Fruit and Vegetable Survey

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Dear Fruit and Vegetable Colleagues:

Missouri’s Fruit and Vegetable Program aims to promote good health among all citizens by increasing fruit and vegetable access and intake. The program is now co-coordinated by Melinda Hemmelgarn, MS, RD, LD and Patricia Kramer, MS, RD, LD. Please take a few minutes to complete the survey below, so that we can better assist your efforts and work better together.

For questions about the survey or Missouri’s Fruit and Vegetable Program please contact Pat or Melinda at pat.kramer@dhss.mo.gov or FoodSleuth@mchsi.com.

Thank you!


* Required Fields
* Name:
* Organization:
* Position/Title:
* County:
* Address:
* City:
* State:	* Zip Code:
Email:


1. Are you a member of the Missouri Council for Activity and Nutrition (MoCAN)? Yes No
2. What is the principle focus of your organization? (Check all that apply)
Community Programs Communications Business/industry/retail (*non-agricultural) Policy/advocacy Research	Education Worksite Health Promotion Childcare Health care/wellness Other, please specify
3. What is the scope/reach of your organization’s activities or programs?
State Regional Countywide Municipality/Neighborhood
4. What setting does your work with fruits and vegetables reach? (check all that apply)
Schools Childcare Food service industry/retail outlets Food manufacturing Communities	Agriculture/Gardening Workplace Health care Other, please specify
5. Please select the target population for your organization’s fruit and vegetable activities. (check all that apply)
Children (2-5 years) Children (6-9 years) Youth (10-18 years) Adults (19-25 years) Adults (26-40 years)	Adults (41-64 years) Older adults (65 years +) Families Health care Providers
6. What is the race/ethnicity of the target population served by organization’s fruit and vegetable activities?
All White, not Hispanic White, Hispanic Black, Not Hispanic Black, Hispanic	Asian/Pacific Islander American Indian/ Alaska Native Other (please specify)
7. What is the socioeconomic status served by your organization’s fruit and vegetable activities?
All Low Moderate High
8. Which of the following activities does your organization use to promote fruits and vegetable consumption? (Check all that apply)
a. Support or implement policies that promote fruit and vegetable consumption. Describe: (optional)
b. Provide incentives for fruit and vegetable consumption. Describe: (optional)
c. Provide incentives for fruit and vegetable consumption. Describe: (optional)
d. Participate in community events/displays. Describe: (optional)
e. Support fruit or vegetable production: Gardening Farming Other
f. Support or utilize practices that increase fruit and vegetable access. Describe: (optional)
g. Distribute promotional materials. Describe: (optional)
h. Conduct media outreach, including newspaper articles, radio or television interviews. Describe: (optional)
i. Support food preparation practices that promote fruit and vegetable consumption. Describe: (optional)
j. Other (please elaborate):
9. How often does your organization participate in activities that promote fruit and vegetable consumption?
Daily Weekly Bi-monthly Monthly	Quarterly Semi-annually Annually
10. How many people are reached annually by your program efforts to promote fruit and vegetable consumption?
1 - 20 21 - 50 51 - 100 101 - 500	501 - 1000 1001 - 5000 More than 5000 Estimate:
11. Who are the partners you work with in your community?
Local health department Schools Childcare Parks & Recreation Civic Organizations Faith based organizations	Health care Food industry Senior Centers Farmers markets Other
12. What level of integration for fruit and vegetable activities most interests you?
Networking - (Informal dialog and common understanding to create base of support for activities) Cooperation or Alliance - (Semi-formal links to match needs and provide coordination, limit duplication of services, further common interests) Partnership or Coalition - (Formal membership to accomplish shared vision, share ideas and pull resources from existing systems)
13. Would you or your organization be willing to meet to establish a Missouri Fruit and Vegetable Coalition?
Yes No If yes, how often? Preferred meeting format (teleconference, face-to-face, etc.)
14. Would your organization be willing to write up a Success Story about your work and/or accomplishments with fruits and vegetables? If yes, please include your contact information.
15. Do you want to continue to receive updates from the state fruit and vegetable program? Yes No
16. What is the best method for communicating fruit and vegetable news to you? Newsletter: Monthly Quarterly Emailed to you Printed and mailed Web site Teleconference (Interactive email list among fruite and vegetable colleagues in Missouri) Other:
17. Are you interested in creating materials and/or promotions using the Fruits & Veggies—More Matters!® logo and brand? Yes No
18. Please describe any information or assistance you need to make your fruit and vegetable activities more successful:
19. Please share any additional feedback about fruits and vegetables:



Thank you for completing the survey!

Thank you for completing the survey!