Abstract

This study focuses on a set of eating habit questions proposed for inclusion in the U.S.

Department of Education's Early Childhood Longitudinal Survey, Birth Cohort. The

study assesses the wording and format of a series of questions for mothers of children in

kindergarten and/or first grade regarding the child’s food consumption habits. Most

mothers were able to answer questions on their child's eating habits by using a variety of

recall strategies or by using references. Most mothers used recall strategies, such as the

recall of preferences and special events or a child’s specific likes or dislikes. They also

used references, such as the presence of a menu or snacking policies at school. Mothers

did not generally struggle with terminology, but some words and concepts required clarification. The biggest problem in answering the questions was the combination of not

remembering what foods were eaten and the desire to reflect socially acceptable and

beneficial eating behaviors.

United States 

Department 

of Agriculture

www.ers.usda.gov

Electronic Report from the Economic Research Service

August 2005

Contractor

and Cooperator

Report No. 10

Developing Effective Wording

and Format Options for a

Children’s Nutrition Behavior

Questionnaire for Mothers of

Children in Kindergarten

By ORC Macro

ERS project representative: Elizabeth Frazão, 

efrazao@ers.usda.gov, 202-694-5455

Food Assistance 

and Nutrition 

Research Program

This report was prepared by the ORC Macro under a cooperative

agreement with the Economic Research Service. The views

expressed are those of the authors and not necessarily those of

ERS or USDA.
Contents

Executive Summary......................................................................................................................... i 

Introduction to the Research ........................................................................................................... 1 

Overview of the Research Design................................................................................................... 2 

The Study Design........................................................................................................................ 3 

Number Of Study Participants.................................................................................................... 3 

A Summary Description of the Research Methodology Employed................................................ 4 

Development of the Study Guides.................................................................................................. 6 

Study Findings: Wave 1.................................................................................................................. 7 

Understanding Of The Terminology......................................................................................... 11 

Understanding the Language Used In Each Question .............................................................. 15 

Recall Ability And Preferences for Answering For Times Per Day Versus Times Over The 

Course Of A Week.................................................................................................................... 17 

Using the Response Options..................................................................................................... 18 

Notable Areas For Follow-Up In Wave 2................................................................................. 22 

Study Findings: Wave 2................................................................................................................ 23 

Understanding Of The Terminology......................................................................................... 26 

Understanding the Language Used In Each Question .............................................................. 30 

Recall Ability And Preferences for Answering For Times Per Day Versus Times Over The 

Course Of A Week.................................................................................................................... 32 

Using the Response Options..................................................................................................... 33 

Conclusions and Recommendations............................................................................................. 35 

Appendix A: Wave 1 Data Collection Guides 

A. Cognitive Interview Guide 

B. Focus Group Moderator’s Guide 

Appendix B: Wave 2 Data Collection Guides 

A. Cognitive Interview Guide 

B. Focus Group Moderator’s Guide 
Executive Summary 

This research study focuses on a set of proposed eating habit questions for inclusion in the U.S. 

Department of Education’s Early Childhood Longitudinal Survey, Birth Cohort (ECLS-B). 

The Economic Research Service (ERS) of the U.S. Department of Agriculture (USDA) is

interested in obtaining a better understanding of the design considerations, with respect to 

interview wording and format, for a series of questions to be asked of mothers of children in 

kindergarten and/or first grade (Grades K-1), regarding their child’s food consumption habits. 

These questions are planned for potential incorporation into the Grades K-1 waves of data 

collection for the U.S. Department of Education’s Early Childhood Longitudinal Survey, Birth

Cohort (ECLS-B). 

The overall objectives of this study were to determine what time period works best for parents 

(mothers) in responding to a series of questions on food consumption habits of their 

kindergarteners and/or first grade children, and to determine how parents understand the 

questions and identify any areas of difficulty or confusion in them or the response options. 

To answer these objectives, the following research questions were developed: 

a. Do the respondents interpret the questions, as asked, in the manner intended by ERS? If 

not, are there changes in wording that will improve understanding?

b. What time period do respondents feel more comfortable with, in responding to the 

questions—for example, the past 24 hours or the past week?

c. Are the response options suggested by ERS appropriate? Are respondents able to use 

these response options to describe their children’s behavior? If not, are there changes in 

response options that would be more appropriate? 

A special concern for this research is not only determining what changes may need to be made to 

improve the usability of the questions for mothers as proxies, but also considerations of 

comparability between the proposed set for mothers of K/grade 1 children and the existing 

questions used with fifth graders. 

To address the research questions, this study included two waves of data collection with mothers 

of kindergarten and /or first grade children, with a total of 36 respondents. Each wave of the 

study included a set of cognitive interviews with nine respondents and one focus group with nine

participants. This approach allowed for the development of iterative findings as alternative 

questions and response options were analyzed. The first wave of the study served as an 

exploratory wave, broadly investigating how mothers of kindergarten and 1st grade students 

interpreted and responded to the questions. The second wave served as a more in-depth testing 

ground for alternatives emerging from the Wave 1 findings. On the basis of the findings of 

Wave 1, a revised set of questions was developed for testing in Wave 2 of the study. The

revised questions incorporated changes that dramatically impact mother’s ability to answer the

questions and response options as related to the initial findings. In Wave 2, this revised set of 

questions was tested. The recommendations for the eating habits questions were then developed 

from the review of the Wave 2 findings, along with relevant comparisons to the Wave 1 

outcomes. 

 i
Conclusions and Recommendations

Overall, most mothers were able to answer the questions on their child’s eating habits by 

reporting to a variety of recall strategies, such as the recall of preferences and special events, the 

recall of a child’s specific eating habits (likes or dislikes), or using references such as the 

presence of a menu, snacking policies at school or with afterschool sports, and rules established 

for eating away from home. Mothers did not generally struggle with terminology used the 

questions, but there were some words and concepts that require clarification to improve mothers' 

ability to answer the questions more easily. First, clarification for the term” regular milk” should 

be added. Additionally, as mothers in both waves of the study commented, the questions are

very clear about what to include, but not clear about what to include in the responses, particularly 

for questions on other vegetables, and potatoes that were not fried. 

There were some specific areas of underestimation that were related to how mothers interpreted 

the question. The data collection revealed that mothers are not always considering all of the 

fruits and vegetables that their child may have consumed when answering the respective 

questions on carrots, potatoes, and other vegetables. Mothers most often struggled with coming 

up with a frequency for fruit or vegetable consumption for their child. Part of this was due to the 

fact that the item was consumed often by children, but not necessarily completely eaten at one 

sitting. 

Perhaps most problematic for the mothers participating in this study were problems encountered 

due to the combination between limits on the ability to recall what foods were consumed and the

desire to reflect socially acceptable and beneficial eating behaviors for young children. Mothers 

struggled with addressing the fluctuation from day to day in the kinds of foods their child may 

have consumed, particularly for items consumed regularly, such as milk, fruits and vegetables

and 100% fruit juice. This impacted their preference for supplying an answer for only the past 

twenty-four hours, as well as their ability to develop a response for the past seven days. A key 

emerging theme was the existence of a tension between the desire to be accurate in their 

responses and the inability to remember every opportunity for consumption of the particular food 

item. The accompanying conversations with mothers provide some limited indication that this 

was in part due to the desire to “talk a good diet,” as some mothers provided commentary on the 

health benefits of particular choices. Mothers repeatedly wanted to provide the most accurate

answer in their responses, particularly in regards to questions about healthy foods choices, like 

vegetables and fruits. In response to the need to select one choice in answering a question, many 

mothers commented that they wished the questions were clearer about whether an average 

response was a correct answer, particularly if they wanted to use the daily response options. 

The findings also illustrate the need for additional reminders to help mothers recall all other 

opportunities where their child may have consumed a food. The cognitive interviewing and 

focus groups revealed some areas when mothers grossly underestimated the number of times

their child consumed a food item. The most common reason for underestimation stemmed from 

the fact that mothers often forgot to include times such as school, play dates, or sporting 

activities in their responses. Cognitive probing revealed that many mothers just didn’t think of 

these times automatically. Mothers needed the reminder to include eating that occurred outside 

of the presence no matter how scheduled their patterns of feeding the child might have been. 

Additionally, language or instruction prior to the eating habit questions needs to be added to the 

 ii
questionnaire to help mothers focus on the food their child actually consumed, and not what they 

offered or prepared. 

Most mothers were able to recall what their child consumed over the past twenty-four hours

more easily than over the past seven days. However, while mothers admitted that this would be 

much easier, there was some hesitancy on the part of mothers for answering in this manner. 

Barriers to answering for just the past twenty-four hours included the tensions mothers 

experienced in wanting to provide the response that best described what their child ate, combined 

with the concern that answering for a day did not reflect the best of their child’s eating habits, 

particularly if the day in question did not follow the “normal” schedule. The findings suggest 

that that the best way to for mothers to answer the questions would be either to provide clear 

instructions asking for an average for the week, or to ask specifically about fewer days—a one to

three-day period was suggested by mothers in this study. Overall, the findings suggest that it is

easier for mothers to tally foods on a daily basis than recalling what was consumed over the

whole week. This tallying method could be applied to either answering for the past twenty-four

hours, or providing a response for the past seven days. However, based on the data provided by 

mothers in this study, using only the past twenty-four hours would limit the answers mothers 

give to questions on green salad, fast food, French fries and fried potatoes, other vegetables, 

consumption of soda pop and drinks that were not 100% fruit juice, and to a lesser extent, candy, 

ice cream, cookies and similar items, as well as potato chips, pretzels, Fritos, and other salty 

snack foods. 

Next, the specific recommendations developed for each eating habit question are presented. The 

tables present the original eating habit question, followed by the revised question, and the 

rationale for making changes. When no changes outside of the adding the statement “including 

school activities, play dates, sports, and the weekend” to the question as described above are 

suggested, the question is not included below. 

Q1: During the past 7 days, how many glasses of milk did your child drink? Include all types of milk, including

cow’s milk, soy milk or any other kind of milk; include the milk your child drank in a glass or cup, from a carton, or

with cereal. Count the half pint of milk served at school as equal to one glass. 

1 Child did not drink milk during the past 7 days. 

2 1 to 3 glasses during the past 7 days. 

3 4 to 6 glasses during the past 7 days. 

4 1 glass per day. 

5 2 glasses per day. 

6 3 glasses per day. 

7 4 or more glasses per day.

DK DON’T KNOW

RF REFUSED

 iii
Revised Q1: During the past 7 days, including school activities, play dates, sports, and the weekend, how many

glasses of milk did your child drink? Include all types of milk, including cow’s milk, soy milk or any other kind of

milk; include the milk your child drank in a glass or cup, from a carton, or with cereal. Count the half pint of milk

served at school as equal to one glass. 

1 Child did not drink milk during the past 7 days 

2 1 to 3 times during the past 7 days 

3 4 to 6 times during the past 7 days 

4 1 time per day

5 2 times per day

6 3 times per day

7 4 or more times per day 

DK DON’T KNOW

RF REFUSED

Rationale: Adding the statement referencing other times where a child may have consumed the

food provided more complete responses by mothers in Wave 2 of the study, although it may have 

also complicated the tallying process for some mothers using the times per day response options. 

However, the inclusion of the statement did prompt mothers to consider a wider range of times 

when their child may have consumed a food item in the question set than the original question 

did. Changing “glasses” to “times” makes all of the response options consistent and removes the

possibility that mothers become frustrated by calculations that convert glasses to servings and 

then to “times.” 

Q2. What kind of milk did your child usually (most often) drink during the past 7 days?

1 Whole milk 

2 2% milk. 

3 Skim milk. 

4 Low fat or 1% milk. 

5 Soy milk. 

6 Both regular milk and soy milk. 

7 Some other kind of milk. 

DK DON’T KNOW

RF REFUSED 

Revised Q2. What kind of milk did your child usually (most often) drink during the past 7 days?

1 Whole milk 

2 2% milk. 

3 Skim milk. 

4 Low fat or 1% milk. 

5 Soy milk. 

6 Both regular cow’s milk and soy milk. 

7 Some other kind of milk. 

DK DON’T KNOW

RF REFUSED 

Rationale: The wording of “regular cow’s milk” improved mothers understanding of the 

question buy making the response option clearer. Add a response option to account for mothers

whose child did not consume any milk. The question set as tested did not include a skip pattern 

for mothers who provided the response “my child did not consume milk in the past seven days”

in question 1. Either a skip pattern should be added, referring these respondents directly to

 iv
question 3, or a response option of “none of the above, child didn’t drink milk” needs to be 

added to question 2. 

Q5. During the past 7 days, how many times did your child eat fresh fruit such as apples, bananas, oranges, berries, 

or other fruit such as applesauce, canned peaches, canned fruit cocktail, or frozen berries? (Do not count fruit juice.) 

1 Child did not eat fruit during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED

 Revised Q5. During the past 7 days, including school activities, play dates, sports, and the weekend, how many

times did your child eat fresh fruit such as apples, bananas, oranges, berries, or other fruit such as applesauce,

canned peaches, canned fruit cocktail, frozen berries or dried fruit? (Do not count fruit juice.) 

1 Child did not eat fruit during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED 

Rationale: Adding the words dried fruit made the list of fruit choices complete for mothers and 

provided them with an opportunity to include all fruit in their response. Clearer guidance on 

self-service snacking and how to count it should be developed. This was one of the most 

challenging questions for mothers to ask due to the popularity of fruit and the variability with 

which it was consumed by children in this age category. In order to address the frustration 

mothers experienced when tallying the fruit for the times per day option and to address 

underestimates, guidance on the accuracy desired for the response would be helpful. 

Specifically, mothers need some direction on how to calculate a “time” for self-service snacking. 

Q7. During the past 7 days, how many times did your child eat potatoes? (DO NOT count French Fries, fried

potatoes, or potato chips). 

1 Child did not eat potatoes during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED 

 v
Revised Q7. During the past 7 days, including school activities, play dates, sports, and the weekend, how many

times did your child eat potatoes? (DO NOT count French Fries, fried potatoes, potato chips, tater tots, or sweet 

potatoes). 

1 Child did not eat potatoes during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED 

Rationale: In addition to the prompting statement described above, adding the wording tater tots 

and sweet potatoes assisted mothers in knowing what kinds of potatoes to exclude from their 

response to this question. 

Q9. During the past 7 days, how many times did your child eat other vegetables? (DO NOT count green salad, 

potatoes, French fries, or carrots.) 

1 Child did not eat other vegetables during the past 7 days.

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED

Revised Q9. During the past 7 days, including school activities, play dates, sports, and the weekend, how many

times did your child eat other vegetables? (DO NOT count green salad, potatoes, French fries, or carrots.) 

1 Child did not eat other vegetables during the past 7 days.

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED

Rationale: In addition to the prompting statement described above, better wording or clearer 

instruction should be provided for Q9 to help mothers know how to classify vegetables served in 

mixes, or as the main component of a main dish need to be added based on the findings of both 

Wave 1 and Wave 2. This clarification would help mothers to produce more accurate counts to

incorporate in their responses. The recommended statement is phrased as “Include vegetables 

like those served as a stir fry, soup or stew in your response.”

 vi
Q10. During the past 7 days, about how many times did your child eat a meal or snack from a fast food restaurant

such as McDonald’s Pizza Hut, Burger King, KFC (Kentucky Fried Chicken), Taco Bell, Wendy’s and so on?

Would you say?

1 Child did not eat food from a fast food restaurant during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED 

Revised Q10. During the past 7 days, including school activities, play dates, sports, and the weekend about how 

many times did your child eat a meal or snack from a fast food restaurant with no wait service such as McDonald’s, 

Pizza Hut, Burger King, KFC (Kentucky Fried Chicken), Taco Bell, Wendy’s and so on? Consider both eating out, 

carry out and delivery of meals in your response. Would you say: 

1 Child did not eat food from a fast food restaurant during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED 

Rationale: The addition of this language appeared work well in clarifying the kinds of places 

mothers should consider in answering the question about fast food. In particular, focus group 

respondents did not seem to struggle with including any meal that their child had eaten out at any 

type of restaurant in their response to the revised question. This wording seemed to alleviate 

mothers conceptualizing fast food as any eating outside of the home. 

Q11. During the past 7 days, how many times did your child eat candy, ice cream, cookies, cakes, brownies, or

other sweets? Would you say:

1 Child did not eat sweets during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED

 vii
Revised Q11. During the past 7 days, including afterschool activities, sports, and the weekend, how many times did 

your child eat candy (including Fruit Roll Ups and similar items), ice cream, cookies, cakes, brownies, or other

sweets? Would you say: 

1 Child did not eat sweets during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED 

Rationale: In addition to the prompting statement described above, adding the wording "Fruit 

Roll-Ups or similar snacks" helped mothers to know where to classify these food items. 

Reporting for the foods included in this question was a sensitive topic, one that may be subject to 

underestimates. 

Q13. During the past 7 days, how many times did your child eat French fries or fried potatoes? 

1 Child did not eat French fries or fried potatoes during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED 

Revised Q13. During the past 7 days, including school activities, play dates, sports, and the weekend, how many

times did your child eat French fries or fried potatoes? 

1 Child did not eat French fries or fried potatoes during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED 

Rationale: In addition to the prompting statement described above, this question should be 

moved to appear after the potato question, and be the new Question 8. Mothers in Wave 2 

recommended that this question be paired conceptually with the question on potatoes. They 

suggested that such a pairing would help mothers answer the question by making it easier to 

recall and answer questions on potato consumption. Also moving the question to follow after the 

original question 7 lessens the probability that mothers who answered the fast food question will 

view this question as asking for the same information.

 viii 
Introduction to the Research 

This research study focuses on a set of proposed eating habit questions for inclusion in the U.S. 

Department of Education’s Early Childhood Longitudinal Survey, Birth Cohort (ECLS-B). 

The Economic Research Service (ERS) of the U.S. Department of Agriculture (USDA) is

interested in obtaining a better understanding of the design considerations, with respect to 

interview wording and format, for a series of questions to be asked of mothers of children in 

kindergarten and/or first grade (Grades K-1), regarding their child’s food consumption habits. 

These questions are planned for potential incorporation into the Grades K-1 waves of data 

collection for the U.S. Department of Education’s Early Childhood Longitudinal Survey, Birth

Cohort (ECLS-B). 

Increasing concern about children’s diet and the development of childhood obesity provides a 

foreground for this research. The ECLS-B provides a unique opportunity to collect longitudinal 

data on the development of children’s eating behaviors from birth through early childhood. Past 

research on the ECLS-K has explored the best response options for fifth graders. In this study, 

the focus is on parents’ ability to answer a similar set of test questions as proxies for their 

kindergarten and/or first grade children. While this study does not directly compare first grade

children’s responses to those provided by parents, it does provide some insight into the factors 

impacting parents’ ability to recall their kindergarten and/or first grade child’s eating behavior. 

The overall objectives of this study were to determine what time period works best for parents 

(mothers) in responding to a series of questions on food consumption habits of their 

kindergarteners and/or first grade children, and to determine how parents understand the 

questions and identify any areas of difficulty or confusion in them or the response options. 

To answer these objectives, the following research questions were developed: 

a. Do the respondents interpret the questions, as asked, in the manner intended by ERS? If 

not, are there changes in wording that will improve understanding?

b. What time period do respondents feel more comfortable with, in responding to the 

questions—for example, the past 24 hours or the past week?

c. Are the response options suggested by ERS appropriate? Are respondents able to use 

these response options to describe their children’s behavior? If not, are there changes in 

response options that would be more appropriate? 

A special concern for this research is not only determining what changes may need to be made to 

improve the usability of the questions for mothers as proxies, but also considerations of 

comparability between the proposed set for mothers of K/grade 1 children and the existing 

questions used with fifth graders. 

1
Overview of the Research Design

The research design developed for this study was influenced by existing research on dietary 

recall and cognitive abilities of respondents in three main areas: 

• the ability of parents to recall dietary consumption for their children, 

• parents’ desires to over or under-report consumption of particular food items, 

• and the types of cognitive cues that may be helpful in promoting better accuracy of 

dietary recall. 

The ability of parents to recall dietary consumption for their children. Despite the variety of 

methods available to collect dietary intake information, the accuracy of dietary intake data 

provided by adults remains a problem, both in cases where they are asked to respond for 

themselves as well as for young children. Problems in accurately recalling what was consumed 

range from memory lapses, to inability to judge portion sizes, to intentional misreporting to 

lower the consumption of less socially acceptable foods. Adults frequently do not recall what 

they ate, or they misreport how much of it they consumed.1

 These recall difficulties are also 

evident when asking parents to report on the eating habits of young children. Recent studies on 

the recall ability of parents when reporting on the food consumption of their children age 6 or 

under indicate that both mothers and fathers are reasonably accurate in recalling their child’s 

food intake, but only within the past 24 hours. However, over the course of several meals, 

parents’ recall provides a somewhat less accurate measure of actual foods eaten, portion sizes, 

and nutrient levels consumed. 2

 

Parents’ desires to over or under-report consumption of particular food items. Research on

parents’ ability to serve as proxies for children in reporting dietary habits suggests that parents 

may also feel more pressure to only report that their child has consumed socially acceptable 

foods, even if their eating patterns in reality do not reflect the ideal healthful diet. In this 

situation, parents over-report the consumption of foods perceived to be healthier and underreport those perceived to be less healthy. Studies have demonstrated that under-reported intake 

may not affect all foods equally but may involve only certain types of foods, such as snacks.3

 

This possibility was also of particular relevance in this study, as it relates directly to parents’ use 

of the response options in the questions, as well as questionnaire item wording that may 

unintentionally make parents feel the need to inflate the number of times their child has

consumed more healthful foods and/or deflate the number of times their children consumed less 

healthful foods. 

The types of cognitive cues that may be helpful in promoting better accuracy of dietary recall. 

 

1 Byers, T., J. Marshall, E. Anthony, R. Fiedler, and M. Zielezny. 1987. The reliability of dietary history from 

the distant past. American Journal of Epidemiology, 125, 999–1011. 2 Basch, C. E., S. Shea, R. Arliss, I. R. Contento, J. Rips, B. Gutin, et al. 1990. Validation of mothers’ reports 

of dietary intake by four to seven year-old children. American Journal of Public Health, 80, 1314–1317. 

3 Poppitt, S. D., D. Swann, A. E. Black, and A. M. Prentice. 1998. Assessment of selective under-reporting 

of food intake by both obese and non-obese females in a metabolic facility. International Journal of Obesity, 22, 

303–311. 

2
The accompanying discussion that parents may engage in when reporting their child’s 

consumption might provide insight into the types of contextual cues that become important for 

prompting better recall of eating habits and more complete responses. Recent research in 

improving the accuracy of recall of dietary intake advocates a new sensitivity to ways in which 

conversations about eating behaviors can better communicate the types of foods consumed, as 

well as the patterns of consumption. Asking respondents to describe everyday food 

consumption, noting cues for difficult areas of reporting, leads to a more accurate recall of food 

intake.4

 It may be the case that these cues either take the form of certain words or concepts that 

could be incorporated into revised questions or serve as a cross-check of the information parents 

provide on their child’s eating behavior. 

The Study Design

To address the research questions, this study included two waves of data collection with mothers 

of kindergarten and /or first grade children. Both waves included a set of cognitive interviews 

with nine respondents and one focus group with nine participants. This approach allowed for 

the development of iterative findings as alternative questions and response options were 

analyzed. The first wave of the study served as an exploratory wave, broadly investigating how

mothers of kindergarten and 1st grade students interpreted and responded to the questions. The 

second wave served as a more in-depth testing ground for alternatives emerging from the Wave 1 

findings. On the basis of the findings of Wave 1, a revised set of questions was developed for 

testing in Wave 2 of the study. The revised questions incorporated changes that dramatically 

impact mother’s ability to answer the questions and response options as related to the initial 

findings. In Wave 2, this revised set of questions was tested. The recommendations for the 

eating habits questions were then developed from the review of the Wave 2 findings, along with 

relevant comparisons to the Wave 1 outcomes. 

Number Of Study Participants

Each wave of the study consisted of a series of in-depth cognitive interviews (with a total of 9

participants) followed by one focus group. Table 1 summarizes the composition of respondents

and data collection activities for both waves of the study. 

Table 1. Summary of Data Collection Approach 

Study Wave

Wave 1: Exploratory Wave 2: Modified Questions 

Data Collection Activity Number of respondents Number of respondents 

In-depth cognitive interviews 9 9 

Focus group 9 9 

Total number of respondents 

(36 mothers)

18 18

 

4 Tapsell, L. C., V. Brenninger, and J. Barnard. 2000. Applying conversation analysis to foster accurate 

reporting in the diet history interview. Journal of the American Dietetic Association, 100(7), 818–824.

3
A Summary Description of the Research Methodology Employed 

Cognitive interviewing and focus groups were the methods developed to answer the research

questions posed by this study. The research design was also developed to include only mothers 

as the primary proxy respondents. This was done because the typical respondents of the ECLS 

are mothers, who are interviewed face-to-face. 

Each set of individual interviews and focus group contained a mix of income levels and 

racial/ethnic groups. The recruitment strategy for this study targeted mothers of different marital 

status, racial/ethnic groups, and income levels and also included mothers with more than one 

child in the target grade levels to assess any additional difficulties that may exist in recalling the

food consumption of only one child. 

Cognitive Interviews. The cognitive interviews were developed to ascertain more indepth understanding of mothers’ abilities to recall what their child consumed and over 

what period of time, use the food categories correctly, use the response options correctly, 

and describe any difficulties encountered with the questions. While modality is not being 

tested in this study, the cognitive interviews also provided some insight into how mothers 

perform in a one-on-one interviewing environment in answering the test questions. 

In Wave 1, using the original set of test questions, interview participants were asked to 

provide their answer to each question, and then to indicate whether the question was easy

for them to answer and how certain they were that their response was correct. After 

answering the set of questions, the interviewee was then read her answers and asked to 

describe how she arrived at an answer, including what things she was thinking of, how 

she answered for time where food was consumed away from home, and how she 

distinguished between what her kindergarten or first grade child consumed versus any 

other children in their household. The Wave 2 cognitive interviews were conducted in a 

similar fashion, but used a revised set of test questions that incorporated the findings 

from Wave 1. Each cognitive interview concluded with the interviewer presenting the

participant with a $75.00 stipend for their time and transportation costs. 

The cognitive interviews incorporated some of the latest practices in encouraging 

respondents’ to better report what their child may have consumed. This was done 

through the use of probes that encouraged conversations on children’s activities, daily 

schedules and preferences, with the intention of jogging the memory of parents by 

recalling specific events and their relation to foods asked about in the test set of 

questions. 

Focus Groups. The focus groups were designed to provide insight into broader topics 

related to mothers’ ability to answer the test questions. The focus groups were used to 

explore mothers’ understanding of the dietary habit questions and response options. The 

focus groups targeted some specific components of understanding mothers’ use of the 

response options and ability to produce responses— these included focusing on their 

reasoning processes, their understanding of concepts and language, as well as their ability 

to accurately recall information. 

4
Each focus group began with introductions and an overview of ground rules to promote

discussion. After a general description of the eating habit questions, mothers were read 

each question, and then asked to select a response option. After each question was

answered, the moderator used the guide to develop specific topics such as understanding 

what food items mothers think of when asked to respond to the questions, the span of 

time mothers believe they can accurately recall what was consumed, how they track the 

consumption of food by the child, contextual cues that may exist for parental knowledge 

about what was or was not consumed at school, and how they respond to the time 

increments for the response options (times a day vs. 7 days). After the two-hour focus 

group concluded, each mother received a $75.00 stipend for her time and transportation

costs. 

5
Development of the Study Guides

The data collection study guides for this research were developed by deconstructing the set of 

eating habit questions to focus on the meanings implied and the strategies used to arrive at 

answers. Key topical areas for the development of the study guides for the cognitive interviews 

and focus groups included understanding parents’ general thought processes as they answer 

questions about their child’s/children’s eating habits, exploring the cognitive limitations, if any, 

to parents’ ability to recall children’s consumption patterns, and understanding how parents

recall dietary consumption for periods of time when the child is away from home. The research 

guides in both waves of the study focused on discovering the areas where mothers indicated that

there were notable distinctions in cognitive interpretation of the questions and response options.

In this way, the emphasis of the research was on the types of changes that could potentially 

improve mothers' ability to answer the ECLS questions. Another consideration for this study 

was the need to maintain comparability between this set of eating habit questions and those

currently used by fifth graders in the ECLS. This need for comparability focused the analysis on

notable changes deemed necessary to improve the understanding and cognition of mothers, 

rather than improving the questions by less dramatic means, such as wordsmithing the questions. 

The following discussion presents the findings for both waves of the study. In each section, the 

research questions are presented, along with notable findings for each. Each discussion begins 

with a description of the demographic characteristics of the respondents, followed by discussion 

on understanding of the terminology, recall ability and preferences for answering for times per 

day versus times over the course of week, and use of the response options. 

6
Study Findings: Wave 1 

In Wave 1 of this study, the cognitive interviews and focus group were used to gather initial data 

about mothers’ ability to answer the set of test questions in an appropriate manner. While 

mothers were generally able to answer the test questions, there were some notable areas of

difficulty encountered with regards to terminology used, answering over a period of time (24 

hours vs. a week), and using the response options. Table 2 presents the original set of questions 

used for this round of data collection. 

7
Table 2. The Initial Set of ECLS-B Test Questions 

1. During the past 7 days, how many glasses of milk did your child drink? Include all types of milk, including cow’s

milk, soy milk or any other kind of milk; include the milk your child drank in a glass or cup, from a carton, or with 

cereal. Count the half pint of milk served at school as equal to one glass. 

1 Child did not drink milk during the past 7 days. 

2 1 to 3 glasses during the past 7 days. 

3 4 to 6 glasses during the past 7 days. 

4 1 glass per day. 

5 2 glasses per day. 

6 3 glasses per day. 

7 4 or more glasses per day.

DK DON’T KNOW

RF REFUSED 

2. What kind of milk did your child usually (most often) drink during the past 7 days?

1 Whole milk 

2 2% milk.

3 Skim milk. 

4 Low fat or 1% milk. 

5 Soy milk. 

6 Both regular milk and soy milk. 

7 Some other kind of milk. 

DK DON’T KNOW

RF REFUSED 

3. During the past 7 days, how many times did your child drink 100% fruit juices such as orange juice, apple juice, or

grape juice? Do not count punch, Sunny Delight, Kool-Aid, sports drinks, or other fruit-flavored drinks. 

1 Child did not drink 100% fruit juice during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED 

4. During the past 7 days, how many times did your child drink Soda pop (for example, Coke, Pepsi, or Mountain

Dew), sports drinks (for example, Gatorade), or fruit drinks that are not 100% fruit juice (for example, Kool-Aid,

Sunny Delight, Hi-C, Fruitopia, or Fruitworks)?

1 Child did not drink any during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

 RF REFUSED 

8
Table 2. The Initial Set of ECLS-B Test Questions 

5. During the past 7 days, how many times did your child eat fresh fruit such as apples, bananas, oranges, berries, or

other fruit such as applesauce, canned peaches, canned fruit cocktail, or frozen berries? (Do not count fruit juice.) 

1 Child did not eat fruit during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED 

6. During the past 7 days, how many times did your child eat green salad?

1 Child did not eat green salad during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED 

7. During the past 7 days, how many times did your child eat potatoes? (DO NOT count French Fries, fried potatoes, 

or potato chips). 

1 Child did not eat potatoes during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED 

8. During the past 7 days, how many times did your child eat carrots?

1 Child did not eat carrots during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED 

9
Table 2. The Initial Set of ECLS-B Test Questions 

9. During the past 7 days, how many times did your child eat other vegetables? (DO NOT count green salad, potatoes, 

French fries, or carrots.) 

1 Child did not eat other vegetables during the past 7 days.

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED 

10. During the past 7 days, about how many times did your child eat a meal or snack from a fast food restaurant such 

as McDonald’s Pizza Hut, Burger King, KFC (Kentucky Fried Chicken), Taco Bell, Wendy’s and so on? Would you 

say: 

1 Child did not eat food from a fast food restaurant during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED 

11. During the past 7 days, how many times did your child eat candy, ice cream, cookies, cakes, brownies, or other

sweets? Would you say: 

1 Child did not eat sweets during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

 RF REFUSED 

12. During the past 7 days, how many times did your child eat potato chips, corn chips (Fritos, Doritos), Cheetos, 

pretzels, popcorn, crackers or other salty snack foods?

1 Child did not eat salty snack foods during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

 RF REFUSED 

10
Table 2. The Initial Set of ECLS-B Test Questions 

13. During the past 7 days, how many times did your child eat French fries or fried potatoes? 

1 Child did not eat French fries or fried potatoes during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 2 times per day.

6 3 times per day.

7 4 or more times per day. 

DK DON’T KNOW

RF REFUSED 

In Wave 1, nine cognitive interviews were conducted and nine mothers participated in the focus 

group, for a total of 18 mothers as respondents in this wave of the study. Interestingly, half of the 

mothers in Wave 1 were stay-at-home moms who spent a great deal of time with their youngest 

children, including those in the kindergarten or first grade. 

Overall, Wave 1 respondents were diverse by age, ethnicity/race, income, and by number of 

children in the household. Out of the nine cognitive respondents, 33% were African American, 

and 67% were Caucasian, with one respondent identifying as Hispanic /Latino. Most of the 

mothers interviewed had completed at least some college, but there were two respondents that 

only had a high school education. The mothers that participated in the cognitive interviews were 

slightly older parents: four mothers were in the 40-49 age group, while three mothers were in the

30-39 age group. In Wave 1, three mothers were parents of kindergarten children, while the 

remaining had first graders. Five of the mothers interviewed had three or more children, while 

three mothers had only one child. The focus group participants were similarly diverse by age, 

ethnicity/race, income, and by number of children in the household. Four of the nine mothers

were African American, while five were Caucasian. Half of the mothers in the focus group had 

more than one child, and most of the mothers had some college or completed college. 

Understanding Of The Terminology

a. Do the respondents interpret the questions, as asked, in the manner intended by 

ERS? If not, are there changes in wording that will improve understanding?

Table 3 presents the answers provided to the eating habit questions by Wave 1 respondents in the

cognitive interviews. As the table depicts, none of the respondents refused to answer the 

questions, nor did any provide a “don’t know” response. The distribution of responses suggests 

that mothers were generally able to use the given response options appropriately. 

11
Table 3. Answers Provided To The Eating Habit Questions By Wave 1 Cognitive Interview 

Respondents 

Food Item Question Response Options 

Child did 

not 

eat/drink 

during the 

past 7 

days. 

1 to 3 

times 

during 

the past 

7 days. 

4 to 6 

times 

during 

the past 7 

days. 

1 time

per day.

2 times 

per day. 

3 times 

per day. 

4 or more 

times per 

day. 

Milk 1 0 0 1 6 0 1

100% juice 0 3 2 3 0 1 0

Drinks not 100% fruit juice 0 3 2 3 1 0 0

Fresh fruit 0 2 1 1 5 0 0

Green salad 3 5 1 0 0 0 0

Potatoes (not fried) 3 5 1 0 0 0 0

Carrots 2 4 2 1 0 0 0

Other vegetables 2 0 3 0 3 1 0

Fast food 3 6 0 0 0 0 0

Candy, ice cream, cookies, 

cakes, brownies, or other 

sweets 0 1 1 7 0 0 0

Salty snacks 0 5 2 1 1 0 0

French fries or fried potatoes 1 6 2 0 0 0 0

Table 4 provides the mean ratings for ease of answering the questions. Those mothers who 

completed a cognitive interview were asked to rate the difficulty of each question. Specifically,

they were asked whether each question was “really easy,” “kind of easy,” or “not so easy.” A 

mean rating was calculated for these responses as a way of targeting conceptual understanding. 

Similar 3-point rating scales have been used successfully in other cognitive development studies. 

Table 4 shows the difficulty ratings for each survey item, ranked by the mean difficulty rating. 

The results suggest that, overall, the mothers interviewed found it fairly easy to answer the 

questions. On average, mothers rated the items as somewhere between “really easy” and “kind

of easy.” Overall, ratings of “not so easy” were relatively rare. 

Questions on drinks that were not 100% fruit juice, green salad, fast food, and French fries or 

fried potatoes were the easiest for mothers to answer, perhaps because these items were

consumed less frequently over the course of seven days and therefore easier to recall because 

child consumption of them was rare, or they were consumed in the context of a “special treat” or 

event (birthday celebration, a party, or Halloween for example). 

12
Table 4. Mean Ratings Of Ease Of Answering The Eating Habit Questions 

Mean 

Rating Rating Scale 

Very Easy

Somewhat 

Easy 

Not At All 

 Easy 

Question 

Number

 

Food Item

1= "very 

easy" to 

3 ="not 

at all 

easy" (%) (%) (%) 

Q3 100% juice 1.6 56 33 11

Q1 Milk 1.4 67 22 11

Q5 Fresh fruit 1.4 67 22 11

Q8 Carrots 1.3 78 11 11

Q9 Other vegetables 1.3 67 33 0

Q7 Potatoes (not fried) 1.2 78 22 0

Q11 Candy, ice cream, cookies, cakes, 

brownies, or other sweets 1.2 78 22 0

Q12 Salty snacks 1.2 78 22 0

Q2 Type of milk 1.1 78 11 0 

Q4 Drinks not 100% fruit juice 1.0 100 0 0 

Q6 Green salad 1.0 100 0 0

Q10 Fast food 1.0 100 0 0

Q13 French fries or fried potatoes 1.0 100 0 0 

The most difficult questions for mothers to answer were those on consumption of 100% fruit 

juice, milk, fresh fruit and carrots, as depicted in table 4. Table 5 presents the mean ratings for 

certainty of answers. For each eating habit question, respondents were asked how sure they were 

of their answers. Respondents might give an answer that does reflect what their child consumed, 

while being unsure of the answer. The existence of this type of tension indicates that mothers 

may have felt unsure about the soundness of their answers; methods used to arrive at an answer 

or were unclear about some of the terminology being used in the question. In the interviewing, 

respondents’ answers to these questions served as a basis for further probing into how mothers

arrived at their answers. Additionally, these responses were used as the basis for calculating a 

“mean certainty rating” for each of the concepts. Based on the analysis of the terminology used, 

which identified few problems, the mean certainty ratings highlight food items where mothers 

were unsure of whether their answer was accurate, accounting for for all of the food their child

may have consumed. When compared to the mean ratings calculated for ease of the question 

(table 4), the answers in table 5 seem to confirm that mothers did indeed experience some

difficulty in answering questions on consumption of milk, 100% fruit juice, carrots and fresh 

fruit. 

13
Further analysis of the cognitive responses indicates that many mothers experienced some

difficulty with these questions (Q3, Q1, Q5 and Q8) because they encountered difficulty in 

recalling and tallying the number of times their child consumed 100% fruit juice, milk, fruit, and 

carrots. Many mothers indicated that these items were consumed daily, and that they had a 

baseline schedule for offering them to their child. However, difficulties were encountered 

because their child’s preferences and consumption fluctuated from day to day. For example, if a 

child did not finish his or her milk at breakfast, the mother may have offered the milk later in the

day to compensate for this non-consumption, which was outside of “normal” milk drinking times

for the child. Additionally, as will be discussed further below, about one half of the mothers

interviewed indicated that it was easier to think about their child’s consumption for these specific

items on a daily basis (within the past twenty-four hours), and was difficult to remember what 

was consumed over a seven-day period of time. One half of the mothers did express the ability

to recall what their child had consumed over the past seven days by thinking about consumption 

in terms of eating a particular item a daily basis. Conversely, mothers reported less difficulty 

and higher certainty of their responses in regards to items such as green salad, French fries, and

drinks that were not 100% fruit juice because consumption of these items was extremely rare or 

occurred in the context of an event, such as a sporting activity, party or other special occasion. 

Table 5. Mean Certainty Ratings for the Eating Habit Questions 

Mean 

Rating Rating Scale 

 Very 

Sure 

Somewhat 

Sure 

Not At All 

Sure 

 

Question 

Number

Food Item 

 

 

1= "very 

sure" to 3 

="not at 

all sure" (%) (%) (%) 

Q1 Milk 1.4 67 22 11

Q3 100% fruit juice 1.3 78 11 11 

Q8 Carrots 1.3 78 11 11

Q5 Fresh fruit 1.3 67 33 0

Q9 Other vegetables 1.3 67 33 0

Q11 Candy, ice cream, cookies, cakes, 

brownies, or other sweets Sweet snacks 1.2 78 22 0

Q13 French fries or fried potatoes 1.2 78 22 0 

Q4 Drinks not 100% fruit juice 1.1 89 11 0 

Q7 Potatoes (not fried) 1.1 89 11 0

Q12 Salty snacks 1.1 89 11 0

Q6 Green salad 1.0 100 0 0

Q2 Type of milk 1.0 100 0 0 

Q10 Fast food 1.0 100 0 0

14
Understanding the Language Used In Each Question

Overall, mothers in the interviews and focus groups did not struggle with any of the terminology 

used in the question. Mothers in both the one-on-one interviews and focus group defined “100% 

fruit juice,” “sports drinks” and “green salad” in similar ways. However, there were several 

questions where mothers wanted more clarification about what foods were actually being

referenced. A general comment emerging from the focus group was that the questions on fruits, 

vegetables, and snacks were relatively clear about what to exclude, but not clear on what to 

include. For example, three mothers in the one-on-one interviews and slightly more than half of 

the mothers in the focus group questioned what foods were included with potatoes as a category 

for Q7. The main issue arising for mothers in the cognitive interviews was whether to include 

items such as instant potatoes in their responses, while others wanted to know if tater tots fell in 

the category of “fried potatoes.” In the focus group, most of the nine mothers indicated that they 

were not sure where to include sweet potatoes, or potatoes that were the main part of a dish, but 

were mixed with other things, like scalloped potatoes or mashed potatoes. 

Other areas where mothers wanted clarification on the terminology, or where their responses 

were inconsistent, are described below. This discussion includes both the cognitive interviews 

and focus group. 

Regular milk. “Regular milk” is included as a response option in Q2. In both the 

cognitive interviews and focus group, there was some confusion among the respondents 

about what “regular milk” actually was. Some respondents thought it was the same as 

whole milk, while others believed that “regular” referred to the type of milk that was 

regularly consumed by their child (for example, 2% milk). Others thought that it was

every other kind of milk besides soy milk, and two respondents of the 18 in this wave of 

the study thought it was the kind of milk one would get directly from a farm. 

Other vegetables. In regards to the question on additional vegetables consumed (Q9), 

about half of the mothers participating in the focus group, and 2 cognitive interviewees (6 

of 18 total respondents or 33%) were not sure how to count dishes that included both rice 

and vegetables, or similarly soups with vegetables. They simply did not include these 

dishes in their responses. This confusion provided an opportunity for mothers to 

undercount the other types of vegetables consumed by their child. 

Fast food. The description provided by mothers on how they arrived at their answers for 

this question revealed a lack of clarity about the concept “fast food.” Overall, among 

both the cognitive interviewees and focus group participants, half of the mothers 

conceptualized fast food as any eating outside of the home, so even if the child had an 

entree that wasn't from the basic kids menu (French fries, chicken nuggets, hamburger) at 

a real restaurant, some mothers counted this as "fast food." The remaining respondents 

viewed “fast food” as the type of food specifically consumed at the chains listed in the 

question. The effect of this conceptualization was that mothers did not count items that 

were not eaten at the specific chains listed in the question, so there was a gray area for 

food eaten at places like Boston Market, Subway, and Arby’s, or Chinese restaurants. In 

reviewing the cognitive data, the respondents generally mentioned the specific restaurant 

in connection with describing what their child ate, but there were two mothers who 

wondered whether to include delivery of food (pizza, Chinese) they had ordered. 

15
Question 11 on consumption of candy, ice cream, cookies, cakes, brownies, or other 

sweets, and Question 12 on consumption of potato chips, corn chips (Fritos, 

Doritos), Cheetos, pretzels, popcorn, crackers or other salty snack foods. While all 

of the mothers in Wave 1 were able to come up with answers for these questions, the 

discussion of their responses revealed that mothers might be tallying foods inaccurately, 

based on how they conceptualize the items as a part of a specific food category, for 

example, “sweet snacks” versus “salty snacks”, or “snacks high in fat.” In particular,

mothers participating in the focus group seemed to be somewhat unsure of their 

responses. 

The focus group findings indicated that a few mothers felt uncertain about their responses 

to Q11 and Q12 because they were unsure of the core distinctions dividing foods that 

should be a part of their responses for Q11 versus those that should be included in 

responses for Q12. For example, some mothers thought the major distinctions was the 

amount of fat in a snack, while others perceived the questions to be about “ good snacks” 

versus “bad snacks.” Mothers were also reluctant to lump things like crackers or popcorn 

with things they perceived to be worse for their children, such as "bad" salty snacks like 

chips. Mothers also didn't know how to classify things like Fruit Roll Ups, granola bars, 

or fruit bars. These concerns combined to create some uncertainty about the accuracy 

and appropriateness of the answers mothers provided to these questions, slightly 

increasing the difficulty experienced in deriving an answer to these questions, as the 

ratings in table 4 present. 

Soda pop. There was some indication that the terminology used in Q3 on the 

consumption of drinks that are not 100% fruit juice could cause parents to intentionally 

underestimate their response. Two mothers who were interviewed indicated that the 

words “soda pop” had a negative connotation because parents did not want to report their 

child had consumed these types of drinks. For example: 

Wave 1Respondent 3: “Parents don’t want to say their child had “soda” because of the 

negative connotation.” 

Additional descriptive discussion provided by some mothers in the cognitive interviews 

and the focus group for Wave 1 indicated that parents felt somewhat sensitive about the 

topic of soda pop, as they made it a point to communicate that they were conscious of the 

negative health effects of these types of drinks. For example, slightly fewer than half of 

the mothers in both the interviews and focus group very assertively commented that they 

never ever allowed their child to consume soda pop, but then reluctantly acknowledged 

that if their child had attended a birthday party or similar event over the past seven days, 

they most likely would have consumed soda pop. Other parents shared that they did try 

to consciously limit the amount of sugar their child consumed, so soft drinks and even 

drinks that weren’t 100% juice weren’t “the best.” For example: 

Wave 1 Cognitive Interviewee 2: “We don’t have it [soda] at home regularly.” 

16
Based on these responses, it might be the case that parents focus on drinks that are not 

100% juice and sports drinks when providing an answer, and intentionally ignore or 

misrepresent the amount of soda consumed because of this sensitivity to a socially less

desirable drink for young children. Thus, the question’s wording might unintentionally 

provide parents with an "out" for under-reporting consumption of soft drinks by grouping 

this item with other drinks that are perceived as less sensitive because they are not as 

“bad” for their child. 

Finally, all of the mothers in the focus group, and about half of the cognitive interview 

respondents (13 respondents) indicated that the questions are clear about what to exclude, 

but not clear about what to include. This impacted the answers that mothers provided for 

the questions on potatoes, as mentioned earlier, but also for the questions on eating fruits

other vegetables and snack items. 

Recall Ability And Preferences for Answering For Times Per Day Versus Times Over The Course Of 

A Week

a. What time period do respondents feel more comfortable with, in responding to the 

questions—for example, the past 24 hours or the past week?

Based on the analysis of data, mothers were able to recall what their child consumed over the

past twenty-four hours more easily than over the past seven days. It was easier for mothers to 

come up with a response for one day, but not necessarily their preference. This was due to the 

fact that the response for one day may not have reflected the full range of what their child 

consumed, and mothers did express some sensitivity to sharing that their child had consumed 

appropriate amounts of healthy choices, such as milk, vegetables, carrots, and drinks that were 

not 100% fruit juice. For some mothers, answering questions on green salad, other vegetables, 

French fries and fast food consumption for only the past twenty four hours would greatly reduce 

the likelihood of their inclusion and suggest that their children do not consume these items at all, 

rather than in limited amounts. Many mothers in both the cognitive interviews and focus group 

indicated that for items that were consumed more frequently, it was easier to use the daily

response options rather than the number of times of the past seven days, because it was too 

difficult to remember the detail about opportunities for the child to consume the item over the 

past week at one time. 

In response to the need to select one choice in answering a question, many mothers commented 

that they wished the questions were clearer about whether an average response was a correct 

answer, particularly if they wanted to use the daily response options. This was true for providing 

an answer for only the past twenty-four hours as well. A repeated request by mothers in the 

cognitive interviewing was for the questions to ask about the average week or day, or the normal 

pattern, rather than the specific consumption of food items. Generally, mothers seemed to 

express a preference for providing an average response over a few days or a week when 

indicating what their child had consumed. When asked, how many days they could best recall 

their child’s consumption, most mothers initially indicated that they could do so for up to a week, 

17
but that they could best recall what had happened for a more limited range of days, such as the 

past three days. Additional reasons for this preference were pursued further in Wave 2 of the 

study. 

Difficulties in Using the Response Options for Responding for the Past Seven Days. When

considering the issue of providing a response for the past week, many mothers in both the 

cognitive interviews and focus group struggled with addressing the fluctuation from day to day 

in the kinds of foods their child may have consumed, particularly for items consumed regularly, 

such as milk, fruits and vegetables and 100% fruit juice when providing a response. A key 

emerging theme was the existence of a tension between the desire to be accurate in their 

responses and the inability to remember every opportunity for consumption of the particular food 

item. The accompanying conversations with mothers provide some limited indication that this 

was in part due to the desire to “talk a good diet,” as some mothers provided commentary on the 

health benefits of particular choices. Mothers repeatedly wanted to provide the most accurate

answer in their responses, particularly in regards to questions about healthy foods choices, like 

vegetables and fruits. For questions on consuming French fries or fried potatoes, fast food and 

green salad, mothers more readily supplied answers in terms of times per week, primarily 

because their child rarely at these items, or the consumption of the item occurred at limited 

intervals, like a “dine out night.” 

Mothers in the focus group repeatedly expressed the desire for an option for “1 to 2 times per 

day.” Recall that some mothers in the cognitive interviews felt frustrated by their inability to 

come up with what they believed to be an accurate response due to the daily fluctuation in their 

child’s actual consumption. A majority of mothers in the focus group recommended that a 

response option of “1 to 2 times per day “ be added so that they could produce more accurate 

answers of what their child consumed. Some mothers indicated that this option would help them

to not develop an average response, but to more accurately reflect what was consumed, 

particularly as they were tallying times of consumption on a daily basis. Mothers believed that 

such a response option would allow them to honestly answer for times when they were not 

exactly sure how much their child had consumed, but were certain of the range of times when 

consumption took place. For example, man y mothers know their child had consumed at least 

one glass of milk per day, but there was a possibility the child had two glasses, due to other 

events. Rather than guessing two glasses or selecting 1 glass, mothers wanted a response option 

that allowed the to answer with the best average of consumption for the day. The desire for this 

response was also expressed for responding for only the past twenty-four hours as well. 

Using the Response Options

b. Are the response options suggested by ERS appropriate? Are respondents able to 

use these response options to describe their children’s behavior? If not, are there 

changes in response options that would be more appropriate?

18
A notable finding from Wave 1 was that mothers used a variety of cognitive strategies to develop 

their answers, often combining methods to develop an answer for one question. The discussion 

of mother’s strategies for arriving at an answer revealed that recalling what their child ate over 

the past seven days or even for the past twenty-four hours was not without some challenges. 

Strategy 1: Recall Of Preferences And Events 

Some mothers based their answers on a combination of their recollection of key events 

over the course of a week (or day), and the kinds of foods they purchased, prepared or 

bought over the course of the week (or day). For example, some mothers indicated that 

they knew their child consumed a particular food item because they had prepared it twice 

over the past seven days and the child normally liked to eat the specific item. This kind 

of strategy seemed most effective when considering a longer period of time. 

Strategy 2: Recall Of Child Specific Eating Habits 

Others mothers provided answers based exclusively on their child’s eating habits. 

Questions on milk, carrots, and green salad were most often answered in this manner. 

Instead of answering for what the child actually ate over the course of the past seven days 

or the past day, some mothers provided answers that used their child’s normal behavior to 

fill in gaps in recollection. In a modification of this, mothers based answers on 

approximation of what food was left in the refrigerator and their child’s eating 

preferences. 

Strategy 3: References 

For some mothers, the presence of a menu, snacking policies at school or with 

afterschool sports, and rules established for eating away from home— either with a 

babysitter or with other relatives— helped them to determine what their child had 

consumed. Some mothers carefully reviewed the menu with a child to review the choices 

with them before a meal was purchased at school. For other mothers (six total 

respondents in Wave 1), the menu was relied upon as a source of what was normally 

served or generally offered to their child, without full knowledge or recollection of the 

specifics. In other words, some mothers determined that their child had not consumed an 

item at school because they did not recall seeing it on the menu, and it seemed 

inconsistent with what had been served previously. Some mothers who used the menu as 

a cue stated that they generally know what was on the menu, but not necessarily for the 

specific seven days being asked about. This general knowledge was helpful in 

eliminating specific foods that were never served or not available like snack foods and 

kinds of milk or fruit juice available at school, but less helpful in recalling items that 

were served, like fruit or other vegetables. 

Many mothers, in both the interviews and particularly in the focus group, expressed some

frustration because they could not determine precisely what their child had consumed. Four 

cognitive interview respondents indicated that this was a reoccurring problem for them in 

supplying an answer, while seven of the nine focus group respondents indicated that this was the 

19
case. Upon further probing in both settings, some of these mothers resolved this tension by 

providing an average amount consumed by their child over the past seven days. Others provided 

an average based on what was normal in a seven-day period for their child, while still others 

simply did not include times when they could not be positive of what their child consumed in

their answers, both in terms of answering for the past twenty-four hours and for providing a 

response covering the past seven days. Additional complications included how to calculate an

amount consumed when the child may not have eaten all of the food offered. This complication 

existed for answering for just the past twenty-four hours and for providing answers over the past 

seven days. 

Generally, mothers understood the time ranges described in the response options, and had no 

problem conceptualizing the past seven days, which was generally understood to include the

weekend and previous five weekdays. However, mothers did have some difficulties in using the 

response options to classify their answer in the ranges provided. An emerging theme for mothers 

in both the interviews and focus group was struggling to understand the term “time” for their 

child’s consumption patterns. Three mothers in the interviews and six of nine mothers in the 

focus group indicated that they had some trouble with the questions because they wanted to 

respond in terms of a serving or a portion size, rather than a “time.” In thinking about “time” as

a sitting or meal time, a majority of the focus group respondents expressed that it would be easier

for them in many cases to supply the number of servings versus “time,” due to the fact that their 

child may eat either 1 carrot or a whole bag at one sitting, and this did not seem to be an accurate

reflection of what was consumed. Still, when the issue of serving was raised, some mothers also

noted that determining a serving could be equally problematic. 

The cognitive interviewing and focus group revealed some areas when mothers grossly 

underestimated the number of times their child consumed a food item. The most common reason 

for underestimation stemmed from the fact that mothers often forgot to include times such as

school, play dates, or sporting activities in their responses. Cognitive probing revealed that 

many mothers just didn’t think of these times automatically. 

The follow up discussion revealed that mothers focused more on times when their child was with 

them in answering the question except for school, perhaps because it was easier to determine and 

answer. In some cases, as with the milk questions, the interviews indicated that the question

wording was helpful by reminding them to include specific school meal times, such as breakfast

or lunch. For questions that did not include this type of specific reference, mothers did not 

generally include outside activities that their child participated in their responses, such as play 

dates, after school care, or sporting events, unless they packed a snack. 

This trend was also confirmed in the focus group discussion, where a majority of the mothers 

(six of nine) did not include the full range of times where their child may have eaten a snack or 

meal. A mother from the focus group commented that “I totally forgot about soccer, and we 

provided the snacks this week.” However, the underestimation also occurred because mothers 

did not want to count events that were not the norm. For example, if the child had attended a 

birthday party, or consumed Halloween candy, some mothers reluctantly provided an answer to 

consumption of sweets because it wasn’t the “norm” for their child. 

There were some specific areas of underestimation that were related to how mothers interpreted 

the question. The data collection revealed that mothers are not always considering all of the 

20
fruits and vegetables that their child may have consumed when answering the respective 

questions on carrots, potatoes, and other vegetables. Mothers most often struggled with coming 

up with a frequency for fruit or vegetable consumption for their child. Part of this was due to the 

fact that the item was consumed often by children, but not necessarily completely eaten at one 

sitting. 

About a one third of the mothers interviewed one-on-one indicated that their child was able to go 

to the refrigerator and obtain a fruit or vegetable item as a snack with limited supervision. This

practice of “self-serve snacking” is where the child goes to the refrigerator to have carrots or 

grapes and can have that fruit in unlimited quantities. The only way mothers reported being able

to track the consumption of this type of food is that “when it is gone, it's gone.” The impact of 

this type of eating on the responses mothers provided in interviews and during the focus group 

was that mothers simply excluded these foods from their count, thus underestimating the fruits 

and vegetables their child may have consumed. Further probing revealed that mothers recalled

that their children consumed these fruits and vegetables, but that they didn't count them because 

there wasn’t any place to record them and no guidance on how to quantify the food being 

consumed as a "time." It was difficult for mothers to determine when a “time” began and ended 

in regards to this type of snacking. 

In the Wave 1 focus group, where this issue was discussed at length, some mothers thought a 

“time” might be however long it took the child to obtain and consume the food, while others 

were concerned about how much food should be included in the self-serve snacking period, 

particularly as the quantity could vary dramatically from day to day and even within the course 

of a day. In particular, four mothers in the focus group described their frustration at counting the 

one or two carrots their child consumed during a self-service snack with the same weight as the

whole bag of carrots the child may have consumed as a latter snack during the day. One mother 

indicated that if she was specifically asked, she would have simply counted all of the vegetables 

or fruits that the child obtained in a self-service mode as one “time,” no matter how much food 

was actually consumed. 

Other counting discrepancies arose as well. Some mothers determined that their child consumed 

a food item by the fact that they had prepared it or served it. This raised the issue of whether 

mothers automatically counted an item as being consumed, simply because they recalled offering 

it, rather than whether the child actually ate the item at a mealtime. 

However, it was also the case that some mothers could clearly and accurately recall what their 

child had consumed both at home and at school because their child had few if any outside

opportunities to consume food items outside of their presence. These four mothers 

communicated that: 

Wave1 Cognitive Interviewee 3: “I know everything they put in their mouths.” 

Wave1 Cognitive Interviewee 2: “I know what I serve him.”

Interestingly, further analysis revealed that most of these mothers either had a kindergarten child 

who did not attend school all day, or a child that did not receive a meal at school. In the 

remaining cases, serious food allergies necessitated a stricter schedule and monitoring by a 

parent to ensure that the child did not consume a prohibited item. 

21
Notable Areas For Follow-Up In Wave 2

The findings from Wave 1 generally indicated that mothers were indeed able to answer the 

questions, but that some improvements could improve their ability to provide more accurate 

answers, as well as some limited clarification on the kinds of foods to include in their responses. 

Most notably, all of the questions received an additional statement at the beginning designed to

assist mothers in recalling all of the places where their child may have consumed a food item.

This was done to address cases where mothers’ descriptive statements indicated that they only 

thought about food that they served or prepared or eating that occurred in their presence. The 

addition of the statement was felt to help in cutting down on the gross underestimates mothers 

seemed to be making because they simply didn’t consider all possible eating opportunities.

Specifically, wording was added to the response option “regular milk,” to help respondents better 

understand what regular milk referred to, as mothers in Wave 1 did not quite understand what

was being referred to. Additional descriptive words were added to give mothers more detail so 

that they could properly respond to Q7 and Q9. Finally, clarifications were added to Q10 on fast

food, and Q11 on consumption of candy, ice cream, cookies, cakes, brownies, or other sweets.

These changes were not so great that they dramatically alter the meaning of the questions, but

they were felt to provide needed clarity that would either improve mothers’ ability to use the

response options themselves, or provide more accurate answers based on their recollections. 

The response option “1 to 2 times a day” was also added, although with caution. The main 

purpose for adding this response option to the Wave 2 questions was to determine whether this 

option would be widely used if offered, and how it might function in helping to resolve the 

tension between providing the best answer and accounting for fluctuation in a child’s actual 

consumption. The Wave 2 cognitive interviews also included specific probes on answering times 

per day versus times per week. These were included to further develop the findings on 

answering preferences discussed under research question b, including answering for the past 

twenty-four hours, and to gather additional data on the implications of adding the “1to 2 times 

per day” response option. 

22
Study Findings: Wave 2 

The results of Wave 1 served as the basis for revising the questions. The questions were revised 

in an attempt to make them easier to understand and answer accurately. The purpose of Wave 2 

was to test the revised set of questions. As with Wave 1, Wave 2 had 18 respondents, nine 

cognitive interviewees and nine focus group participants. 

Overall, Wave 2 respondents were also diverse by age, ethnicity/race, and income and by 

number of children in the household. Four of the cognitive interviewees were African 

American, one was Asian and three were Caucasian. All of the mothers except for one had 

completed some higher education beyond high school. Out of these eight respondents, two 

mothers had completed postgraduate education. Five of the cognitive interviewees had two 

children. Three respondents had only one child and one respondent had three children. 

For the Wave 2 focus group, five mothers were African American, one mother was Asian 

American, and the remaining were Caucasian. Seven mothers also had two school-aged 

children. Three mothers had some college education or less, while the remaining participants had 

completed college. 

Table 7 presents the initial revisions made to the set of test questions based on the analysis of the 

Wave 1 data. Changes are underlined. 

Table 7. The Revised Set of ECLS-B Test Questions Used in Wave 2 Cognitive Interviews

1. During the past 7 days, including afterschool activities, sports, and the weekend, how many glasses of milk did 

your child drink? Include all types of milk, including cow’s milk, soy milk or any other kind of milk; include the 

milk your child drank in a glass or cup, from a carton, or with cereal. Count the half pint of milk served at school as

equal to one glass. 

1 Child did not drink milk during the past 7 days. 

2 1 to 3 glasses during the past 7 days. 

3 4 to 6 glasses during the past 7 days. 

4 1 glass per day. 

5 1 to 2 glasses per day

6 2 glasses per day. 

7 3 glasses per day. 

8 4 or more glasses per day.

2. What kind of milk did your child usually (most often) drink during the past 7 days?

1 Whole milk 

2 2% milk. 

3 Skim milk. 

4 Low fat or 1% milk. 

5 Soy milk. 

6 Both regular cow’s milk and soy milk. 

23
Table 7. The Revised Set of ECLS-B Test Questions Used in Wave 2 Cognitive Interviews

7 Some other kind of milk. 

3. During the past 7 days, including afterschool activities, sports, and the weekend, how many times did your child 

drink 100% fruit juices such as orange juice, apple juice, or grape juice? Do not count punch, Sunny Delight, KoolAid, sports drinks, or other fruit-flavored drinks. 

1 Child did not drink 100% fruit juice during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

5 1 time per day.

6 1 to 2 times per day

6 2 times per day.

7 3 times per day.

8 4 or more times per day. 

4. During the past 7 days, including afterschool activities, sports, and the weekend, how many times did your child 

drink Soda pop (for example, Coke, Pepsi, or Mountain Dew), sports drinks (for example, Gatorade), or fruit drinks

that are not 100% fruit juice (for example, Kool-Aid, Sunny Delight, Hi-C, Fruitopia, or Fruitworks)?

1 Child did not drink any during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

7 1 time per day.

8 1 to 2 times per day

6 2 times per day.

7 3 times per day.

9 4 or more times per day. 

5. During the past 7 days, including afterschool activities, sports, and the weekend, how many times did your child 

eat fresh fruit such as apples, bananas, oranges, berries, other fruit such as applesauce, canned peaches, canned fruit

cocktail, or frozen berries (Do not count fruit juice.) 

1 Child did not eat fruit during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 1 to 2 times per day

6 2 times per day.

7 3 times per day.

8 4 or more times per day. 

6 During the past 7 days, including afterschool activities, sports, and the weekend, how many times did your child

eat green salad?

1 Child did not eat green salad during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 1 to 2 times per day 

6 2 times per day.

7 3 times per day.

8 4 or more times per day. 

24
Table 7. The Revised Set of ECLS-B Test Questions Used in Wave 2 Cognitive Interviews

7. During the past 7 days, including afterschool activities, sports, and the weekend, how many times did your child 

eat potatoes? (DO NOT count French Fries, fried potatoes, potato chips or sweet potatoes). 

1 Child did not eat potatoes during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 1 to 2 times per day

6 2 times per day.

7 3 times per day.

8 4 or more times per day. 

8. During the past 7 days, including afterschool activities, sports, and the weekend, how many times did your child 

eat carrots?

1 Child did not eat carrots during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day

5 1 to 2 times per day.

6 2 times per day.

7 3 times per day.

8 4 or more times per day. 

9. During the past 7 days, including afterschool activities, sports, and the weekend, how many times did your child 

eat other vegetables, such as sweet potatoes or broccoli? (DO NOT count green salad, potatoes, French fries, or

carrots.) 

1 Child did not eat other vegetables during the past 7 days.

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 1 to 2 times per day.

6 2 times per day.

7 3 times per day.

8 4 or more times per day. 

10. During the past 7 days, including afterschool activities, sports, and the weekend, about how many times did your

child eat a meal or snack from a fast food restaurant with no wait service such as McDonald’s Pizza Hut, Burger

King, KFC (Kentucky Fried Chicken), Taco Bell, Wendy’s and so on? Consider both eating out, carry out and 

delivery of meals in your response. Would you say:

1 Child did not eat food from a fast food restaurant during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5. 1 to 2 times per day. 

6 2 times per day. 

7 3 times per day.

8 4 or more times per day. 

25
Table 7. The Revised Set of ECLS-B Test Questions Used in Wave 2 Cognitive Interviews

11. During the past 7 days, including afterschool activities, sports, and the weekend, how many times did your child

eat candy (including Fruit Roll Ups and similar items), ice cream, cookies, cakes, brownies, or other sweets? Would 

you say:

1 Child did not eat sweets during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

 5 1 to 2 times per day.

 6 2 times per day. 

 7 3 times per day. 

 8 4 or more times per day. 

12. During the past 7 days, including afterschool activities, sports, and the weekend, how many times did your child

eat potato chips, corn chips (Fritos, Doritos), Cheetos, pretzels, popcorn, crackers or other salty snack foods?

1 Child did not eat salty snack foods during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 1 to 2 times per day

6 2 times per day.

7 3 times per day.

8 4 or more times per day. 

13. During the past 7 days, including afterschool activities, sports, and the weekend, how many times did your child

eat French fries or fried potatoes? 

1 Child did not eat French fries or fried potatoes during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day.

5 1 to 2 times per day.

6 2 times per day.

7 3 times per day.

8 4 or more times per day. 

Understanding Of The Terminology

a. Do the respondents interpret the questions, as asked, in the manner intended by 

ERS? If not, are there changes in wording that will improve understanding?

Table 8 presents the answers provided by Wave 2 respondents to the eating habit questions. 

Similar to Wave 1 respondents, there were no mothers who refused to answer the question, nor 

did any provide a “don’t know” response. The distribution of responses suggests that mothers 

were generally able to use the given response options appropriately. What is interesting is to see 

26
the way in which mothers in this wave of the interviewing use the new response option “1 to 2 

times per day”. The option “1 to 2 times per day” was used by mothers for the items consumed 

on an everyday basis by small children with some frequency: milk, 100% fruit juice, and fresh 

fruit in particular. 

27
Table 8. Answers Provided To The Eating Habit Questions By Wave 2 Cognitive Interview 

Respondents 

Question Response Options

Food Item

Child did 

not 

eat/drink 

during the 

past 7 days

1 to 3 

times 

during 

the past 

7 days 

4 to 6 

times 

during 

the past 

7 days 

1 time

per day

1 to 2 

times 

per day

2 times 

per day 

3 times 

per day

4 or 

more 

times 

per day

Milk 0 2 1 0 3 2 0 1

100% fruit juice 0 1 2 3 3 0 0 0

Drinks not 100% fruit juice 0 2 2 0 0 0 1 0 

Fresh fruit 0 1 0 1 5 2 0 0

Green salad 4 3 2 0 0 0 0 0

Potatoes (not fried) 4 5 0 0 0 0 0 0

Carrots 2 4 3 0 0 0 0 0

Other vegetables 2 0 2 2 2 1 0 0

Fast food 3 6 0 0 0 0 0 0

Candy, ice cream, cookies, 

cakes, brownies, or other 

sweets 

0 0 4 2 3 0 0 0

Salty snacks 1 4 3 0 1 0 0 0

French fries or fried 

potatoes 

4 5 0 0 0 0 0 0

As in Wave 1, items that were consumed less frequently include green salad, potatoes that were 

not fried, fast food, and French fries or other fried potatoes. Notably, “4 or more times per day” 

was only selected once, as was “3 times per day.” 

28
Table 9. Mean Ratings Of Ease Of Answering The Eating Habit Questions 

Mean 

Rating Rating Scale 

Question 

Number

Very Easy

Somewhat 

Easy 

Not At All 

Easy 

Food Item 

1= "very 

easy" to 

3 ="not 

at all 

easy" (%) (%) (%) 

Q11 Candy, ice cream, cookies, cakes, 

brownies, or other sweets 1.7 44 44 11

Q12 Salty snacks 1.6 44 56 0

Q7 Potatoes (not fried) 1.4 67 22 11

Q9 Other vegetables 1.4 56 44 0

Q1 Milk 1.3 67 33 0

Q3 100% fruit juice 1.3 67 33 0 

Q8 Carrots 1.2 78 22 0

Q4 Drinks not 100% fruit juice 1.2 78 22 0 

Q5 Fresh fruit 1.1 89 11 0

Q6 Green salad 1.1 89 11 0

Q2 Type of milk 1.1 89 11 0 

Q10 Fast food 1.1 89 11 0

Q13 French fries or fried potatoes 1.0 100 0 0 

The mean ratings indicate that there are some key differences between Wave 1 and Wave 2. For 

example, respondents in Wave 2 found the questions on candy, ice cream, cookies, cakes, 

brownies, or other sweets, salty snacks, potatoes (not fried) and other vegetables to be most 

difficult to answer. In Wave 1, questions on milk, 100% fruit juice and fresh fruit consumption 

were most difficult. Recall that Wave 2 interviews included some additional wording designed 

to help mothers recall all of the opportunities where their child may have consumed a food item. 

It is likely that this language increased the difficulty for some of these questions where the food 

item was consumed less frequently over all, as mothers were specifically asked to think about 

and account for times what their child ate when their child was not in their presence. As will be 

described further below, quite a few mothers in the cognitive interviews readily admitted that 

they could not be sure their child actually ate an item away from home. Additionally the use of 

the “1 to 2 times per day” option for the items that were most difficult in Wave 1 suggests that 

this response option decreased the difficulty by providing a means to account for fluctuation in 

what the child actually consumed when mothers used the daily tally method for coming up with 

an answer, for responding for just the past twenty-four hours and for developing a response that 

covered the past week. The following quotes from some of the interviews add some insight to 

how mothers approached the questions in Wave 2: 

29
Wave 2 Cognitive Interviewee1: It was hard to keep track of everything, afterschool, with 

their dad. It was difficult...trying to remember when exactly. Was it this week or last 

week? You know, recalling the seven days backward, to a specific date.

Wave 2 Cognitive Interview 3: It {the question} was pretty easy. But I think that -- just 

trying to think -- again, think back to, you know, the kinds of food she ate the last seven 

days. But I think it's easier like when I think of, okay, well, that was something they had. 

I think just accounting for the variability is hard. I was just trying to think of what we ate 

last week and what the -- like when she bought a school lunch, what was on the menu, 

where we were. 

Understanding the Language Used In Each Question

Overall, the additional language clarified the questions for mothers and improved the recall of 

consumption that occurred outside of the mother’s presence, thus improving the completeness of 

responses. As with Wave 1, mothers clearly understood terms like “green salad,” “sports 

drinks,” and “100% fruit juice.” However, mothers in the Wave 2 focus group felt that the 

language included in Q9 to prompt “other types of vegetables” was not helpful and 

recommended eliminating it completely. 

Q1, “glasses” of milk. Wave 2 focus group respondents raised some issues with the language 

“glasses.” In Q1, the mothers felt that using the term “glasses” did not seem to fit in with the rest 

of the questions, and it made them wonder if what they provided as a glass was appropriate, or if 

they had misunderstood the question. A natural outcome from the discussion about glasses was 

what glass size (8 oz, 6 oz) was considered a serving. This discussion made four respondents 

think about how much is in a serving and convert what they believed their child had consumed 

into “servings” based on their understanding, instead of how often milk was provided. Other 

mothers focused on how many times their child actually had milk. 

The addition of the statement “including afterschool activities, sports, and the weekend” to 

each question. The addition of this wording at the beginning of each question did indeed help 

mothers in both the interviews and the focus group to better recall opportunities where their child 

may have consumed the food items in each of the eating habit questions. Five mothers in the 

cognitive interviews, and most of the mothers in the focus group commented that they liked the 

reminder, because it helped them to think about all the places where their child may have 

consumed something. Two focus group respondents noted that having the reminder in every 

question made the questions seem a bit longer, but these mothers still affirmed the value of

having the language for each question, rather than just once or twice with a question. A few 

mothers in the focus group and two mothers in the interviews suggested also adding the words 

“play date,” as that was the main activity kindergarteners might be at outside of the home, as 

many were too young to play an organized sport. 

The addition of “with no wait service” and “Consider both eating out, carry out and 

delivery of meals in your response.” to Q10. The addition of this language appeared to work 

well in clarifying the kinds of places mothers should consider in answering the question about 

eating fast food. In particular, focus group respondents did not seem to struggle with whether or 

30
not to include all of the meals their child ate outside of the home in a restaurant in their response 

to the revised question. 

Addition of “Fruit Roll Ups and similar items” to Q 11. Mothers in the cognitive interviews 

did not raise any concerns with the addition of this language. Mothers in the focus group 

indicated that it helped them to better classify the foods their child had consumed by knowing to 

include Fruit Roll Ups and similar snacks in responses to Q11. However, a few mothers still felt 

that these types of foods were “better snacks” than the others included on the list, and expressed 

some reluctance at having to include them in their response to this question. 

Potatoes that were not French fries or fried. The inclusion of the wording “sweet potatoes” 

on the DO NOT COUNT list for Q7 was viewed as moderately helpful. 

Other Food Classification Issues. Some mothers still encountered difficulties in classifying 

other vegetables that were included as a major portion of a main dish, or served in a mix. Two of 

the interviewees simply didn’t count these foods, while three of the focus group respondents 

expressed that they weren’t sure where to classify these items, which included things like stir fry 

and the vegetables that were a part of a soup. One mother in the focus group raised the question 

about where to count vegetable juice. Fewer mothers than in Wave 1 raised concerns with 

knowing what kind of potatoes to include in Q7. 

Two mothers who completed an interview recommended adding the words “dried fruit” to the 

list of fruits provided in Q5. These mothers indicated that the addition of this wording would 

assist them in knowing whether to include dried fruit as a part of their child’s fruit consumption, 

given that the question currently asks for fresh, canned and frozen fruit. This language was 

added to the question for the focus group, where it was well received. 

As with Wave 1, mothers in Wave 2 were surprised that other dairy foods, specifically cheese 

and yogurt, were not asked for. Once again, many mothers wanted to provide an answer for 

overall dairy consumption, particularly if their child had milk allergies and obtained calcium in 

some other way. Even among mothers whose children did drink a lot of milk, it was felt that the 

exclusion of cheese and yogurt didn’t provide them with an opportunity to best reflect what their 

child consumed. Mothers raised similar concerns about the exclusion of meats, breads and 

grains, and water as well. The general comments about the exclusion of these items focused on 

mothers having a better understanding of the intent of the questions, as many believed that the 

food categories that were asked about didn’t communicate a full picture of the basic consumption 

of their child. 

31
Recall Ability And Preferences for Answering For Times Per Day Versus Times Over The Course Of 

A Week

b. What time period do respondents feel more comfortable with, in responding to the 

questions—for example, the past 24 hours or the past week?

Respondents talked more readily in this wave of the study about difficulties they faced in 

recalling what had occurred over the past seven days. Four of the nine interviewees commented 

that it was challenging for them to recall what had actually taken place over the last week and 

what foods their child had actually consumed. They expressed a preference for providing an 

answer for a shorter period of time. In particular, mothers who provided this feedback seemed to 

be trying to recall specific events or changes to their routine schedule in order to make 

determinations about what their child had consumed. When asked to respond for the past week, 

these mothers selected the response options that used the language times per day, as responding 

in terms of times per week was viewed as too complex to recall as a whole. 

As with Wave 1, respondents demonstrated a preference for answering questions for items 

consumed more frequently with the “times per day” options. Most mothers in the cognitive 

interviews communicated that this was easier or them, because they could tally up the items their 

child had easier on a day-to-day basis. Overall, the items per week option was used for foods 

consumed less frequently, as described in Wave 1. Mothers did seem to use the "1 to2 times a 

day" option for items consumed more regularly as well, particularly fresh fruit. It seems as if 

this option did provide mothers with a means of answering the question using the daily tally 

method. 

As with Wave 1, mothers were able to recall what their child consumed over the past twenty-four

hours more easily than over the past seven days. However, while mothers admitted that this

would be much easier, there was some hesitancy on the part of mothers for answering in this 

manner. Barriers to answering for just the past twenty- four hours included the tensions mothers 

experienced in wanting to provide the response that best described what their child ate, combined 

with the concern that answering for a day did not reflect the best of their child’s eating habits, 

particularly if the day in question did not follow the “normal” schedule. In the Wave 2 focus 

group discussion, about half of the mothers indicated that the best way to for mothers to answer 

the questions would be either to provide clear instructions asking for an average for the week, or

to ask specifically about fewer days. These mothers believed that it was easier to tally foods and 

reconcile the fluctuation in their child’s preferences by answering for one to three days instead of

the week. The main reason seemed to be the better ability to recall with more accuracy what was 

eaten. 

It is interesting to note that when asking mothers about the past twenty four hours, the additional 

descriptive information provided by mothers still indicated that the recall strategies described 

earlier were used, particularly relying on a menu, or viewing offering a food the same as the

child consuming it. This type of reconstruction of what may have been consumed still occurred,

thus there were still areas for misrepresentation to occur even when asking about the past twentyfour hours. 

32
Using the Response Options

c. Are the response options suggested by ERS appropriate? Are respondents able to 

use these response options to describe their children’s behavior? If not, are there 

changes in response options that would be more appropriate?

Mothers in Wave 2 understood the time ranges described in the response options, and had no 

problem conceptualizing the past seven days, which was generally understood to include the 

weekend and previous five weekdays. As with Wave 1, Wave 2 interviewees and focus group 

participants described using a variety of cognitive strategies to develop their answers, often 

combining methods to develop an answer for one question. 

Once again, many mothers in both the interviews and particularly in the focus group expressed 

some frustration because they could not determine precisely what their child had consumed for 

either the past day or past seven days. Five cognitive interview respondents indicated that this 

was a reoccurring problem for them in supplying an answer, while six of the nine focus group 

respondents indicated that this was the case. As with the Wave 1 respondents, mothers used the 

strategies of recalling what they had purchased, their child’s regular habits and schedule, and 

what was left in the refrigerator at the end of the week to reconstruct what food items were 

consumed by their child. Mothers in this wave of the interviewing more readily discussed the 

fact that they could only guess what their child may have consumed at school, and that there was 

no real way of knowing. Many mothers relied on knowing what they served as a means of 

answering the question. About half of the mothers who used this strategy commented that while 

it was easy to remember what they prepared for a meal, it was much more difficult to determine 

whether their child ate the food, or how much of the food the child ate. The following statements 

are examples of how mothers used different strategies to develop their response to what their 

child consumed. 

Wave 2Cognitive Interviewee 5: “I pretty much fix all their meals. So I know what they 

have.” 

Wave 2 Cognitive Interviewee 4: “I know what activities are planned on different days, 

so that way I can -- based on the activities, I can somewhat guess whether or not they're 

more likely to be out and grab fast food, which would mean most likely they would drink 

soda or some other watered-down juice product.” 

Wave 2 Cognitive Interviewee 8: “I just try to average in the times I'm not certain about, 

like, okay, thinking, you know, how many play dates? How many other things did she do 

that I'm not certain about?” 

33
Based on analysis of the descriptions of how mothers arrived at their answers, some mothers still 

relied upon a strategy of determining an average response for their child, even though the 

question wording does not indicate that they should do so. This was the case for answering for 

either the past day or the past seven days. As the previous quote illustrates, some mothers 

described thinking about how many times an item was served and rounding it off to arrive at 

their answer. 

Mothers in Wave 2 confirmed that self-service snacking was not an unusual practice. It was also 

still the most problematic for mothers in terms of tallying a number of times per day for the 

reasons stated in Wave 1. However, some of the discussion provided additional insight as to 

how mothers incorporated these practices into their responses. One cognitive interviewee 

commented that she just counted times, while another mother said that her child usually told her 

when he was going to refrigerator, so she could generally track how often he snacked on foods in 

this fashion.

In Wave 2, mothers in the focus group also experienced difficulty in classifying some of the 

responses because of the language “times.” Five of nine mothers in the focus groups indicated

that they had some trouble with the questions because they wanted to respond in terms of a

serving or a portion size, rather than a “time.” This concern was discussed further as mothers

compared the wording of the response options across all of the questions. A few mothers in this

focus group stated that for them, figuring out a serving would have been easier. As a way of

shifting the focus away from the term serving, some mothers suggested that the language for all 

of the response options refer to “times.” 

As with Wave 1, there were some mothers who determined that their child consumed a food item 

by the fact that they had prepared it or served it. This raises the possibility that additional 

language or instruction needs to be added to the question to remind mothers not to count 

consumption in this manner. 

34
Conclusions and Recommendations 

Overall, most mothers were able to answer the questions on their child’s eating habits by 

reporting to a variety of recall strategies, such as the recall of preferences and special events, the 

recall of a child’s specific eating habits(likes or dislikes), or using references such as the 

presence of a menu, snacking policies at school or with afterschool sports, and rules established 

for eating away from home. 

Mothers did not generally struggle with terminology used the questions, but there were some

words and concepts that require clarification to improve mothers' ability to answer the questions

more easily. First, clarification for the term” regular milk” should be added. Additionally, as 

mothers in both waves of the study commented, the questions are very clear about what to 

include, but not clear about what to include in the responses, particularly for questions on other 

vegetables, and potatoes that were not fried. 

Perhaps most problematic for the mothers participating in this study were problems encountered 

due to the combination between limits on the ability to recall what foods were consumed and the

desire to reflect socially acceptable and beneficial eating behaviors for young children. Mothers 

struggled with addressing the fluctuation from day to day in the kinds of foods their child may 

have consumed, particularly for items consumed regularly, such as milk, fruits and vegetables

and 100% fruit juice. This impacted their preference for supplying an answer for only the past 

twenty-four hours, as well as their ability to develop a response for the past seven days. A key 

emerging theme was the existence of a tension between the desire to be accurate in their 

responses and the inability to remember every opportunity for consumption of the particular food 

item. The accompanying conversations with mothers provide some limited indication that this 

was in part due to the desire to “talk a good diet,” as some mothers provided commentary on the 

health benefits of particular choices. Mothers repeatedly wanted to provide the most accurate

answer in their responses, particularly in regards to questions about healthy foods choices, like 

vegetables and fruits. In response to the need to select one choice in answering a question, many 

mothers commented that they wished the questions were clearer about whether an average 

response was a correct answer, particularly if they wanted to use the daily response options. 

The findings also illustrate the need for additional reminders to help mothers recall all other 

opportunities where their child may have consumed a food. The cognitive interviewing and 

focus groups revealed some areas when mothers grossly underestimated the number of times

their child consumed a food item. The most common reason for underestimation stemmed from 

the fact that mothers often forgot to include times such as school, play dates, or sporting 

activities in their responses. Cognitive probing revealed that many mothers just didn’t think of 

these times automatically. Mothers needed the reminder to include eating that occurred outside 

of the presence no matter how scheduled their patterns of feeding the child might have been. 

Additionally, language or instruction prior to the eating habit questions needs to be added to the 

questionnaire to help mothers focus on the food their child actually consumed, and not what they 

offered or prepared. Recall that a popular strategy for determining what the child had consumed 

was for mothers to reflect on what meals they had prepared over the course of the week, or what 

food they have offered, without any clear reflection on whether or not the child had actually 

consumed the item. A similar problem occurred when considering foods children may have

35
consumed at school: mothers know what they sent packed in a lunch or snack, but unless the

child came home with the food, they was no clear way for mothers to determine if what was 

offered was actually eaten. While the school consumption is harder to track, wording can be 

added to help mothers distinguish between what was offered and was actually eaten. 

While the “1 to 2 times a day” option was used by mothers and did seem to address a core 

problem, it may be possible to resolve the issue in some other fashion that does not alter the

responses to prohibit comparability with the Grade 5 ECLS questions. This could be

accomplished by providing language that will give mothers clear guidance on whether their 

answers should be averages or as precise as possible. This language would assist the 

development of responses by helping mothers to focus more specifically on how they should 

count the items they are considering for inclusion in their responses, and also provide a solution 

to whether or not the “1 to 2 times per day” option is indeed viable. If the guidance provided 

instructs respondents to calculate their answers as an average, then mothers would have less need 

for an option like “1to 2 times per day”, which functions well because it allows mothers to

account for fluctuation in daily consumption patterns. If they are calculating an average, mothers 

could more readily make a determination between options like “1 time a day”, or “2 times a 

day.” 

Most mothers were able to recall what their child consumed over the past twenty-four hours

more easily than over the past seven days. However, while mothers admitted that this would be 

much easier, there was some hesitancy on the part of mothers for answering in this manner. 

Barriers to answering for just the past twenty-four hours included the tensions mothers 

experienced in wanting to provide the response that best described what their child ate, combined 

with the concern that answering for a day did not reflect the best of their child’s eating habits, 

particularly if the day in question did not follow the “normal” schedule. The findings suggest 

that that the best way to for mothers to answer the questions would be either to provide clear 

instructions asking for an average for the week, or to ask specifically about fewer days—a one to

three-day period was suggested by mothers in this study. Overall, the findings suggest that it is

easier for mothers to tally foods on a daily basis than recalling what was consumed over the

whole week. This tallying method could be applied to either answering for the past twenty-four

hours, or providing a response for the past seven days. However, based on the data provided by 

mothers in this study, using only the past twenty-four hours would limit the answers mothers 

give to questions on green salad, fast food, French fries and fried potatoes, other vegetables, 

consumption of soda pop and drinks that were not 100% fruit juice, and to a lesser extent, candy, 

ice cream, cookies and similar items, as well as potato chips, pretzels, Fritos, and other salty 

snack foods. 

However, the underlining issue of whether or not it is acceptable or desirable to provide an 

average response for a given time period (twenty-four hours, past seven days or some other time

frame) would need to be clarified in order to improve respondents’ ability to answer the 

questions, particularly when additional language asking respondents to consider a wider range of

potential eating times is added to the questions. 

The following discussion presents the recommendations developed for the eating habit questions. 

The recommendations were developed after careful review of the findings in both Wave 1 and 2. 

36
The discussion presents the original question, the revised question and the rationale for making 

changes. The original eating habit question is presented first. 

37
Q1: During the past 7 days, how many glasses of milk did your child drink? Include all types of 

milk, including cow’s milk, soy milk or any other kind of milk; include the milk your child drank 

in a glass or cup, from a carton, or with cereal. Count the half pint of milk served at school as 

equal to one glass. 

1 Child did not drink milk during the past 7 days. 

2 1 to 3 glasses during the past 7 days. 

3 4 to 6 glasses during the past 7 days. 

4 1 glass per day. 

5 2 glasses per day. 

6 3 glasses per day. 

7 4 or more glasses per day. 

DK DON’T KNOW 

RF REFUSED

Revised Q1: During the past 7 days, including school activities, play dates, sports, and the 

weekend, how many glasses of milk did your child drink? Include all types of milk, including 

cow’s milk, soy milk or any other kind of milk; include the milk your child drank in a glass or 

cup, from a carton, or with cereal. Count the half pint of milk served at school as equal to one 

glass. 

1 Child did not drink milk during the past 7 days 

2 1 to 3 times during the past 7 days 

3 4 to 6 times during the past 7 days 

10 1 time per day 

5 2 times per day 

6 3 times per day 

7 4 or more times per day 

DK DON’T KNOW 

RF REFUSED

Rationale: Adding the statement referencing other times where a child may have consumed the 

food provided more complete responses by mothers in Wave 2 of the study, although it may have 

also complicated the tallying process for some mothers using the times per day response options. 

However, the inclusion of the statement did prompt mothers to consider a wider range of times 

when their child may have consumed a food item in the question set than the original question 

did. Changing “glasses” to “times” makes all of the response options consistent and removes the 

possibility that mothers become frustrated by calculations that convert glasses to servings and 

then to “times.” 

38
Q2. What kind of milk did your child usually (most often) drink during the past 7 days?

1 Whole milk 

2 2% milk. 

3 Skim milk. 

4 Low fat or 1% milk. 

5 Soy milk. 

6 Both regular milk and soy milk. 

7 Some other kind of milk. 

DK DON’T KNOW 

RF REFUSED 

Revised Q2. What kind of milk did your child usually (most often) drink during the past 7 days?

1 Whole milk 

2 2% milk. 

3 Skim milk. 

4 Low fat or 1% milk. 

5 Soy milk. 

6 Both regular cow’s milk and soy milk. 

7 Some other kind of milk. 

DK DON’T KNOW 

RF REFUSED 

Rationale: The wording of “regular cow’s milk” improved mothers understanding of the 

question buy making the response option clearer. Add a response option to account for mothers 

whose child did not consume any milk. The question set as tested did not include a skip pattern 

for mothers who provided the response “my child did not consume milk in the past seven days” 

in question 1. Either a skip pattern should be added, referring these respondents directly to 

question 3, or a response option of “none of the above, child didn’t drink milk” needs to be 

added to question 2. 

39
Q3. During the past 7 days, how many times did your child drink 100% fruit juices such as 

orange juice, apple juice, or grape juice? Do not count punch, Sunny Delight, Kool-Aid, sports 

drinks, or other fruit-flavored drinks. 

1 Child did not drink 100% fruit juice during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED 

Revised Q3. During the past 7 days, including school activities, play dates, sports, and the

weekend, how many times did your child drink 100% fruit juices such as orange juice, apple 

juice, or grape juice? Do not count punch, Sunny Delight, Kool-Aid, sports drinks, or other 

fruit-flavored drinks. 

1 Child did not drink 100% fruit juice during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED 

Rationale: The rationale for the statement referencing additional times where children may be 

consuming food is described above. No other changes are recommended. 

40
Q4. During the past 7 days how many times did your child drink Soda pop (for example, Coke, 

Pepsi, or Mountain Dew), sports drinks (for example, Gatorade), or fruit drinks that are not 

100% fruit juice (for example, Kool-Aid, Sunny Delight, Hi-C, Fruitopia, or Fruitworks)?

1 Child did not drink any during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED 

Revised Q4. During the past 7 days, including school activities, play dates, sports, and the 

weekend, how many times did your child drink Soda pop (for example, Coke, Pepsi, or 

Mountain Dew), sports drinks (for example, Gatorade), or fruit drinks that are not 100% fruit 

juice (for example, Kool-Aid, Sunny Delight, Hi-C, Fruitopia, or Fruitworks)?

1 Child did not drink any during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED 

Rationale: In addition to the prompting statement described above, no changes are 

recommended. It should be mentioned that findings in both waves of the study indicate that this 

question does have some sensitive aspects for parents, ones that may cause them to talk a good 

diet and underestimate the number of sodas their child consumed. 

41
Q5. During the past 7 days, how many times did your child eat fresh fruit such as apples, 

bananas, oranges, berries, or other fruit such as applesauce, canned peaches, canned fruit 

cocktail, or frozen berries? (Do not count fruit juice.) 

1 Child did not eat fruit during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED

 Revised Q5. During the past 7 days, including school activities, play dates, sports, and the 

weekend, how many times did your child eat fresh fruit such as apples, bananas, oranges, berries, 

or other fruit such as applesauce, canned peaches, canned fruit cocktail, frozen berries or dried 

fruit? (Do not count fruit juice.) 

1 Child did not eat fruit during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED

Rationale: Adding the words dried fruit made the list of fruit choices complete for mothers and

provided them with an opportunity to include all fruit in their response. 

Additional recommendation: Clearer guidance on self-service snacking and how to count it 

should be developed. This was one of the most challenging questions for mothers to ask due to 

the popularity of fruit and the variability with which it was consumed by children in this age 

category. In order to address the frustration mothers experienced when tallying the fruit for the 

times per day option and to address underestimates, guidance on the accuracy desired for the 

response would be helpful. Specifically, mothers need some direction on how to calculate a 

“time” for self-service snacking. 

42
Q6. During the past 7 days, how many times did your child eat green salad?

1 Child did not eat green salad during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED

Revised Q6. During the past 7 days, including school activities, play dates, sports, and the

weekend, how many times did your child eat green salad? 

1 Child did not eat green salad during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED 

Rationale: In addition to the prompting statement described above, no changes are 

recommended. 

43
Q7. During the past 7 days, how many times did your child eat potatoes? (DO NOT count

French Fries, fired potatoes, or potato chips). 

1 Child did not eat potatoes during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED 

Revised Q7. During the past 7 days, including school activities, play dates, sports, and the 

weekend, how many times did your child eat potatoes? (DO NOT count French Fries, fried 

potatoes, potato chips, tater tots, or sweet potatoes). 

1 Child did not eat potatoes during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED 

Rationale: In addition to the prompting statement described above, adding the wording tater tots 

and sweet potatoes assisted mothers in knowing what kinds of potatoes to exclude from their 

response to this question. 

44
Q8. During the past 7 days, how many times did your child eat carrots?

1 Child did not eat carrots during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED 

Revised Q8. During the past 7 days, including school activities, play dates, sports, and the 

weekend, how many times did your child eat carrots?

1 Child did not eat carrots during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED

Rationale: In addition to the prompting statement described above, no changes are 

recommended. 

45
Q9. During the past 7 days, how many times did your child eat other vegetables? (DO NOT 

count green salad, potatoes, French fries, or carrots.) 

1 Child did not eat other vegetables during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED

Revised Q9. During the past 7 days, including school activities, play dates, sports, and the 

weekend, how many times did your child eat other vegetables? (DO NOT count green salad, 

potatoes, French fries, or carrots.) 

1 Child did not eat other vegetables during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED

Rationale: In addition to the prompting statement described above, better wording or clearer 

instruction should be provided for Q 9 to help mothers know how to classify vegetables served in 

mixes, or as the main component of a main dish need to be added based on the findings of both 

Wave 1 and Wave 2. This clarification would help mothers to produce more accurate counts to 

incorporate in their responses. The recommended statement is phrased as “Include vegetables 

like those served as a stir fry, soup or stew in your response.”

46
Q10. During the past 7 days, about how many times did your child eat a meal or snack from a

fast food restaurant such as McDonald’s Pizza Hut, Burger King, KFC (Kentucky Fried 

Chicken), Taco Bell, Wendy’s and so on? Would you say?

1 Child did not eat food from a fast food restaurant during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED 

Revised Q10. During the past 7 days, including school activities, play dates, sports, and the 

weekend about how many times did your child eat a meal or snack from a fast food restaurant 

with no wait service such as McDonald’s, Pizza Hut, Burger King, KFC (Kentucky Fried 

Chicken), Taco Bell, Wendy’s and so on? Consider both eating out, carry out and delivery of 

meals in your response. Would you say: 

1 Child did not eat food from a fast food restaurant during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED 

Rationale: The addition of this language appeared work well in clarifying the kinds of places 

mothers should consider in answering the question about fast food. In particular, focus group 

respondents did not seem to struggle with including any meal that their child had eaten out at any 

type of restaurant in their response to the revised question. This wording seemed to alleviate 

mothers conceptualizing fast food as any eating outside of the home. 

47
Q11. During the past 7 days, how many times did your child eat candy, ice cream, cookies, 

cakes, brownies, or other sweets? Would you say: 

1 Child did not eat sweets during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED

Revised Q11. During the past 7 days, including afterschool activities, sports, and the weekend, 

how many times did your child eat candy (including Fruit Roll Ups and similar items), ice cream,

cookies, cakes, brownies, or other sweets? Would you say: 

1 Child did not eat sweets during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED 

Rationale: In addition to the prompting statement described above, adding the wording "Fruit 

Roll-Ups or similar snacks" helped mothers to know where to classify these food items. 

Reporting for sweet snacks was a sensitive topic, one that may be subject to underestimates. In 

describing their answers, mothers repeated their practices of trying not to offer too many of these 

items to their child, perhaps in an effort to talk a good diet. As one respondent put it, “parents 

know their kids aren’t supposed to have a lot of snacks, but they do serve them and there is some

guilt there.” [not really clear what this means] A few respondents suggested that framing the 

question responses as averages or what is normal consumption would help relieve some of the 

sensitivity associated with this question. 

48
Q12. During the past 7 days, how many times did your child eat potato chips, corn chips (Fritos, 

Doritos), Cheetos, pretzels, popcorn, crackers or other salty snack foods? 

1 Child did not eat salty snack foods during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED

Revised Q12. During the past 7 days, including school activities, play dates, sports, and the 

weekend how many times did your child eat potato chips, corn chips (Fritos, Doritos), Cheetos, 

pretzels, popcorn, crackers or other salty snack foods?

1 Child did not eat salty snack foods during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED

Rationale: In addition to the prompting statement described above, no other changes are 

recommended. However, it should be noted that some mothers in both waves of the study 

perceived this question as sensitive. These mothers felt that some of the snacks on the list were 

"better" for their child than others and did not want to classify them with items such as Doritos, 

potato chips, or Cheetos. 

49
Q13. During the past 7 days, how many times did your child eat French fries or fried potatoes? 

1 Child did not eat French fries or fried potatoes during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED 

Revised Q13. During the past 7 days, including school activities, play dates, sports, and the 

weekend, how many times did your child eat French fries or fried potatoes? 

1 Child did not eat French fries or fried potatoes during the past 7 days. 

2 1 to 3 times during the past 7 days. 

3 4 to 6 times during the past 7 days. 

4 1 time per day. 

5 2 times per day. 

6 3 times per day. 

7 4 or more times per day. 

DK DON’T KNOW 

RF REFUSED 

Rationale: In addition to the prompting statement described above, this question should be 

moved to appear after the potato question, and be the new Question 8. Mothers in Wave 2 

recommended that this question be paired conceptually with the question on potatoes. They 

suggested that such a pairing would help mothers answer the question by making it easier to 

recall and answer questions on potato consumption. Also moving the question to follow after the 

original question 7 lessens the probability that mothers who answered the fast food question will 

view this question as asking for the same information (a few mothers in wave two focus group 

did believe that the fast food question and the question on fried potatoes referred to the exact 

same foods and viewed them as repetitive).

50
APPENDIX A: WAVE 1 DATA COLLECTION GUIDES 

A. Cognitive Interview Guide 

B. Focus Group Moderator’s Guide
WAVE 1:COGNITIVE INTERVIEW GUIDE

Date: Interview Time:Interviewee Name: Interviewer: Case ID: Completed and collected consent form:Number of children in K/Grade 1 Number of children in other grades Total number of children 

INTERVIEWER SCRIPT: GENERAL INTRODUCTION [In today’s interview, I am going to ask you some questi

food your child consumes. The purpose of the interview is to see how well the questions can be answered, so twrong answers. I’d like for your to take your time when necessary to, so that you can think about your answer. 

questions, I am going to ask you a few follow up questions. In the second part of this interview, we are going to and I’m going to ask you to describe how you arrived your answer, or determined how to respond to the questioWhile we are discussing the questions, I am going to be recording this interview. The recording is to help me mcaptured all of your responses. The recording will only be used for data analysis and will be kept confidential. Dobjections to recording your interview? ] 

NOTE OBJECTIONS:
Part I Part II Answer/Additiona

Probes 

 In question 1 (interviewer reads 

question again) your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 

1. During the past 7 days, how many glasses of milk did your child drink? Include all types of milk, including cow’s milk, soy milk or any other kind of milk; include the milk your child drank in a glass or cup, from a carton, or withcereal. Count the half pint of milk served atschool as equal to one glass. 

1 Child did not drink milk during the past 7 days. 2 1 to 3 glasses during the past 7 days. 3 4 to 6 glasses during the past 7 days. 4 1 glass per day. 5 2 glasses per day. 6 3 glasses per day. 7 4 or more glasses per day. DK DON’T KNOW 

RF REFUSED

1. What you were thinking about 

as you answered the question? 

2. What helped you to recall how 

much milk your child consumed? 

3⁄4 How did you determine the 

number of glasses your child consumed per day? 

How easy is it to answer this question? Is it really easy, somewhat easy, or not at all easy? 

3. How do you know how much 

milk your child may have drunk away from home? 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

4. If more than one child: 

What helps you to recall what this K/Grade 1 child drank incomparison to what your other child may have consumed? 

5. What was most difficult about 

answering this question? What would you change about it? 
Part I Part II Answer/Additiona

Probes 

6 What was difficult about the 

response options that were read to you? What would you change? 

2. What kind of milk did your child usually(most often) drink during the past 7 days? 

1 Whole milk 2 2% milk. 3 Skim milk. 4 Low fat or 1% milk. 5 Soy milk. 6 Both regular milk and soy milk. 7 Some other kind of milk. DK DON’T KNOW 

 RF REFUSED 

In question 2 (interviewer reads question again) your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 

How easy is it to answer this question? Is it really easy, somewhat easy, or not at all easy? 

1. What you were thinking about 

as you answered the question? 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

2. What helped you to recall the 

type of milk your child consumed? 

3. What did regular milk mean to 

you? 

4. What was most difficult about 

answering this question? What 
Part I Part II Answer/Additiona

Probes 

would you change about it? 

5. What was difficult about the 

response options that were read to you? 

 In question 3 (interviewer reads question again) your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 

3. During the past 7 days, how many times did your child drink 100% fruit juices such as orange juice, apple juice, or grape juice? Donot count punch, Sunny Delight, Kool-Aid, sports drinks, or other fruit-flavored drinks. 1 Child did not drink 100% fruit juice during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 4 1 time per day. 5 2 times per day. 6 3 times per day. 7 4 or more times per day. DK DON’T KNOW RF REFUSED 

1. What you were thinking about 

as you answered the question? 

2. What helped you to recall how 

much 100% fruit juice your child consumed? 

3⁄4 How did you determine the 

number of servings your child consumed per day? 

How easy is it to answer this question? Is it really easy, somewhat easy, or not at all easy? 

3. What specific 100% fruit juice 

drinks were you thinking of in your answer? 
Part I Part II Answer/Additiona

Probes 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

4. How do you know how much 

100% fruit juice your child may have drunk away from home? 

5. If more than one child: 

What helps you to recall what this K/Grade 1 child drank incomparison to what your other child may have consumed? 

6. What was most difficult about 

answering this question? What would you change about it? 

7 What was difficult about the 

response options that were read to you? 

4. During the past 7 days, how many times did your child drink Soda pop (for example, Coke, Pepsi, or Mountain Dew), sports drinks (for example, Gatorade), or fruit drinks that are not 100% fruit juice (for example, Kool-Aid, Sunny Delight, Hi-C, Fruitopia, or Fruitworks)? 

1 Child did not drink any during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 4 1 time per day. 

 In question 4 (interviewer reads 

question again) your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 1. What you were thinking about 

as you answered the question? 
Part I Part II Answer/Additiona

Probes 

2. What helped you to recall how 

much Soda pop, Sport drinks, or fruit drinks that are not 100% fruit juice your child consumed? 

5 2 times per day. 6 3 times per day. 7 4 or more times per day. DK DON’T KNOW 

 RF REFUSED

8 How did you determine the 

number of servings your child consumed per day? 

How easy is it to answer this question? Is it really easy, somewhat easy, or not at all easy? 

3. What specific items were you 

thinking of in your answer? 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

4. How did you answer for time 

periods when your child is away from home?

5. If more than one child: 

What helps you to recall what this K/Grade 1 child drank incomparison to what your other child may have consumed? 

6. What was most difficult about 

answering this question? What would you change about it? 

9 What was difficult about the 

response options that were read to you? 

5. During the past 7 days, how many times didyour child eat fresh fruit such as apples,bananas, oranges, berries, or other fruit suchas applesauce, canned peaches, canned fruit

 In question 5 (interviewer reads 

question again) your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 
Part I Part II Answer/Additiona

Probes 

1. What you were thinking about 

as you answered the question? 

2. What helped you to recall how 

much (food item-fresh fruit or other fruit) your child consumed? 

10 How did you determine the 

number of servings your child consumed per day? 

cocktail, or frozen berries? (Do not count fruitjuice.) 1 Child did not eat fruit during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 4 1 time per day. 5 2 times per day. 6 3 times per day. 7 4 or more times per day. DK DON’T KNOW RF REFUSED 3. What specific foods were you 

thinking of in your answer? 

How easy is it to answer this question? Is it really easy, somewhat easy, or not at all easy? 

4. How did you answer for time 

periods when your child is away from home?

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

5. If more than one child: 

What helps you to recall what this K/Grade 1 child ate in comparison to what your other child may have consumed? 

6. What was most difficult about 

answering this question? What would you change about it? 

3⁄4 What was difficult about the 

response options that were read to you? 
Part I Part II Answer/Additiona

Probes 

 In question 6 (interviewer reads question again) your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 1. What you were thinking about 

as you answered the question? 

6. During the past 7 days, how many times did your child eat green salad? 1 Child did not eat green salad during the past 7 days.2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 4 1 time per day. 5 2 times per day. 6 3 times per day. 7 4 or more times per day. DK DON’T KNOW RF REFUSED

2. What helped you to recall how 

much (food item green salad) your child consumed? 

3⁄4 How did you determine the 

number of servings your child consumed per day? 

How easy is it to answer this question? Is it really easy, somewhat easy, or not at all easy? 

3. What specific foods were you 

thinking of in your answer? 

11 What’s a green salad? 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

4. How did you answer for time 

periods when your child is away from home?

5. If more than one child: What helps you to recall what this K/Grade 1 child ate in comparison to what your other child may have consumed? 
Part I Part II Answer/Additiona

Probes 

6. What was most difficult about 

answering this question? What would you change about it? 

3⁄4 What was difficult about the 

response options that were read to you? 

 In question 7 (interviewer reads 

question again) your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 

1. What you were thinking about 

as you answered the question? 

7. During the past 7 days, how many times did your child eat potatoes? (DO NOT count French Fries, fried potatoes, or potato chips). 1 Child did not eat potatoes during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 4 1 time per day. 5 2 times per day. 6 3 times per day. 7 4 or more times per day. DK DON’T KNOW RF REFUSED 

2. What helped you to recall how 

much (food item) your child consumed? 

3⁄4 How did you determine the 

number of servings your child consumed per day? 

How easy is it to answer this question? Is it really easy, somewhat easy, or not at all easy? 

3. How did you answer for time 

periods when your child is away from home?

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

4. If more than one child: 

What helps you to recall what this K/Grade 1 child ate in comparison 
Part I Part II Answer/Additiona

Probes 

to what your other child may have consumed? 

5. What was most difficult about 

answering this question? What would you change about it? 

3⁄4 What was difficult about the 

response options that were read to you? 

 In question 8 (interviewer reads 

question again) your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 

1. What you were thinking about 

as you answered the question? 

8. During the past 7 days, how many times did your child eat carrots? 1 Child did not eat carrots during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 4 1 time per day. 5 2 times per day. 6 3 times per day. 7 4 or more times per day. DK DON’T KNOW RF REFUSED 

2. What helped you to recall how 

much (food item) your child consumed? 

3⁄4 How did you determine the 

number of servings your child consumed per day? 

How easy is it to answer this question? Is it really easy, somewhat easy, or not at all easy? 

3. How did you answer for time 

periods when your child is away from home?
Part I Part II Answer/Additiona

Probes 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

If more than one child: 

4. What helps you to recall what 

this K/Grade 1 child ate in comparison to what your other child may have consumed? 

5. What was most difficult about 

answering this question? What would you change about it? 

3⁄4 What was difficult about the 

response options that were read to you? 

 In question 9 (interviewer reads 

question again) your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 

1. What you were thinking about 

as you answered the question? 

9. During the past 7 days, how many times did your child eat other vegetables? (DO NOTcount green salad, potatoes, French fries, or carrots.) 1 Child did not eat other vegetables during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 4 1 time per day. 5 2 times per day. 6 3 times per day. 7 4 or more times per day. DK DON’T KNOW RF REFUSED 

2. What helped you to recall how 

much (food item) your child consumed? 

3⁄4 How did you determine the 

number of servings your child consumed per day? 
Part I Part II Answer/Additiona

Probes 

3. What specific foods were you 

thinking of in your response? 

How easy is it to answer this question? Is it really easy, somewhat easy, or not at all easy? 

4. How did you answer for time 

periods when your child is away from home?

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

5. If more than one child: 

What helps you to recall what this K/Grade 1 child ate in comparison to what your other child may have consumed? 

6. What was most difficult about 

answering this question? What would you change about it? 

3⁄4 What was difficult about the 

response options that were read to you? 

 In question 10 (interviewer reads 

question again) your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 

10. During the past 7 days, about how manytimes did your child eat a meal or snack from afast food restaurant such as McDonald’s PizzaHut, Burger King, KFC (Kentucky FriedChicken), Taco Bell, Wendy’s and so on? Would you say: 

1 Child did not eat food from a fast food restaurant during the past 7 days. 

1. What you were thinking about 

as you answered the question? 
Part I Part II Answer/Additiona

Probes 

2. What helped you to recall how 

much (food item) your child consumed? 

3⁄4 How did you determine the 

number of servings your child consumed per day? 

3. What specific foods were you 

thinking of in your response? 

2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 4 1 time per day. 5 2 times per day. 6 3 times per day. 7 4 or more times per day. DK DON’T KNOW 

 RF REFUSED

4. How did you answer for time 

periods when your child is away from home?

How easy is it to answer this question? Is it really easy, somewhat easy, or not at all easy? 

5. If more than one child: 

3⁄4 What helps you to recall what 

this K/Grade 1 child ate in comparison to what your other child may have consumed? 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

6. What was most difficult about 

answering this question? What would you change about it? 

12 What was difficult about the 

response options that were read to you? 
Part I Part II Answer/Additiona

Probes 

 In question 11 (interviewer reads 

question again) your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 

1. What you were thinking about 

as you answered the question? 

11. During the past 7 days, how many timesdid your child eat candy, ice cream, cookies, cakes, brownies, or other sweets? Would yousay:

1 Child did not eat sweets during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 4 1 time per day. 5 2 times per day. 6 3 times per day. 7 4 or more times per day. DK DON’T KNOW 

RF REFUSED

2. What helped you to recall how 

much (food item) your child consumed? 

3⁄4 How did you determine the 

number of servings your child consumed per day? 

How easy is it to answer this question? Is it really easy, somewhat easy, or not at all easy? 

3. What specific foods were you 

thinking of in your response? 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

4. How did you answer for time 

periods when your child is away from home?

5. If more than one child: 

What helps you to recall what this K/Grade 1 child ate in comparison to what your other child may have consumed? 
Part I Part II Answer/Additiona

Probes 

6. What was most difficult about 

answering this question? What would you change about it? 

3⁄4 What was difficult about the 

response options that were read to you? 

 In question 12 (interviewer reads 

question again) your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 

1. What you were thinking about 

as you answered the question? 

2. What helped you to recall how 

much (food item) your child consumed? 

3⁄4 How did you determine the 

number of servings your child consumed per day? 

13. During the past 7 days, how many times 

did your child eat potato chips, corn chips (Fritos, Doritos), Cheetos, pretzels,popcorn, crackers or other salty snack foods? 

1 Child did not eat salty snack foods during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 4 1 time per day. 5 2 times per day. 6 3 times per day. 7 4 or more times per day. DK DON’T KNOW RF REFUSED 

3. What specific foods were you 

thinking of in your response? 

How easy is it to answer this question? Is it really easy, somewhat easy, or not at all easy? 

4. How did you answer for time 

periods when your child is away from home?
Part I Part II Answer/Additiona

Probes 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

5. If more than one child: 

3⁄4 What helps you to recall what 

this K/Grade 1 child ate in comparison to what your other child may have consumed? 

6. What was most difficult about 

answering this question? What would you change about it? 

3⁄4 What was difficult about the 

response options that were read to you? 

 In question 13 (interviewer reads 

question again) your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 

1. What you were thinking about 

as you answered the question? 

14. During the past 7 days, how many times 

did your child eat French fries or fried potatoes? 

1 Child did not eat French fries or fried potatoes during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 4 1 time per day. 5 2 times per day. 6 3 times per day. 7 4 or more times per day. DK DON’T KNOW RF REFUSED 

2. What helped you to recall how 

much (food item) your child consumed? 

3⁄4 How did you determine the 

number of servings your child consumed per day? 
Part I Part II Answer/Additiona

Probes 

How easy is it to answer this question? Is it really easy, somewhat easy, or not at all easy? 

3. How did you answer for time 

periods when your child is away from home?

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

4. If more than one child: 

What helps you to recall what this K/Grade 1 child ate in comparison to what your other child may have consumed? 

5. What was most difficult about 

answering this question? What would you change about it? 

3⁄4 What was difficult about the 

response options that were read to you? 
B. Focus Group Moderator’s Guide
WAVE 1 FOCUS GROUP GUIDE: 

(Mothers of K/Grade 1 ECLS-B Child Habits Study)

I. Study Objectives: 

1. Do the respondents interpret the questions, as asked, in the manner intended by ERS?

If not, are there changes in wording that will improve understanding? 

2. Are the response options suggested by ERS appropriate? Are respondents able to use

these response options to describe their children’s behavior? If not, are there changes 

in response options that would be more appropriate? 

3. What time period do respondents feel more comfortable with, in responding to the

questions—past 24 hours, the past week, or the past month?

II. Introduction: 

Thank you for joining us for today’s focus group on questions mothers can answer about their 

kindergarten/first grade child’s eating habits. Today we are going to be talking about the eating 

habits of your children – those in kindergarten and 1st grade. We have a set of questions for 

mothers to answer about certain types of food that your children may eat, and we are interested 

in whether or not these questions are ones mothers can answer easily and accurately. 

III. Purpose: 

These are preliminary questions that you can help us improve. Today, you’ll be helping us by 

answering some questions on how you recall what your child ate, what kinds of foods you think 

of when asked to respond to certain questions, sharing with us how you came up with your 

answers and what things would make it easier for you to answer the questions. With your help, 

the questions that are used in a national survey will be improved. 

My name is , and I am from ORC Macro, the research firm that has been hired to help 

test these questions. As the moderator for today, my role is to encourage the discussion by 

asking questions. I’d like to outline some guidelines that will help this discussion. 

• You have been asked here to offer your views and opinions; everyone's 

participation and viewpoints are important: there are no right or wrong answers. 

• Detailed explanations are desired. 

• Please speak one at a time, so that we can all hear and understand the 

conversation

• You are being audio-taped and videotaped today 

• All of your answers will remain confidential, so feel free to speak your mind. Our 

review of your answers will report findings as aggregate data. 

IV. Icebreaker: 

1
Before we begin, I’d like to ask everyone to first introduce themselves. Please introduce yourself 

and tell us what grade your child is in, and what their favorite food is. 

V. Research Questions (Mothers respond to set of test questions in writing): 

Review of the Test Set Questions:

[Instructions (paraphrase)]: “Now I have some questions about how often your children drink 

or eat certain things. I will read a question and give you each a moment to think about the 

question. Please indicate your answer on the sheet I have provided. Please answer the 

question to the best of your ability. When you’re done answering all of the questions, we’ll 

talk about your questions and your answers. Do you have any questions about this process? 

[Moderator distributes test questions sheets and pencils to group. Reads set of test 

questions. If participants ask what the question means, reply with: 

“I can’t help you interpret the question or tell you what it means; because that’s 

one of the things we want to learn today. So, use your best judgment and after 

everyone has a chance to answer the question, we’ll talk about what it means.”] 

VI. Discussion of Mothers’ Comprehension of the Questions:

[Instructions (paraphrase)]: “Now let’s talk about what you thought these questions were asking 

– or what it meant to you. We can talk about words that may have been confusing, or difficulty 

you had in figuring out whether a certain food is or is not included, and so on. Let’s start with 

question 1.”

Probes: Interviewer should cover the following topics (do not need to cover each topic in 

detail for each question, if the topic was discussed earlier): 

• How did you answer Question 1? (Ask mothers to provide their answers for all the 

questions, and have following discussion for each question, as appropriate)

• How did you know what your K/Grade 1 child eats and how much this child eats? (Probe: 

Ask mothers to describe how they arrived at their answer, including how mother arrived at 

the exact amount of food/drink stated in the answer) 

• What food items were your thinking about when you answered the question about your 

child’s consumption? [Ask for examples of items described by the term (e.g., “what are the 

names of other kinds of [term] that you think of?”)] 

• What was difficult about this question (Probe for explanations of the difficulties)

2
• What kind of milk were you thinking of in answering the question?(Probe for Yohoo as milk) 

• What drinks do you think of when someone says 100% fruit juice? How do you know they 

are 100% fruit juice? 

• What drinks are not 100% fruit juice? (Probe for examples). How do you know? 

• What’s a sports drink? 

• What is a green salad? What’s included? Did you include these vegetables in other

responses?

• What are salty snack foods? 

• When you answered the question about other vegetables, what kinds of food were you 

thinking about? (Probe for combinations, such as vegetables in soups or stews)

• What do you consider fried potatoes or French fries to be? (Vegetable, potatoes etc.. Probe 

for where parents count these foods). 

VII. Mothers’ Ability to Use Response Options 

• How often are you typically asked to recall what your child ate? 

• For what period of time can you best recall what your K/grade 1 child ate? (Probe for time

period) 

• (Follow-up probe) Can you recall what your child ate for the last 7 days? How do you do 

this? (Probe for contextual cue that assist in recall). 

• When you selected an option that was the 7-day period, what 7 days did you include in your 

answer? 

• How did you arrive at an option/ amount for 7 days? 

• How did you arrive at the number of times your child consumed an item per day? 

• Tell me how you know what foods your child has eaten while they are away from home? 

(Probes: Do you regularly ask your child what they ate at school? Do they come home and 

report? Lunch box checking/lunch money?)

VIII. General Questions 

• How does having more than one child complicate your ability to recall what your K/G1 child 

ate? 

3
• Can you think of a better way to ask/answer any of these questions? 

• What would you change about the response options in these questions?

• What would improve your understanding of the questions? 

IX. False Close 

Moderator briefly leaves room to ask project director if there are any other questions that remain 

unanswered or require further probing. 

X. Conclusion and Thank you

4
APPENDIX B: WAVE 2 DATA COLLECTION GUIDES 

A. Cognitive Interview Guide 

B. Focus Group Moderator’s Guide
WAVE 2 COGNITIVE INTERVIEW GUIDE 

Date: Interview Time:Interviewee Name: Interviewer:Case ID: Completed and collected consent form:Number of children in K/Grade 1 Number of children in other grades Total number of children 

INTERVIEWER SCRIPT: GENERAL INTRODUCTION [In today’s interview, I am going to ask you som

the kinds of food your child consumes. The purpose of the interview is to see how well the questions c

so there are no right or wrong answers. I’d like for your to take your time when necessary to, so that yyour answer. After you answer the questions, I am going to ask you a few follow up questions. In the sinterview, we are going to review your answers, and I’m going to ask you to describe how you arrived ydetermined how to respond to the question. While we are discussing the questions, I am going to be recording this interview. The recording is to hthat I have captured all of your responses. The recording will only be used for data analysis and will b

Do you have any objections to recording your interview? ] 

NOTE OBJECTIONS:
Part I Part II Answer

 In question 1 (interviewer reads question again)

your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. • What you were thinking about as you 

answered the question? 

• What helped you to recall how much milk your 

child consumed? 

• How did you determine the number of servings 

your child consumed per day? 

• How do you know how much milk your child 

may have drunk away from home? 

• How was the milk your child drank away from 

home included as a part of your response? 

1. During the past 7 days, including afterschoolactivities, sports, and the weekend, how many glasses of milk did your child drink? Include alltypes of milk, including cow’s milk, soy milk or any other kind of milk; include the milk your childdrank in a glass or cup, from a carton, or with cereal. Count the half pint of milk served atschool as equal to one glass. 

1 Child did not drink milk during the past 7 days. 2 1 to 3 glasses during the past 7 days. 3 4 to 6 glasses during the past 7 days. 6 1 glass per day. 

7 1 to 2 glasses per day 6 2 glasses per day. 7 3 glasses per day. 8 4 or more glasses per day.DK DON’T KNOW 

RF REFUSED

• How did you include times such as after school 

activities, sports, playdates/daycare, or weekends in your response? 

How easy is it to answer this question? Is it reallyeasy, somewhat easy, or not at all easy? 

• If more than one child: • What helps you to recall what this K/Grade 1 

child drank in comparison to what your other child may have consumed?
Part I Part II Answer

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

• What was most difficult about answering this 

question? What would you change about it? 

• What was difficult about the response options 

that were read to you? 

• Is it easier to answer for consumption per day, 

or times per week? Why?

In question 2 (interviewer reads question again)your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 6. What you were thinking about as you 

answered the question? 

2. What kind of milk did your child usually (mostoften) drink during the past 7 days? 

1 Whole milk 2 2% milk. 3 Skim milk. 4 Low fat or 1% milk. 5 Soy milk. 

6 Both regular cow’s milk and soy milk. 7 Some other kind of milk. DK DON’T KNOW 

 RF REFUSED 

• What helped you to recall the type of milk your 

child consumed? 
Part I Part II Answer

How easy is it to answer this question? Is it reallyeasy, somewhat easy, or not at all easy? 

• What did regular cow’s milk mean to you? 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

• What was most difficult about answering this 

question? What would you change about it? 

• What was difficult about the response options 

that were read to you? 

3. During the past 7 days, including afterschool activities, sports, and the weekend, how many times did your child drink 100% fruit juices suchas orange juice, apple juice, or grape juice? Donot count punch, Sunny Delight, Kool-Aid, sports 

 In question 3 (interviewer reads question again)your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 
Part I Part II Answer

• What you were thinking about as you 

answered the question? 

• What helped you to recall how much 100% fruit 

juice your child consumed?

• How did you determine the number of servings 

your child consumed per day? 

• What specific 100% fruit juice drinks were you 

thinking of in your answer?

• How do you know how much 100% fruit juice 

your child may have drunk away from home? 

• How was the 100% fruit juice your child drank 

away from home included as a part of your response? 

drinks, or other fruit-flavored drinks. 1 Child did not drink 100% fruit juice duringthe past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 11 1 time per day. 12 1 to 2 times per day 6 2 times per day. 7 3 times per day. 8 4 or more times per day. DK DON’T KNOW RF REFUSED 

• How did you include times such as after school 

activities, sports, playdates/daycare, or weekends in your response? 

How easy is it to answer this question? Is it reallyeasy, somewhat easy, or not at all easy? 

• If more than one child: • What helps you to recall what this K/Grade 1 

child drank in comparison to what your other child may have consumed?

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

• What was most difficult about answering this 

question? What would you change about it? 
Part I Part II Answer

• Is it easier to answer for consumption per day, 

or times per week? Why? 

• In question 4 (interviewer reads question 

again) your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 

• What you were thinking about as you 

answered the question? 

• What helped you to recall how much Soda pop, 

Sport drinks, or fruit drinks that are not 100% fruit juice your child consumed? 

• How did you determine the number of servings 

your child consumed per day? 

• What specific items were you thinking of in 

your answer?

4. During the past 7 days, including afterschool activities, sports, and the weekend, how many times did your child drink Soda pop (for example,Coke, Pepsi, or Mountain Dew), sports drinks (for example, Gatorade), or fruit drinks that are not 100% fruit juice (for example, Kool-Aid, Sunny Delight, Hi-C, Fruitopia, or Fruitworks)? 

1 Child did not drink any during the past 7 days. 

2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 13 1 time per day. 14 1 to 2 times per day 6 2 times per day. 7 3 times per day. 8 4 or more times per day. DK DON’T KNOW RF REFUSED 

• How did you answer for time periods when 

your child is away from home? 

• How were the Soda pop, Sport drinks, or fruit 

drinks that are not 100% fruit juice that your child drank away from home included as a part of your response? 

How easy is it to answer this question? Is it reallyeasy, somewhat easy, or not at all easy? 

• How did you include times such as after school 

activities, sports, playdates/daycare, or weekends in your response? 
Part I Part II Answer

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

• If more than one child: • What helps you to recall what this K/Grade 1 

child drank in comparison to what your other child may have consumed?

• What was most difficult about answering this 

question? What would you change about it? 

• What was difficult about the response options 

that were read to you? 

• Is it easier to answer for consumption per day, 

or times per week? Why? 

 In question 5 (interviewer reads question again)

your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. • What you were thinking about as you 

answered the question? 

• What helped you to recall how much (food 

item-fresh fruit or other fruit) your child consumed? 

• How did you determine the number of servings 

your child consumed per day? 

5. During the past 7 days, including afterschool activities, sports, and the weekend, how many times did your child eat fresh fruit such as apples,bananas, oranges, berries, or other fruit such asapplesauce, canned peaches, canned fruitcocktail, or frozen berries? (Do not count fruitjuice.) 1 Child did not eat fruit during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 6 1 time per day. 7 1 to 2 times per day 6 2 times per day. 7 3 times per day. 8 4 or more times per day. DK DON’T KNOW 

• What specific foods were you thinking of in 

your answer?
Part I Part II Answer

RF REFUSED • How did you answer for time periods when 

your child is away from home? 

• How were the fresh fruits that your child ate 

away from home included as a part of your response? 

How easy is it to answer this question? Is it reallyeasy, somewhat easy, or not at all easy? 

• How did you include times such as after school 

activities, sports, playdates/daycare, or weekends in your response? 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

• If more than one child: • What helps you to recall what this K/Grade 1 

child ate in comparison to what your other child may have consumed? 

• What was most difficult about answering this 

question? What would you change about it? 

• What was difficult about the response options 

that were read to you? 

• Is it easier to answer for consumption per day, 

or times per week? Why? 

 In question 6 (interviewer reads question again)your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 

6 During the past 7 days, including afterschoolactivities, sports, and the weekend, how many times did your child eat green salad? 1 Child did not eat green salad during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 

• What you were thinking about as you 

answered the question? 
Part I Part II Answer

• What helped you to recall how much (food item 

green salad) your child consumed? 

• How did you determine the number of servings 

your child consumed per day? 

6 1 time per day. 7 1 to 2 times per day 6 2 times per day. 7 3 times per day. 8 4 or more times per day. DK DON’T KNOW RF REFUSED

• What specific foods were you thinking of in 

your answer?

• What’s a green salad? 

How easy is it to answer this question? Is it reallyeasy, somewhat easy, or not at all easy? 

• How did you answer for time periods when 

your child is away from home? 

• How was the green salad that your child ate 

away from home included as a part of your response? 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

• How did you include times such as after school 

activities, sports, playdates/daycare, or weekends in your response? 

• If more than one child: • What helps you to recall what this K/Grade 1 

child ate in comparison to what your other child may have consumed? 

• What was most difficult about answering this 

question? What would you change about it? 

• What was difficult difficult about the response 

options that were read to you? 

• Is it easier to answer for consumption per day, 

or times per week? Why? 
Part I Part II Answer

 In question 7 (interviewer reads question again)

your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. • What you were thinking about as you 

answered the question? 

• What helped you to recall how much (food 

item) your child consumed? 

• How did you determine the number of servings 

your child consumed per day? 

7. During the past 7 days, including afterschool activities, sports, and the weekend, how many times did your child eat potatoes? (DO NOT count French Fries, fried potatoes, potato chips or sweet potatoes). 1 Child did not eat potatoes during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 6 1 time per day. 7 5 1 to 2 times per day 6 2 times per day. 7 3 times per day. 8 4 or more times per day. DK DON’T KNOWRF REFUSED 

• How did you answer for time periods when 

your child is away from home? 

• How were the potatoes that your child ate 

away from home included as a part of your response? 

How easy is it to answer this question? Is it reallyeasy, somewhat easy, or not at all easy? 

• How did you include times such as after school 

activities, sports, playdates/daycare, or weekends in your response? 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

• If more than one child: • What helps you to recall what this K/Grade 1 

child ate in comparison to what your other child may have consumed? 

• What was most difficult about answering this 

question? What would you change about it? 
Part I Part II Answer

• What was difficult about the response options 

that were read to you? 

• Is it easier to answer for consumption per day, 

or times per week? Why? 

 In question 8 (interviewer reads question again)

your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. • What you were thinking about as you 

answered the question? 

• What helped you to recall how much (food 

item) your child consumed? 

• How did you determine the number of servings 

your child consumed per day? 

8. During the past 7 days, including afterschool activities, sports, and the weekend, how many times did your child eat carrots? 1 Child did not eat carrots during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 6 1 time per day 7 1 to 2 times per day. 6 2 times per day. 7 3 times per day. 8 4 or more times per day. DK DON’T KNOW RF REFUSED 

• How did you answer for time periods when 

your child is away from home? 

• How were the carrots that your child ate away 

from home included as a part of your response? 

How easy is it to answer this question? Is it reallyeasy, somewhat easy, or not at all easy? 

• How did you include times such as after school 

activities, sports, playdates/daycare, or weekends in your response? 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

• If more than one child: • What helps you to recall what this K/Grade 1 

child ate in comparison to what your other child may have consumed? 
Part I Part II Answer

• What was most difficult about answering this 

question? What would you change about it? 

• What was difficult about the response options 

that were read to you? 

• Is it easier to answer for consumption per day, 

or times per week? Why?

 In question 9 (interviewer reads question again)

your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. • What you were thinking about as you 

answered the question? 

• What helped you to recall how much (food 

item) your child consumed? 

• How did you determine the number of servings 

your child consumed per day? 

9. During the past 7 days, including afterschool activities, sports, and the weekend, how many times did your child eat other vegetables, such assweet potatoes or broccoli? (DO NOT count green salad, potatoes, French fries, or carrots.) 1 Child did not eat other vegetables during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 15 1 time per day. 16 1 to 2 times per day. 6 2 times per day. 7 3 times per day. 8 4 or more times per day. DK DON’T KNOW RF REFUSED • What specific foods were you thinking of in your response? How easy is it to answer this question? Is it reallyeasy, somewhat easy, or not at all easy? 

• How did you answer for time periods when 

your child is away from home? 

• How were the other vegetables that your child 

ate away from home included as a part of your response? 
Part I Part II Answer

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

• How did you include times such as after school 

activities, sports, playdates/daycare, or weekends in your response? 

• If more than one child: What helps you to recall what this K/Grade 1 child ate in comparison to what your other child may have consumed? • What was most difficult about answering this 

question? What would you change about it? 

• What was difficult about the response options 

that were read to you? 

• Is it easier to answer for consumption per day, 

or times per week? Why?

2 In question 10 (interviewer reads question again) 

your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. 

10. During the past 7 days, including afterschoolactivities, sports, and the weekend, about how many times did your child eat a meal or snack from a fast food restaurant with no wait servicesuch as McDonald’s Pizza Hut, Burger King, KFC (Kentucky Fried Chicken), Taco Bell, Wendy’sand so on? Would you say: 

1 Child did not eat food from a fast food 

• What you were thinking about as you 

answered the question? 
Part I Part II Answer

• What helped you to recall how much (food 

item) your child consumed? 

• How did you determine the number of servings 

your child consumed per day? 

• What specific foods were you thinking of in 

your response? 

restaurant during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 4 1 time per day. 5. 1 to 2 times per day.6 2 times per day.7 3 times per day. 8 4 or more times per day. DK DON’T KNOW 

 RF REFUSED • How did you answer for time periods when 

your child is away from home? 

How easy is it to answer this question? Is it reallyeasy, somewhat easy, or not at all easy? 

• How did you include times such as after school 

activities, sports, playdates/daycare, or weekends in your response? 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

• If more than one child: What helps you to recall what this K/Grade 1 child ate in comparison to what your other child may have consumed? • What was most difficult about answering this 

question? What would you change about it? 

• What was difficult about the response options 

that were read to you? 

• Is it easier to answer for consumption per day, 

or times per week? Why? 
Part I Part II Answer

 In question 11 (interviewer reads question again) 

your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. • What you were thinking about as you 

answered the question? 

• What helped you to recall how much (food 

item) your child consumed? 

• How did you determine the number of servings 

your child consumed per day? 

• What specific foods were you thinking of in 

your response? 

11. During the past 7 days, including afterschoolactivities, sports, and the weekend, how many times did your child eat candy (including fruit rollups and similar items), ice cream, cookies, cakes, brownies, or other sweets? Would you say:

1 Child did not eat sweets during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 4 1 time per day. 

 5 1 to 2 times per day. 6 2 times per day.  7 3 times per day.  8 4 or more times per day. DK DON’T KNOW 

RF REFUSED • How did you answer for time periods when 

your child is away from home? 

• How was the candy, ice cream, cookies, cakes,

brownies, or other sweets that your child ate away from home included as a part of your response? 

How easy is it to answer this question? Is it reallyeasy, somewhat easy, or not at all easy? 

• How did you include times such as after school 

activities, sports, playdates/daycare, or weekends in your response? 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

• If more than one child: What helps you to recall what this K/Grade 1 child ate in comparison to what your other child may have consumed? • What was most difficult about answering this 

question? What would you change about it? 

• What was difficult about the response options 
Part I Part II Answer

that were read to you? 

• Is it easier to answer for consumption per day, 

or times per week? Why? 

 In question 12 (interviewer reads question again) 

your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. • What you were thinking about as you 

answered the question? 

• What helped you to recall how much (food 

item) your child consumed? 

• How did you determine the number of servings 

your child consumed per day? 

• What specific foods were you thinking of in 

your response? 

• How did you answer for time periods when 

your child is away from home? 

• How were the salty snack foods your child ate 

away from home included as a part of your response? 

14. During the past 7 days, including afterschool

activities, sports, and the weekend, how many times did your child eat potato chips, corn chips (Fritos, Doritos), Cheetos, pretzels, popcorn, crackers or other salty snack foods?

1 Child did not eat salty snack foods during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 6 1 time per day. 7 1 to 2 times per day 6 2 times per day. 7 3 times per day. 8 4 or more times per day. DK DON’T KNOW RF REFUSED 

• How did you include times such as after school 

activities, sports, playdates/daycare, or weekends in your response? 
Part I Part II Answer

How easy is it to answer this question? Is it reallyeasy, somewhat easy, or not at all easy? 

• If more than one child: What helps you to recall what this K/Grade 1 child ate in comparison to what your other child may have consumed? 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure? 

• What was most difficult about answering this 

question? What would you change about it? 

• What was difficult about the response options 

that were read to you? 

• Is it easier to answer for consumption per day, 

or times per week? Why? 

 In question 13 (interviewer reads question again) 

your answer was (interviewer reads respondent’s answer). Please tell me how you decided on your answer. • What you were thinking about as you 

answered the question? 

• What helped you to recall how much (food 

item) your child consumed? 

• How did you determine the number of servings 

your child consumed per day? 

15. During the past 7 days, including afterschool

activities, sports, and the weekend, how many times did your child eat French fries or fried potatoes? 

1 Child did not eat French fries or fried potatoes during the past 7 days. 2 1 to 3 times during the past 7 days. 3 4 to 6 times during the past 7 days. 6 1 time per day. 7 1 to 2 times per day. 6 2 times per day. 7 3 times per day. 8 4 or more times per day. DK DON’T KNOW RF REFUSED • How did you answer for time periods when 

your child is away from home? 

• How were the French fries or fried potatoes 

your child ate away from home included as a part of your response? 
Part I Part II Answer

How easy is it to answer this question? Is it reallyeasy, somewhat easy, or not at all easy? 

• How did you include times such as after school 

activities, sports, playdates/daycare, or weekends in your response? 

How sure are you of your response? Are you really sure, somewhat sure, or not so sure?

• If more than one child: What helps you to recall what this K/Grade 1 child ate in comparison to what your other child may have consumed? • What was most difficult about answering this 

question? What would you change about it? 

• What was difficult about the response options 

that were read to you? 

• Is it easier to answer for consumption per day, 

or times per week? Why? 
B. Wave 2 Focus Group Moderator’s Guide 

 20
WAVE 2 FOCUS GROUP GUIDE: 

(Mothers of K/Grade 1 ECLS-B Child Habits Study)

I. Study Objectives: 

1. Do the respondents interpret the questions, as asked, in the manner intended by ERS?

If not, are there changes in wording that will improve understanding? 

2. Are the response options suggested by ERS appropriate? Are respondents able to use

these response options to describe their children’s behavior? If not, are there changes 

in response options that would be more appropriate? 

3. What time period do respondents feel more comfortable with, in responding to the

questions—past 24 hours, the past week, or the past month?

II. Introduction: 

Thank you for joining us for today’s focus group on questions mothers can answer about their 

kindergarten/first grade child’s eating habits. Today we are going to be talking about the eating 

habits of your children – those in kindergarten and 1st grade. We have a set of questions for 

mothers to answer about certain types of food that your children may eat, and we are interested 

in whether or not these questions are ones mothers can answer easily and accurately. 

III. Purpose: 

These are preliminary questions that you can help us improve. Today, you’ll be helping us by 

answering some questions on how you recall what your child ate, what kinds of foods you think 

of when asked to respond to certain questions, sharing with us how you came up with your 

answers and what things would make it easier for you to answer the questions. With your help, 

the questions that are used in a national survey will be improved. 

My name is , and I am from ORC Macro, the research firm that has been hired to help 

test these questions. As the moderator for today, my role is to encourage the discussion by 

asking questions. I’d like to outline some guidelines that will help this discussion. 

• You have been asked here to offer your views and opinions; everyone's 

participation and viewpoints are important: there are no right or wrong answers. 

• Detailed explanations are desired. 

• Please speak one at a time, so that we can all hear and understand the 

conversation

• You are being audio-taped and videotaped today 

• All of your answers will remain confidential, so feel free to speak your mind. Our 

review of your answers will report findings as aggregate data. 

IV. Icebreaker: 

Before we begin, I’d like to ask everyone to first introduce themselves. Please introduce yourself 

and tell us what grade your child is in, and what their favorite food is. 

 1
V. Research Questions (Mothers respond to set of test questions in writing): 

Review of the Test Set Questions:

[Instructions (paraphrase)]: “Now I have some questions about how often your children drink 

or eat certain things. I will read a question and give you each a moment to think about the 

question. Please indicate your answer on the sheet I have provided. Please answer the 

question to the best of your ability. When you’re done answering all of the questions, we’ll 

talk about your questions and your answers. Do you have any questions about this process? 

[Moderator distributes test questions sheets and pencils to group. Reads set of test 

questions. If participants ask what the question means, reply with: 

“I can’t help you interpret the question or tell you what it means; because that’s 

one of the things we want to learn today. So, use your best judgment and after 

everyone has a chance to answer the question, we’ll talk about what it means.”] 

VI. Discussion of Mothers’ Comprehension of the Questions: 

[Instructions (paraphrase)]: “Now let’s talk about what you thought these questions were asking 

– or what it meant to you. We can talk about words that may have been confusing, or difficulty 

you had in figuring out whether a certain food is or is not included, and so on. Let’s start with 

question 1.”

Probes: Interviewer should cover the following topics (do not need to cover each topic in 

detail for each question, if the topic was discussed earlier): 

• How did you answer Question 1? (Ask mothers to provide their answers for all the 

questions, and have following discussion for each question, as appropriate)

• How did you know what your K/Grade 1 child eats and how much this child eats? (Probe: 

Ask mothers to describe how they arrived at their answer, including how mother arrived at 

the exact amount of food/drink stated in the answer) 

• What was difficult about this question? (Probe for explanations of the difficulties)

• What kind of milk were you thinking of in answering the question?(Probe for Yohoo as milk) 

• What do you think is meant by regular cow’s milk? 

• What drinks do you think of when someone says 100% fruit juice? How do you know they 

are 100% fruit juice? 

 2
• What is a green salad? What’s included? Did you include these vegetables in other

responses?

• What is fast food? 

• What fast food places did you include in your response- how did you know which ones to 

count? (Probe for understanding of “no wait service” versus eating out as de facto fast food)

• How did you classify sweet versus salty snack foods? (Probe for what foods fall into each 

category) 

• When you answered the question about other vegetables, what kinds of food were you 

thinking about? (Probe for combinations, usefulness of the cue)

• What type of food do you consider fried potatoes or French fries to be? (Vegetable, 

potatoes: probe for where parents count these foods). 

• How would moving this question to somewhere else in the questionnaire increase the ease 

of answering it? (probe for question ordering, where mothers would put the question and 

why it becomes easier to answer) 

VII. Mothers’ Ability to Use Response Options 

• What was difficult about the response options that were read to you? (Probe for issues with 

length of the list, viability of 1-2 times per day option, other ranges mothers could provide 

answers for, like 2-4 times per day, 4 to 6 times per day) 

• How did you determine the number of times your child ate or drank a food item for these 

questions? (Probe for whether mothers provided exact answer or the average behavior for 

their child, count respondents) 

• What words in the questions helped you to recall the total consumption for your child over 

the past seven days? 

• What kinds of things or events were you thinking of as you determined the number of times 

your child ate or drank a food item? (Probe for cues, like meal prep, grocery shopping) 

o What memories helped you the most in recalling what your child ate? 

 3
• How did you distinguish between what your child actually ate versus what they were served

in answering these questions? (Probe for distinction between/and answering for what was 

actually eaten, not what mothers served) 

• Tell me how you know what foods your child has eaten while they are away from home, like 

at school, aftercare, play dates, athletics and other events? (Probes: Do you regularly ask 

your child what they ate at school? Do they come home and report? Lunch box 

checking/lunch money? Menu review?)

• How did you include aftercare, play dates, athletics and other events in your answers to the 

questions? (Probe for whether mothers included these because they had knowledge of what 

was consumed or just guessed) 

• For you, what is the difference between providing an answer for a week versus each day in 

a seven-day time period? What makes one easier versus the other? (Probe for usability, 

ability to recall detail) 

• For what period of time can you best recall what your K/grade 1 child ate? (Interviewer 

Prompt) One day, three days, four days, five days? (Probe for time period)

• When you selected an option that was the 7-day period, what 7 days did you include in your 

answer? 

• How would including language instructing mothers to only answer for times they are certain 

about and not use an average affect your ability to answer the questions? 

• Some parents may provide their kids with permission to go the refrigerator and have 

unlimited access to easy-to-eat snacks, like grapes, baby carrots, and raisins. Kids may 

have just a few of these, or munch between meals. How did you include this type of eating 

in your response to Question 5? 

VIII. General Questions 

• Some of these questions are about foods that some parents may feel sensitive about 

revealing that their child actually consumed them. What would help to encourage mothers 

 4
not to underestimate their child’s consumption of soda pop, snacks, French fries and the 

times their ate a meal at a fast food place? 

• How does having more than one child impact your ability to recall what your K/G1 child ate? 

o How did you separate what the K/Grade 1 child ate from the others in answering 

the questions? 

o What would you change about the response options in these questions?

• Can you think of a better way to ask/answer any of these questions? 

• What would improve your understanding of the questions? 

IX. False Close 

Moderator briefly leaves room to ask project director if there are any other questions that remain 

unanswered or require further probing. 

X. Conclusion and Thank you

 5