INCA 2015 #ModernParent Survey

SCREENING QUESTIONS:

1. Have you or your partner given birth or adopted a baby in the past 12 months?

a. Yes

b. No (termination of survey)

2. What did you feed your baby during his/her first three months?

a. Breast milk only (go to survey question 1A)

b. Infant formula only (go to survey question 1B)

c. A combination of breast milk and infant formula (go to survey question 1C)

d. Other (termination of survey)

 

SURVEY QUESTIONS:

1A. When did you make the decision to exclusively feed your baby formula during their first three months?

a. Before you found out you were pregnant/adopting a baby

b. While you were pregnant/awaiting the arrival of your baby

c. While in the hospital to give birth/when you first met your baby

d. Once you brought your baby home.

e. Other (Specify)

1B. When did you make the decision to exclusively feed your baby breast milk during their first three months?

a. Before you became pregnant/adopting a baby

b. While you were pregnant/awaiting the arrival of your baby

c. While in the hospital to give birth/when you first met your babye. Other (Specify)

d. Once you brought your baby home.

1C. When did you make the decision to feed your baby a combination of breast milk and baby formula during their first three months?

a. Before you found out you were pregnant/adopting a baby

b. While you were pregnant/awaiting the arrival of your baby

c. While in the hospital to give birth/when you first met your baby

d. Once you brought your baby home.

e. Other (Specify)

2A. (If screening question 2 = A or C) Please review the list below and rank the options to indicate how much influence an attribute had on your decision to feed your baby breast milk, with #1 being the most influential.

     Rank
a.       General health of the mother
b.      General health of the baby
c.       Medical concerns/complications with mother
d.      Medical concerns/complications with baby
e.      Doctor/other healthcare professional recommendation
f.        Advice from family/friends
g.       I believe breastfeeding should be the only source of nutrition for a baby
h.      I believe infant formula is an inferior source of nutrition for a baby
i.         Received a WIC voucher that supported breastfeeding

2B. (If screening question 2 = B or C) Please review the list below and rank the options to indicate how much influence an attribute had on your decision to feed your baby infant formula, with #1 being the most influential.

        Rank
a.       General health of the mother
b.      General health of the baby
c.       Medical concerns/complications with mother
d.      Medical concerns/complications with baby
e.      Doctor/other healthcare professional recommendation
f.        Advice from family/friends
g.       Baby going to daycare/babysitter
h.      Parent had to go back to work or school
i.         Parent had difficulties breastfeeding
j.        Parent felt embarrassed/uncomfortable breastfeeding in public
k.       I believe infant formula is a safe and nutritious source of nutrition for a baby
l.         Received a WIC voucher for infant formula

2C. (If screening question 2 = B or C) Please review the list below and rank the options to indicate how much influence an attribute had on your decision to feed your baby a combination of breast milk and infant formula.

       Rank
a.       General health of the mother
b.      General health of the baby
c.       Medical concerns/complications with mother
d.      Medical concerns/complications with baby
e.      Doctor/other healthcare professional recommendation
f.        Advice from family/friends
g.       Baby going to daycare/babysitter
h.      Parent had to go back to work or school
i.         Parent had difficulties breastfeeding
j.        Parent felt embarrassed/uncomfortable breastfeeding in public

3. Where/from whom did you get information that helped you decide how to feed your baby? (Check all that apply)

a. OBGYN and/or nurse

b. Pediatrician and/or nurse

c. Other healthcare professional (specify)

d. Lactation consultant

e. Friends

f. Family

g. Blogs

h. Online chat rooms

i. Hospital/medical websites

j. Magazines

k. Television

l. Radio

m. Books and/or DVDs

n. Infant formula manufacturer

o. Breastfeeding promotion/support group

p. Other (Specify)

4. If this is not your first child, is the way you will be/are feeding this child for the first three months different from your previous child/children?

a. The same as my first child

b. Different from my first child (Please specify how they differ)

c. This is my first child

5. What three words you would use to describe breastfeeding? FREE FORM RESPONSE

6. What three words you would use to describe formula feeding? FREE FORM RESPONSE

7. What three words you would use to describe a combination of breast and formula feeding? FREE FORM RESPONSE

8. In your opinion, how safe would you say the following infant feeding options are?

Very Safe Safe Unsafe Very Unsafe Don’t Know
a.       Breast milk from baby’s mother
b.      Breast milk purchased online
c.       Breast milk from a friend
d.      Breast milk from a milk bank
e.      Infant formula purchased at a brick and mortar store (ex: Baby’s R Us, Target, Grocery Store, Pharmacy)
f.        Infant formula purchased from an established business-to-consumer online store (ex: manufacturer website, buybuybaby.com, target.com,  toysrus.com)
g.       Homemade infant formula
h.      Infant formula bought on a consumer-to-consumer             e-commerce website (ex: eBay, Craig’s List)

9. In your opinion has media coverage of breastfeeding been:

a. Very positive

b. Somewhat positive

c. Neutral

d. Somewhat negative

e. Very negative

10. In your opinion has media coverage of infant formula been:

a. Very positive

b. Somewhat positive

c. Neutral

d. Somewhat negative

e. Very negative

11. Are you….?

a. Single, Never Married

b. Married

c. Living with Partner

d. Separated

e. Divorced

f. Widowed

g. Prefer Not to Answer

12. How do you identify yourself?

a. Straight

b. Lesbian

c. Gay

d. Bisexual

e. I prefer not to say

13. What is your net family income per year?

a. Less than $25,000

b. Between $25,000 and $49,000

c. Between $50,000 and $74,000

d. Between $75,000 and $99,000

e. Between $100,000 and $199,000

f. More than $200,000

g. I prefer not to say

14. What is your employment status?

a. Stay-at-home parent

b. Work full-time outside or inside the home

c. Work part-time outside or inside the home

d. Unemployed

e. Other (specify)

f. I prefer not to say

15. What is the highest degree or level of school you have completed? If currently enrolled, choose the highest degree received.

a. No schooling completed

b. Some high school, no diploma

c. High school graduate, diploma or the equivalent (for example: GED)

d. Some college credit, no degree

e. Trade/technical/vocational training

f. Associate degree

g. Bachelor’s degree

h. Master’s degree

i. Professional degree

j. Doctorate degree

k. I prefer not to say

Download

Logged in as:

User: user ID is incorrect