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Maternal Exit Survey
Program Feedback
Your Shopping Behavior
Your insights will help us enhance our services. Please take a moment to share your thoughts on your experience so far.
You have participated in the Attane Health program for 5 months now. We would like to learn more about the role of Attane Health in your food shopping behaviors.
Please take a moment to share your thoughts on your experience so far.
Since starting this program, in what ways, if any, have your food orders from Attane Health changed your access to high-quality foods?
(Required)
No change
Some change
Significant change
Not sure/
I don’t know
How confident are you that you know how to shop for healthy foods?
(Required)
1 (Not confident)
2
3
4
5 (Very confident)
Since starting this program, how many times did you utilize an emergency food provider (e.g., a food pantry)?
(Required)
Never
1-5 times
6-10 times
11 or more times
Since starting this program, how many different markets, stores, pantries, or websites did you visit or use to shop for groceries (including Attane-Health.com)?
(Required)
1
2
3
4 or more
Since starting this program, what change, if any, did shopping on Attane-Health.com have on your financial stress levels?
(Required)
1
(Did not change my financial stress at all)
2
3
4
5
(Significantly reduced my financial stress)
Since starting this program, has your household’s overall financial situation changed?
(Required)
1
(Financial situation has gotten much worse)
2
3
4
5
(Financial situation has improved significantly)
Do you feel you and your family eat any differently when you get food from Attane Health?
(Required)
Select all that apply
No difference
Eat more fruits
Eat more vegetables
Try new foods
More variety
Prepare new meals
Cook more at home
Eat more healthfully (generally)
Eat less unhealthy foods
Other
Over the past 6 months, did shopping on Attane-Health.com change the amount of fruits and vegetables you ate compared to before the program?
(Required)
1
(Did not change my fruit and vegetable intake at all)
2
3
4
5
(Significantly increased my fruit and vegetable intake)
How likely are you to recommend Attane Health to a friend or family member?
(Required)
1
(Not likely to recommend)
2
3
4
5
(Very likely to recommend)
Would having access to a future program like this make you more likely to re-enroll in your healthcare plan?
(Required)
1
(Wouldn’t change my enrollment)
2
3
4
5
(Would make me very likely to re-enroll)
Below are two statements that people have made about their food situation. Please select whether the statement was OFTEN, SOMETIMES, or NEVER true for you and the other members of your household in this last six months.
“Within the past 6 months we worried whether our food would run out before we got money to buy more.”
(Required)
Often true
Sometimes true
Never true
“Within the past 6 months the food we bought just didn’t last and we didn’t have money to get more.”
(Required)
Often true
Sometimes true
Never true
As you may know, Attane Health also offers free nutrition coaching in addition to the online food ordering.
How would you describe your current nutrition knowledge:
(Required)
1 Very low
2 Low
3 Moderate
4 High
5 Very High
During the Attane Health program, did you participate in the free nutrition coaching?
(Required)
Yes, I participated and met with a coach
I signed up but never had any coaching sessions
No, I did not sign up
If you either did not participate, or did not sign up for nutrition coaching, why not?
(Required)
Select all that apply
Not interested
Lack of time
Unaware of the service
Unable to reach coach
Other
Other (please specify)
Did participating in one-on-one Nutrition Coaching change your nutrition knowledge at all?
(Required)
1 (No change in my knowledge)
2
3
4
5 (Significantly improved my nutrition knowledge)
Did participating in one-on-one Nutrition Coaching change how you manage your health at all?
(Required)
1 (Did not change how I manage my health)
2
3
4
5 (Significantly improved my ability to manage my health)
Do you have any suggestions for how we can improve the nutrition coaching?
In this last section, we want to learn a little bit more about how you are feeling, how you feel about your health, and the food that you eat.
Compared to before the program, how would you rate your health in general?
(Required)
1 - Much better than before the program -
2 - Somewhat better now than before the program
3 - About the same
4 - Somewhat worse now than before the program
5 - Much worse now than before the program
To what extent do you experience stress around managing your health?
(Required)
1 No stress at all
2
3
4
5 Significant stress
How confident do you feel about managing your health?
(Required)
1 (Not at all confident)
2
3
4
5 (Totally confident)
If you have feedback for the Attane Health program, please provide below. We are very interested to hear any of your thoughts and comments on how we can improve.
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