> **2008 NORTH DAKOTA WIC SURVEY**
>
> *You may have heard that the WIC Program will be making some changes
> to the kinds and amounts of food WIC offers. To help us serve you
> better, please tell us how you feel about WIC and the kinds of food
> choices you currently make. Please fill out all sides of this survey.*

1.  **How many people live in your household? \_\_\_\_\_\_\_**

2.  **How many people in your family are on WIC? \_\_\_\_\_\_**

3.  **Which best describes your family\'s employment situation?
    \"Employment\" means any job bringing income into the household
    (example: wages, salary, in-home business, self-employment, sales,
    farming, childcare, etc.).** *Circle one letter only.*

    a.  Single parent: employed full-time

    b.  Single parent: employed part-time

    c.  Single parent: not employed

    d.  Two-parent family: both employed full-time

    e.  Two-parent family: one employed full-time

    f.  Two-parent family: both employed part-time

    g.  Two-parent family: one employed full-time and one employed
        part-time

    h.  Two-parent family: one employed part-time

    i.  Two-parent family: both unemployed

4.  **Do you participate with any of these services?** *Circle all that
    apply.*

    a.  TEEM/TANF- Temporary Assistance for Needy Families

    b.  Food Stamps/Commodity Foods

    c.  Housing and/or Fuel Assistance

    d.  Medical Assistance/Medicaid

    e.  Health Tracks- EPSDT

    f.  State Child Health Insurance Program (SCHIP) -- Healthy Steps

    g.  Head Start

    h.  Food Pantry

5.  **WIC has helped my family and me make the following choices.**
    *Circle all that apply.*

    a.  Cook/prepare a larger variety of foods on my own

    b.  Cook with foods lower in fat

    c.  Drink a lower fat milk

    d.  Eat more fruits

    e.  Eat more vegetables

    f.  Eat more dry beans

    g.  Let my children decide how much to eat

    h.  Let my children (if old enough) help in the kitchen

    i.  Have a regular mealtime

    j.  Have regular snack times for my children

    k.  Watch less TV

    l.  Breastfeed my baby

**6. We want our WIC services to be provided to you in the best way
possible.** *Please circle the best answer.*

(N/A means the question does not apply to you, or you don't have an
opinion.)

> **a.** WIC staff see me on time. Always Usually Sometimes Never N/A

**b.** WIC lets me know about other services, like shots. Always Usually
Sometimes Never N/A

**c.** WIC staff are friendly and are happy to see me. Always Usually
Sometimes Never N/A

d.  WIC staff and I discuss *my* needs or concerns. Always Usually
    Sometimes Never N/A

**7.** **How do you rate your WIC program?** *Circle a number.*

> Everything is great ........................................ Many
> things could be better.

**1 2 3 4 5**

[]{.mark}

**8. Please share any suggestions or comments about your WIC program or
your WIC shopping experiences:**

**Thinking about possible changes to the WIC food package, we would like
to ask you some questions about what you feed your baby. [If you do not
have a baby, please skip to Question 17.]{.underline}**

**9. How old is your baby?** *Select one answer.*

a.  0-3 months

b.  4-6 months

c.  7-11 months

**10. Does your baby eat or drink anything other than breastmilk,
formula, or water?** *Select one answer.*

a.  Yes -- Go to Question 11

b.  No -- Go to Question 17

c.  Don't know

**11. Do you buy baby foods for your baby?** *Select one answer*.

a.  Yes -- Go to Question 12

b.  No -- Go to Question 17

c.  Don't know

**12. Which type of baby foods do you buy?** *Select all that apply*

a.  Fruit

b.  Vegetable

c.  Meats

d.  Dinners

e.  Desserts

f.  Organic

g.  Other -- please specify
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

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13. **If WIC offered baby foods, which of the following would you like
    to buy with your WIC check?** *Select all that apply*

    a.  Fruit

    b.  Vegetable

    c.  Meats

    d.  Dinners

    e.  Desserts

    f.  Organic

    g.  Other -- please specify
        \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

14. **Do you purchase Stage 1 foods?** *Select only one answer*.

    a.  Yes

    b.  Yes, but only used them initially

    c.  No, I never used the Stage 1 foods

15. **Do you purchase Stage 2 foods?** *Select only one answer*.

    a.  Yes, once my baby was older

    b.  Yes, have used since my baby started baby foods

    c.  No, my baby is still using Stage 1 foods

    d.  No, my baby is only using Stage 3 foods

16. **Do you purchase Stage 3 foods?** *Select only one answer.*

    a.  Yes, once my baby was older

    b.  Yes, have used since my baby started foods

    c.  No, my baby is still using Stage 1 foods

    d.  No, my baby is still using Stage 2 foods

    e.  No, my baby never used -- transitioned to table foods

**The next section is a few questions about the type(s) of milk you
buy/drink.**

**17. What type(s) of milk do you usually buy for you and your family?**
*Select all that apply.*

a.  Whole milk (Vitamin D milk)

b.  2% reduced fat milk

c.  1% low fat milk

d.  Skim or nonfat milk

e.  Lactose free or reduced milk

f.  Acidophilus milk

g.  Soy milk

h.  Goat's milk

i.  Do not drink any milk or soy milk

j.  Other -- please specify
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**18.** **What type of milk do you (the adult) drink most of the time?**
*Select only one answer*.

a.  Whole milk (Vitamin D milk)

b.  2% reduced fat milk

c.  1% low fat milk

d.  Skim or nonfat milk

e.  Lactose free or reduced milk

f.  Acidophilus milk

g.  Soy milk

h.  Goat's milk

i.  Do not drink any milk or soy milk

j.  Other -- please specify
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**19.** **Why do you drink this type of milk?** *Select all that apply.*

a.  It's best for me (healthier)

b.  I like the taste

c.  It's the only type available where I shop

d.  My family prefers it

e.  I have lactose intolerance or a milk allergy

f.  It is more economical

g.  Don't know

h.  Other -- please specify
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**The next few questions are for a child between the ages of 2-5. [If
you do not have any children this age, please go to Question
23.]{.underline}**

**20. What type of milk does/do your child/children drink most of the
time?** *Select only one answer.*

a.  Whole milk (Vitamin D milk)

b.  2% reduced fat milk

c.  1% low fat milk

d.  Skim or nonfat milk

e.  Lactose free or reduced milk

f.  Acidophilus milk

g.  Soy milk

h.  Goat's milk

i.  Do not drink any milk or soy milk

**If you have more than one child and they drink different types of
milk, please specify what type(s): \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**21. What do you think about the amount of milk your family gets from
WIC?** *Select only one answer.*

a.  Too much

b.  Just right

c.  Not enough

d.  Don't know

**22.** **If you could buy lower fat milk (2%, 1% or skim/nonfat milk)
and [not]{.underline} whole milk with your WIC checks for everyone older
than 2 years, what would you buy with your WIC checks?** *Select all
that apply.*

a.  2% milk

b.  1% milk

c.  Skim/nonfat milk

d.  Acidophilus

e.  Lactose free or reduced milk

f.  Less milk

g.  No milk

h.  I would continue to buy whole milk with my own money.

i.  Don't know

j.  Other -- please specify:
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**The next few questions are about soy milk. [If you do not drink/buy
soy milk, go to Question 27.]{.underline}**

**23.** **How much soy milk do you usually buy for your family in a
week?** *Select only one answer*

a.  Only buy occasionally

b.  1 quart

c.  Half gallon

d.  1 gallon

e.  1-2 gallons

f.  More than 2 gallons

g.  Don't know

h.  Other -- please specify:
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**24.** **What type of soy milk do you buy?** *Select all that apply.*

a.  Refrigerated

b.  Shelf stable (not refrigerated)

c.  Regular or plain flavored

d.  Vanilla flavor

e.  Chocolate flavor

f.  Don't know

g.  Other -- please
    specify:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**25.** **Why does your family drink soy milk?** *Select all that
apply.*

a.  Lactose intolerance or milk allergy

b.  Don't like the taste of regular milk

c.  Like the taste of soy milk

d.  Soy milk is good for our health

e.  Don't know

f.  Other -- please
    specify:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

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26. **If WIC offered soy milk in place of all or some of the cow's milk,
    what would you buy with WIC checks?** *Select one answer.*

    a.  Only cow's milk

    b.  Only soy milk

    c.  Some soy milk and some cow's milk

    d.  Don't know

    e.  Other -- please
        specify:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**The next few questions will ask your opinions about cheese and tofu.
Select one answer.**

**27. What do you think about the amount of cheese you get from WIC?**

a.  Too much

b.  Just right

c.  Not enough

d.  Don't know

e.  I do not get cheese on my WIC checks

f.  Other -- please
    specify:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**28.** **Do you ever buy tofu for your family?**

a.  Yes

b.  No

c.  Don't know

d.  Other -- please
    specify:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

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29. **If you could create your own WIC check with a combination of milk,
    cheese, soy milk, and tofu, which items would you prefer to buy with
    WIC checks?**

    a.  Mostly milk with some (Select all that apply)  Tofu  Cheese 
        Soy milk

    b.  Mostly soy milk with some (Select all that apply)  Tofu 
        Cheese  Milk

    c.  All milk (No tofu, cheese, or soy milk)

    d.  All soy milk (No tofu, cheese, or milk)

**The next few questions will ask about the fruits and vegetables you
buy for your family.**

30. **How often do you buy the following?** Select *[one]{.underline}*
    checkbox per line.

  ------------------ ---------- ------------ ------------ ----------- -----------
                     **Every    **Every      **Rarely**   **Never**   **Don't
                     week**     month**                               know**

  **Fresh fruits**                                                

  **Canned fruits**                                               

  **Frozen fruits**                                               

  **Dried fruits                                                  
  (including                                                          
  raisins)**                                                          
  ------------------ ---------- ------------ ------------ ----------- -----------

**31.** **If WIC offered you fruit, would you use your WIC checks to buy
the following?** Select *[one]{.underline}* checkbox per line.

  --------------------------------- ----------- ------------ -------------
                                    **Yes**     **No**       **Don't
                                                             know**

  **Fresh fruits**                                         

  **Canned fruits**                                        

  **Frozen fruits**                                        

  **Dried fruits (including                                
  raisins)**                                                 
  --------------------------------- ----------- ------------ -------------

32. **How often do you buy the following?** Select *[one]{.underline}*
    checkbox per line.

  ----------------- ----------- ------------ ------------ ----------- -----------
                    **Every     **Every      **Rarely**   **Never**   **Don't
                    week**      month**                               know**

  **Fresh                                                         
  vegetables**                                                        

  **Canned                                                        
  vegetables**                                                        

  **Frozen                                                        
  vegetables**                                                        
  ----------------- ----------- ------------ ------------ ----------- -----------

**33.** **If WIC offered you vegetables, would you use your WIC checks
to buy the following?** Select *[one]{.underline}* checkbox per line.

  ----------------------------- ---------- ------------ ------------------
                                **Yes**    **No**       **Don't know**

  **Fresh vegetables**                                

  **Canned vegetables**                               

  **Frozen vegetables**                               
  ----------------------------- ---------- ------------ ------------------

**34. What do you think about the amount of juice you now get from
WIC?** Select only *one* answer**.**

a.  Too much

b.  Just right

c.  Not enough

d.  Don't know

e.  Other -- please
    specify:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**The next few questions will ask about bread and grain products you buy
for your family.**

**35. How often do you buy the following?** Select *[one]{.underline}*
checkbox per line.

  ------------------------------------ ---------- ------------ -----------
                                       **Yes**    **No**       **Don't
                                                               know**

  **Whole wheat bread or whole grain   ****      ****        ****
  bread**                                                      

  **White bread**                      ****      ****        ****

  **Corn tortillas**                   ****      ****        ****

  **Whole wheat tortillas**            ****      ****        ****

  **Flour tortillas**                  ****      ****        ****

  **Oatmeal (not instant individual    ****      ****        ****
  packets)**                                                   

  **Brown rice**                       ****      ****        ****

  **White rice**                       ****      ****        ****

  **Barley**                           ****      ****        ****

  **Bulgur**                           ****      ****        ****
  ------------------------------------ ---------- ------------ -----------

**36. If you said "no" to buying whole wheat or whole grain breads in
Question 35 what is the reason you do not buy them? If you said "yes" to
buying whole wheat or whole grain breads in Question 35, please go to
Question 37.**

*Select all that apply*

a.  I don't know how to correctly identify these products

b.  I have never tried them

c.  I don't like how they taste

d.  My family doesn't like them

e.  They cost too much

f.  I can't find these products in the store

g.  Don't know

h.  Other -- please
    specify:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**37.** **If you said "no" to buying whole wheat tortillas in Question
35, what is the reason you do not buy them? If you said "yes" to buying
whole wheat tortillas in Question 35, please go to Question 38.**
*Select all that apply*

a.  I don't know how to correctly identify these products

b.  I have never tried them

c.  I don't like how they taste

d.  My family doesn't like them

e.  They cost too much

f.  I can't find these products in the store

g.  Don't know

h.  Other -- please
    specify:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**38. If you said "no" to buying brown rice in Question 35 what is the
reason you do not buy it? If you said "yes" to buying brown rice in
Question 35, please go to Question 39.** *Select all that apply*

a.  I don't know what this is

b.  I have never tried it

c.  I don't know how to cook it

d.  It takes too long to cook

e.  I don't like the taste

f.  My family doesn't like it

g.  It costs too much

h.  I can't find it in the store

i.  Don't know

j.  Other -- please
    specify:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**39.** **If WIC offered whole grain products, which of the following
items would you purchase with your WIC checks?** Select
*[one]{.underline}* checkbox per line**.**

  ------------------------------------- --------- -------- --------------
                                        **Yes**   **No**   **Don't know**

  **Whole wheat/whole grain bread**                      

  **Tortillas**                                          

  **Oatmeal (not instant individual                      
  packets)**                                               

  **Brown rice**                                         

  **Barley**                                             

  **Bulgur**                                             
  ------------------------------------- --------- -------- --------------

**The next few questions are about canned beans.**

**40.** **How often do you eat canned beans in your household?** *Select
only one answer.*

a.  Often (at least once a week)

b.  Occasionally (at least once a month)

c.  Rarely (less than once a month)

d.  Never

e.  Don't know

f.  Other -- please
    specify:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**41.** **If you chose "Never" for Question 40, what is the reason you
don't buy canned beans? If you chose any other option for Question 40,
go to Question 42.** *Select all that apply***.**

a.  I buy dried beans

b.  My family does not like canned beans

c.  Too expensive

d.  Don't know

e.  Other -- please
    specify:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**42.** **When you buy canned beans, what is your favorite brand?**
*Select one answer.*

a.  Bush's

b.  Joan of Arc

c.  Progresso

d.  Butter Kernel

e.  Store brand

f.  Don't know/I don't have a favorite brand

g.  Other -- please
    specify:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**43.** **If you chose a favorite brand of canned beans in Question 42,
would you consider buying a different brand if you were able to purchase
canned beans with your WIC checks?** *Select one answer*

a.  Yes

b.  No

c.  Don't know

d.  Other -- please
    specify:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**44.** **If you could create your own WIC checks with a combination of
canned beans, dried beans, and peanut butter, which items would you
include?** *Select all that apply.*

a.  Canned beans

b.  Dried beans

c.  Peanut butter

Thank you for taking the time to complete this survey about the foods
you currently eat and buy. We value your input.