For Question #7 enter a value from 0 to 7. 0 1 2 3 4 5 6 7 7. During the past 7 days, how many days 0 days 1 day 2 days 3 days 4 days 5 days 6 days 7 days were you physically active for at least 1 hour? 1 2 3 4 5 8. During the past 7 days, how often were you so active 4 or more 1 time last 2 times 3 times that your heart beat fast and you breathed hard most of Never times last week last week last week the time? week 9. How many hours a day do you spend watching TV or 1 hour or 5 or more movies, playing electronic games or using a computer for 2 hours 3 hours 4 hours less hours something that is not school work? 1 2 3 4 5 Once in a Most of 10. How often do you wash your hands before eating? Think Never Sometimes Always while the time about eating at school or at home. 11. How often do you wash vegetables and fruits before Once in a Most of Never Sometimes Always eating them? while the time 12. When you take foods out of the refrigerator, how often Once in a Most of Never Sometimes Always do you put them back within 2 hours? while the time 1 2 3 4 13. How confident are you in using measuring cups Totally Somewhat Not confident Confident and measuring spoons? confident confident 14. How confident are you in following directions in a Somewhat Totally Not confident Confident recipe? confident confident
For Question #7 enter a value from 0 to 7. 0 1 2 3 4 5 6 7 7. During the past 7 days, how many days were you physically active for at least 1 hour? 0 days 1 day 2 days 3 days 4 days 5 days 6 days 7 days 1 2 3 4 5 8. During the past 7 days, how often were you so active that your heart beat fast and you breathed hard most of the time? Never 1 time last week 2 times last week 3 times last week 4 or more times last week 9. How many hours a day do you spend watching TV or movies, playing electronic games or using a computer for something that is not school work? 1 hour or less 2 hours 3 hours 4 hours 5 or more hours 1 2 3 4 5 10. How often do you wash your hands before eating? Think about eating at school or at home. Never Once in a while Sometimes Most of the time Always 11. How often do you wash vegetables and fruits before eating them? Never Once in a while Sometimes Most of the time Always 12. When you take foods out of the refrigerator, how often do you put them back within 2 hours? Never Once in a while Sometimes Most of the time Always 1 2 3 4 13. How confident are you in using measuring cups and measuring spoons? Not confident Somewhat confident Confident Totally confident 14. How confident are you in following directions in a recipe? Not confident Somewhat confident Confident Totally confident
6-8%20Scoring%20and%20Data%20Entry%20Instructions.docx