Economic 

Research 

Service

Electronic Publications from the Food Assistance & Nutrition Research Program

Prototype Notebook

Short Questions on Dietary Intake,

Knowledge, Attitudes, and Behaviors

By Heather Hartline-Grafton, Rebecca Nyman, Ronette Briefel,

and Rhoda Cohen, Mathematica Policy Research, Inc.

ERS project representatives: Joanne Guthrie, 202-694-5373,

jguthrie@ers.usda.gov, and Eileen Stommes, 202-694-5414,

estommes@ers.usda.gov

Abstract

This report provides a compendium of 128 survey questions used in previous research to

assess dietary knowledge, attitudes, and behaviors for low-income populations over the age of

18. The short questions or sets of questions on nine topics, including fruits and vegetables;

grains, legumes, and fiber; variety; fat; calcium food sources; nonalcoholic beverages; knowledge, attitudes; and behaviors, are drawn from an extensive inventory and evaluation of available questions reported in the research literature. Each question is presented using a common

template including the citations, data sources, and characteristics such as question reliability,

validity, sensitivity to change, availability in other languages, mode of administration, use in

populations with low-income and/or low-education levels, relation to nutrition and health outcomes, and availability of comparative data. This report is part of a larger ERS research effort

to develop a common core set of questions to assess the dietary behavior impact of Food

Stamp Nutrition Education (FSNE) on Food Stamp Program participants. 

E-FAN-04-010

September 2004

This report was prepared by Mathematica Policy Research, Inc., under a

cooperative assistance agreement with the Economic Research Service.

The views expressed are those of the authors and not necessarily those

of ERS or USDA.
FSNE 
iii

CONTENTS 

Section Page 

 EXECUTIVE SUMMARY ...................................................................................... iv

PROTOTYPE NOTEBOOK 

A. INTRODUCTION ......................................................................................................1 

B. COVERAGE OF TOPICS..........................................................................................1 

C. PROCESS USED TO LOCATE AND INVENTORY QUESTIONS .......................2 

D. PROCESS FOR PRELIMINARY RANKING AND SELECTING 

 RECOMMENDED QUESTIONS..............................................................................3 

E. APPLICATIONS........................................................................................................4 

F. THE NEXT STEPS ....................................................................................................4 

REFERENCES ...........................................................................................................6 

ACRONYMS..............................................................................................................8 

RECOMMENDED QUESTIONS 

Fruits and Vegetables ............................................................................................................10 

Grains, Legumes, and Fiber...................................................................................................24

Variety ...................................................................................................................................38 

Fat ..........................................................................................................................................50 

Calcium Food Sources...........................................................................................................65 

Nonalcoholic Beverages ........................................................................................................74 

Knowledge.............................................................................................................................87 

Attitudes...............................................................................................................................102 

Behaviors .............................................................................................................................128

 APPENDIX A: INSTRUMENTS INVENTORIED AND QUESTION TOPIC AREAS

APPENDIX B: INSTRUMENTS REVIEWED BUT NOT INVENTORIED

APPENDIX C: GLOSSARY OF TERMS USED IN THE NOTEBOOK TEMPLATE

APPENDIX D: INSTRUMENTS WITH QUESTIONS THAT WERE NOT RANKED

APPENDIX E: CITATIONS
iv

EXECUTIVE SUMMARY 

Background. The Economic Research Service (ERS) contracted with Mathematica Policy 

Research, Inc. (MPR) to develop a prototype notebook to be used by an expert panel at an ERS 

workshop entitled “Developing Common Core Survey Questions to Assess Key Dietary 

Behavior Outcomes of FSNE: Launching the Research Process.” The prototype notebook 

contains a selection of short questions or sets of questions on dietary intake (fruits and 

vegetables; grains, legumes, and fiber; variety; fat; calcium food sources; nonalcoholic 

beverages), knowledge, attitudes, and behaviors, drawn from an extensive inventory and 

evaluation of available questions. The expert panel will use the selected questions in the 

prototype notebook as a starting point to develop and test a core set of questions to assess key 

dietary behavioral outcomes with the Food Stamp Nutrition Education (FSNE) audience. 

Process. The literature search focused on research publications since 1998 that included 

U.S. adults 18 years of age and older and/or FSNE or low-income populations. However, 

several older surveys were reviewed to ensure that relevant topics were fully addressed. MPR 

project team members reviewed questions by critically examining and interpreting the available 

evidence and data and including this information in an inventory. The inventory incorporated not 

only the questions, but also the citations, data sources, and characteristics such as question 

reliability, validity, sensitivity to change, availability in other languages, mode of administration, 

use in populations with low-income and/or low-education levels, relation to nutrition and health 

outcomes, and availability of comparative data. To assist in evaluating the questions for 

inclusion in the notebook, MPR team members assigned a preliminary ranking to each question. 

Two senior members of the team independently reviewed the selected questions and achieved 

consensus on the final selections for the notebook, using their expert judgment to select 

questions from the inventory for inclusion based on readability, ease and mode of administration, 

question sequence, question structure or style, reference period, and balance across and within 

topic areas. 

Results. MPR team members reviewed 48 survey instruments and inventoried 459 

questions, or sets of questions, from 26 of these instruments. The most questions were available 

for the behaviors topic area, whereas the fewest were available for the nonalcoholic beverages 

topic area. To expand available questions on healthy weight for the expert panel’s use, 13 

questions were included in the notebook at the request of ERS. These questions did not undergo 

the same intense review of testing and outcome criteria, and therefore were not ranked. The final 

prototype notebook includes 128 questions categorized by topic area. 

Applications/considerations. As the expert panel selects questions for an instrument for use 

with the FSNE population, careful attention must be given to question format, lead-ins, response 

categories, and reference periods. It will also be necessary to consider whether questions can be 

“pulled out” from their set or module from another instrument and recombined. Finally, there 

were several topics or subtopics most in need of research and development based on how few 

useful questions were found: variety, moderation, portion size and portion control, nonalcoholic 

beverages, weight loss and maintenance, whole grains, and snacking related to television 

watching. 
1

PROTOTYPE NOTEBOOK 

A. INTRODUCTION 

The primary goal of USDA’s Food and Nutrition Service (FNS) Food Stamp Nutrition 

Education (FSNE) is to increase the likelihood of food stamp recipients making healthful food 

choices consistent with USDA dietary guidance. FSNE is managed and operated by a variety of 

implementing agencies across and sometimes within states. The specific dietary goals and 

educational approaches to achieve them also vary substantially. While some components are 

evaluated by FSNE implementing agencies or local providers, there are no common outcome 

measures that can be used to track changes by all FSNE providers. To address the need for 

common measures or indicators of dietary behavior for assessing key dietary behavioral 

outcomes of the FSNE program, the Economic Research Service (ERS) plans to work with 

FSNE stakeholders and nutrition education experts to develop a 15-minute core set of questions 

that are manageable, flexible, and appropriate for use in multiple settings, including local and 

state monitoring efforts. FSNE is actually a component of the Food Stamp Program and does not 

have “Program” status itself. 

ERS contracted with Mathematica Policy Research, Inc. (MPR) to develop a prototype 

notebook to be used by an expert panel at an ERS workshop entitled “Developing Common Core 

Survey Questions to Assess Key Dietary Behavior Outcomes of FSNE: Launching the Research 

Process.” The prototype notebook contains a selection of short questions or sets of questions on 

dietary intake, knowledge, attitudes, and behaviors, drawn from an extensive inventory and 

evaluation of available questions. The expert panel will use the selected questions in the 

prototype notebook as a starting point to develop and test a core set of questions with the FSNE 

audience. 

B. COVERAGE OF TOPICS 

Question topics reflect the major areas of emphasis of FSNE interventions, including dietary 

quality and healthy weight, which are consistent with the USDA Food Guide Pyramid and U.S. 

Dietary Guidelines. The nine main topic areas are: 

• Fruits and vegetables (dark green vegetables, deep yellow/orange vegetables, fruits, 

100% fruit juice) 

• Grains, legumes, and fiber 

• Variety (variety within a Food Guide Pyramid group) 

• Fat (fat and saturated fat) 

• Calcium food sources 

• Nonalcoholic beverages 
2

 

• Knowledge (diet and health relationships, Food Guide Pyramid servings) 

• Attitudes (about diet, health, and a healthy weight) 

• Other behaviors (food label reading, shopping practices, breakfast consumption, 

eating away from home, portion size modification/selection, snack foods, weight loss 

practices) 

The subtopics in parentheses were created to assure the selection of questions was 

comprehensive. Topics considered outside the scope of this project, as agreed upon by ERS and 

MPR, were: dietary supplements, alcoholic beverages, awareness of diet and health, food 

expenditures, food security, pregnancy and folic acid, and physical activity. 

C. PROCESS USED TO LOCATE AND INVENTORY QUESTIONS 

There were several primary review articles or resources that were used as a starting point in 

the review (1-13). MPR researchers then reviewed all major national nutrition surveys and state 

surveillance systems, and conducted searches of the nutrition education and epidemiology 

literature to identify a wide selection of relevant instruments and potential questions (especially 

targeting cancer, cardiovascular disease, and osteoporosis). The literature search focused on 

research publications since 1998 that included U.S. adults 18 years of age and older and/or FSNE 

or low-income populations.1

 However, project team members reviewed several older surveys 

that were precursors to more current instruments or to ensure that relevant topics (e.g., healthy 

weight) were fully addressed. 

After locating articles and instruments, it was often necessary to obtain original research 

articles on survey questionnaire development, many of which were published prior to 1999. In 

some instances, personal contacts were necessary to obtain a copy of the instrument or additional 

information on testing of the instrument. Some instruments were derived from other instruments, 

had the same name as other instruments, or had inconsistent names across sources, providing 

additional challenges during the project. 

After reviewing articles and instruments, questions within the project scope were 

inventoried (see Appendix A for a list of instruments and coverage of topics). In general, short 

questions or sets of questions within the topic areas were selected as opposed to traditional 

dietary intake methods (dietary recalls, diet records, or food frequency questionnaires (FFQs)). 

Only when questions were severely limited in a topic area were FFQ questions inventoried. 

Several instruments and questions were reviewed, but not inventoried, as they were primarily 

used as screening tools or checklists (e.g., Nutrition Screening Initiative, Quick Check for Fat), 

too long (i.e., more than 6-8 items in a set of questions), or outdated (e.g. National Health 

Interview Survey Cancer Control Supplement). In addition, some questions or sets of questions 

1

One exception was the inclusion of instruments that contained questions to fill content gaps 

that were only used with children and adolescents, but recommended for use with adults. 
3

 

could not feasibly stand on their own when separated from the larger instrument, and thus were 

not inventoried (See Appendix B). 

Project team members reviewed questions by critically examining and interpreting the 

available evidence and data and including this information in the inventory. The inventory 

incorporated not only the questions, but also the citations, data sources, and characteristics such 

as question reliability, validity, sensitivity to change, availability in other languages, method of 

administration, use in populations with low-income and/or low-education levels, relation to 

nutrition and health outcomes, and availability of comparative data.2

 To maintain consistency 

within the project team, MPR developed a standardized set of definitions for the characteristics 

(See Appendix C). In many cases, information on indicators of reliability and validity was 

available only for entire questionnaires or subscales within questionnaires, not for individual 

items. When the information on reliability or validity refers to a larger group of questions, not 

the specific question under examination, we present the data with appropriate information on 

level of specificity so the reader can assess its value. Available information was captured in a 

user-friendly template for use by the expert panel. Due to the emphasis on healthy weight in 

FSNE efforts, project team members identified questions relating specifically to healthy weight 

and/or with outcomes related to weight or body mass index in the notes section of the template. 

D. PROCESS FOR PRELIMINARY RANKING AND SELECTING RECOMMENDED 

QUESTIONS 

To assist in evaluating the questions, MPR team members developed an approach for 

standardizing their preliminary ranking. The preliminary ranking is included in the template (see 

Table 1). 

After questions were ranked using the guidelines shown in Table 1, MPR sorted the 

questions by topic area (with the exception of those that were ‘not ranked’), and used expert 

judgment to select questions for inclusion in the notebook based on readability, ease and mode of 

administration, question sequence, question structure or style, and reference period. It was also 

desired to ensure a balance of questions across and within topic areas (e.g., including questions 

on a variety of types of fruits and vegetables). When similar questions had a variation in 

wording, higher priority was given to the most recent question and the question with the most 

testing or that was derived from an instrument with extensive testing in the target population. 

Occasionally, senior project staff chose questions with lower rankings based on their judgments 

about superior readability and ease of administration; however, no ‘low’ ranked questions were 

included in the notebook. Two senior members of the team independently reviewed the selected 

questions and achieved consensus on the final selections. The target was to include about 12 

questions per topic area in the notebook. For a few topics that cover a broad number of 

subtopics, MPR included a few additional questions for the expert panel’s consideration. 

2

Initially, MPR searched for documentation regarding the reading or literacy level of the 

sample population. This information was not available in any of the reviewed citations; 

therefore, the analysis focused on the reported education level of the sample population. 
4

 

E. APPLICATIONS 

We reviewed 48 instruments and inventoried 459 questions or sets of questions from 26 of these 

instruments.3

 The final notebook includes 128 questions, including the 13 questions that were 

not ranked. The most questions were available for the behaviors topic area, whereas the 

fewest were available for the nonalcoholic beverages topic area. There were several topics or 

subtopics most in need of research and development based on how few useful questions were 

found: variety, moderation, portion size and portion control, nonalcoholic beverages,4

 weight 

loss and maintenance, whole grains, and snacking related to television watching. 

Several issues arose during the course of this project. An individual question or set of 

questions from an instrument was not always worded consistently in different sources or 

citations. Along similar lines, response categories were not always in agreement with the 

question wording. For example, one question asked about the number of servings, but the 

response categories only included the number of times during specified time periods. 

In addition, some questions or sets of questions were not designed to be used or tested 

independently from the instrument in which they were included. (With this in mind, questions or 

sets of questions in the notebook and excluded inventory are sorted by topic area, and then 

alphabetically by instrument within the topic area.) During the selection and field-testing 

process, the expert panel will need to determine if it is appropriate to include such questions or 

sets of questions that are taken out of context, and then develop a strategy for handling this issue. 

In particular, it will be necessary to consider whether questions can be 'pulled out' from their set 

or module from another instrument and recombined, taking into consideration flow, response 

categories, and rephrasing needs. 

F. THE NEXT STEPS 

As the expert panel selects questions for the 15-minute instrument, careful attention must be 

given to question format, lead-ins, response categories, and reference periods. Questions cannot 

be selected in isolation but must be considered in the totality of the instrument. Frequent 

variations in question format, response categories, and reference periods will impede the flow of 

the instrument and cause confusion for respondents. In some instances, wording revisions to 

questions will be necessary to improve the internal consistency and ease of administration. For 

some questions or sets of questions, the project team provided rephrasing suggestions in the 

“Notes” section of the template. 

3

Appendix E includes citations for questions. 

4

Regarding nonalcoholic beverages, there were no questions specifically focused on 

sweetened iced tea consumption, which is a common regional and seasonal sweetened beverage. 
TABLE 1 

GUIDELINES FOR PRELIMINARY RANKINGS BASED ON USE WITH 

THE FSNE POPULATION, EVIDENCE OF TESTING, AND 

NUTRITION OR HEALTH OUTCOMES 

Preliminary Rank Guidelines

Ideal This question has been used in national or state surveys and/or with the 

food stamp population. 

This question has had some testing, showing either reliability or

internal validity. 

This question is related to a nutrition or health outcome. 

High This question has been used in a national or state survey and/or with 

the food stamp population. 

This question has had some testing, showing either reliability or

internal validity, 

 OR 

This question is related to a nutrition or health outcome. 

Medium This question has been used in a national or state survey or with the

food stamp population, with little or no testing, 

 OR 

This question has been used with a local population with some testing. 

Low This question has not been used in a national or state survey or the food 

stamp population. 

This question has not had any validity or reliability testing. 

Not ranked This question was requested by the client for inclusion in the notebook 

to expand available questions on healthy weight. Since this question 

did not undergo the same intense review of testing and outcome criteria 

as other questions, it is not ranked. 

NOTE: The instrument sources of ‘not ranked’ questions are provided in Appendix D. This 

review of testing goes beyond cognitive testing. 

5
6

 REFERENCES 

1. An C, Hersey J, Richa N. A compendium of data resources for planning and assessing state 

and community-based nutrition education programs. Final report submitted to the U.S. 

Department of Agriculture, Economic Research Service. Washington, DC: Research 

Triangle Institute, January 2003. 

2. Contento IR, Randell JS, Basch CE. Review and analysis of evaluation measures used in 

nutrition education intervention research. J Nutr Educ Behav 2002;34:2-25. 

3. Doner L, ed. Charting the course for evaluation: how do we measure the success of nutrition 

education and promotion in food assistance programs? Summary of proceedings. Silver 

Spring, MD: KRA Corporation, February 1997. 

4. Fourney A (contact). A compendium of survey instruments for fruit and vegetable 

consumption and physical activity. 2003-2004 edition. Sacramento, CA: Research and 

Evaluation Unit, Cancer Prevention and Nutrition Section, California Department of Health 

Services. 

5. Hamilton WL, Rossi PH. Effects of food assistance and nutrition programs on nutrition and 

health: volume 1, research design. FANRR-19-1. Washington, DC: U.S. Department of 

Agriculture, Economic Research Service, February 2002. 

6. Kim DJ, Holowaty EJ. Brief, validated survey instruments for the measurement of fruit and 

vegetable intakes in adults: a review. Prev Med 2003;36:440-447. 

7. Logan C, Fox MK, Lin B. Effects of food assistance and nutrition programs on nutrition and 

health: volume 2, data sources. FANRR-19-2. Washington, DC: U.S. Department of 

Agriculture, Economic Research Service, September 2002. 

8. McClelland JW, Keenan DP, Lewis J, Foerster S, Sugerman S, Mara P, Wu S, Lee S, Keller 

K, Hersey J, Lindquist C. Review of evaluation tools used to assess the impact of nutrition 

education on dietary intake and quality, weight management practices, and physical activity 

of low-income audiences. J Nutr Educ 2001;33(Supplement 1):S35-S48. 

9. National Cancer Institute. Dietary assessment calibration/validation (DACV) register. 

Available at: http://www.dacv.ims.nci.nih.gov/index.html. Accessed February 10, 2004. 

10. Nutrition education in FNS: a coordinated approach for promoting healthy behaviors, a 

report to Congress. Alexandria, VA: U.S. Department of Agriculture, Food and Nutrition 

Service. Accessed February 10, 2004. 

11. Thompson FE, Byers T. Dietary assessment resource manual. J Nutr 1994;124 

(Supplement). 
7

12. Voichick J, ed. Evaluation of nutrition education with low-income families. J Nutr Educ 

2001;33 (Supplement 1). 

13. Yaroch AL, Resnicow K, Khan LK. Validity and reliability of qualitative dietary fat index 

questionnaires: a review. J Am Diet Assoc 2000;100:240-244. 
8

ACRONYMS 

AARP American Association for Retired Persons 

CAPI Computer Assisted Personal Interview 

CATI Computer Assisted Telephone Interview 

CI Confidence Interval 

DK Don’t Know 

EATS Eating at America’s Table Study 

F False 

FFQ Food Frequency Questionnaire 

FSP Food Stamp Program 

HEI Healthy Eating Index 

HS High School 

N No 

NA Not Applicable 

NCHS National Center for Health Statistics 

NHLBI National Heart, Lung, and Blood Institute 

NIH National Institutes of Health 

NS Not Significant 

OR Odds Ratio 

RDD Random Digit Dialing 

T True 

WIC Special Supplemental Nutrition Program for Women, Infants, and 

Children 

Y Yes 

NOTE : Acronyms for instruments reviewed, inventoried, and/or not ranked are included in 

Appendices A, B, and D. 
9

RECOMMENDED QUESTIONS
10

FRUITS AND VEGETABLES
11

Fruits and Vegetables 

Not counting juice, how often do you eat fruit? (# per day, week, month, year; never) 

Preliminary Rank High Instrument BRFSS (2003) 

Administration 

Population National, state, local 

Subgroup Wisconsin/Medicare/women; Chicago/low-income/Hispanic/nonpregant/WIC/women; Arizona/adults/45+, Augusta, GA; Adults 30-74 in Cancer 

Prevention Study in MN; Low-income parents. 

Sample Size(s) n=507 in WI, n=97 in Chicago, n=93 in AZ, n=193 in Augusta, GA Serdula M et al. 

1993; n=201 Smith-Warner SA, et al. 1997; n=1465 Weaver M et al. 1999. 

Mode Self:Paper/pencil; Interviewer:CAPI and CATI (18%). 

Documented Description

Other Languages X Spanish

Low-Income X Study population in Chicago had low incomes. Used with WIC and food 

stamp participants. 

Low Education Level X Most of study population in Chicago had limited education. 

Evidence

Reliability X Test-retest with control population at baseline and 3 months. Correlation 

coefficient = .57. Internal consistency alpha coefficient was .77. 

Internal Validity X Criterion correlation coefficients: .56, .54, .35, and .58 FFQ; .66 and .33 

dietary records; -.04 dietary recall; .70 diet recall and .68 FFQ. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing. 

Notes: The BRFSS estimates of fruits and vegetable consumption were lower than the FFQ, but similar to 

the food records or recalls. 

Citations: Serdula M et al. 1993; Smith-Warner SA et al. 1997; Weaver M et al. 1999; CDC 2003. 
12

Fruits and Vegetables 

How often do you eat carrots? (# per day, week, month, year; never) 

Preliminary Rank High Instrument BRFSS (2003) 

Administration 

Population National, state, local 

Subgroup Wisconsin/Medicare/women; Chicago/low-income/Hispanic/nonpregant/WIC/women; Arizona/adults/45+, Augusta, GA; Adults 30-74 in Cancer 

Prevention Study in MN; Low-income parents. 

Sample Size(s) n=507 in WI, n=97 in Chicago, n=93 in AZ, n=193 in Augusta, GA Serdula M et al. 

1993; n=201 Smith-Warner SA, et al. 1997; n=1465 Weaver M et al. 1999. 

Mode Self:Paper/pencil; Interviewer:CAPI and CATI (18%). 

Documented Description

Other Languages X Spanish

Low-Income X Study population in Chicago had low incomes. Used with WIC and food 

stamp participants. 

Low Education Level X Most of study population in Chicago had limited education. 

Evidence

Reliability X Test-retest with control population at baseline and 3 months. Correlation 

coefficient = .49. Internal consistency alpha coefficient was .77. 

Internal Validity X Criterion correlation coefficients: .40, .57, .41, and .51 FFQ; 23 and .31 

dietary records; .34 dietary recall; .45 diet recall and .63 FFQ. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing. 

Notes: The BRFSS estimates of fruits and vegetable consumption were lower than the FFQ, but similar to 

the food records or recalls. 

Citations: Serdula M et al. 1993; Smith-Warner SA et al. 1997; Weaver M et al. 1999; CDC 2003. 
13

Fruits and Vegetables 

How often do you eat green salad? (# per day, week, month, year; never) 

Preliminary Rank High Instrument BRFSS (2003) 

Administration 

Population National, state, local 

Subgroup Wisconsin/Medicare/women; Chicago/low-income/Hispanic/nonpregant/WIC/women; Arizona/adults/45+, Augusta, GA; Adults 30-74 in Cancer 

Prevention Study in MN; Low-income parents. 

Sample Size(s) n=507 in WI, n=97 in Chicago, n=93 in AZ, n=193 in Augusta, GA Serdula M et al. 

1993; n=201 Smith-Warner SA, et al. 1997; n=1465 Weaver M et al. 1999. 

Mode Self:Paper/pencil; Interviewer:CAPI and CATI (18%). 

Documented Description

Other Languages X Spanish

Low-Income X Study population in Chicago had low incomes. Used with WIC and food 

stamp participants. 

Low Education Level X Most of study population in Chicago had limited education. 

Evidence

Reliability X Test-retest with control population at baseline and 3 months. Correlation 

coefficient = .66. Internal consistency alpha coefficient was .77. 

Internal Validity X Criterion correlation coefficients: .55, .63, .13, and .37 FFQ; .50 and .16 

dietary records; .11 dietary recall; .59 diet recall and .66 FFQ. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing. 

Notes: The BRFSS estimates of fruits and vegetable consumption were lower than the FFQ, but similar to 

the food records or recalls. 

Citations: Serdula M et al. 1993; Smith-Warner SA et al. 1997; Weaver M et al. 1999; CDC 2003. 
14

Fruits and Vegetables 

During the past week did you have citrus fruit or citrus juice? (Y, N) 

Preliminary Rank Ideal Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Test-retest correlation coefficient = .58. 

Internal Validity X Correlation coefficient to servings of fruit from 24 hour recall = .29. 

Coefficient to average of fruit =.27. 

External Validity 

Sensitive to Change Not significant. 

Related to 

Outcome(s) 

X Correlation to serum carotenoid level =.35. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
15

Fruits and Vegetables 

How many servings of vegetables do you eat each day? (#) 

Preliminary Rank Ideal Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Test-retest correlation coefficient = .58. 

Internal Validity X Correlation coefficient to servings of vegetables from 24 hour recall = 

.38. Coefficient to average of vegetables =.32 and fiber = .35. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

X Correlation to serum carotenoid level =.33. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
16

Fruits and Vegetables 

Think about how you usually do things now. Do you eat two or more servings of 

vegetables at your main meal? (usually/always, often, sometimes, rarely, never) 

Preliminary Rank Ideal Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Test-retest correlation coefficient = .55. 

Internal Validity X Correlation coefficient to servings of vegetables from 24 hour recall = 

.26. Coefficient to average of vegetables =.28 and fiber = .27. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

X Correlation to serum carotenoid level =.35. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
17

Fruits and Vegetables 

How many servings of fruit do you eat each day? (#) 

Preliminary Rank Ideal Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Test-retest correlation coefficient = .42. 

Internal Validity X Correlation coefficient to servings of fruit from 24 hour recall = .39. 

Coefficient to average of fruit =.39 and fiber = .32. 

External Validity 

Sensitive to Change X p value = <.01 

Related to 

Outcome(s) 

X Correlation to serum carotenoid level =.31. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
18

Fruits and Vegetables 

During the past week did you have raw vegetables? (Y, N) 

Preliminary Rank High Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Test-retest correlation coefficient = .78. 

Internal Validity X Correlation coefficient to cholesterol from 24 hour recall =-.23. 

Coefficient to HEI =.22. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

No significant correlation to serum carotenoid level. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
19

Fruits and Vegetables 

During the past week did you have cooked vegetables? (Y, N) 

Preliminary Rank Medium Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability Control group reliability test not significant. 

Internal Validity No significant correlations. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

No significant correlation to serum carotenoid level. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
20

Fruits and Vegetables 

In the past month, about how often did you: Drink 100% orange juice or grapefruit 

juice? Drink other 100% fruit juices, not counting fruit drinks? Eat green salad (with or 

without other vegetables)? Eat French fries or fried potatoes? Eat baked, boiled, or 

mashed potatoes? (never, 1-3 times per month, 1-2 times per week, 3-4 times per week, 5-

6 times per week, 1 time per day, 2 times per day, 3 times per day, 4 times per day, 5 or 

more times per day) About how many servings of vegetables, overall, do you eat per day 

or per week, not counting salad or potatoes? (number of servings per day, week, month, 

year) About how many servings of fruit do you eat per day or per week, not counting 

juices? (number of servings per day, week, month, year) (7-item set) 

Preliminary Rank Ideal Instrument National 5 A Day Survey, local NCI 5 A Day 

projects (1997) 

Administration 

Population National, local (5 adult NCI 5 A Day projects) 

Subgroup Nationally representative survey (random digit dialing, 18+ years old, oversampled 

African-Americans and Latinos, 17% and 15% below 130% poverty at baseline and 

followup), Massachusetts' TreatWell 5 A Day Program (22 community health 

centers, 23% Hispanic, 18% African-American, 20% had 12th grade education or 

less), Seattle's 5 A Day program (28 worksites with cafeterias), North Carolina's 

Black Churches United for Better Health (50 churches in 10 randomized counties, 

72% female, 98% African American, mean age 53.8), Maryland WIC 5 A Day 

Promotion Program (16 WIC sites in Baltimore City and six Maryland counties, 

55% African-American, 41% White, 100% female, mean age 27). 

Sample Size(s) National 5 A Day survey n=2,837 baseline and n=2,602 followup, TreatWell study 

n=1,359 (only women's responses included in analysis n=1,096), North Carolina's 

Black Churches United for Better Health n=3,737 baseline and n=2,519 follow-up, 

Maryland WIC 5 A Day Promotion Program n=3,122, Warneke et al. study n=146. 

Mode Self:Paper/pencil; Interviewer:In-person interview. 

Documented Description

Other Languages 

Low-Income X WIC participants 

Low Education Level 21.1% of baseline and 19.8% of final sample had less than a HS degree. 

Range of education levels in 5 A Day studies and projects with 10-30% 

having less than a HS degree. 

Evidence

Reliability X Test-retest two weeks apart indicates poor reliability (corrected fruit juice 

r=0.40 vs r=0.67, fruit excluding juice r=0.18 vs r=0.68, fruit and fruit 

juice r=0.41 vs r=0.77, vegetables r=0.69 vs 0.69, total r=0.72 vs 0.70). 
21

Internal Validity X r=0.52 (95% confidence limits=0.46 to 0.57) between screener and 

Willett's 61-item FFQ; r=0.52 between screener and 3-day food records; 

r=0.77 for fruit juice, r=0.58 for fruit excluding juice, r=0.68 for fruit and 

fruit juice, r=0.34 for vegetables, r=0.53 for total between screener and 

31-item FFQ (Warneke et al. 2001); r=0.33 to 0.57 for fruit and 0.24 to 

0.32 for vegetables compared to dietary recalls, 100- and 122- item FFQ, 

and serum carotenoids (Kristal et al. 2000); r=0.52 for men and 0.50 for 

women compared to dietary recall (underestimated intake compared to 

FFQ) (Thompson et al. 2000). 

External Validity 

Sensitive to Change X Fruit and vegetable intake increased in the intervention groups. 

Related to 

Outcome(s) 

X All 5 A Day sites used the same survey as a pretest and post test. 

Intervention effects: Arizona's 5 A Day for the Overlooked Worker 

Program 0.46 servings (p<0.002), Massachusetts' TreatWell 5 A Day 

Program 0.55 servings for worksite-plus-family intervention group 

(p=0.05), Seattle's 5 A Day program 0.3 serving (p=0.06), Black 

Churches United for Better Health 0.85 servings (p<0.0001), Maryland 

WIC 5 A Day Promotion Program 0.43 servings (p=0.002); r=0.27 for 

fruit and serum carotenoids, r=0.15 for vegetables and serum carotenoids, 

r=0.58 for total fruit and vegetable intake and serum carotenoids 

Other Based on the national 5 A Day surveys and other fruit and vegetable 

screeners (i.e. BRFSS). 

Notes: Simple to administer and analyze, well suited for population level surveillance and intervention 

evaluation. 

Citations: Havas S et al. 1994; Hunt MK et al. 1998; Sorensen G et al. 1999. 
22

Fruits and Vegetables 

Over the last month, how often did you eat tomato sauce? Include tomato sauce on pasta 

or macaroni, rice, pizza and other dishes. (never, 1-3 times last month, 1-2 times per 

week, 3-4 times per week, 1 time per day, 2 times per day, 3 times per day, 4 times per 

day, 5 or more times per day) 

Preliminary Rank High Instrument NCI All-Day Screener 

Administration 

Population National 

Subgroup RDD of adults 20-70 years old who were part of the NCI Eating at America's Table 

Study; Random sample of members from the Calibration Study of the NIH-AARP 

Diet and Health Study (50-69 years of age). 

Sample Size(s) n=202 men and n=260 women from EATS; n=874 from NIH-AARP. 

Mode Self:Paper/pencil. 

Documented Description

Other Languages 

Low-Income 

Low Education Level 79% had received more than a HS degree in Thompson FE et al. 2002b. 

Evidence

Reliability 

Internal Validity X r=0.66 for men and 0.51 for women between complete All Day screener 

and four nonconsecutive 24-hour recalls; r=0.54 for men and 0.59 for 

women for All Day screener compared to dietary recall (underestimated 

intake compared to FFQ). 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive, think-aloud interviews with 30 men and women. 

Notes: 

Citations: Thompson FE et al. 2002a; Thompson FE et al. 2002b. 
23

Fruits and Vegetables 

During the past 12 months, how often per day, per week, per month or per year did you 

eat dark green vegetables, such as the food listed on this card? (# OF TIMES PER DAY, 

WEEK, MONTH OR YEAR; NEVER IN THE PAST 12 MONTHS) (See notes) 

Preliminary Rank High Instrument NHANES Diet Behavior and Nutrition Sample 

Person Questionnaire 2001-2002 

Administration 

Population National 

Subgroup Nationally representative; Question for 60+ years of age only; Survey oversamples 

older persons (60 years and over), African Americans, Mexican Americans, low 

income persons (less than 130 percent of poverty), and adolescents 12-19 years old. 

Sample Size(s) n=approximately 7,000 interviewed annually (all ages). 

Mode Interviewer:In-person interview; trained interviewer using CAPI; individual setting 

at respondent's home. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Some items underwent reliability testing. 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X New questions were added or modified based on recommendations from 

survey collaborators, NCHS staff, and other interagency work groups, and 

through large-scale field testing of English-Spanish speaking participants. 

Notes: The following examples of dark green vegetables are given to the respondent on the DBQ1 hand 

card: broccoli; spinach; romaine and other dark green lettuce; turnip, beet and mustard greens; collards; 

kale; chard. 

Citations: NCHS/NHANES 2004; An C et al. 2003. 
24

GRAINS, LEGUMES, AND FIBER
25

Grains, Legumes, and Fiber 

How many servings of whole grain breads/whole wheat tortillas did you have yesterday? 

A serving is one slice of bread, one tortilla, 1/2 an English muffin, or a small dinner 

roll.(#) 

Preliminary Rank Medium Instrument California Dietary Practices Survey (2001) 

Administration 

Population State 

Subgroup Adults in California, oversampling of low-income, African American, and Latino 

participants. 

Sample Size(s) n=1,500-1,700 adults biennially. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Oppen M et al. 2002. 
26

Grains, Legumes, and Fiber 

Yesterday did you eat any whole-grain bread such as 100% whole wheat, wheatberry, 

bran bread, rye, pumpernickel, or whole wheat tortillas? [INTERVIEWER: DO NOT 

INCLUDE FLOUR OR CORN TORTILLAS] (Y, N) 

Preliminary Rank Medium Instrument California Dietary Practices Survey (2001) 

Administration 

Population State 

Subgroup Adults in California, oversampling of low-income, African American, and Latino 

participants. 

Sample Size(s) n=1,500-1,700 adults biennially. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Oppen M et al. 2002. 
27

Grains, Legumes, and Fiber 

Yesterday did you eat any beans such as kidney beans, refried beans, chili beans, bean 

soup, bean salad, or lentils? (Y, N) 

Preliminary Rank Medium Instrument California Dietary Practices Survey (2001) 

Administration 

Population State 

Subgroup Adults in California, oversampling of low-income, African American, and Latino 

participants. 

Sample Size(s) n=1,500-1,700 adults biennially. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Oppen M et al. 2002. 
28

Grains, Legumes, and Fiber 

How many bowls of cereal did you have yesterday? (#) 

Preliminary Rank Medium Instrument California Dietary Practices Survey (2001) 

Administration 

Population State 

Subgroup Adults in California, oversampling of low-income, African American, and Latino 

participants. 

Sample Size(s) n=1,500-1,700 adults biennially. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Oppen M et al. 2002. 
29

Grains, Legumes, and Fiber 

When you eat fresh fruits with peels that can be eaten, do you eat the peel always, 

sometimes, rarely, or never? (ALWAYS, SOMETIMES, RARELY, NEVER) 

Preliminary Rank Medium Instrument Diet and Health Knowledge Survey (DHKS) 

1994-1996 (conducted as follow-up to CSFII) 

Administration 

Population National 

Subgroup Nationally representative; Adults 20+ years of age; Oversampling of low-income. 

Sample Size(s) n=5,649 in national study; n=1,196 for Obayashi S et al 2003 analysis. 

Mode Interviewer:Telephone interview; Trained interviewer. 

Documented Description

Other Languages 

Low-Income X 

Low Education Level 10.8% had less than a HS degree in Obayashi S et al. 2003. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Other tests for reliability and validity were conducted on the DHKS 1989-

1991 instrument. 

Notes: DHKS data indicate that many low-income adults do not know specific facts related to the health 

consequences or benefits of certain dietary practices, lack confidence that their diets comply with healthful 

dietary practices (especially among FSP participants), do not engage in dietary habits to lower fat and 

cholesterol, do not meet the Food Guide Pyramid or Dietary Guidelines recommendations, and have 

inadequate usual intakes of several micronutrients; DHKS data provide little evidence of differences in 

dietary intake between FSP participants and other low-income nonparticipants. DHKS 1994-1996 results 

cannot be compared to DHKS 1989-1991 results. 

Citations: USDA/ARS 2004; Gleason P et al. 2000; Obayashi S et al. 2003; Capps O et al. 2002. 
30

Grains, Legumes, and Fiber 

In the past 3 months, how often did you eat high fiber cereals? (usually/always, 

sometimes, rarely, never) 

Preliminary Rank Medium Instrument Fat and Fiber Behavior Questionnaire (1997) 

Administration 

Population Local 

Subgroup Randomized clinical trial in Puget Sound area. 68% were women, mean age = 51. 

Sample Size(s) n=1,796. 

Mode Interviewer:Telephone. 

Documented Description

Other Languages 

Low-Income 

Low Education Level Participants were well educated. 

Evidence

Reliability X Within "cereals and grains" group test-retest correlation coefficient =.62, 

baseline internal consistency = .44. 

Internal Validity X Within "cereals and grains" criterion: FFQ baseline correlation = .39. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: Modified version of the Food Habits Questionnaire. 

Citations: Shannon J et al. 1997. 
31

Grains, Legumes, and Fiber 

In the past 3 months, how often did you eat brown rice instead of white rice? 

(usually/always, sometimes, rarely, never) 

Preliminary Rank Medium Instrument Fat and Fiber Behavior Questionnaire (1997) 

Administration 

Population Local 

Subgroup Randomized clinical trial in Puget Sound area. 68% were women, mean age = 51. 

Sample Size(s) n=1,796. 

Mode Interviewer:Telephone. 

Documented Description

Other Languages 

Low-Income 

Low Education Level Participants were well educated. 

Evidence

Reliability X Within "substitute high-fiber" group test-retest correlation coefficient 

=.70, baseline internal consistency = .51. 

Internal Validity X Within "substitute high-fiber" criterion: FFQ baseline correlation = .24. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: Modified version of the Food Habits Questionnaire. 

Citations: Shannon J et al. 1997. 
32

Grains, Legumes, and Fiber 

Think about how you usually do things now. When you eat bread, do you eat whole wheat 

bread? (usually/always, often, sometimes, rarely, never) 

Preliminary Rank Medium Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability Control group reliability test not significant. 

Internal Validity No significant correlations. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
33

Grains, Legumes, and Fiber 

Think about your eating habits over the past year or so. About how often do you eat each 

of the following foods? Remember breakfast, lunch, dinner, snacks, and eating out: beans 

such as baked beans, pinto, kidney, or lentils (not green beans)? (less than 1/week, once a 

week, 2-3 times a week, 4-6 times a week, once a day, 2+ a day) 

Preliminary Rank Medium Instrument Fruit, Vegetable, and Fiber Screener (1996-

2002) 

Administration 

Population Local 

Subgroup Multi-ethnic group of one company's employees in the San Francisco area. 

Sample Size(s) n=208. 

Mode Self:Paper/pencil. Available online. 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity X Criteria: Fruit/Vegetable score with FFQ correlation coefficients= .62 

dietary fiber (includes beans and legumes). 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Block G et al. 2001; Berkeley Nutrition Services 1996-2002. 
34

Grains, Legumes, and Fiber 

When you ate bread, how often did you eat whole-grain breads? (almost always, often 

sometimes, seldom, never) 

Preliminary Rank Medium Instrument Massachusetts' TreatWell 5 A Day Program 

(1996) 

Administration 

Population Local 

Subgroup Massachusetts' TreatWell 5 A Day Program (22 community health centers, 23% 

Hispanic, 18% African-American, 20% had 12th grade education or less, 84% 

female). 

Sample Size(s) n=1,359 (only women's responses included in analysis n=1,096). 

Mode

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity X r=0.64 for whole grain bread servings and r=0.20 for fiber when 

compared to Willett's 61-item FFQ. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Havas S et al. 1994; Hunt MK et al. 1998; Sorensen G et al. 1999. 
35

Grains, Legumes, and Fiber 

Over the last month, how many times per month, week, or day did you eat cooked dried 

beans? Count baked beans, bean soup, refried bean, pork and beans, and other bean 

dishes. (never, 1-3 times last month, 1-2 times per week, 3-4 times per week, 1 time per 

day, 2 times per day, 3 times per day, 4 times per day, 5 or more times per day) Each 

time you ate these beans, how much did you usually eat? (less than 1/2 cup, 1/2 to 1 cup, 

1 to 1 1/2 cups, more than 1 1/2 cups) 

Preliminary Rank High Instrument NCI All-Day Screener 

Administration 

Population National 

Subgroup RDD of adults 20-70 years old who were part of the NCI Eating at America's Table 

Study; Random sample of members from the Calibration Study of the NIH-AARP 

Diet and Health Study (50-69 years of age). 

Sample Size(s) n=202 men and n=260 women from EATS; n=874 from NIH-AARP. 

Mode Self:Paper/pencil. 

Documented Description

Other Languages 

Low-Income 

Low Education Level 79% had received more than a HS degree in Thompson FE et al. 2002b. 

Evidence

Reliability 

Internal Validity X r=0.66 for men and 0.51 for women between complete All Day screener 

and four nonconsecutive 24-hour recalls; r=0.54 for men and 0.59 for 

women for All Day screener compared to dietary recall (underestimated 

intake compared to FFQ). 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive, think-aloud interviews with 30 men and women. 

Notes: 

Citations: Thompson FE et al. 2002a; Thompson FE et al. 2002b. 
36

Grains, Legumes, and Fiber 

On an average day, how many helpings of the following kinds of foods do you eat? 

Breads and other foods that are made from grains, such as cereals, spaghetti, pasta, rice, 

or tortillas. (# OF HELPINGS PER DAY; NONE, NEVER, OR RARELY EAT THESE 

FOODS) 

Preliminary Rank High Instrument NHANES Diet Behavior and Nutrition Sample 

Person Questionnaire 1999-2003 

Administration 

Population National 

Subgroup Nationally representative; Question for 60+ years of age only; Survey oversamples 

older persons (60 years and over), African Americans, Mexican Americans, low 

income persons (less than 130 percent of poverty), and adolescents 12-19 years old. 

Sample Size(s) n=approximately 7,000 interviewed annually (all ages). 

Mode Interviewer:In-person interview; trained interviewer using CAPI; individual setting 

at respondent's home. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Some items underwent reliability testing. 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X New questions were added or modified based on recommendations from 

survey collaborators, NCHS staff, and other interagency work groups, and 

through large-scale field testing of English-Spanish speaking participants. 

Notes: The sizes of helpings were not defined and responses represent "number of helpings" as 

determined by the respondent. 

Citations: NCHS/NHANES 2004; An C et al. 2003. 
37

Grains, Legumes, and Fiber 

During the past 12 months, how often per day, per week, per month or per year did you 

eat dried beans or peas, such as the foods listed on this card? (# OF TIMES PER DAY, 

WEEK, MONTH OR YEAR; NEVER IN THE PAST 12 MONTHS) (See notes) 

Preliminary Rank High Instrument NHANES Diet Behavior and Nutrition Sample 

Person Questionnaire 2001-2002 

Administration 

Population National 

Subgroup Nationally representative; Question for 60+ years of age only; Survey oversamples 

older persons (60 years and over), African Americans, Mexican Americans, low 

income persons (less than 130 percent of poverty), and adolescents 12-19 years old. 

Sample Size(s) n=approximately 7,000 interviewed annually (all ages). 

Mode Interviewer:In-person interview; trained interviewer using CAPI; individual setting 

at respondent's home. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Some items underwent reliability testing. 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X New questions were added or modified based on recommendations from 

survey collaborators, NCHS staff, and other interagency work groups, and 

through large-scale field testing of English-Spanish speaking participants. 

Notes: The following examples of dried beans or peas are given to the respondent on the DBQ2 hand 

card: refried beans; baked beans; bean, lentil and split pea soup; hummus; kidney beans; black beans; 

white beans; navy beans; chickpeas; lentils; split peas. 

Citations: NCHS/NHANES 2004; An C et al. 2003. 
38

VARIETY
39

Variety 

Yesterday, how many times did you eat soy products, such as soy beans, soy burgers, tofu, 

soy cheese, or soy milk? (#) 

Preliminary Rank Medium Instrument California Dietary Practices Survey (2001) 

Administration 

Population State 

Subgroup Adults in California, oversampling of low-income, African American, and Latino 

participants. 

Sample Size(s) n=1,500-1,700 adults biennially. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Oppen M et al. 2002. 
40

Variety 

Now think about the foods you eat. Would you say you always, sometimes, rarely, or 

never: Eat fish or poultry instead of meat? [IF NEEDED, SAY: "Meat refers to beef, 

pork or lamb."] (always, sometimes, rarely, never) 

Preliminary Rank High Instrument Diet and Health Knowledge Survey (DHKS) 

1994-1996 (conducted as follow-up to CSFII) 

Administration 

Population National 

Subgroup Nationally representative; Adults 20+ years of age; Oversampling of low-income. 

Sample Size(s) n=5,649 in national study; n=1,196 for Obayashi S et al 2003 analysis. 

Mode Interviewer:Telephone interview; Trained interviewer. 

Documented Description

Other Languages 

Low-Income X 

Low Education Level 10.8% had less than a HS degree in Obayashi S et al. 2003. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

X Significant predictor of saturated fat intake. 

Other X Other tests for reliability and validity were conducted on the DHKS 1989-

1991 instrument. 

Notes: Question is in FDA's HDS. DHKS data indicate that many low-income adults do not know 

specific facts related to the health consequences or benefits of certain dietary practices, lack confidence 

that their diets comply with healthful dietary practices (especially among FSP participants), do not engage 

in dietary habits to lower fat and cholesterol, do not meet the Food Guide Pyramid or Dietary Guidelines 

recommendations, and have inadequate usual intakes of several micronutrients; DHKS data provide little 

evidence of differences in dietary intake between FSP participants and other low-income nonparticipants.. 

DHKS 1994-1996 results cannot be compared to DHKS 1989-1991 results. 

Citations: USDA/ARS 2004; Gleason P et al. 2000; Obayashi S et al. 2003; Capps O et al. 2002. 
41

Variety 

Think about how you usually do things now. Do you eat more than one kind of fruit 

daily? (usually/always, often, sometimes, rarely, never) 

Preliminary Rank Ideal Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Test-retest correlation coefficient = .35. 

Internal Validity X Correlation coefficient to servings of fruit from 24 hour recall = .38. 

Coefficient to average of fruit =.30. 

External Validity 

Sensitive to Change X p value = <.05 

Related to 

Outcome(s) 

X Correlation to serum carotenoid level =.32. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
42

Variety 

Think about how you usually do things now. Do you eat more than one kind of vegetable 

a day? (usually/always, often, sometimes, rarely, never) 

Preliminary Rank Ideal Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Test-retest correlation coefficient = .65. 

Internal Validity X Correlation coefficient to servings of fruit from 24 hour recall = .26 and 

servings of vegetables from 24 hour recall = .24. Coefficient to average of 

vegetables =.34 and fiber = .24. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

X Correlation to serum carotenoid level =.28. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
43

Variety 

During the past week did you have eggs? (Y, N) 

Preliminary Rank High Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability Control group reliability test not significant. 

Internal Validity X Correlation coefficient to fat from 24 hour recall = .22. Coefficient to fat 

.23. 

External Validity 

Sensitive to Change X p value = <.05 

Related to 

Outcome(s) 

No significant correlation to serum carotenoid level. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
44

Variety 

If you eat eggs, about how many eggs do you usually eat in a week? (#) 

Preliminary Rank High Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Test-retest correlation coefficient = .75. 

Internal Validity X Correlation coefficient to fat from 24 hour recall = .29. Coefficient to fat 

= .23 and saturated fat = .25. 

External Validity 

Sensitive to Change X p value = <.05 

Related to 

Outcome(s) 

No significant correlation to serum carotenoid level. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
45

Variety 

During the past week did you have fish? (Y, N) 

Preliminary Rank High Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Test-retest correlation coefficient = .68. 

Internal Validity X Correlation coefficient to servings of fruit from 24 hour recall = .21. 

Coefficient to % energy from fat = .23. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

No significant correlation to serum carotenoid level. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
46

Variety 

In the past month, how often did you...When eating chicken, have it baked or broiled? 

(usually/always, often, sometimes, rarely, never, NA) 

Preliminary Rank Medium Instrument Food Habits Questionnaire (1990) 

Administration 

Population Local 

Subgroup Women ages 49-59 years; women ages 45-69. 

Sample Size(s) n=97; n=1,814. 

Mode Self:Paper/pencil; Interviewer:Telephone. 

Documented Description

Other Languages 

Low-Income X 8.8% made less than $20,000/yr. 

Low Education Level High school graduates or above. 

Evidence

Reliability Was not assigned to a group that was tested. 

Internal Validity Was not assigned to a group that was tested. 

External Validity 

Sensitive to Change X The change between the percent of energy from fat and fat-related diet 

habits scale between baseline and year 1 = 0.14. 

Related to 

Outcome(s) 

X See notes. 

Other 

Notes: Spoon MP et al. 2002 also evaluates a modified FHQ. The article does not specify how questions 

were grouped, but for "replace with fruit" group, internal consistency=.69, test re-test=.48, and no 

significant relationship with total fat. 

Citations: Kristal AR et al. 1990; Kristal AR et al. 1994; Spoon MP et al. 2002. 
47

Variety 

Do you ever eat poultry such as chicken and turkey? Please include foods that are made 

with poultry such as soups, sandwiches, stews and salads. (Y, N) 

Preliminary Rank High Instrument NHANES Diet Behavior and Nutrition Sample 

Person Questionnaire 1999-2003 

Administration 

Population National 

Subgroup Nationally representative; Question for 60+ years of age only; Survey oversamples 

older persons (60 years and over), African Americans, Mexican Americans, low 

income persons (less than 130 percent of poverty), and adolescents 12-19 years old. 

Sample Size(s) n=approximately 7,000 interviewed annually (all ages). 

Mode Interviewer:In-person interview; trained interviewer using CAPI; individual setting 

at respondent's home. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Some items underwent reliability testing. 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X New questions were added or modified based on recommendations from 

survey collaborators, NCHS staff, and other interagency work groups, and 

through large-scale field testing of English-Spanish speaking participants. 

Notes: 

Citations: NCHS/NHANES 2004; An C et al. 2003. 
48

Variety 

Do you ever eat meat such as beef, pork, lamb and veal? Please include foods that are 

made with meat such as soups, stews, sandwiches, lunch meats, and casseroles. (Y, N) 

Preliminary Rank High Instrument NHANES Diet Behavior and Nutrition Sample 

Person Questionnaire 1999-2003 

Administration 

Population National 

Subgroup Nationally representative; Question for 60+ years of age only; Survey oversamples 

older persons (60 years and over), African Americans, Mexican Americans, low 

income persons (less than 130 percent of poverty), and adolescents 12-19 years old. 

Sample Size(s) n=approximately 7,000 interviewed annually (all ages). 

Mode Interviewer:In-person interview; trained interviewer using CAPI; individual setting 

at respondent's home. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Some items underwent reliability testing. 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X New questions were added or modified based on recommendations from 

survey collaborators, NCHS staff, and other interagency work groups, and 

through large-scale field testing of English-Spanish speaking participants. 

Notes: Consider revising to "red" meat. 

Citations: NCHS/NHANES 2004; An C et al. 2003. 
49

Variety 

On an average day, how many helpings of the following kinds of foods do you eat? 

Protein foods, such as meat, fish, seafood, chicken, turkey, or eggs. Also include protein 

foods, such as peanut butter or foods that are made from dried beans, such as bean soup, 

baked beans, or refried beans, meat substitutes and soy protein foods such as tofu. (# OF 

HELPINGS PER DAY; NONE, NEVER, OR RARELY EAT THESE FOODS) 

Preliminary Rank High Instrument NHANES Diet Behavior and Nutrition Sample 

Person Questionnaire 1999-2003 

Administration 

Population National 

Subgroup Nationally representative; Question for 60+ years of age only; Survey oversamples 

older persons (60 years and over), African Americans, Mexican Americans, low 

income persons (less than 130 percent of poverty), and adolescents 12-19 years old. 

Sample Size(s) n=approximately 7,000 interviewed annually (all ages). 

Mode Interviewer:In-person interview; trained interviewer using CAPI; individual setting 

at respondent's home. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Some items underwent reliability testing. 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X New questions were added or modified based on recommendations from 

survey collaborators, NCHS staff, and other interagency work groups, and 

through large-scale field testing of English-Spanish speaking participants. 

Notes: Response categories are given to the respondent on the DBQ6 hand card. The sizes of helpings 

were not defined and responses represent "number of helpings" as determined by the respondent. 

Citations: NCHS/NHANES 2004; An C et al. 2003. 
50

FAT
51

Fat 

How often do you use butter, margarine, or mayonnaise on your bread or tortillas? 

Would you say ________________? (always, sometimes, rarely, never) 

Preliminary Rank Medium Instrument California Dietary Practices Survey (2001) 

Administration 

Population State 

Subgroup Adults in California, oversampling of low-income, African American, and Latino 

participants. 

Sample Size(s) n=1,500-1,700 adults biennially. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Oppen M et al. 2002. 
52

Fat 

Now think about the foods you eat. Would you say you always, sometimes, rarely, or 

never: Use low-calorie instead of regular salad dressing? (always, sometimes, rarely, 

never) 

Preliminary Rank Medium Instrument Diet and Health Knowledge Survey (DHKS) 

1994-1996 (conducted as follow-up to CSFII) 

Administration 

Population National 

Subgroup Nationally representative; Adults 20+ years of age; Oversampling of low-income. 

Sample Size(s) n=5,649 in national study; n=1,196 for Obayashi S et al 2003 analysis. 

Mode Interviewer:Telephone interview; Trained interviewer. 

Documented Description

Other Languages 

Low-Income X 

Low Education Level 10.8% had less than a HS degree in Obayashi S et al. 2003. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Other tests for reliability and validity were conducted on the DHKS 1989-

1991 instrument. 

Notes: DHKS data indicate that many low-income adults do not know specific facts related to the health 

consequences or benefits of certain dietary practices, lack confidence that their diets comply with healthful 

dietary practices (especially among FSP participants), do not engage in dietary habits to lower fat and 

cholesterol, do not meet the Food Guide Pyramid or Dietary Guidelines recommendations, and have 

inadequate usual intakes of several micronutrients; DHKS data provide little evidence of differences in 

dietary intake between FSP participants and other low-income nonparticipants. DHKS 1994-1996 results 

cannot be compared to DHKS 1989-1991 results. 

Citations: USDA/ARS 2004; Gleason P et al. 2000; Obayashi S et al. 2003; Capps O et al. 2002. 
53

Fat 

Now think about the foods you eat. Would you say you always, sometimes, rarely, or 

never: Eat ice milk, frozen yogurt, or sherbet instead of ice cream? (always, sometimes, 

rarely, never) 

Preliminary Rank High Instrument Diet and Health Knowledge Survey (DHKS) 

1994-1996 (conducted as follow-up to CSFII) 

Administration 

Population National 

Subgroup Nationally representative; Adults 20+ years of age; Oversampling of low-income. 

Sample Size(s) n=5,649 in national study; n=1,196 for Obayashi S et al 2003 analysis. 

Mode Interviewer:Telephone interview; Trained interviewer. 

Documented Description

Other Languages 

Low-Income X 

Low Education Level 10.8% had less than a HS degree in Obayashi S et al. 2003. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

X Significant predictor of total fat intake. 

Other X Other tests for reliability and validity were conducted on the DHKS 1989-

1991 instrument. 

Notes: DHKS data indicate that many low-income adults do not know specific facts related to the health 

consequences or benefits of certain dietary practices, lack confidence that their diets comply with healthful 

dietary practices (especially among FSP participants), do not engage in dietary habits to lower fat and 

cholesterol, do not meet the Food Guide Pyramid or Dietary Guidelines recommendations, and have 

inadequate usual intakes of several micronutrients; DHKS data provide little evidence of differences in 

dietary intake between FSP participants and other low-income nonparticipants. DHKS 1994-1996 results 

cannot be compared to DHKS 1989-1991 results. 

Citations: USDA/ARS 2004; Gleason P et al. 2000; Obayashi S et al. 2003; Capps O et al. 2002. 
54

Fat 

Think about your eating habits over the past year or so. About how often do you eat the 

following foods? Remember breakfast, lunch, dinner, snacks, and eating out: bacon or 

breakfast sausage? (1/month or less; 2-3 times a months; 1-2, 3-4, 5+ times a week) 

Preliminary Rank Medium Instrument Fat Screener (1996-2002) 

Administration 

Population Local 

Subgroup Multi-ethnic group of one company's employees in the San Francisco area. 

Sample Size(s) n=208. 

Mode Self:Paper/pen. Available online. 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity X Criteria: Meat/Snack score with FFQ correlation coefficients = .69 total 

fat, .72 saturated fat. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Block G et al. 2000. 
55

Fat 

Think about your eating habits over the past year or so. About how often do you eat the 

following foods? Remember breakfast, lunch, dinner, snacks, and eating out: cold cuts, 

lunch meats, ham (not low fat)? (1/month or less; 2-3 times a months; 1-2, 3-4, 5+ times a 

week) 

Preliminary Rank Medium Instrument Fat Screener (1996-2002) 

Administration 

Population Local 

Subgroup Multi-ethnic group of one company's employees in the San Francisco area. 

Sample Size(s) n=208. 

Mode Self:Paper/pen. Available online. 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity X Criteria: Meat/Snack score with FFQ correlation coefficients = .69 total 

fat, .72 saturated fat. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Block G et al. 2000. 
56

Fat 

Think about your eating habits over the past year or so. About how often do you eat the 

following foods? Remember breakfast, lunch, dinner, snacks, and eating out: French 

fries, fried potatoes? (1/month or less; 2-3 times a months; 1-2, 3-4, 5+ times a week) 

Preliminary Rank Medium Instrument Fat Screener (1996-2002) 

Administration 

Population Local 

Subgroup Multi-ethnic group of one company's employees in the San Francisco area. 

Sample Size(s) n=208. 

Mode Self:Paper/pen. Available online. 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity X Criteria: Meat/Snack score with FFQ correlation coefficients = .69 total 

fat, .72 saturated fat. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Block G et al. 2000. 
57

Fat 

Think about how you usually do things now. Do you eat low-fat instead of high-fat foods? 

(usually/always, often, sometimes, rarely, never) 

Preliminary Rank Ideal Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability Control group reliability test not significant. Test-retest correlation was 

not significant. 

Internal Validity X Coefficient to carotene =.31. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

X Correlation to serum carotenoid level =.48. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
58

Fat 

Think about how you usually do things now. When you eat hamburger, chicken, fish, or 

other meat, is it fried? (usually/always, often, sometimes, rarely, never) 

Preliminary Rank High Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability Control group reliability test not significant. 

Internal Validity X Correlation coefficient to HEI from 24 hour recall = .19. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
59

Fat 

In the past month, how often did you...Put butter or margarine on cooked vegetables? 

(usually/always, often, sometimes, rarely, never, NA) 

Preliminary Rank Medium Instrument Food Habits Questionnaire (1990) 

Administration 

Population Local 

Subgroup Women ages 49-59 years; women ages 45-69. 

Sample Size(s) n=97; n=1,814. 

Mode Self:Paper/pencil; Interviewer:Telephone. 

Documented Description

Other Languages 

Low-Income X 8.8% made less than $20,000/yr. 

Low Education Level High school graduates or above. 

Evidence

Reliability X Within "avoid fat as seasoning" group test-retest correlation coefficient 

=.90, internal consistency =.76. 

Internal Validity X Within "avoid fat as seasoning" group diet recall and FFQ correlation 

coefficient =-.57. 

External Validity 

Sensitive to Change X The change between the percent of energy from fat and fat-related diet 

habits scale between baseline and year 1 = 0.14. 

Related to 

Outcome(s) 

X See notes. 

Other 

Notes: Spoon MP et al. 2002 also evaluates a modified FHQ. The article does not specify how questions 

were grouped, but for "replace with fruit" group, internal consistency=.69, test re-test=.48, and no 

significant relationship with total fat. 

Citations: Kristal AR et al. 1990; Kristal AR et al. 1994; Spoon MP et al. 2002. 
60

Fat 

In the past month, how often did you...Eat boiled or baked potatoes without butter or 

margarine? (usually/always, often, sometimes, rarely, never, NA) 

Preliminary Rank Medium Instrument Food Habits Questionnaire (1990) 

Administration 

Population Local 

Subgroup Women ages 49-59 years; women ages 45-69. 

Sample Size(s) n=97; n=1,814. 

Mode Self:Paper/pencil; Interviewer:Telephone. 

Documented Description

Other Languages 

Low-Income X 8.8% made less than $20,000/yr. 

Low Education Level High school graduates or above. 

Evidence

Reliability X Within "avoid fat as seasoning" group test-retest correlation coefficient 

=.90, internal consistency = .76. 

Internal Validity X Within "avoid fat as seasoning" group diet recall and FFQ correlation 

coefficient =-.57. 

External Validity 

Sensitive to Change X The change between the percent of energy from fat and fat-related diet 

habits scale between baseline and year 1 = 0.14. 

Related to 

Outcome(s) 

X See notes. 

Other 

Notes: Spoon MP et al. 2002 also evaluates a modified FHQ. The article does not specify how questions 

were grouped, but for "replace with fruit" group, internal consistency=.69, test re-test=.48, and no 

significant relationship with total fat. 

Citations: Kristal AR et al. 1990; Kristal AR et al. 1994; Spoon MP et al. 2002. 
61

Fat 

In the past month, how often did you...Put sour cream, cheese or other sauces on 

vegetables and potatoes? (usually/always, often, sometimes, rarely, never, NA) 

Preliminary Rank Medium Instrument Food Habits Questionnaire (1990) 

Administration 

Population Local 

Subgroup Women ages 49-59 years; women ages 45-69. 

Sample Size(s) n=97; n=1,814. 

Mode Self:Paper/pencil; Interviewer:Telephone. 

Documented Description

Other Languages 

Low-Income X 8.8% made less than $20,000/yr. 

Low Education Level High school graduates or above. 

Evidence

Reliability X Within "avoid fat as seasoning" group test-retest correlation coefficient 

=.90, internal consistency =.76. 

Internal Validity X Within "avoid fat as seasoning" group diet recall and FFQ correlation 

coefficient =-.57. 

External Validity 

Sensitive to Change X The change between the percent of energy from fat and fat-related diet 

habits scale between baseline and year 1 = 0.14. 

Related to 

Outcome(s) 

X See notes. 

Other 

Notes: Spoon MP et al. 2002 also evaluates a modified FHQ. The article does not specify how questions 

were grouped, but for "replace with fruit" group, internal consistency=.69, test re-test=.48, and no 

significant relationship with total fat. 

Citations: Kristal AR et al. 1990; Kristal AR et al. 1994; Spoon MP et al. 2002. 
62

Fat 

How often do you use fat or oil in cooking? For example, in frying eggs, meat, or 

vegetables (# per day, week, month) 

Preliminary Rank High Instrument Health Habits and History Questionnaire (1987) 

Administration 

Population State 

Subgroup Cancer Prevention Study (CPS-II) individuals ages 40-92 in CA, CT, FL, GA, IL, 

IA, LA, MD, MA, MI, MN, MO, NJ, NM, NY, NC, PA, UT, VA, WA, and WI. 

Sample Size(s) n=184,194. 

Mode Self:Paper/pencil; Interviewer:Computer assisted with DIETQL. 

Documented Description

Other Languages X Spanish and Italian

Low-Income 

Low Education Level 6.7% have less than HS degree. 

Evidence

Reliability Only checklist (not questions) was tested. 

Internal Validity X Content validity from experts. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Calle EE et al. 2001; NCI 1997; Smucker R et al. 1989. 
63

Fat 

When you eat chicken or other types of poultry, how often do you eat the skin? Would 

you say _____? (never, rarely or seldom, sometimes or occasionally, often or very often, 

always) 

Preliminary Rank High Instrument NHANES Diet Behavior and Nutrition Sample 

Person Questionnaire 1999-2003 

Administration 

Population National 

Subgroup Nationally representative; Question for 60+ years of age only; Survey oversamples 

older persons (60 years and over), African Americans, Mexican Americans, low 

income persons (less than 130 percent of poverty), and adolescents 12-19 years old. 

Sample Size(s) n=approximately 7,000 interviewed annually (all ages). 

Mode Interviewer:In-person interview; trained interviewer using CAPI; individual setting 

at respondent's home. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Some items underwent reliability testing. 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X New questions were added or modified based on recommendations from 

survey collaborators, NCHS staff, and other interagency work groups, and 

through large-scale field testing of English-Spanish speaking participants. 

Notes: 

Citations: NCHS/NHANES 2004; An C et al. 2003. 
64

Fat 

When you eat meat, how often do you eat the visible fat? Would you say _____? (never, 

rarely or seldom, sometimes or occasionally, often or very often, always) 

Preliminary Rank High Instrument NHANES Diet Behavior and Nutrition Sample 

Person Questionnaire 1999-2003 

Administration 

Population National 

Subgroup Nationally representative; Question for 60+ years of age only; Survey oversamples 

older persons (60 years and over), African Americans, Mexican Americans, low 

income persons (less than 130 percent of poverty), and adolescents 12-19 years old. 

Sample Size(s) n=approximately 7,000 interviewed annually (all ages). 

Mode Interviewer:In-person interview; trained interviewer using CAPI; individual setting 

at respondent's home. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Some items underwent reliability testing. 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X New questions were added or modified based on recommendations from 

survey collaborators, NCHS staff, and other interagency work groups, and 

through large-scale field testing of English-Spanish speaking participants. 

Notes: 

Citations: NCHS/NHANES 2004; An C et al. 2003. 
65

CALCIUM FOOD SOURCES
66

Calcium Food Sources 

Yesterday, did you drink any milk or drinks made with milk, such as chocolate milk, fastfood milk shake, chai, latte, or have milk on cereal? (Y, N) 

Preliminary Rank Medium Instrument California Dietary Practices Survey (2001) 

Administration 

Population State 

Subgroup Adults in California, oversampling of low-income, African American, and Latino 

participants. 

Sample Size(s) n=1,500-1,700 adults biennially. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Oppen M et al. 2002. 
67

Calcium Food Sources 

Yesterday, did you eat any cheese, like on a cheeseburger, pizza, in a casserole, on a 

sandwich, or as a snack? (Y, N) 

Preliminary Rank Medium Instrument California Dietary Practices Survey (2001) 

Administration 

Population State 

Subgroup Adults in California, oversampling of low-income, African American, and Latino 

participants. 

Sample Size(s) n=1,500-1,700 adults biennially. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Oppen M et al. 2002. 
68

Calcium Food Sources 

Now think about the foods you eat. Would you say you always, sometimes, rarely, or 

never: Use skim or 1% milk instead of 2% or whole milk? (always, sometimes, rarely, 

never) 

Preliminary Rank High Instrument Diet and Health Knowledge Survey (DHKS) 

1994-1996 (conducted as follow-up to CSFII) 

Administration 

Population National 

Subgroup Nationally representative; Adults 20+ years of age; Oversampling of low-income. 

Sample Size(s) n=5,649 in national study; n=1,196 for Obayashi S et al 2003 analysis; n=5,512 for 

Kuchler F et al 2002 analysis; n=2419 adult women for Lin BH et al 2004 analysis. 

Mode Interviewer:Telephone interview; Trained interviewer. 

Documented Description

Other Languages 

Low-Income X 

Low Education Level 10.8% had less than a HS degree in Obayashi S et al. 2003. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

X Significant predictor of total and saturated fat intake; exclusive use of 

skim or lowfat milk is associated with higher BMI values by 0.76 for 

women (t-ratio=2.47, P<0.05) and 1.09 for men (t-ratio=3.89, P<0.01); 

low-income women who exclusively drink skim or lowfat milk had a 

higher BMI by 0.77 (P<0.10, t-ratio=1.77) than other low-income women; 

high-income women who exclusively drink skim or lowfat milk had a 

higher BMI by 0.67 (P<0.01, t-ratio=2.47) than other high-income 

women. 

Other X Other tests for reliability and validity were conducted on the DHKS 1989-

1991 instrument. 

Notes: Relates to "healthy weight." DHKS data indicate that many low-income adults do not know specific 

facts related to the health consequences or benefits of certain dietary practices, lack confidence that their diets 

comply with healthful dietary practices (especially among FSP participants), do not engage in dietary habits to lower 

fat and cholesterol, do not meet the Food Guide Pyramid or Dietary Guidelines recommendations, and have 

inadequate usual intakes of several micronutrients; DHKS data provide little evidence of differences in dietary intake 

between FSP participants and other low-income nonparticipants. DHKS 1994-1996 results cannot be compared to 

DHKS 1989-1991 results. 

Citations: USDA/ARS 2004; Gleason P et al. 2000; Obayashi S et al. 2003; Capps O et al. 2002; Kuchler F et al. 

2002; Lin BH et al. 2004.
69

Calcium Food Sources 

Do you use low-fat (2%), very low-fat (1%), buttermilk or non-fat skim milk? 

(usually/always, often, sometimes, rarely, never) 

Preliminary Rank High Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability Control group reliability test not significant. 

Internal Validity X Correlation coefficient to HEI from 24 hour recall = .18. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
70

Calcium Food Sources 

Do you drink milk daily? (usually/always, often, sometimes, rarely, never) 

Preliminary Rank High Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Test-retest correlation coefficient = .77. 

Internal Validity X Correlation coefficient to servings of dairy from 24 hour recall = .32 and 

Calcium Foods = .29. Coefficient to Calcium Foods = .30. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

No significant correlation to serum carotenoid level. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
71

Calcium Food Sources 

During the past week did you have milk as a beverage or on cereal? (Y, N) 

Preliminary Rank High Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Test-retest correlation coefficient = .38. 

Internal Validity X Correlation coefficient to servings of dairy from 24 hour recall = .25 and 

Calcium Foods =.25. Coefficient to average of dairy = .23 and Calcium 

Foods = .21. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

No significant correlation to serum carotenoid level. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
72

Calcium Food Sources 

When you drank milk as a beverage, what kind was it usually? (whole milk, 2% milk, 

1% milk, skim milk) 

Preliminary Rank Medium Instrument Massachusetts' TreatWell 5 A Day Program 

(1996) 

Administration 

Population Local 

Subgroup Massachusetts' TreatWell 5 A Day Program (22 community health centers, 23% 

Hispanic, 18% African-American, 20% had 12th grade education or less, 84% 

female). 

Sample Size(s) n=1,359 (only women's responses included in analysis n=1,096). 

Mode

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity X r=0.72 for low-fat milk servings and r=0.31 for fat when compared to 

Willett's 61-item FFQ. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Havas S et al. 1994; Hunt MK et al. 1998; Sorensen G et al. 1999. 
73

Calcium Food Sources 

On an average day, how many helpings of the following kinds of foods do you eat? Milk 

or dairy foods that are made from milk, such as cheese, cottage cheese, ice cream, milk 

shakes, or yogurt. (# OF HELPINGS PER DAY; NONE, NEVER, OR RARELY EAT 

THESE FOODS) 

Preliminary Rank High Instrument NHANES Diet Behavior and Nutrition Sample 

Person Questionnaire 1999-2003 

Administration 

Population National 

Subgroup Nationally representative; Question for 60+ years of age only; Survey oversamples 

older persons (60 years and over), African Americans, Mexican Americans, low 

income persons (less than 130 percent of poverty), and adolescents 12-19 years old. 

Sample Size(s) n=approximately 7,000 interviewed annually (all ages). 

Mode Interviewer:In-person interview; trained interviewer using CAPI; individual setting 

at respondent's home. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Some items underwent reliability testing. 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X New questions were added or modified based on recommendations from 

survey collaborators, NCHS staff, and other interagency work groups, and 

through large-scale field testing of English-Spanish speaking participants. 

Notes: Rewording suggested: eliminate "Milk or" since "milk" is covered in another recommended 

question. The sizes of helpings were not defined and responses represent "number of helpings" as 

determined by the respondent. 

Citations: NCHS/NHANES 2004; An C et al. 2003. 
74

NONALCOHOLIC BEVERAGES
75

Nonalcoholic Beverages 

Yesterday, how many cans or glasses or regular soda (such as cola, lemon-lime), 

sweetened carbonated beverages (such as Clearly Canadian), or sweetened noncarbonated beverages (such as Gatorade, Snapple, SoBe) did you drink? [NOTE TO 

INTERVIEWER: THAT WOULD BE A LARGE GLASS OR A 12 OZ CAN OR 

BOTTLE, DO NOT INCLUDE DIET DRINKS OR CARBONATED WATER]. (#) 

Preliminary Rank Medium Instrument California Dietary Practices Survey (2001) 

Administration 

Population State 

Subgroup Adults in California, oversampling of low-income, African American, and Latino 

participants. 

Sample Size(s) n=1,500-1,700 adults biennially 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Oppen M et al. 2002. 
76

Nonalcoholic Beverages 

Do you drink diet soft drinks? (usually/always, often, sometimes, rarely, never) 

Preliminary Rank Medium Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability Control group reliability test not significant. 

Internal Validity No significant correlations. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
77

Nonalcoholic Beverages 

Do you drink regular soft drinks? (usually/always, often, sometimes, rarely, never) 

Preliminary Rank High Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Test-retest correlation coefficient = .83. 

Internal Validity X Correlation coefficient to HEI from 24 hour recall = .23. 

External Validity 

Sensitive to Change X p value = <.0001 

Related to 

Outcome(s) 

No significant correlation to serum carotenoid level. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
78

Nonalcoholic Beverages 

Do you buy Kool-Aid, Gatorade Sunny Delight, or other fruit drink/punch? 

(usually/always, often, sometimes, rarely, never) 

Preliminary Rank High Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Test-retest correlation coefficient = .72. 

Internal Validity X Correlation coefficient to servings of fruit from 24 hour recall = .26 and 

HEI = .19. Coefficient to HEI=.26. 

External Validity 

Sensitive to Change X p value = <.0001 

Related to 

Outcome(s) 

No significant correlation to serum carotenoid level. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
79

Nonalcoholic Beverages 

How often were your fruit drinks diet or sugar-free drinks? (almost never or never, 

about 1/4 of the time, about 1/2 of the time, about 3/4 of the time, almost always or 

always) 

Preliminary Rank High Instrument NCI Diet History Questionnaire, NCI Food 

Propensity Questionnaire added and pilot tested 

in NHANES 2003 

Administration 

Population National, local 

Subgroup Tested with Washington DC participants ages 25-70 (64% female, 14% AfricanAmerican); tested in Eating at America's Table Study (nationally representative 

sample, RDD, 20-70 years of age, 79% White, 10% African-American, 51% 

women); RDD of adults 20-70 years old in Thompson FE et al. 2002b validation 

study with Eating at America's Table Study sample. 

Sample Size(s) n=623 in Thompson FE et al. 2002a validation study; n=1,301 in Eating at 

America's Table Study; n=202 men and 260 women in smaller Thompson FE et al. 

2002b validation study with Eating at America's Table Study sample. 

Mode Self:Paper/pencil. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 4.8% had less than a HS degree in Eating at America's Table Study; 1% 

had less than a HS degree in Thompson FE et al. 2002a; 79% had more 

than a HS degree in Thompson FE et al. 2002b. 

Evidence

Reliability 

Internal Validity X Compared to Daily Food Report: r=0.48 for women and r=0.49 for men 

for energy for entire instrument compared to four 24-hour recalls; 

adjusted deattenuated correlations for entire instrument across nutrients 

range from 0.51 to 0.77 for women and 0.41 to 0.83 for men compared to 

four 24-hour recalls; r=0.68 for entire instrument for men and 0.54 for 

women compared to four 24-hour recalls. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing indicates instrument is easy to use; HHHG questions 

were redesigned based on cognitive think-aloud interviewing and 

incorporated into a test-DHQ. 

Citations: NCI 2004; Thompson FE et al. 2002a; Subar AF et al. 2001; Thompson FE et al. 2002b; 

NCHS/NHANES 2004.
80

Nonalcoholic Beverages 

How often were these soft drinks, soda, or pop diet or sugar-free? (almost never or 

never, about 1/4 of the time, about 1/2 of the time, about 3/4 of the time, almost always or 

always) 

Preliminary Rank High Instrument NCI Diet History Questionnaire, NCI Food 

Propensity Questionnaire added and pilot tested 

in NHANES 2003 

Administration 

Population National, local 

Subgroup Tested with Washington DC participants ages 25-70 (64% female, 14% AfricanAmerican); tested in Eating at America's Table Study (nationally representative 

sample, RDD, 20-70 years of age, 79% White, 10% African-American, 51% 

women); RDD of adults 20-70 years old in Thompson FE et al. 2002b validation 

study with Eating at America's Table Study sample. 

Sample Size(s) n=623 in Thompson FE et al. 2002a validation study; n=1,301 in Eating at 

America's Table Study; n=202 men and 260 women in smaller Thompson FE et al. 

2002b validation study with Eating at America's Table Study sample. 

Mode Self:Paper/pencil. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 4.8% had less than a HS degree in Eating at America's Table Study; 1% 

had less than a HS degree in Thompson FE et al. 2002a; 79% had more 

than a HS degree in Thompson FE et al. 2002b. 

Evidence

Reliability 

Internal Validity X Compared to Daily Food Report: r=0.48 for women and r=0.49 for men 

for energy for entire instrument compared to four 24-hour recalls; 

adjusted deattenuated correlations for entire instrument across nutrients 

range from 0.51 to 0.77 for women and 0.41 to 0.83 for men compared to 

four 24-hour recalls; r=0.68 for entire instrument for men and 0.54 for 

women compared to four 24-hour recalls. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing indicates instrument is easy to use; HHHG questions 

were redesigned based on cognitive think-aloud interviewing and 

incorporated into a test-DHQ. 

Citations: NCI 2004; Thompson FE et al. 2002a; Subar AF et al. 2001; Thompson FE et al. 2002b; 

NCHS/NHANES 2004.
81

Nonalcoholic Beverages 

How often did you drink other fruit drinks (such as cranberry cocktail, Hi-C, lemonade, 

or Kool-Aid, diet or regular)? (1 time per month or less, 2-3 times per month, 1-2 times 

per week, 3-4 times per week, 5-6 times per week, 1 time per day, 2-3 times per day, 4-5 

times per day, 6 or more times per day) 

Preliminary Rank High Instrument NCI Diet History Questionnaire, NCI Food 

Propensity Questionnaire added and pilot tested 

in NHANES 2003 

Administration 

Population National, local 

Subgroup Tested with Washington DC participants ages 25-70 (64% female, 14% AfricanAmerican); tested in Eating at America's Table Study (nationally representative 

sample, RDD, 20-70 years of age, 79% White, 10% African-American, 51% 

women); RDD of adults 20-70 years old in Thompson FE et al. 2002b validation 

study with Eating at America's Table Study sample. 

Sample Size(s) n=623 in Thompson FE et al. 2002a validation study; n=1,301 in Eating at 

America's Table Study; n=202 men and 260 women in smaller Thompson FE et al. 

2002b validation study with Eating at America's Table Study sample. 

Mode Self:Paper/pencil. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 4.8% had less than a HS degree in Eating at America's Table Study; 1% 

had less than a HS degree in Thompson FE et al. 2002a; 79% had more 

than a HS degree in Thompson FE et al. 2002b. 

Evidence

Reliability 

Internal Validity X Compared to Daily Food Report: r=0.48 for women and r=0.49 for men 

for energy for entire instrument compared to four 24-hour recalls; 

adjusted deattenuated correlations for entire instrument across nutrients 

range from 0.51 to 0.77 for women and 0.41 to 0.83 for men compared to 

four 24-hour recalls; r=0.68 for entire instrument for men and 0.54 for 

women compared to four 24-hour recalls. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing indicates instrument is easy to use; HHHG questions 

were redesigned based on cognitive think-aloud interviewing and 

incorporated into a test-DHQ. 

Citations: NCI 2004; Thompson FE et al. 2002a; Subar AF et al. 2001; Thompson FE et al. 2002b; 

NCHS/NHANES 2004.
82

Nonalcoholic Beverages 

Each time you drank fruit drinks, how much did you usually drink? (less than 1 cup/8 

ounces, 1 to 2 cups/8 to 16 ounces, more than 2 cups/16 ounces) 

Preliminary Rank High Instrument NCI Diet History Questionnaire, NCI Food 

Propensity Questionnaire added and pilot tested 

in NHANES 2003 

Administration 

Population National, local 

Subgroup Tested with Washington DC participants ages 25-70 (64% female, 14% AfricanAmerican); tested in Eating at America's Table Study (nationally representative 

sample, RDD, 20-70 years of age, 79% White, 10% African-American, 51% 

women); RDD of adults 20-70 years old in Thompson FE et al. 2002b validation 

study with Eating at America's Table Study sample. 

Sample Size(s) n=623 in Thompson FE et al. 2002a validation study; n=1,301 in Eating at 

America's Table Study; n=202 men and 260 women in smaller Thompson FE et al. 

2002b validation study with Eating at America's Table Study sample. 

Mode Self:Paper/pencil. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 4.8% had less than a HS degree in Eating at America's Table Study; 1% 

had less than a HS degree in Thompson FE et al. 2002a; 79% had more 

than a HS degree in Thompson FE et al. 2002b. 

Evidence

Reliability 

Internal Validity X Compared to Daily Food Report: r=0.48 for women and r=0.49 for men 

for energy for entire instrument compared to four 24-hour recalls; 

adjusted deattenuated correlations for entire instrument across nutrients 

range from 0.51 to 0.77 for women and 0.41 to 0.83 for men compared to 

four 24-hour recalls; r=0.68 for entire instrument for men and 0.54 for 

women compared to four 24-hour recalls. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing indicates instrument is easy to use; HHHG questions 

were redesigned based on cognitive think-aloud interviewing and 

incorporated into a test-DHQ. 

Citations: NCI 2004; Thompson FE et al. 2002a; Subar AF et al. 2001; Thompson FE et al. 2002b; 

NCHS/NHANES 2004. 
83

Nonalcoholic Beverages 

Over the past 12 months, did you drink soft drinks, soda, or pop? (Y, N) 

Preliminary Rank High Instrument NCI Diet History Questionnaire, NCI Food 

Propensity Questionnaire added and pilot tested 

in NHANES 2003 

Administration 

Population National, local 

Subgroup Tested with Washington DC participants ages 25-70 (64% female, 14% AfricanAmerican); tested in Eating at America's Table Study (nationally representative 

sample, RDD, 20-70 years of age, 79% White, 10% African-American, 51% 

women); RDD of adults 20-70 years old in Thompson FE et al. 2002b validation 

study with Eating at America's Table Study sample. 

Sample Size(s) n=623 in Thompson FE et al. 2002a validation study; n=1,301 in Eating at 

America's Table Study; n=202 men and 260 women in smaller Thompson FE et al. 

2002b validation study with Eating at America's Table Study sample. 

Mode Self:Paper/pencil. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 4.8% had less than a HS degree in Eating at America's Table Study; 1% 

had less than a HS degree in Thompson FE et al. 2002a; 79% had more 

than a HS degree in Thompson FE et al. 2002b. 

Evidence

Reliability 

Internal Validity X Compared to Daily Food Report: r=0.48 for women and r=0.49 for men 

for energy for entire instrument compared to four 24-hour recalls; 

adjusted deattenuated correlations for entire instrument across nutrients 

range from 0.51 to 0.77 for women and 0.41 to 0.83 for men compared to 

four 24-hour recalls; r=0.68 for entire instrument for men and 0.54 for 

women compared to four 24-hour recalls. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing indicates instrument is easy to use; HHHG questions 

were redesigned based on cognitive think-aloud interviewing and 

incorporated into a test-DHQ. 

Citations: NCI 2004; Thompson FE et al. 2002a; Subar AF et al. 2001; Thompson FE et al. 2002b; 

NCHS/NHANES 2004.
84

Nonalcoholic Beverages 

How often did you drink soft drinks, soda, or pop in the summer? (1 time per month or 

less, 2-3 times per month, 1-2 times per week, 3-4 times per week, 5-6 times per week, 1 

time per day, 2-3 times per day, 4-5 times per day, 6 or more times per day) 

Preliminary Rank High Instrument NCI Diet History Questionnaire, NCI Food 

Propensity Questionnaire added and pilot tested 

in NHANES 2003 

Administration 

Population National, local 

Subgroup Tested with Washington DC participants ages 25-70 (64% female, 14% AfricanAmerican); tested in Eating at America's Table Study (nationally representative 

sample, RDD, 20-70 years of age, 79% White, 10% African-American, 51% 

women); RDD of adults 20-70 years old in Thompson FE et al. 2002b validation 

study with Eating at America's Table Study sample. 

Sample Size(s) n=623 in Thompson FE et al. 2002a validation study; n=1,301 in Eating at 

America's Table Study; n=202 men and 260 women in smaller Thompson FE et al. 

2002b validation study with Eating at America's Table Study sample. 

Mode Self:Paper/pencil. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 4.8% had less than a HS degree in Eating at America's Table Study; 1% 

had less than a HS degree in Thompson FE et al. 2002a; 79% had more 

than a HS degree in Thompson FE et al. 2002b. 

Evidence

Reliability 

Internal Validity X Compared to Daily Food Report: r=0.48 for women and r=0.49 for men 

for energy for entire instrument compared to four 24-hour recalls; 

adjusted deattenuated correlations for entire instrument across nutrients 

range from 0.51 to 0.77 for women and 0.41 to 0.83 for men compared to 

four 24-hour recalls; r=0.68 for entire instrument for men and 0.54 for 

women compared to four 24-hour recalls. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing indicates instrument is easy to use; HHHG questions 

were redesigned based on cognitive think-aloud interviewing and 

incorporated into a test-DHQ. 

Citations: NCI 2004; Thompson FE et al. 2002a; Subar AF et al. 2001; Thompson FE et al. 2002b; 

NCHS/NHANES 2004.
85

Nonalcoholic Beverages 

How often did you drink soft drinks, soda, or pop during the rest of the year? (1 time per 

month or less, 2-3 times per month, 1-2 times per week, 3-4 times per week, 5-6 times per 

week, 1 time per day, 2-3 times per day, 4-5 times per day, 6 or more times per day) 

Preliminary Rank High Instrument NCI Diet History Questionnaire, NCI Food 

Propensity Questionnaire added and pilot tested 

in NHANES 2003 

Administration 

Population National, local 

Subgroup Tested with Washington DC participants ages 25-70 (64% female, 14% AfricanAmerican); tested in Eating at America's Table Study (nationally representative 

sample, RDD, 20-70 years of age, 79% White, 10% African-American, 51% 

women); RDD of adults 20-70 years old in Thompson FE et al. 2002b validation 

study with Eating at America's Table Study sample. 

Sample Size(s) n=623 in Thompson FE et al. 2002a validation study; n=1,301 in Eating at 

America's Table Study; n=202 men and 260 women in smaller Thompson FE et al. 

2002b validation study with Eating at America's Table Study sample. 

Mode Self:Paper/pencil. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 4.8% had less than a HS degree in Eating at America's Table Study; 1% 

had less than a HS degree in Thompson FE et al. 2002a; 79% had more 

than a HS degree in Thompson FE et al. 2002b. 

Evidence

Reliability 

Internal Validity X Compared to Daily Food Report: r=0.48 for women and r=0.49 for men 

for energy for entire instrument compared to four 24-hour recalls; 

adjusted deattenuated correlations for entire instrument across nutrients 

range from 0.51 to 0.77 for women and 0.41 to 0.83 for men compared to 

four 24-hour recalls; r=0.68 for entire instrument for men and 0.54 for 

women compared to four 24-hour recalls. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing indicates instrument is easy to use; HHHG questions 

were redesigned based on cognitive think-aloud interviewing and 

incorporated into a test-DHQ. 

Citations: NCI 2004; Thompson FE et al. 2002a; Subar AF et al. 2001; Thompson FE et al. 2002b; 

NCHS/NHANES 2004.
86

Nonalcoholic Beverages 

Each time you drank soft drinks, soda, or pop, how much did you usually drink? (less 

than 12 ounces or less than 1 can or bottle, 12 to 16 ounces or 1 can or bottle, more than 

16 ounces or more than 1 can or bottle) 

Preliminary Rank High Instrument NCI Diet History Questionnaire, NCI Food 

Propensity Questionnaire added and pilot tested 

in NHANES 2003 

Administration 

Population National, local 

Subgroup Tested with Washington DC participants ages 25-70 (64% female, 14% AfricanAmerican); tested in Eating at America's Table Study (nationally representative 

sample, RDD, 20-70 years of age, 79% White, 10% African-American, 51% 

women); RDD of adults 20-70 years old in Thompson FE et al. 2002b validation 

study with Eating at America's Table Study sample. 

Sample Size(s) n=623 in Thompson FE et al. 2002a validation study; n=1,301 in Eating at 

America's Table Study; n=202 men and 260 women in smaller Thompson FE et al. 

2002b validation study with Eating at America's Table Study sample. 

Mode Self:Paper/pencil. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 4.8% had less than a HS degree in Eating at America's Table Study; 1% 

had less than a HS degree in Thompson FE et al. 2002a; 79% had more 

than a HS degree in Thompson FE et al. 2002b. 

Evidence

Reliability 

Internal Validity X Compared to Daily Food Report: r=0.48 for women and r=0.49 for men 

for energy for entire instrument compared to four 24-hour recalls; 

adjusted deattenuated correlations for entire instrument across nutrients 

range from 0.51 to 0.77 for women and 0.41 to 0.83 for men compared to 

four 24-hour recalls; r=0.68 for entire instrument for men and 0.54 for 

women compared to four 24-hour recalls. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing indicates instrument is easy to use; HHHG questions 

were redesigned based on cognitive think-aloud interviewing and 

incorporated into a test-DHQ. 

Citations: NCI 2004; Thompson FE et al. 2002a; Subar AF et al. 2001; Thompson FE et al. 2002b; 

NCHS/NHANES 2004.
87

KNOWLEDGE
88

Knowledge 

In the produce section of your grocery store, have you ever seen any banners, posters, 

pamphlets or special recipes about the number of fruits and vegetables to eat for better 

health? (Y, N) 

Preliminary Rank Medium Instrument California Dietary Practices Survey (2001) 

Administration 

Population State 

Subgroup Adults in California, oversampling of low-income, African American, and Latino 

participants. 

Sample Size(s) n=1,500-1,700 adults biennially. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Oppen M et al. 2002. 
89

Knowledge 

How many total servings of fruits and vegetables do YOU think YOU should eat every 

day for good health? [PAUSE] That's a combined total of BOTH fruits and vegetables. 

[INTERVIEWER: DO NOT ALLOW RANGE. PROBE FOR SINGLE NUMBER] (#) 

Preliminary Rank Medium Instrument California Dietary Practices Survey (2001) 

Administration 

Population State 

Subgroup Adults in California, oversampling of low-income, African American, and Latino 

participants. 

Sample Size(s) n=1,500-1,700 adults biennially. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Oppen M et al. 2002. 
90

Knowledge 

Based on your knowledge, which has more saturated fat: a. liver or T-bone steak?, b. 

butter or margarine?, c. egg white or egg yolk?, d. skim milk or whole milk? 

Preliminary Rank Ideal Instrument Diet and Health Knowledge Survey (DHKS) 

1994-1996 (conducted as follow-up to CSFII) 

Administration 

Population National 

Subgroup Nationally representative; Adults 20+ years of age; Oversampling of low-income. 

Sample Size(s) n=5,649 in national study; n=1,196 for Obayashi S et al 2003 analysis; n=2,952 for 

Perez-Escamilla R et al 2002 analysis. 

Mode Interviewer:Telephone interview; Trained interviewer. 

Documented Description

Other Languages 

Low-Income X 

Low Education Level 10.8% had less than a HS degree in Obayashi S et al. 2003. 

Evidence

Reliability X Internal consistency for knowledge of nutrient contents between products 

(Cronbach alpha = 0.46). 

Internal Validity X Expert panel decided section had content validity; Discriminant validity 

for 4/6 studies; Convergent validity on nutrition knowledge construct on 

diet-disease relationships and nutrient content between products (r=0.2 at 

P<0.0001); Correspondence validity on nutrition knowledge about the 

nutrient content between products and total HEI (r=0.1 P<0.001). 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

X Scoring low on nutrition knowledge for food fat content, food groups, 

obesity/health relationships, and food labels was associated with a low 

HEI (OR=1.40, 95% CI: 1.17, 1.68, P<0.001). 

Other X Other tests for reliability and validity were conducted on the DHKS 1989-

1991 instrument. 

Notes: DHKS data indicate that many low-income adults do not know specific facts related to the health 

consequences or benefits of certain dietary practices, lack confidence that their diets comply with healthful dietary 

practices (especially among FSP participants), do not engage in dietary habits to lower fat and cholesterol, do not 

meet the Food Guide Pyramid or Dietary Guidelines recommendations, and have inadequate usual intakes of several 

micronutrients; DHKS data provide little evidence of differences in dietary intake between FSP participants and 

other low-income nonparticipants. DHKS 1994-1996 results cannot be compared to DHKS 1989-1991 results. 

Citations: USDA/ARS 2004; Gleason P et al. 2000; Obayashi S et al. 2003; Capps O et al. 2002; Perez-Escamilla R 

et al. 2002.
91

Knowledge 

Which of these would be the best way to add a fruit or vegetable to your meal at a fast 

food restaurant? (add a tomato slice to your hamburger, order apple pie for dessert, 

order a large serving of French fries, order a side of salad) 

Preliminary Rank Medium Instrument General Knowledge (Reynolds) (2002) 

Administration 

Population Local 

Subgroup Parents of fourth grade students in three school districts. 

Sample Size(s) Year 1 n=1,292, Year 2 n=1,124, Year 3 n=949. 

Mode Self:Paper/pencil. 

Documented Description

Other Languages 

Low-Income X 30% of participants in the study had a household income of $30,000 or 

less. 

Low Education Level 

Evidence

Reliability X Internal consistency among 10 questions = .23. 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

X Increases in parent knowledge were related to increases in children's 

consumption of fruits and vegetables 

Other 

Notes: 

Citations: CA Dept of Health Services 2003-2004; Reynolds RD et al. 2002. 
92

Knowledge 

Who needs to eat plenty of fruits and vegetables? (children, adults, teenagers, 

grandparents, all of the above) 

Preliminary Rank Medium Instrument Gimme 5 Fruit, Juice, and Vegetables for Fun 

and Health (1996) 

Administration 

Population Local 

Subgroup 4 southeastern metropolitan schools and 12 southeastern suburban schools in 

Georgia (4th-6th grade students, 15.3% African American, 84.7% Euro-American). 

Sample Size(s) n=1,172 children. 

Mode Self:Paper/pencil. 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability X Internal reliability for 16-item fruit, juice, and vegetable knowledge 

questions (Cronbach's alpha=0.67 year 1, 0.71 year 2, 0.77 year 3). 

Internal Validity 

External Validity 

Sensitive to Change X Time effects for the 16-item fruit, juice, and vegetable knowledge 

questions favored the treatment group (p=0.04) 

Related to 

Outcome(s) 

Other 

Notes: Considered this study on children and adolescents since questions are recommended and also 

appropriate for use with adults. 

Citations: Baranowski T et al. 2000; CA Dept of Health Services 2003-2004; Stables G et al. 2001. 
93

Knowledge 

Is saturated fat usually found in _____? (vegetables and vegetable oils, animal products 

like meat and dairy products) (Y, N) 

Preliminary Rank Medium Instrument Health and Diet Survey (2001) 

Administration 

Population National 

Subgroup Adults in 50 states and District of Columbia; RDD. 

Sample Size(s) n=2,743. 

Mode Interviewer:RDD telephone survey. 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: FDA 2002. 
94

Knowledge 

Which kind of fat is higher in calories? (saturated fat, polyunsaturated fat, they are both 

the same) 

Preliminary Rank Medium Instrument Health and Diet Survey (2001) 

Administration 

Population National 

Subgroup Adults in 50 states and District of Columbia; RDD. 

Sample Size(s) n=2,743 

Mode Interviewer:RDD telephone survey. 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: FDA 2002. 
95

Knowledge 

How many servings from the milk, yogurt, and cheese group would you say a person of 

your age and sex should eat each day for good health? (#) 

Preliminary Rank Medium Instrument National Food Stamp Program Survey (1996) 

Administration 

Population National 

Subgroup Food use questions were posed to a nationally representative population of Food 

Stamp Program (FSP) participants, FSP eligible nonparticipants, and near eligible 

nonparticipants. 

Sample Size(s) n=3,309. 

Mode Interviewer:1,109 in-person and 2,200 telephone. 

Documented Description

Other Languages 

Low-Income X Average gross income for FSP participants was $8,468. 

Low Education Level X 43.1% of FSP participants had less than HS degree. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing 

Notes: 

Citations: Zambrowski A and Ohls J 1999. 
96

Knowledge 

How many servings from the bread, cereal, rice and pasta group would you say a person 

of your age and sex should eat each day for good health? (#) 

Preliminary Rank Medium Instrument National Food Stamp Program Survey (1996) 

Administration 

Population National 

Subgroup Food use questions were posed to a nationally representative population of Food 

Stamp Program (FSP) participants, FSP eligible nonparticipants, and near eligible 

nonparticipants. 

Sample Size(s) n=3,309. 

Mode Interviewer:1,109 in-person and 2,200 telephone. 

Documented Description

Other Languages 

Low-Income X Average gross income for FSP participants was $8,468. 

Low Education Level X 43.1% of FSP participants had less than HS degree. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing 

Notes: 

Citations: Zambrowski A and Ohls J 1999. 
97

Knowledge 

How many servings from the meat, poultry, fish, dry beans, and eggs group would you 

say a person of your age and sex should eat each day for good health? (#) 

Preliminary Rank Medium Instrument National Food Stamp Program Survey (1996) 

Administration 

Population National 

Subgroup Food use questions were posed to a nationally representative population of Food 

Stamp Program (FSP) participants, FSP eligible nonparticipants, and near eligible 

nonparticipants. 

Sample Size(s) n=3,309. 

Mode Interviewer:1,109 in-person and 2,200 telephone. 

Documented Description

Other Languages 

Low-Income X Average gross income for FSP participants was $8,468. 

Low Education Level X 43.1% of FSP participants had less than HS degree. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing 

Notes: 

Citations: Zambrowski A and Ohls J 1999. 
98

Knowledge 

Which one of the following fast food items do you think is lowest in fat? (a cheeseburger, 

a fish sandwich, chicken nuggets, a grilled chicken sandwich) 

Preliminary Rank Medium Instrument National Food Stamp Program Survey (1996) 

Administration 

Population National 

Subgroup Food use questions were posed to a nationally representative population of Food 

Stamp Program (FSP) participants, FSP eligible nonparticipants, and near eligible 

nonparticipants. 

Sample Size(s) n=3,309. 

Mode Interviewer:1,109 in-person and 2,200 telephone. 

Documented Description

Other Languages 

Low-Income X Average gross income for FSP participants was $8,468. 

Low Education Level X 43.1% of FSP participants had less than HS degree. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing 

Notes: 

Citations: Zambrowski A and Ohls J 1999. 
99

Knowledge 

Have you ever heard of a program called The Food Guide Pyramid? (Y/N) 

Preliminary Rank Not Ranked Instrument PSID (1999) 

Administration 

Population National 

Subgroup Biennial survey of a representative sample of U.S. individuals (men, women, and 

children) and the family units in which they reside. 

Sample Size(s) Approximately 7,000 families. 

Mode Interviewer:CATI. 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: University of Michigan 2004. 
100

Knowledge 

Have you ever heard of a program called The 5-A-Day Program? (Y/N) 

Preliminary Rank Not Ranked Instrument PSID (1999) 

Administration 

Population National 

Subgroup Biennial survey of a representative sample of U.S. individuals (men, women, and 

children) and the family units in which they reside. 

Sample Size(s) Approximately 7,000 families. 

Interviewer:CATI. 

Documented

Mode

Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: University of Michigan 2004. 
101

Knowledge 

Have you ever heard of a program called The Dietary Guidelines for Americans? (Y/N) 

Preliminary Rank Not Ranked Instrument PSID (1999) 

Administration 

Population National 

Subgroup Biennial survey of a representative sample of U.S. individuals (men, women, and 

children) and the family units in which they reside. 

Sample Size(s) Approximately 7,000 families. 

Mode Interviewer:CATI. 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: University of Michigan 2004. 
102

ATTITUDES
103

Attitudes 

Do you consider yourself to be overweight, underweight, or about average for your 

height? (overweight, underweight, about average) 

Preliminary Rank Medium Instrument California Dietary Practices Survey (2001) 

Administration 

Population State 

Subgroup Adults in California, oversampling of low-income, African American, and Latino 

participants. 

Sample Size(s) n=1,500-1,700 adults biennially. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: Relates to "healthy weight." 

Citations: Oppen M et al. 2002. 
104

Attitudes 

Do you think you eat the right amount of fruits and vegetables now, or do you think you 

should eat more? (eat right amount, should eat more) 

Preliminary Rank Medium Instrument California Dietary Practices Survey (2001) 

Administration 

Population State 

Subgroup Adults in California, oversampling of low-income, African American, and Latino 

participants. 

Sample Size(s) n=1,500-1,700 adults biennially. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Oppen M et al. 2002. 
105

Attitudes 

Do you consider yourself to be ______? (overweight, underweight, about right) 

Preliminary Rank Medium Instrument Diet and Health Knowledge Survey (DHKS) 

1994-1996 (conducted as follow-up to CSFII) 

Administration 

Population National 

Subgroup Nationally representative; Adults 20+ years of age; Oversampling of low-income. 

Sample Size(s) n=5,649 in national study; n=1,196 for Obayashi S et al 2003 analysis. 

Mode Interviewer:Telephone interview; Trained interviewer. 

Documented Description

Other Languages 

Low-Income X 

Low Education Level 10.8% had less than a HS degree in Obayashi S et al. 2003. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Other tests for reliability and validity were conducted on the DHKS 1989-

1991 instrument. 

Notes: Relates to "healthy weight." DHKS data indicate that many low-income adults do not know 

specific facts related to the health consequences or benefits of certain dietary practices, lack confidence 

that their diets comply with healthful dietary practices (especially among FSP participants), do not engage 

in dietary habits to lower fat and cholesterol, do not meet the Food Guide Pyramid or Dietary Guidelines 

recommendations, and have inadequate usual intakes of several micronutrients; DHKS data provide little 

evidence of differences in dietary intake between FSP participants and other low-income nonparticipants. 

DHKS 1994-1996 results cannot be compared to DHKS 1989-1991 results. 

Citations: USDA/ARS 2004; Gleason P et al. 2000; Obayashi S et al. 2003; Capps O et al. 2002. 
106

Attitudes 

To you personally, is it very important, somewhat important, not too important, or not at all 

important to: Maintain a healthy weight? (very important, somewhat important, not too 

important, not at all important) [If NEEDED, SAY: "The question is not asking about your 

actual eating habits, it is asking about the importance of the statement to you personally."] 

Preliminary Rank Ideal Instrument Diet and Health Knowledge Survey (DHKS) 

1994-1996 (conducted as follow-up to CSFII) 

Administration 

Population National 

Subgroup Nationally representative; Adults 20+ years of age; Oversampling of low-income. 

Sample Size(s) n=5,649 in national study; n=1,196 for Obayashi S et al 2003 analysis; n=5,512 for 

Kuchler F et al 2002 analysis; n=2419 adult women for Lin BH et al 2004 analysis. 

Mode Interviewer:Telephone interview; Trained interviewer. 

Documented Description

Other Languages 

Low-Income X 

Low Education Level 10.8% had less than a HS degree in Obayashi S et al. 2003. 

Evidence

Reliability X Internal consistency for perceived ease of understanding food labels 

(Cronbach alpha = 0.82). 

Internal Validity X Expert panel decided perceived ease of understanding food labels section 

had content validity; Discriminant validity for 3/3 studies 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

X Women who consider it important to maintain a healthy weight had a 

lower BMI by 2.26 than women who did not (t-ratio=-1.98, P<0.05); no 

significant association between importance of maintaining a healthy 

weight and BMI among men; high-income women who consider it 

important to maintain a healthy weight had a lower BMI by 3.17(P<0.05, 

t-ratio=-2.26) than other high-income women; no significant association 

between importance of maintaining a healthy weight and BMI among 

low-income women. 

Other X Other tests for reliability and validity were conducted on the DHKS 1989-

1991 instrument. 

Notes: Relates to "healthy weight." DHKS data indicate that many low-income adults do not know 

specific facts related to the health consequences or benefits of certain dietary practices, lack confidence 

that their diets comply with healthful dietary practices (especially among FSP participants), do not engage 

in dietary habits to lower fat and cholesterol, do not meet the Food Guide Pyramid or Dietary Guidelines 

recommendations, and have inadequate usual intakes of several micronutrients; DHKS data provide little 

evidence of differences in dietary intake between FSP participants and other low-income nonparticipants. 

DHKS 1994-1996 results cannot be compared to DHKS 1989-1991 results. 

Citations: USDA/ARS 2004; Gleason P et al. 2000; Obayashi S et al. 2003; Capps O et al. 2002; Kuchler F et al. 

2002; Lin BH et al. 2004.
107

Attitudes 

Please tell me if you strongly agree, somewhat agree, somewhat disagree, or strongly 

disagree with the statement: Some people are born to be fat and some thin; there is not 

much you can do to change this. (strongly agree, somewhat agree, somewhat disagree, 

strongly disagree) 

Preliminary Rank High Instrument Diet and Health Knowledge Survey (DHKS) 

1994-1996 (conducted as follow-up to CSFII) 

Administration 

Population National 

Subgroup Nationally representative; Adults 20+ years of age; Oversampling of low-income. 

Sample Size(s) n=5,649 in national study; n=1,196 for Obayashi S et al 2003 analysis; n=5,512 for 

Kuchler F et al 2002 analysis; n=2419 adult women for Lin BH et al 2004 analysis. 

Mode Interviewer:Telephone interview; Trained interviewer. 

Documented Description

Other Languages 

Low-Income X 

Low Education Level 10.8% had less than a HS degree in Obayashi S et al. 2003. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

X Women who disagree with this gene theory have lower BMI values by 

0.75 than those who agree (t-ratio=-2.47, P<0.05); men who disagree with 

this gene theory are similar to those who agree by BMI (t-ratio=-0.09, 

NS); low-income women who agree with the gene theory had a higher 

BMI by 1.16 (P<0.05, t-ratio=2.47) than other low-income women; no 

significant association between gene theory and BMI among high income 

women. 

Other X Other tests for reliability and validity were conducted on the DHKS 1989-

1991 instrument. 

Notes: Relates to "healthy weight." DHKS data indicate that many low-income adults do not know 

specific facts related to the health consequences or benefits of certain dietary practices, lack confidence 

that their diets comply with healthful dietary practices (especially among FSP participants), do not engage 

in dietary habits to lower fat and cholesterol, do not meet the Food Guide Pyramid or Dietary Guidelines 

recommendations, and have inadequate usual intakes of several micronutrients; DHKS data provide little 

evidence of differences in dietary intake between FSP participants and other low-income nonparticipants. 

DHKS 1994-1996 results cannot be compared to DHKS 1989-1991 results. 

Citations: USDA/ARS 2004; Gleason P et al. 2000; Obayashi S et al. 2003; Capps O et al. 2002; Kuchler F et al. 

2002; Lin BH et al. 2004.
108

Attitudes 

To you personally, is it very important, somewhat important, not too important, or not at 

all important to: Eat at least two servings of dairy products daily? (very important, 

somewhat important, not too important, not at all important) [IF NEEDED, SAY: "The 

question is not asking about your actual eating habits, it is asking about the importance of 

the statement to you personally."] 

Preliminary Rank High Instrument Diet and Health Knowledge Survey (DHKS) 

1994-1996 (conducted as follow-up to CSFII) 

Administration 

Population National 

Subgroup Nationally representative; Adults 20+ years of age; Oversampling of low-income. 

Sample Size(s) n=5,800. 

Mode Interviewer:Telephone interview; Trained interviewer. 

Documented Description

Other Languages 

Low-Income X 

Low Education Level 10.8% had less than a HS degree in Obayashi S et al. 2003. 

Evidence

Reliability X Internal consistency for perceived ease of understanding food labels 

(Cronbach alpha = 0.82). 

Internal Validity X Expert panel decided perceived ease of understanding food labels section 

had content validity; Discriminant validity for 3/3 studies. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Other tests for reliability and validity were conducted on the DHKS 1989-

1991 instrument. 

Notes: DHKS data indicate that many low-income adults do not know specific facts related to the health 

consequences or benefits of certain dietary practices, lack confidence that their diets comply with healthful 

dietary practices (especially among FSP participants), do not engage in dietary habits to lower fat and 

cholesterol, do not meet the Food Guide Pyramid or Dietary Guidelines recommendations, and have 

inadequate usual intakes of several micronutrients; DHKS data provide little evidence of differences in 

dietary intake between FSP participants and other low-income nonparticipants. DHKS 1994-1996 results 

cannot be compared to DHKS 1989-1991 results. 

Citations: USDA/ARS 2004; Gleason P et al. 2000; Obayashi S et al. 2003; Capps O et al. 2002. 
109

Attitudes 

To you personally, is it very important, somewhat important, not too important, or not at 

all important to: Use sugars only in moderation? (very important, somewhat important, 

not too important, not at all important) [IF NEEDED, SAY: "The question is not asking 

about your actual eating habits, it is asking about the importance of the statement to you 

personally."] 

Preliminary Rank High Instrument Diet and Health Knowledge Survey (DHKS) 

1994-1996 (conducted as follow-up to CSFII) 

Administration 

Population National 

Subgroup Nationally representative; Adults 20+ years of age; Oversampling of low-income. 

Sample Size(s) n=5,800. 

Mode Interviewer:Telephone interview; Trained interviewer. 

Documented Description

Other Languages 

Low-Income X 

Low Education Level 10.8% had less than a HS degree in Obayashi S et al. 2003. 

Evidence

Reliability X Internal consistency for perceived ease of understanding food labels 

(Cronbach alpha = 0.82). 

Internal Validity X Expert panel decided perceived ease of understanding food labels section 

had content validity; Discriminant validity for 3/3 studies. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Other tests for reliability and validity were conducted on the DHKS 1989-

1991 instrument. 

Notes: DHKS data indicate that many low-income adults do not know specific facts related to the health 

consequences or benefits of certain dietary practices, lack confidence that their diets comply with healthful 

dietary practices (especially among FSP participants), do not engage in dietary habits to lower fat and 

cholesterol, do not meet the Food Guide Pyramid or Dietary Guidelines recommendations, and have 

inadequate usual intakes of several micronutrients; DHKS data provide little evidence of differences in 

dietary intake between FSP participants and other low-income nonparticipants. DHKS 1994-1996 results 

cannot be compared to DHKS 1989-1991 results. 

Citations: USDA/ARS 2004; Gleason P et al. 2000; Obayashi S et al. 2003; Capps O et al. 2002. 
110

Attitudes 

Please tell me if you strongly agree, somewhat agree, somewhat disagree, or strongly 

disagree with the statement: Reading food labels takes more time than I can spare. 

(strongly agree, somewhat agree, somewhat disagree, strongly disagree) 

Preliminary Rank High Instrument Diet and Health Knowledge Survey (DHKS) 

1994-1996 (conducted as follow-up to CSFII) 

Administration 

Population National 

Subgroup Nationally representative; Adults 20+ years of age; Oversampling of low-income. 

Sample Size(s) n=5,649 in national study; n=1,196 for Obayashi S et al 2003 analysis. 

Mode Interviewer:Telephone interview; Trained interviewer. 

Documented Description

Other Languages 

Low-Income X 

Low Education Level 10.8% had less than a HS degree in Obayashi S et al. 2003. 

Evidence

Reliability X Internal consistency for perceived barriers to using the food label 

(Cronbach alpha = 0.48) 

Internal Validity X Expert panel decided perceived barrier and benefit to using the food label 

section had content validity; Discriminant validity for 1/2 studies for 

perceived barriers 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Other tests for reliability and validity were conducted on the DHKS 1989-

1991 instrument. 

Notes: DHKS data indicate that many low-income adults do not know specific facts related to the health 

consequences or benefits of certain dietary practices, lack confidence that their diets comply with healthful 

dietary practices (especially among FSP participants), do not engage in dietary habits to lower fat and 

cholesterol, do not meet the Food Guide Pyramid or Dietary Guidelines recommendations, and have 

inadequate usual intakes of several micronutrients; DHKS data provide little evidence of differences in 

dietary intake between FSP participants and other low-income nonparticipants. DHKS 1994-1996 results 

cannot be compared to DHKS 1989-1991 results. 

Citations: USDA/ARS 2004; Gleason P et al. 2000; Obayashi S et al. 2003; Capps O et al. 2002. 
111

Attitudes 

Now think about buying food. When you buy food, how important is: a. how safe the 

food is to eat?, b. nutrition?, c. price?, d. how well the food keeps?, e. how easy the 

food is to prepare?, f. taste? (very important, somewhat important, not too important, 

not at all important) 

Preliminary Rank High Instrument Diet and Health Knowledge Survey (DHKS) 

1994-1996 (conducted as follow-up to CSFII) 

Administration 

Population National 

Subgroup Nationally representative; Adults 20+ years of age; Oversampling of low-income. 

Sample Size(s) n=5,649 in national study; n=1,196 for Obayashi S et al 2003 analysis; n=5,512 for 

Kuchler F et al 2002 analysis. 

Mode Interviewer:Telephone interview; Trained interviewer. 

Documented Description

Other Languages 

Low-Income X 

Low Education Level 10.8% had less than a HS degree in Obayashi S et al. 2003. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

X Taste is important for men (t-ratio for BMI regression of 1.83, P<0.10) 

but insignificant for women (t-ratio for BMI regression of 1.39, NS) 

(pooled t-ratio for BMI regression of 2.57, P<0.05). 

Other X Other tests for reliability and validity were conducted on the DHKS 1989-

1991 instrument. 

Notes: DHKS data indicate that many low-income adults do not know specific facts related to the health 

consequences or benefits of certain dietary practices, lack confidence that their diets comply with healthful 

dietary practices (especially among FSP participants), do not engage in dietary habits to lower fat and 

cholesterol, do not meet the Food Guide Pyramid or Dietary Guidelines recommendations, and have 

inadequate usual intakes of several micronutrients; DHKS data provide little evidence of differences in 

dietary intake between FSP participants and other low-income nonparticipants. Relates to "healthy 

weight." DHKS 1994-1996 results cannot be compared to DHKS 1989-1991 results. 

Citations: USDA/ARS 2004; Gleason P et al. 2000; Obayashi S et al. 2003; Capps O et al. 2002; 

Kuchler F et al. 2002. 
112

Attitudes 

It is very important, somewhat important, not too important, or not important at all to 

maintain a healthy weight? (very important, somewhat important, not too important, not 

important at all) 

Preliminary Rank Medium Instrument National Food Stamp Program Survey (1996) 

Administration 

Population National 

Subgroup Food use questions were posed to a nationally representative population of Food 

Stamp Program (FSP) participants, FSP eligible nonparticipants, and near eligible 

nonparticipants. 

Sample Size(s) n=3,309. 

Mode Interviewer:1,109 in-person and 2,200 telephone. 

Documented Description

Other Languages 

Low-Income X Average gross income for FSP participants was $8,468. 

Low Education Level X 43.1% of FSP participants had less than HS degree. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing. 

Notes: Relates to "healthy weight." 

Citations: Zambrowski A and Ohls J 1999. 
113

Attitudes 

Some people are born to be fat and some thin; there is not much you can do to change 

this. (strongly agree, somewhat agree, somewhat disagree, strongly disagree) 

Preliminary Rank Medium Instrument National Food Stamp Program Survey (1996) 

Administration 

Population National 

Subgroup Food use questions were posed to a nationally representative population of Food 

Stamp Program (FSP) participants, FSP eligible nonparticipants, and near eligible 

nonparticipants. 

Sample Size(s) n=3,309. 

Mode Interviewer:1,109 in-person and 2,200 telephone. 

Documented Description

Other Languages 

Low-Income X Average gross income for FSP participants was $8,468. 

Low Education Level X 43.1% of FSP participants had less than HS degree. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing. 

Notes: Relates to "healthy weight." 

Citations: Zambrowski A and Ohls J 1999. 
114

Attitudes 

Eating a variety of foods each day probably gives you all the vitamins and minerals you 

need. (strongly agree, somewhat agree, somewhat disagree, strongly disagree) 

Preliminary Rank Medium Instrument National Food Stamp Program Survey (1996) 

Administration 

Population National 

Subgroup Food use questions were posed to a nationally representative population of Food 

Stamp Program (FSP) participants, FSP eligible nonparticipants, and near eligible 

nonparticipants. 

Sample Size(s) n=3,309. 

Mode Interviewer:1,109 in-person and 2,200 telephone. 

Documented Description

Other Languages 

Low-Income X Average gross income for FSP participants was $8,468. 

Low Education Level X 43.1% of FSP participants had less than HS degree. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing 

Notes: 

Citations: Zambrowski A and Ohls J 1999. 
115

Attitudes 

My diet is high in fat and cholesterol. (strongly agree, somewhat agree, somewhat 

disagree, strongly disagree) 

Preliminary Rank Medium Instrument National Food Stamp Program Survey (1996) 

Administration 

Population National 

Subgroup Food use questions were posed to a nationally representative population of Food 

Stamp Program (FSP) participants, FSP eligible nonparticipants, and near eligible 

nonparticipants. 

Sample Size(s) n=3,309. 

Mode Interviewer:1,109 in-person and 2,200 telephone. 

Documented Description

Other Languages 

Low-Income X Average gross income for FSP participants was $8,468. 

Low Education Level X 43.1% of FSP participants had less than HS degree. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing. 

Notes: 

Citations: Zambrowski A and Ohls J 1999. 
116

Attitudes 

It is very important, somewhat important, not too important, or not important at all to 

choose a daily diet with 5 or more servings of fruits and vegetables? (very important, 

somewhat important, not too important, not important at all) 

Preliminary Rank Medium Instrument National Food Stamp Program Survey (1996) 

Administration 

Population National 

Subgroup Food use questions were posed to a nationally representative population of Food 

Stamp Program (FSP) participants, FSP eligible nonparticipants, and near eligible 

nonparticipants. 

Sample Size(s) n=3,309. 

Mode Interviewer:1,109 in-person and 2,200 telephone. 

Documented Description

Other Languages 

Low-Income X Average gross income for FSP participants was $8,468. 

Low Education Level X 43.1% of FSP participants had less than HS degree. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing. 

Notes: 

Citations: Zambrowski A and Ohls J 1999. 
117

Attitudes 

In the past month, have you thought about changes you could make to increase the 

amount of fruits and vegetables in your diet? (Y, N) How confident are you that you will 

make some of these changes during the next month? (very confident, somewhat confident, 

mildly confident, not at all confident) 

Preliminary Rank Medium Instrument National Food Stamp Program Survey (1996) 

Administration 

Population National 

Subgroup Food use questions were posed to a nationally representative population of Food 

Stamp Program (FSP) participants, FSP eligible nonparticipants, and near eligible 

nonparticipants. 

Sample Size(s) n=3,309. 

Mode Interviewer:1,109 in-person and 2,200 telephone. 

Documented Description

Other Languages 

Low-Income X Average gross income for FSP participants was $8,468. 

Low Education Level X 43.1% of FSP participants had less than HS degree. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing. 

Notes: 

Citations: Zambrowski A and Ohls J 1999. 
118

Attitudes 

It is very important, somewhat important, not too important, or not important at all to 

use choose foods low in saturated fat? (very important, somewhat important, not too 

important, not important at all) 

Preliminary Rank Medium Instrument National Food Stamp Program Survey (1996) 

Administration 

Population National 

Subgroup Food use questions were posed to a nationally representative population of Food 

Stamp Program (FSP) participants, FSP eligible nonparticipants, and near eligible 

nonparticipants. 

Sample Size(s) n=3,309. 

Mode Interviewer:1,109 in-person and 2,200 telephone. 

Documented Description

Other Languages 

Low-Income X Average gross income for FSP participants was $8,468. 

Low Education Level X 43.1% of FSP participants had less than HS degree. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing. 

Notes: 

Citations: Zambrowski A and Ohls J 1999. 
119

Attitudes 

In the past month, have you thought about changes you could make to decrease the 

amount of fat in your diet? (Y, N) How confident are you that you will make some of 

these changes during the next month? (very confident, somewhat confident, mildly 

confident, not at all confident) 

Preliminary Rank Medium Instrument National Food Stamp Program Survey (1996) 

Administration 

Population National 

Subgroup Food use questions were posed to a nationally representative population of Food 

Stamp Program (FSP) participants, FSP eligible nonparticipants, and near eligible 

nonparticipants. 

Sample Size(s) n=3,309. 

Mode Interviewer:1,109 in-person and 2,200 telephone. 

Documented Description

Other Languages 

Low-Income X Average gross income for FSP participants was $8,468. 

Low Education Level X 43.1% of FSP participants had less than HS degree. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing. 

Notes: 

Citations: Zambrowski A and Ohls J 1999. 
120

Attitudes 

It is very important, somewhat important, not too important, or not important at all to 

use choose foods with adequate fiber? (very important, somewhat important, not too 

important, not important at all) 

Preliminary Rank Medium Instrument National Food Stamp Program Survey (1996) 

Administration 

Population National 

Subgroup Food use questions were posed to a nationally representative population of Food 

Stamp Program (FSP) participants, FSP eligible nonparticipants, and near eligible 

nonparticipants. 

Sample Size(s) n=3,309. 

Mode Interviewer:1,109 in-person and 2,200 telephone. 

Documented Description

Other Languages 

Low-Income X Average gross income for FSP participants was $8,468. 

Low Education Level X 43.1% of FSP participants had less than HS degree. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing. 

Notes: 

Citations: Zambrowski A and Ohls J 1999. 
121

Attitudes 

On a scale of 1 to 6, where "1" is Not at All Important and "6" is Very Important, when 

shopping for food, how important is nutrition? (1-6) 

Preliminary Rank Medium Instrument National Food Stamp Program Survey (1996) 

Administration 

Population National 

Subgroup Food use questions were posed to a nationally representative population of Food 

Stamp Program (FSP) participants, FSP eligible nonparticipants, and near eligible 

nonparticipants. 

Sample Size(s) n=3,309. 

Mode Interviewer:1,109 in-person and 2,200 telephone. 

Documented Description

Other Languages 

Low-Income X Average gross income for FSP participants was $8,468. 

Low Education Level X 43.1% of FSP participants had less than HS degree. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other X Cognitive testing. 

Notes: 

Citations: Zambrowski A and Ohls J 1999. 
122

Attitudes 

Do you strongly agree, somewhat agree, somewhat disagree, or strongly disagree with this 

statement? I eat foods I enjoy, even if they’re not so good for me. (strongly agree, 

somewhat agree, somewhat disagree, strongly disagree) 

Preliminary Rank Not Ranked Instrument Shopping for Health (2003) 

Administration 

Population National 

Subgroup Nationally representative population of adults. 

Sample Size(s) n=1,003. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Food Marketing Institute 2003. 
123

Attitudes 

Do you strongly agree, somewhat agree, somewhat disagree, or strongly disagree with this 

statement? I try hard to eat healthfully so that I can avoid health problems later in life. 

(strongly agree, somewhat agree, somewhat disagree, strongly disagree) 

Preliminary Rank Not Ranked Instrument Shopping for Health (2003) 

Administration 

Population National 

Subgroup Nationally representative population of adults. 

Sample Size(s) n=1,003. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Food Marketing Institute 2003. 
124

Attitudes 

[BASED ON THOSE WHO SAY THEIR DIET COULD BE HEALTHIER] Is this a 

major reason, a minor reason, or not a reason (your diet is not as healthy as it could be)? 

It costs more to eat healthy foods. (major reason, a minor reason, not a reason) 

Preliminary Rank Not Ranked Instrument Shopping for Health (2003) 

Administration 

Population National 

Subgroup Nationally representative population of adults. 

Sample Size(s) n=1,003. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Food Marketing Institute 2003. 
125

Attitudes 

[BASED ON THOSE WHO SAY THEIR DIET COULD BE HEALTHIER] Is this a 

major reason, a minor reason, or not a reason (your diet is not as healthy as it could be)? 

I'm too busy to take the time to eat healthfully. (major reason, a minor reason, not a 

reason) 

Preliminary Rank Not Ranked Instrument Shopping for Health (2003) 

Administration 

Population National 

Subgroup Nationally representative population of adults. 

Sample Size(s) n=1,003. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Food Marketing Institute 2003. 
126

Attitudes 

[BASED ON THOSE WHO SAY THEIR DIET COULD BE HEALTHIER] Is this a 

major reason, a minor reason, or not a reason (your diet is not as healthy as it could be)? 

Healthy foods don't taste good. (major reason, a minor reason, not a reason) 

Preliminary Rank Not Ranked Instrument Shopping for Health (2003) 

Administration 

Population National 

Subgroup Nationally representative population of adults. 

Sample Size(s) n=1,003. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Food Marketing Institute 2003. 
127

Attitudes 

[BASED ON THOSE WHO SAY THEIR DIET COULD BE HEALTHIER] Is this a 

major reason, a minor reason, or not a reason (your diet is not as healthy as it could be)? 

Healthy foods are difficult to prepare. (major reason, a minor reason, not a reason) 

Preliminary Rank Not Ranked Instrument Shopping for Health (2003) 

Administration 

Population National 

Subgroup Nationally representative population of adults. 

Sample Size(s) n=1,003. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Food Marketing Institute 2003. 
128

BEHAVIORS
129

Behaviors 

Did you eat a morning meal (breakfast) yesterday? (Y, N) 

Preliminary Rank Medium Instrument California Dietary Practices Survey (2001) 

Administration 

Population State 

Subgroup Adults in California, oversampling of low-income, African American, and Latino 

participants. 

Sample Size(s) n=1,500-1,700 adults biennially 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Oppen M et al. 2002. 
130

Behaviors 

Are you presently trying to lose weight? (Y, N) 

Preliminary Rank Medium Instrument California Dietary Practices Survey (2001) 

Administration 

Population State 

Subgroup Adults in California, oversampling of low-income, African American, and Latino 

participants. 

Sample Size(s) n=1,500-1,700 adults biennially 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: Relates to "healthy weight." 

Citations: Oppen M et al. 2002. 
131

Behaviors 

Yesterday, did you eat any potato chips, corn chips, cheese puffs, pork rinds or other 

fried snack foods? Do not include reduced fat or fat-free items. [INTERVIEWER: 

INCLUDE ALL FRIED SNACK FOODS] (Y, N) 

Preliminary Rank Medium Instrument California Dietary Practices Survey (2001) 

Administration 

Population State 

Subgroup Adults in California, oversampling of low-income, African American, and Latino 

participants. 

Sample Size(s) n=1,500-1,700 adults biennially. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Oppen M et al. 2002. 
132

Behaviors 

Now think about food labels. When you buy foods, do you use (SECTION) often, 

sometimes, rarely, or never? SECTION: a. The list of ingredients? B. The short 

phrases on the label like "low-fat" or "light" or "good source of fiber"?, c. The nutrition 

panel that tells the amount of calories, protein, fat, and such in a serving of the food?, d. 

The information about the size of a serving? e. Statements on the label that describe 

health benefits of nutrients or foods? (often, sometimes, rarely, never) 

Preliminary Rank Ideal Instrument Diet and Health Knowledge Survey (DHKS) 

1994-1996 (conducted as follow-up to CSFII) 

Administration 

Population National 

Subgroup Nationally representative; Adults 20+ years of age; Oversampling of low-income. 

Sample Size(s) n=5,649 in national study; n=1,196 for Obayashi S et al 2003 analysis; n=2,952 for 

Perez-Escamilla R et al 2002 analysis. 

Mode Interviewer:Telephone interview; Trained interviewer. 

Documented Description

Other Languages 

Low-Income X 

Low Education Level 10.8% had less than a HS degree in Obayashi S et al. 2003. 

Evidence

Reliability X Internal consistency for use of food labels (Cronbach alpha = 0.91) 

Internal Validity X Expert panel decided section had content validity; Discriminant validity 

for 2/4 studies; Correspondence validity of food label use and total HEI 

(r=0.2 P<0.0001). 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

X Compared to a reference group, those that were high-income and used 

food labels were significantly less likely to have a lower HEI (OR=0.42, 

95% CI: 0.31, 0.56, P<0.001), those that were high-income but did not 

use food labels were as likely to have a low HEI (OR=1.08, 95% CI: 0.74, 

1.54), and those that were low-income and used food labels were 

significantly less likely to have a low HEI (OR=0.62, 95% CI: 0.48, 0.80, 

P<0.001). 

Other X Other tests for reliability and validity were conducted on the DHKS 1989-

1991 instrument. 

Notes: DHKS data indicate that many low-income adults do not know specific facts related to the health 

consequences or benefits of certain dietary practices, lack confidence that their diets comply with healthful dietary 

practices (especially among FSP participants), do not engage in dietary habits to lower fat and cholesterol, do not 

meet the Food Guide Pyramid or Dietary Guidelines recommendations, and have inadequate usual intakes of several 

micronutrients; DHKS data provide little evidence of differences in dietary intake between FSP participants and 

other low-income nonparticipants. DHKS 1994-1996 results cannot be compared to DHKS 1989-1991 results. 

Citations: USDA/ARS 2004; Gleason P et al. 2000; Obayashi S et al. 2003; Capps O et al. 2002; Perez-Escamilla R 

et al. 2002.
133

Behaviors 

Now think about the foods you eat. Would you say you always, sometimes, rarely, or 

never: Have fruit for dessert when you eat dessert? (always, sometimes, rarely, never) 

Preliminary Rank High Instrument Diet and Health Knowledge Survey (DHKS) 

1994-1996 (conducted as follow-up to CSFII) 

Administration 

Population National 

Subgroup Nationally representative; Adults 20+ years of age; Oversampling of low-income. 

Sample Size(s) n=5,649 in national study; n=1,196 for Obayashi S et al 2003 analysis. 

Mode Interviewer:Telephone interview; Trained interviewer. 

Documented Description

Other Languages 

Low-Income X 

Low Education Level 10.8% had less than a HS degree in Obayashi S et al. 2003. 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

X Significant predictor of saturated fat intake. 

Other X Other tests for reliability and validity were conducted on the DHKS 1989-

1991 instrument. 

Notes: DHKS data indicate that many low-income adults do not know specific facts related to the health 

consequences or benefits of certain dietary practices, lack confidence that their diets comply with healthful 

dietary practices (especially among FSP participants), do not engage in dietary habits to lower fat and 

cholesterol, do not meet the Food Guide Pyramid or Dietary Guidelines recommendations, and have 

inadequate usual intakes of several micronutrients; DHKS data provide little evidence of differences in 

dietary intake between FSP participants and other low-income nonparticipants. DHKS 1994-1996 results 

cannot be compared to DHKS 1989-1991 results. 

Citations: USDA/ARS 2004; Gleason P et al. 2000; Obayashi S et al. 2003; Capps O et al. 2002. 
134

Behaviors 

I reduce fat in recipes by substituting ingredients and cutting portions. (strongly disagree, 

disagree, neutral/NA, agree, strongly agree) 

Preliminary Rank Medium Instrument Eating Behavior Patterns Questionnaire (2003) 

Administration 

Population Local 

Subgroup Convenience sample of African American women in Nashville, TN. 

Sample Size(s) n=277. 

Mode Not specified. 

Documented Description

Other Languages 

Low-Income 

Low Education Level 23% had less than HS degree. 

Evidence

Reliability X Within "low-fat eating" group, internal consistency = .84. 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

X Within "low-fat eating" group, FFQ correlations: total fat = -.37, 

saturated fat = -.37, fiber= -.04. 

Other X Cognitive testing. 

Notes: Suggest that this question be made into 2 questions. 

Citations: Schulndt DG et al. 2003. 
135

Behaviors 

I choose healthy foods to prevent heart disease. (strongly disagree, disagree, neutral/NA, 

agree, strongly agree) 

Preliminary Rank Medium Instrument Eating Behavior Patterns Questionnaire (2003) 

Administration 

Population Local 

Subgroup Convenience sample of African American women in Nashville, TN. 

Sample Size(s) n=277. 

Mode Not specified. 

Documented Description

Other Languages 

Low-Income 

Low Education Level 23% had less than HS degree. 

Evidence

Reliability X Within "low-fat eating" group, internal consistency = .84. 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

X Within "low-fat eating" group, FFQ correlations: total fat = -.37, saturated 

fat = -.37, fiber= -.04. 

Other X Cognitive testing. 

Notes: 

Citations: Schulndt DG et al. 2003. 
136

Behaviors 

I carefully watch the portion sizes of my foods. (strongly disagree, disagree, neutral/NA, 

agree, strongly agree) 

Preliminary Rank Medium Instrument Eating Behavior Patterns Questionnaire (2003) 

Administration 

Population Local 

Subgroup Convenience sample of African American women in Nashville, TN. 

Sample Size(s) n=277. 

Mode Not specified. 

Documented Description

Other Languages 

Low-Income 

Low Education Level 23% had less than HS degree. 

Evidence

Reliability X Within "low-fat eating" group, internal consistency = .84. 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

X Within "low-fat eating" group, FFQ correlations: total fat = -.37, saturated 

fat = -.37, fiber= -.04. 

Other X Cognitive testing. 

Notes: 

Citations: Schulndt DG et al. 2003. 
137

Behaviors 

How often do you shop with a grocery list? (do not do, seldom, sometimes, most of the 

time, almost always) 

Preliminary Rank High Instrument EFNEP (2001) 

Administration 

Population State 

Subgroup Nonpregnant nonlactating women ages 12-50 in VA, CO, OK, SD. 

Sample Size(s) n=5,159. 

Mode Interviewer:Program administrators. 

Documented Description

Other Languages 

Low-Income X Two-thirds of the sample had a household income of less than $500 per 

month. 

Low Education Level 

Evidence

Reliability X Internal consistency: .27 thinks about healthy choices, .30 plans meals, 

.22 use food labels. 

Internal Validity X Content validity by experts. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

No significant correlations found. 

Other 

Notes: 

Citations: Hersey J et al. 2001; Anliker J et al. 2003. 
138

Behaviors 

In the past 3 months, how often did you eat fruit for dessert? (usually/always, sometimes, 

rarely, never) 

Preliminary Rank Medium Instrument Fat and Fiber Behavior Questionnaire (1997) 

Administration 

Population Local 

Subgroup Randomized clinical trial in Puget Sound area. 68% were women, mean age = 51. 

Sample Size(s) n=1,796. 

Mode Interviewer:Telephone. 

Documented Description

Other Languages 

Low-Income 

Low Education Level Participants were well educated. 

Evidence

Reliability X Within "replace high-fat with fruits and vegetables" group test-retest 

correlation coefficient =.61, baseline internal consistency = .50. 

Internal Validity X Within "replace high-fat with fruits and vegetables" criterion: FFQ 

baseline correlation = .33. Within "fruits and vegetables" criterion: FFQ 

baseline correlation = .43. 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: Modified version of the Food Habits Questionnaire. 

Citations: Shannon J et al. 1997. 
139

Behaviors 

Does your current weight loss plan include: some form of dieting, that is, eating 

differently from the way you usually eat for the sake of losing weight? Physical exercise, 

such as walking, swimming or calisthenics? Eating meal replacements, such as ultra SlimFast, in powder, liquid, tablet, or water form? Fasting for twenty-four hours or longer? 

Going to a weight loss program such as Weight Watchers or Nutri-System, which may 

offer diet counseling, therapy, behavior modification, or hypnosis? Going to any other 

kind of weight loss program offered by a physician, weight loss center, school or clinic? 

Causing yourself to vomit after you eat? Surgery, such as wiring your jaw, liposuction, 

gastric bubble, or some other medical procedure? (Y/N) 

Preliminary Rank Not Ranked Instrument FDA/NHLBI Weight Loss Practices Survey 

(1991) 

Administration 

Population National 

Subgroup Noninstitutionalized adults who are trying to lose weight at the time of the survey. 

Sample Size(s) n=1,655. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: There were inquiries about 8 other weight loss practices not included among the response category 

options above. Relates to "healthy weight." 

Citations: Interagency Board for Nutrition Monitoring and Related Research 2000. 
140

Behaviors 

[IF RESPONDENT DOES NOT CONSIDER "DIETING" AS PART OF WEIGHT 

LOSS PLAN, SKIP] Does your diet plan call for avoiding or eating less of certain foods 

than you did before you began your diet plan? (Y/N) What types of food are you trying to 

avoid or eat less of? [MARK ALL THAT APPLY. IF "FATTENING FOODS" OR 

"JUNK FOODS" MENTIONED, ASK: WHAT KINDS OF FOOD DO YOU MEAN?] 

(PORK; OTHER RED MEATS; FRIED FOODS; CAKE, PIES, COOKIES, ICE 

CREAM, DOUGHNUTS; BREADS, BISCUITS, ROLLS; STARCHY FOODS, RICE, 

POTATOES; SALT; SUGAR, SWEETS, CANDY, SYRUPS; CHIPS, NUTS, PORK 

RINDS, PRETZELS, SALTY SNACKS; EGGS; WHOLE MILK/CHEESE/OTHER 

DAIRY PRODUCTS; MARGARINE, BUTTER, OIL; FAT/SATURATED FAT/FATTY 

FOODS; SWEET DRINKS, COKE, KOOL-AID, SWEET TEA; ALCOHOL; OTHER 

(SPECIFY)) 

Preliminary Rank Not Ranked Instrument FDA/NHLBI Weight Loss Practices Survey 

(1991) 

Administration 

Population National 

Subgroup Noninstitutionalized adults who are trying to lose weight at the time of the survey. 

Sample Size(s) n=1,656. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: Relates to "healthy weight." 

Citations: Interagency Board for Nutrition Monitoring and Related Research 2000. 
141

Behaviors 

[IF RESPONDENT DOES NOT CONSIDER "DIETING" AS PART OF WEIGHT 

LOSS PLAN, SKIP] Does your diet plan call for eating more of certain foods than you 

did before you began your diet plan? (Y/N) What types of food are you trying to eat more 

of? [MARK ALL THAT APPLY.] (CHICKEN, PORK; OTHER RED MEAT; SALADS; 

FRUITS; VEGETABLES; CEREALS, GRAINS, BREAD; OTHER HIGH FIBER 

FOODS; EGGS, LOWFAT/SKIM MILK; OTHER LOWFAT FOODS; OTHER 

(SPECIFY)) 

Preliminary Rank Not Ranked Instrument FDA/NHLBI Weight Loss Practices Survey 

(1991) 

Administration 

Population National 

Subgroup Noninstitutionalized adults who are trying to lose weight at the time of the survey. 

Sample Size(s) n=1,657. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: Relates to "healthy weight." 

Citations: Interagency Board for Nutrition Monitoring and Related Research 2000. 
142

Behaviors 

[IF RESPONDENT DOES NOT CONSIDER "DIETING" AS PART OF WEIGHT 

LOSS PLAN, SKIP] As part of your current weight loss plan, are you skipping any 

meals? (Y/N) Which meal or meals are you skipping [MARK ALL THAT APPLY.] 

(BREAKFAST; LUNCH/MIDDAY OR NOON MEAL; DINNER /EVENING MEAL) 

Preliminary Rank Not Ranked Instrument FDA/NHLBI Weight Loss Practices Survey 

(1991) 

Administration 

Population National 

Subgroup Noninstitutionalized adults who are trying to lose weight at the time of the survey. 

Sample Size(s) n=1,658. 

Mode Interviewer:Telephone (RDD). 

Documented Description

Other Languages 

Low-Income 

Low Education Level 

Evidence

Reliability 

Internal Validity 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: Relates to "healthy weight." 

Citations: Interagency Board for Nutrition Monitoring and Related Research 2000. 
143

Behaviors 

Do you eat fruit and vegetables as snacks? (usually/always, often, sometimes, rarely, 

never) 

Preliminary Rank Ideal Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Test-retest correlation coefficient = .53. 

Internal Validity X Correlation coefficient to servings of fruit from 24 hour recall = .22. 

External Validity 

Sensitive to Change X p value = <.05 

Related to 

Outcome(s) 

X Correlation to serum carotenoid level =.27 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
144

Behaviors 

Would you describe your diet as excellent, very good, good, fair, or poor? 

Preliminary Rank Ideal Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability Control group reliability test not significant. 

Internal Validity X Correlation coefficient to servings of fruit from 24 hour recall = .35. 

Coefficient to average of fruit =.30. 

External Validity 

Sensitive to Change X p value = <.001 

Related to 

Outcome(s) 

X Correlation to serum carotenoid level =.45. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
145

Behaviors 

When shopping, do you use the Nutrition Facts on the food label to choose foods? 

(usually/always, often, sometimes, rarely, never) 

Preliminary Rank Ideal Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Test-retest correlation coefficient = 0.39. 

Internal Validity X Correlation coefficient to servings of fruit from 24 hour recall = .23. 

Coefficient to HEI =.25. 

External Validity 

Sensitive to Change X p value = <.001 

Related to 

Outcome(s) 

X Correlation to serum carotenoid level =.25. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
146

Behaviors 

Do you buy sweetened cereal (like Frosted Flakes, Fruit Loops, Lucky Charms, etc.)? 

(usually/always, often, sometimes, rarely, never) 

Preliminary Rank High Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability Control group reliability test not significant. 

Internal Validity X Correlation coefficient to servings of fruit from 24 hour recall = .23 

External Validity 

Sensitive to Change 

Related to 

Outcome(s) 

Other 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003. 
147

Behaviors 

Think about how you usually do things now. How many times a week do you usually eat 

food from a fast-food restaurant? (#) 

Preliminary Rank High Instrument Food Behavior Checklist (1997) 

Administration 

Population Local 

Subgroup African American and White FSP participants from 7 counties in CA. 8 California 

counties among women eligible for food stamps. 9 counties in California of women 

receiving food stamps. 

Sample Size(s) n=95, n=100, n=132. 

Mode Interviewer:Telephone and in-person among a group. 

Documented Description

Other Languages X Spanish

Low-Income X 

Low Education Level 

Evidence

Reliability X Test-retest correlation coefficient = .58. 

Internal Validity X Correlation coefficient to servings of vegetables from 24 hour recall = -

.20 and carotene = -.27. Coefficient to total fat =.28 and saturated fat = 

.25. 

External Validity 

Sensitive to Change Not significant. 

Related to 

Outcome(s) 

No significant correlation to serum carotenoid level. 

Other X A Flesch Reading Ease score of 96 and a Flesch Kincaid score of 2.8 

indicates less than fourth grade reading level. 

Notes: 

Citations: Murphy SP et al. 1998; Murphy SP et al. 2001; Townsend MS et al. 2003.
APPENDIX A 

INSTRUMENTS INVENTORIED AND QUESTION TOPIC AREAS
A-1 

TABLE A.1 

INSTRUMENTS INVENTORIED AND QUESTION TOPIC AREAS 

Dietary Intake 

Instrument 

Number of 

Questions 

Inventoried

Fruits and 

Vegetables 

Grains, 

Legumes, 

and Fiber Variety Fat 

Calcium 

Food 

Sources 

Nonalcoholic 

Beverages Knowled

Behavioral Risk Factor Surveillance System State (BRFSS) Questionnaire (2003) 

6 X

California Dietary Practices Survey (2001) 34 X X X X X X Current Population Survey (CPS) (2001) 4 Diet and Health Knowledge Survey (DHKS) 1994-1996 80 X X X X X X Eating Behavior Patterns Questionnaire (2003) 51 X X Expanded Food and Nutrition Education Program (EFNEP) Survey (2001) 

4 

Fat and Fiber Behavior Questionnaire (1997) 28 X X X X X Fat Screener (1996-2002) 17 X X X Food Behavior Checklist (Murphy) (1997) 34 X X X X X X Food Habits Questionnaire (FHQ) (1990) 20 X X X X Fruit, Vegetable, and Fiber Screener (1996-2002) 9 X XGeneral Knowledge (Reynolds) (2002) 9 XGimme 5 Fruit, Juice, and Vegetables for Fun and Health Project (1996) 

2 X

Health Behaviors Module (2000) 4 X Health Beliefs Questionnaire (1997) 2 X
TABLE A.1 (continued) 

A-2 

Dietary Intake 

Instrument 

Number of 

Questions 

Inventoried

Fruits and 

Vegetables 

Grains, 

Legumes, 

and Fiber Variety Fat 

Calcium 

Food 

Sources 

Nonalcoholic 

Beverages Knowled

Health and Diet Survey (2001) 35 X X Health Habits and History Questionnaire (HHHQ) (1987) 8 X X X Massachusetts' TreatWell 5 A Day Program (1996) 3 X X XNational 5 A Day Survey (1997) 2 X XNational Cancer Institute (NCI) All-Day Screener (2000) 

11 X X

National Cancer Institute (NCI) By Meal Screener (2000) 

10 X X

National Cancer Institute (NCI) Diet History Questionnaire (DHQ) (2002) 

9 X X

National Food Stamp Program Survey (1996) 47 X X X National Health Interview Survey (NHIS) Sample Adult Core (2001) 

1 X

National Health and Nutrition Examination Survey (NHANES) Diet Behavior and Nutrition Sample Person Questionnaire (DBQ) (1999-2003) 

14 X X X X X 

National Health and Nutrition Examination Survey (NHANES) Weight History Sample Person Questionnaire (WHQ) (1999-2003) 

2 

NOTE: This table does not include the 13 ‘not ranked’ questions from instruments listed in Appendix D. 
APPENDIX B 

INSTRUMENTS REVIEWED BUT NOT INVENTORIED
TABLE B.1

INSTRUMENTS REVIEWED BUT NOT INVENTORIED 

Instrument 

Date of Development, 

Publication, or Most 

Recent Revision 

Block Food Frequency Questionnaire 1987 

Continuing Survey of Food Intakes by Individuals (CSFII) 1994-1996 

Diet Habit Survey 1992 

Diet Quality Index for Pregnancy 2002 

Dietary Risk Assessment 1991 

Food Behavior Checklist (Kristal) 1990 

Fruit, Juice, and Vegetable Food Frequency Questionnaire 1999 

Harvard Food Frequency Questionnaire 1985 

MEDFICTS 2001

Modified Food Habits Questionnaire 1997 

National Health Interview Survey 2003 

National Health Interview Survey Cancer Control Supplement 1987 

National Survey of America's Families 1999 

Nutrition Screening Initiative 2002 

Pediatric Nutrition Surveillance System 2001 

Perceived Diabetes and Dietary Competence 2002 

Pregnancy Nutrition Surveillance System 1996 

Pregnancy Risk Assessment Monitoring System 2002 

PrimeScreen 2000

Quick Check for Fat 1992 

Survey of Income and Program Participation 2001 

Women's Health Trial Food Frequency Questionnaire 1996 

B-1 
APPENDIX C 

GLOSSARY OF TERMS USED IN THE NOTEBOOK TEMPLATE
C-1

 

GLOSSARY 

The notebook template is designed to show the primary research findings with respect to the 

administration and testing of the survey instruments and the questions or sets of questions that 

were selected for the notebook.1

 This appendix defines the terms we used in our reporting of the 

documented evidence that we reviewed. 

INSTRUMENT 

‘Instrument’ refers to the larger data collection questionnaire or other survey tool that a 

single question or set of questions came from, if applicable. Potential descriptions include the 

specific national, state, or local instruments (e.g., BRFSS; NHANES; EFNEP module; Food 

Behavior Checklist; Gimme 5 Fruit, Juice, and Vegetables for Fun and Health). In addition, we 

include the year of the most recent instrument. 

ADMINISTRATION 

Population 

The ‘population’ refers to whether the single question or set of questions was used with a 

national, state, or local sample. 

Subgroup 

The ‘sub-group’ characteristic captures specific information on the sample population the 

single question or set of questions was used with, including, as available: 

• Geographical setting 

• Age range 

• Gender 

• Ethnic breakdown of the sample 

• Lifecycle stage (e.g., elderly, pregnant women, lactating women) 

• FSNE or other federal assistance program audience 

1

Each template contains one question or set of questions, the corresponding response 

categories in parentheses, and, if applicable, interviewer instructions. Response categories and 

interviewer instructions in capital letters indicate that the information was not read to the 

respondent. 
C-2

• Over-sampling of a specific group 

Sample Size(s) 

This section includes the sample size(s) the single question or set of questions was used 

with, or the sample size that the research findings are reported for. 

Mode 

‘Self-administered’ refers to the individual subject entering a response to the single question 

or set of questions. If known, we indicate whether the subject used a paper/pencil or automated 

instrument, the time it took to complete the question or set of questions, the setting (e.g., office, 

home, clinic), and whether the instrument was administered in a group or individual setting. 

‘Interviewer-administered’ refers to a person other than the subject entering a response to 

the single question or set of questions based on an in-person or telephone interview. If known, 

we indicate whether this person was a trained interviewer, instructor, caregiver, or other 

designation. We also include the time it took to complete the question or set of questions, the 

setting (e.g., office, home, clinic), and whether the instrument was administered in a group or 

individual setting. 

Other Languages 

The review indicates if the question or set of questions was administered in other languages 

or dialects, if known. 

Low-Income 

Low-income is defined as gross income below 130% of the poverty level, which represents 

the cut-off point for Food Stamp Program eligibility. The percent-of-poverty-line information 

was not specifically included in all of the citations we reviewed; if the author used the term lowincome to describe their sample, we indicated that it was a low-income audience. 

Low Education Level 

A ‘low education level’ is defined as having less than a high school degree or equivalent. 

EVIDENCE 

Reliability 

‘Reliability’ refers to whether an estimate can be reproduced when the measure is repeated 

(1,2). There are various forms of reliability noted in our review, as defined below: 
C-3

• Internal consistency: assesses the consistency within a set of items and is often 

reported as a Cronbach’s coefficient alpha. For example, a respondent may indicate 

from one question that they never consume dairy products, but then respond to a 

different question that they drink 3 glasses of cow’s milk a day. If these responses 

were typical, these questions would have low internal consistency (2,3,4,5). 

• Test-retest reliability: also referred to as stability; assesses the consistency of a 

measure over time and is usually expressed as a correlation coefficient. For example, 

suppose an individual responds that they average two servings of vegetables a day, 

and two weeks later when asked the same question, they say they average two 

servings of vegetables a day. The question would have high test-retest reliability if 

the intake was truly unchanged (2,4,5,6). 

• Inter-rater reliability: sometimes referred to as inter-observer reliability; assesses the 

degree to which different raters/observers give consistent estimates of the same 

phenomenon (2). 

If included in the citation, correlation coefficients and Cronbach’s alpha coefficients are 

provided to express reliability. 

Validity refers to whether the method measures what it purports to measure and provides an 

unbiased estimate. There are two general categories of validity: internal and external (1,2). 

Internal Validity 

‘Internal validity’ refers to whether the study was properly conducted without major 

methodologic problems and is without substantial measurement, selection or confounding bias. 

There are various forms of internal validity, as defined below (1,2). 

• Construct validity: scores from an instrument provide a good measure of a concept. 

For example, if questions are tested between two groups with extreme differences in 

knowledge about the relevant topic, the group with more knowledge should score 

higher. It can also be tested before and after an intervention, and the scores after the 

intervention should be higher if the intervention is known to have had an effect 

(3,4,6). 

• Content validity: the instrument items reasonably represent the subject under 

investigation. For example, a detailed description justifying the content of the 

questionnaire could be provided, the questionnaire could be reviewed by a panel of 

experts to ensure all of the important aspects are covered, or members of the target 

audience could be asked if all the appropriate questions are included (3,4,6). 

• Criterion validity: this measures a newly developed instrument against another 

standard. For example, mean nutrient intakes calculated from a short food frequency 

questionnaire can be compared to mean nutrient intakes calculated from a 

standardized dietary method (e.g., 24-hour dietary recalls, dietary records, or dietary 
C-4

history), or to biomarkers (2,3,4,5,7). Predictive validity, a type of criterion validity, 

describes the extent to which the measure will predict future outcomes (1,3). 

If included in the citation, correlation coefficients are provided to express internal validity. 

This could include comparison to self-report methods (e.g., 24-hour recall, record, diet history, 

food frequency questionnaire) or non-self-report methods (e.g., biomarkers, urinary nitrogen, 

doubly-labeled water, observation). 

External Validity 

‘External validity’ refers to whether the results can be generalized to a larger population. 

This might be indicated, for example, if the results were externally validated, or if the items were 

used with a randomized, representative sample (1,2). 

Sensitive to Change 

The ‘sensitive to change’ characteristic refers to the magnitude of difference over time by 

comparing a pre-test to a post-test. For example, in comparing results from a pre-test and posttest, the response to a question should change in the proposed direction after intervention, if the 

intervention is known to have an effect. 

Related to Outcome(s)

This section indicates whether the question or set of questions has been shown to be related 

to an intermediate or long-term nutrition outcome (e.g., usual dietary or nutrient intake, iron 

deficiency anemia, serum carotenoids) or health outcome (e.g., overweight, serum cholesterol, 

blood pressure level). Outcomes of interest are those that are consistent with the conceptual 

model of ‘diet to health’ (8). 

Other 

The ‘other’ characteristic includes the following information if specifically noted in a 

citation: 

• Cognitive testing: ensuring the instruments are appropriate in terms of age, literacy 

level, and culture. This typically refers to one-on-one testing or ‘think-aloud’ testing 

of the questions prior to final development and use. For example, focus groups can be 

used to explore concepts and conduct retrospective ‘think aloud’ interviews to form 

the development of survey questions (4). 

• Field or pilot testing 

• Reading ease or reading level scores 

• Additional validity or reliability testing on early versions of the instrument 
C-5

NOTES 

The ‘notes’ section of the template contains information regarding other outcomes related to 

an instrument, rephrasing suggestions from the project team, derivation or duplication of a 

question or set of questions from another instrument, and other relevant information relating to 

the question and/or instrument. 
C-6

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APPENDIX D 

INSTRUMENTS WITH QUESTIONS THAT WERE NOT RANKED
D-1

TABLE D.1 

INSTRUMENTS WITH QUESTIONS THAT WERE NOT RANKED 

Instrument 

Date of Development, 

Publication, or Most 

Recent Revision 

Panel Study of Income Dynamics (PSID) 1999 

Shopping for Health (Food Marketing Institute) 2003 

Weight Loss Practices Survey 1991 
APPENDIX E 

CITATIONS
E-1

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Bell RA, Quandt SA, Arcury TA, McDonald J, Vitolins MZ. Health behaviors of rural white 

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Beresford SA, Thompson B, Feng Z, Christianson A, McLerran D, Patrick DL. Seattle 5 a Day 

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Block G, Gillespie C, Rosenbaum EH, Jenson C. A rapid food screener to assess fat and fruit and 

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California Department of Health Servince. Cancer Prevention and Nutrition Section. Research 

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Campbell MK, Demark Wahnefried W, Symons M, Kalsbeek WD, Dodds J, Cowan A, Jackson 

B, Motsinger B, Hoben K, Lashley J, Demissie S, McClelland JW. Fruit and vegetable 

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Survey Questionnaire. Atlanta, Georgia: U.S. Department of Health and Human Services, 

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Food and Drug Administration, Center for Food Safety and Applied Nutrition. Health and Diet 

Survey 2002. 
E-2

Food Marketing Institute. Shopping for Health 2003: whole health for the whole family. 

Prevention Magazine 2003; 1-58. 

Gleason P, Rangarajan A, Olson C. Dietary Intake and Dietary Attitudes Among Food Stamp 

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Maryland WIC 5-A-Day promotion program. Am J Public Health 1998; 88(8): 1161-1167. 

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Freimuth V, Feldman R. The Maryland WIC 5 A Day promotion program pilot study: 

rationale, results, and lessons learned. J Nutr Educ 1997; 29: 343-350. 

Havas S, Heimendinger J, Reynolds K, Baranowski T, Nicklas T, Bishop D, Buller D, Sorensen 

G, Beresford SA, Cowan A, Damron D. 5 A Day for Better Health: A new research 

initiative. J Am Diet Assoc 1994; 94: 32-36. 

Hersey J, Anliker J, Miller C, Mullis RM, Daugherty S, Das S, Bray CR, Bennee P, SigmanGrant M, Thomas HO. Food shopping practices are associated with dietary quality in low 

income households. J Nutr Educ 2001; 33(1): S16-S26. 

Hunt MK, Stoddard AM, Peterson K, Sorensen G, Hebert JR, Cohen N. Comparison of dietary 

assessment measures in the Treatwell 5 A Day worksite study. J Am Diet Assoc 1998; 98: 

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Interagency Board for Nutrition Monitoring and Related Research. Bialostosky K, ed. Nutrition 

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Clin Nutr 1994; 54(Supp): 185S-9S. 

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2002;26:1017-1022. 
E-3

Lin BH, Huang CL, French SA. Factors associated with women's and children's body mass 

indices by income status. Int J Obes. 2004 (in press). 

McClelland JW, Demark-Wahnefried W, Mustian RD, Cowan AT, Campbell MK. Fruit and 

vegetable consumption of rural African Americans: baseline survey results of the Black 

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2003. Available at: http://www.cdc.gov/nchs/nhanes.htm. Accessed February 16, 2004. 

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E-4

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E-5

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