeling of gluten-free, allergy free, lower sugar items in the cafeteria

h. Identifying best choice food options for the cafeteria and vending areas

What nutrition topics are you interested in learning more about?

What are some examples of more healthful food items you would like available in the cafeteria?

How can you see your idea benefiting the associates and drivers within Prime?

Demographics

User code or Driver code(Required)

Phone(Required)

Gender

Male

Female

Age

Work unit

Driver

In-house associate

Cafe Grant Survey

On a scale of 1-5 with ‘1’ being a very low interest and ‘5’ being a very high interest rate your interest in the following nutrition options.

Demographics

2740 N Mayfair Ave, Springfield, MO, 65803

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