Youth ID______________Grade ____ Date____________ 3rd-5th Grade EFNEP Pre-Post Survey Pre______ Post_____ 1. In the past week, I drank fruit-flavored drinks or sports drinks … Never 1-3 days 4-6 days About once a day 2 or more times a day 2. In the past week, I drank soda or pop … Never 1-3 days 4-6 days About once a day 2 or more times a day 3. In the past week, I ate vegetables … Never 1-3 days 4-6 days About once a day 2 or more times a day 4. In the past week, I ate vegetables as a snack … Never 1-3 days 4-6 days About once a day 2 or more times a day 5. In the past week, I ate fruit as a snack … Never 1-3 days 4-6 days About once a day 2 or more times a day 6. In the past week, I ate vegetables at lunch … Never 1-3 days 4-6 days Every day 7. When I am offered a new food, I will try it … Never or almost never Sometimes Most of the time Always or almost always 8. I read Nutrition Facts labels … Never or almost never Sometimes Most of the time Always or almost always 9. I wash fruits and vegetables before I eat them … Never or almost never Sometimes Most of the time Always or almost always Someone else does this for me Youth ID__________________ Pre_____ Post____ 10. When I make myself something to eat, I put cold foods back in the refrigerator right away … Never or almost never Sometimes Most of the time Always or almost always Someone else does this for me 11. Before I eat or touch food, I wash my hands with warm water and soap for at least 20 seconds … Never or almost never Sometimes Most of the time Always or almost always 12. In the past week, I did physical activities … Not at all 1-2 days 3-4 days (or some days) 5-6 days (or most days) 7 days (every day) 13. In the past week, for how long did you usually do physical activities? Less than 15 minutes a day About 15 minutes a day About 30 minutes a day About an hour a day More than an hour a day 14. In the past week, when I was not doing homework, I used a computer, TV, smartphone, tablet or played video games … Less than 1 hour a day 1-2 hours a day 3-4 hours a day 5-6 hours a day 7 or more hours a day Youth ID__________________ Pre Post