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Attachment M.2 – Child Care Director Email, Consent Letter, and Survey – Web
Version
OMB BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995, an agency may not
conduct or sponsor, and a person is not required to respond to, a collection of information unless it
displays a valid OMB control number. The valid OMB control number for this information collection is
0584-0524. The time required to complete this information collection is estimated to average 5 minutes
per response, including the time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information.
Child Care Director Email
[Email Subject] Share your thoughts to help create free materials!
Dear Director,
The USDA’s Food and Nutrition Service (FNS) is creating nutrition education materials
with multicultural recipes and family events. The materials will be free and the
recipes can be used as part of a reimbursable meal under CACFP.
We’d love your thoughts to help develop these materials! Please complete this survey
[insert link] to make sure these resources are fun, useful, and engaging!
Sincerely,
Gerad O’Shea, Research Director
Applied Curiosity Research
Director Consent Letter
OMB Control # 0584-0524
Expiration Date: 9/30/2019
Background & Purpose :You’re invited to participate in a research study conducted by ACR as part of a USDA FNS sponsored effort to
develop nutrition education materials with multicultural recipes for child care centers and family day care homes. We’re working to
ensure these recipes and activities are clear, relevant, and engaging.
Process:Your only involvement in this study is completing the following survey.
Possible Risks & Benefits: We do not anticipate any risks associated with being in this study. The study will lead to the development of
free resources developed by FNS
Compensation: You will not be compensated for your participation.
Participant’s Rights: Participation in this study is voluntary. You have the right to change your mind and withdraw your consent or
discontinue participation at any time without any penalty or loss of the benefits to which you are otherwise entitled. You have the right to
refuse to answer particular questions. Your name, email address, and phone number will only be used to contact you about this
research. They will not be given to anyone else for other purposes. Your name will never be used in any reports of our research
findings. Your information will be kept secure and only used for research purposes, except as otherwise required by law. All data will
be identified only by an ID number, not by any name.
Contact Information: If you have any questions, concerns, or complaints about this research study, its procedures, or risks and
benefits, please contact the Principal Investigator, at the telephone number listed on the first page of this form.
If you have other questions about this research project, contact:
Mail: USDA, Food and Nutrition Service, Team Nutrition; 3101 Park Center Drive, 6th Floor Alexandria, VA 22302; |
Call: (703) 305-1624 | Email: teamnutrition@fns.usda.gov
*
1.
Selecting the "yes" button below indicates that:
• You have read the above information
• You voluntarily agree to participate
If you do not wish to participate in the survey, please decline participation by selecting "no".
Yes
No
Director Survey
OMB Control # 0584-0524 | Expiration Date: 9/30/2019
OMB BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a
not
person is required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control
number for this information collection is 0584-0524. The time required to complete this information collection is estimated to
se,
average 5 minutes per response including the time for reviewing instructions, searching existing data sources, gathering and
and
maintaining the data needed, and completing reviewing the collection of information.
2. Approximately how many children attend your site?
3. Is your site a Child Care Center or a Family Day Care Home?
4. Which ages does your site serve (select all that apply)?
1 year or younger
5 years old
2 years old
Ages 6-8 years
3 years old
Ages 9-12 years
4 years old
Ages 13 years or older
5. How often do providers at your site offer nutrition education to
children?
Never
Every other week
Only on special occasions
1x a week
1x a month
6. Which, if any, nutrition education topics do children at your site learn
about (select all that apply)?
MyPlate/Food Groups
Eating the rainbow
Avoiding sweets
Choosing healthy snacks
Vitamins and minerals (like calcium for strong bones)
Learning about different types of fruits and vegetables
How plants grow/where food comes from/edible garden
Drinking Water
Trying new foods
Trying new fruits and vegetables
Importance of physical activity
Other (please specify)
7. How often is food preparation (cooking) conducted with children at
your site?
Never
Every other week
Only on special occasions
1x a week
1x a month
What kind of cooking activities are done with students at your site?
8. What Web sites, social media, print media, or social networks do you
or other providers at your site use to find recipes and nutrition-related
activity ideas to do with children?
9. What size posters do you prefer for displaying information for children
at your site?
8.5 x 11
11 x 17
18 x 24
24 x 36
Other (please specify)
10. Please read the following statements and select your level of
agreement from “strongly disagree” to “strongly agree”.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I feel confident that the
classroom teachers at
my site can
successfully teach
nutrition education
lessons.
I feel confident that the
classroom teachers at
my site can lead
cooking
demonstrations with
children.
I feel confident that the
classroom teachers at
my site can teach
children about
different cultures
around the world.
11. Which of the following factors would prevent you or the classroom
providers at your site from leading cooking activities with children?
(check all that apply)
The staff lacks the appropriate training
Availability of kid-safe cooking equipment
Lack of the number of staff needed to conduct/supervise
the activities
Lack of space to conduct the activities
Lack of time in the day
Other (please specify)
Availability of appropriate recipes or activities
12. How often does your school host family events?
Never
Every other week
On special occasions
1x a week
1x a month
What kind of family events are hosted at your site?
13. What is your Ethnicity?
Hispanic or Latino
Not Hispanic or Latino
14. What is your Race?
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian/Other Pacific Islander
White
Director Survey
Optional Follow-Up Interview
We’d like to talk to child care providers and parents from 8 specific cultural backgrounds to review recipes and give their
thoughts to make sure the recipes are culturally accurate! Are there providers, staff, or families at your site from any of these
backgrounds?
15. Child Care Staff?
Asian Indian
American Indian
Native Alaskan
Mexican
Puerto Rican
Chinese
French
Sub-Saharan African
Don't know/not sure
16. Families?
Asian Indian
American Indian
Native Alaskan
Mexican
Puerto Rican
Chinese
French
Sub-Saharan African
Don't know/not sure
17. Is it ok for us to follow up with you to get feedback about a few
recipes?
Yes
No
18. Please provide the best way for us to follow up below:
Email
Call
Text
19. Additional cultures will be added after these first eight. Do you have
any suggestions for additional cultural recipes that we should include?
File Type | application/pdf |
File Title | Microsoft Word - Attachment M.2 Page 1.docx |
File Modified | 2018-08-13 |
File Created | 2018-06-27 |