Activity 1.
1: Healthy Lifestyle Assessment
Name:__________________________________________ Date: ___________
Assess your habits in sleeping, eating, and physical activity. Along with how you managed your stress,
these factors influence your health, which in turn affect your capacity as a student to think, remember,
process information, and learn.
Rate yourself using the following scale by checking the corresponding box:
1-Rarely if ever; 2-sometimes; 3-Most of the time; 4-Always
SLEEP HABITS 1 2 3 4
I sleep between 7 to 9 hours on most nights.
I wake up feeling rested.
I have trouble staying awake in class or when reading
I often feel tired during the day.
EATING HABITS
I drink 6 – 8 glasses of water each day.
I eat a variety of fruits and vegetables each day.
I eat 3 servings of fruits and vegetables each day.
I eat 6 – 8 servings of whole grain products (bead) rice, corn, or roots crops each day.
I eat 2-3 servings of protein-rich foods (meat, poultry, eggs, fish, beans, and nuts) each
day.
STRESS MANAGEMENT
I feel stress when I’m at home.
I feel stress when I’m not at home.
When I feel stress, I worry all the time.
When I feel stress, I have difficulty sleeping (cannot get to sleep/stay asleep).
When I feel stress, I have difficulty concentrating.
When I fell stress, my appetite is affected (tend to eat more or do not feel like eating).
I’d rather be alone when I feel stress.
I have someone I can talk to about my private feelings.
I have faith in a greater power or being (God).
PHYSICAL ACTIVITY
I perform active house chores (mopping or scrubbing floors, cleaning the car, fetching
water in a pail) daily.
I walk, bike, or take the public transport when going to school.
I perform at least 40 minutes of aerobic activities (sports or dance) on most days of week.
I engage in at least 20 minutes of sustained vigorous activities that result in rapid
breathing on most days of the week.
I perform muscle- and bone-strengthening (resistance or weight training) activities 2-3
times a week.
I spend no longer than 2 hours per day watching television, playing passive video games,
or playing on the computer.
I do not have time for exercise, sports, or dance.
I am too tired to exercise, play sports, or dance.
Based on the results of your assessment, identify the areas where you feel are problematic.
Write them on the space below.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Activity 1.2 General Physical Activity Questionnaire (WHO)
Name: _________________________________________ Date: _______________
You will be asked about the time you spend doing different types of physical activity in a typical
week, Please answer the questions even if you do not consider yourself to be a physically active
person. Place a check under the column of your answer.
Think first about the time you spend doing work. Think of work as the things that you
have to do, such as study, household chores, and employment, if you are a working student.
In answering the following questions, ‘vigorous-intensity’ activities are those that
require hard physical effort and cause large increases in breathing or heart rate. ‘Moderate-
intensity’ activities are those that require physical exertion that cause small increases in
breathing or heart rate.
ACTIVITY AT WORK YES NO
1. Does your work involve vigorous – intensity that causes large increases in If No, got to Q4
breathing or heart rate (like carrying or lifting heavy loads, digging or
construction work) for at least 10 minutes
2. In a typical week, how many days do you do vigorous-intensity activities on
a typical day? Number of days____
3. How much time do you spend doing vigorous-intensity activities on a
typical day? Hours: Minutes____
4. Does your work involve moderate-intensity that causes small increases in If No, go to Q7
breathing or heart rate (like brisk walking or carrying light loads) for at
least 10 minutes continuously?
5. In atypical week, how many days do you do moderate-intensity activities
on a typical day Number of days____
6. How much time do you spend doing moderate-intensity activities on a
typical day Hours: Minutes____
TRAVEL TO AND FROM PLACES YES NO
The next questions exclude the physical activities that you have already mentioned earlier.
Now, I would like to ask you about the usual way you travel to and from places. For example, to school, for shopping, to
market, Now I would like to ask you about the usual way you travel to and from places. For example, to school, for shopping,
to market, to place of worship, or to work if you are a working student.
7. Do you walk or use a bicycle for at least 10 minutes continuously to get to If No, go to
and from places? Q10
8. In a typical week, on how many days do you walk or bike for at least 10
minutes continuously to get to and from places? Number of days____
9. How much time do you spend walking or biking for travel on a typical day? Hours: Minutes____
RECREATIONAL ACTIVITIES YES NO
The next questions exclude the work and transport activities that you have already mentioned. Now, I would like to ask you
about sports, fitness, and recreational activities that you do during leisure time.
10. Do you do any vigorous-intensity sports, fitness, or recreational activities If No, go to
that cause large increases in breathing or heart rate (like running or Q13
football) for at least 10 minutes continuously?
11. In a typical week, how many days do you do vigorous-intensity sports,
fitness or recreational? Number of days____
12. How many times do you spend doing vigorous-intensity sports, fitness, or
recreational activities on a typical day? Hours: Minutes____
13. Do you do any moderate-intensity sports, fitness, or recreational activities If No, go to
that causes small increases in breathing or heart rate (like brisk walking, Q16
volleyball, swimming) for at least 10 minutes continuously?
14. In a typical week, how many days do you do moderate-intensity sports,
fitness or recreational activities on a typical day? Number of days____
15. How much time do you spend doing moderate-intensity sports, fitness or
recreational activities on a typical day? Hours: Minutes____
SEDENTARY BEHAVIOR
The following question is about sitting at school or work, at home, including time spent sitting with friends, travelling in a
car, bus, train, reading, laying cards or video games, computer work or watching television, but do not include time spent
sleeping.
16. How much time do you usually spend sitting or reclining on a typical day?
Hours: Minutes____
Activity 1.3 Inventory of Barriers to Being Active
Name: ____________________________________ Date: ____________
Listed below are common reasons of individuals why they do not get as much physical activity
as they should. Please read each statement carefully and indicate how likely you are to say to
each of the following:
3 - Very likely; 2- Somewhat likely; 1 – Somewhat likely; 0 - Very unlikely
HOW LIKELY ARE YOU TO SAY… 3 2 1 0
My day is so busy now, I just do not think I can make the time to include
physical activity in my regular schedule.
None of my family members or friends like to do anything active, so I do not
have a chance to exercise.
I am just too tired after school to get any exercise.
I have been thinking about getting more exercise, but I just cannot seem to get
started.
I am getting older so exercise can be risky.
I do not get enough exercise because I have never learned the skills for any
sport.
I do not have any access to gym facilities, jogging trails, swimming pools, bike
paths, etc.
Physical activity takes too much time away takes too much time away from
other commitments-me, studies, family, etc.
I am embarrassed about how I will look when I exercise with others.
I do not get enough sleep as it is. I just could not get up early or stay up late to
get some exercise.
It is easier for me to find excuses not to exercise than to go out to do
something.
I know of too many people who have hurt themselves by overdoing it with
exercise.
I Cannot see myself learning a new sport or activities.
It is just too expensive to take a gym class, join a club or buy the right
equipment.
My free times during the day are too short to include exercise.
My usual social activities with family or friends do not include physical activity.
I am too tired during the week and I need the weekend to catch up on my rest.
I want to get more exercise, but I just cannot seem to make myself stick to
anything.
I am afraid I might hurt or inure myself during exercise or while playing.
I am not good enough at any physical activity to make it fun.
Follow these instructions to score yourself:
Enter your rating in each item below.
Add the three scores on each line. A score of 5 or above means this is an important barrier for
you to overcome.
Your barriers to physical activity fall into one or more categories: lack of time, social influences,
lack of energy, lack of willpower, fear of injury, lack of skill, and lack of resources.
_______ + _______ + _______ = __________________
1 8 15 Lack of time
_______ + _______ + _______ = __________________
2 9 16 Social influence
_______ + _______ + _______ = __________________
3 10 17 Lack of energy
_______ + _______ + _______ = __________________
4 11 18 Lack of motivation
_______ + _______ + _______ = __________________
5 12 19 Fear of injury
_______ + _______ + _______ = __________________
6 13 20 Lack of skill
_______ + _______ + _______ = __________________
7 14 21 Lack of resources
