GHR - 1002 T3-CS | QuestionPro Survey

HEALTH & DIET SURVEY

INTRODUCTION: We are studying attitudes about health and healthy eating. Your feedback will be anonymous and will help to shape the educational materials and healthy products that are made available to Americans. Please begin the survey now.

Please indicate whether you are concerned about any of these health problems. . . . (check all that apply)

	Concerned for Myself	I've Been Diagnosed With This Condition	Concerned for a Family Member
Diabetes

Heart attack

Heart disease

High blood pressure

High cholesterol

Overweight

Peripheral Artery Disease

Stroke

Have any of your close relatives suffered from the health problems mentioned above? If yes, please indicate which relatives. (check all that apply)

Do you wish you knew more about any of these health topics? (check all that apply)

Now for some questions about eating habits....

What brand(s) of Probiotic Yogurts have you heard of, have you bought in the last 3 months, and which ones do you plan to buy next? (Please complete all 3 columns, marking any that apply)

Which soups/broths have you bought in the last 6 months, which ones do you plan to buy next, and which ones do you buy most often? (Please complete all 3 columns, marking any that apply)

Do you take an aspirin a day to prevent a heart attack?

Yes

No

Which brands of aspirin have you heard of, have you bought in the past 3 months, and which ones do you plan to buy next? (Please complete all 3 columns, marking any that apply)

Are you currently taking prescription medications to control any of these? (check all that apply)