Please read the following questions and all the possible answers carefully. Choose the best response for each question and tick the appropriate box.
1. Do you consistently use seatbelts as a driver or passenger in a car?
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
2. Do you consistently avoid eating high fat foods?
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
3. Have you been eating a diet high in fiber?
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
4. Have you been trying to lose weight?
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
5. Do you exercise three times a week for at least 20 minutes each time?
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
6. Do you take precautions against exposure to the sun?
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
7. Do you consistently use sunscreens when in the sun for more than 15 minutes?
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
8. Have you attempted to reduce the amount of stress in your daily life?
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
9. Have you quit smoking cigarettes?
a YES, I quit More than 6 months ago.
b YES, I quit LESS than 6 months ago.
c NO, but I intend to quit in the next 30 days.
d NO, but I intend to quit in the next 6 months.
e NO, and I do NOT intend to quit in the next 6 months.
I was NEVER a cigarette smoker.
10. Do you examine yourself for warning signs of cancer (for example, breast, testicles, skin)?
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
Scoring
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
2. Do you consistently avoid eating high fat foods?
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
3. Have you been eating a diet high in fiber?
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
4. Have you been trying to lose weight?
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
5. Do you exercise three times a week for at least 20 minutes each time?
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
6. Do you take precautions against exposure to the sun?
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
7. Do you consistently use sunscreens when in the sun for more than 15 minutes?
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
8. Have you attempted to reduce the amount of stress in your daily life?
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
9. Have you quit smoking cigarettes?
a YES, I quit More than 6 months ago.
b YES, I quit LESS than 6 months ago.
c NO, but I intend to quit in the next 30 days.
d NO, but I intend to quit in the next 6 months.
e NO, and I do NOT intend to quit in the next 6 months.
I was NEVER a cigarette smoker.
10. Do you examine yourself for warning signs of cancer (for example, breast, testicles, skin)?
a YES, I have been for More than 6 months.
b YES, I have been, but for LESS than 6 months.
c NO, but I intend to in the next 30 days.
d NO, but I intend to in the next 6 months.
e NO, and I do NOT intend to in the next 6 months.
Scoring
For all questions:
Answer choice (A) - Maintenance Stage
Answer choice (B) - Action Stage
Answer choice (C) - Preparation Stage
Answer choice (D) - Contemplation Stage
Answer choice (E) - Precontemplation Stage
Answer choice (A) - Maintenance Stage
Answer choice (B) - Action Stage
Answer choice (C) - Preparation Stage
Answer choice (D) - Contemplation Stage
Answer choice (E) - Precontemplation Stage
References
Nigg, C.R., Burbank, P., Padula, C., Dufresne, R., Rossi, J. S., Velicer, W. F., Laforge, R. G. & Prochaska, J. O. (1999). Stages of change across ten health risk behaviors for older adults. The Gerontologist, 39, 473-482
Nigg, C.R., Burbank, P., Padula, C., Dufresne, R., Rossi, J. S., Velicer, W. F., Laforge, R. G. & Prochaska, J. O. (1999). Stages of change across ten health risk behaviors for older adults. The Gerontologist, 39, 473-482
No comments:
Post a Comment