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P R E - S U R V E Y

Welcome to today’s seminar! Before we begin, we would like to get some information about you so that we can continue to develop seminars such as this in the future. Please take a few minutes to answer all of the questions. Thank you!

All your responses are confidential. However, we would like to keep track of the data to evaluate the effectiveness of this course, so please complete the following information. This information will NOT be shared with or seen by anyone other than members of the course development team.

Date of Birth & Zip Code

Email Address

1. What is your current position/title? Please check all that apply.
Registered Dietitian
Nutritionist
Nurse
Teacher
Other - please specify

2. What type of organization do you work for?
School
Hospital
Extension office
Health center
State agency
Other - please specify

3. How many years have you been in your current position?
0-5 years
6-10 years
11-15 years
16 or more years

4. How did you hear about this seminar? Please check all that apply.
Word of mouth
Website
Listserv
Journal or magazine
Other – please specify

5. Why did you decide to take this seminar? Please check all that apply.
Continuing education credits
General interest
Required
Other – please specify

6. What type of computer will you use to access this seminar?
PC
Macintosh

7. What type of computer connection do you have?
Dial-up
High-speed Internet
Other (please specify)

8. What is the one thing you hope to get out of this seminar?

Now we would like to know a little bit about you and how you learn.

9. Read the descriptions of three different Learning Styles below. Choose your most preferred style of
learning, one that best describes your style most of the time.

VISUAL: Learning through seeing. Likes to see pictures or diagrams. Likes demonstrations and
watching videos.

AUDITORY: Learning through hearing. Likes to listen to debates, audiotapes, lectures, discussion and
verbal instructions.

KINESTHETIC: Learns through physical activities and through direct involvement. Likes to be "hands- on," moving, touching, and experiencing first hand.

Next, we would like to know a little bit about your knowledge of the topic. This is only for planning purposes, so please respond to these questions to the best of your ability.

10. There is reasonably strong evidence to support the association of all of the following health
benefits with fish and omega-3 fatty acids, except:
Lowered triglycerides
Reduced plaque formation
Reduced risk for hypertension
Reduced risk for obesity

11. Swordfish is a high mercury species of fish and should be consumed with caution by sensitive populations.
True
False

12. Dietary sources rich in alpha linolenic acid include (check all that apply):
Flaxseeds
Canola oil
Walnuts
Soybean oil
Palm oil

13. The recommended weekly intake of fish for healthy individuals is:
1 serving (4 oz.) of high EPA and DHA fish
2 servings (8 oz.) of high EPA and DHA fish
3 servings (12 oz.) of high EPA and DHA fish
4 servings (16 oz.) of high EPA and DHA fish

14. Omega-3 fatty acids are essential fatty acids.
True
False

 
Developed by The University of Massachusetts-Amherst Department of Nutrition, UMass Extension Nutrition Education Program, in cooperation with the UMass Amherst Department of Food Science, STEM Education Institute and the Department of Computer Science, copyright 2005. This project is funded in part by grant #2001-4526 from IFAFS, CSREES, USDA under the Nutritional Impacts of Functional Food Program.