Appendix D
1
Population-based Food Consumption Survey of the People of Hong Kong 2005-07
Conducted for the Food and Environmental
Hygiene Department
by the Chinese
University of Hong Kong
DAY ONE INTAKE QUESTIONNAIRE
Sample Person ID:
⎜__⎟__⎟__⎟__⎟
Interviewer ID:
⎟__⎟__⎟
⎟__⎟__⎟:⎟__⎟__⎟ (am / pm)
Time Started
Date of Interview:
⎟__⎟__⎟-⎟__⎟__⎟-20⎟__⎟__⎟
⎟__⎟__⎟:⎟__⎟__⎟ (am / pm)
D M
Y
Time Ended
Date of Intake:
⎟__⎟__⎟-⎟__⎟__⎟-20⎟__⎟__⎟
Interview
conducted
at:
D M Y
(1) Respondent’s Home
(2)
Survey
Interview
Centre
Day: Mon / Tue / Wed / Thu / Fri / Sat / Sun
(3) Other location ___________
Are you the person most responsible for planning or preparing the meals in your household?
(0) No
(1) Yes
(9) Refused
(8) Don’t know/Not sure
General Introduction
Hello! I am__________ and I am an interviewer of the Chinese University of Hong Kong.
We are commissioned by Food and Environmental Hygiene Department to conduct a
Population-based Food Consumption Survey.
Today I would like to ask about your food consumption, your second interview. It will take about
40-45 minutes. Do you have any questions?
[Conduct 1
st
24-hr
recall interview, and use introduction on page two of that questionnaire.]
[Conduct food frequency interview and use introduction on page two of that questionnaire.]