Module One Wellness Plan

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Fill in all logs and answer the reflection questions completely with supporting details
for sections 1-5. After completing all five sections, submit this file as your Module One
Wellness Plan assignment.

Section 1: Goals

List the four wellness goals that you created earlier in Module 1 before completing the
reflection questions. Think about how you can make your goals MAD (measurable,
attainable, and deadline driven). This will help you keep your eye on the target as you
work toward each goal.

Sample Goals:
1. Physical – I will walk non-stop for at least 30 minutes five days a week over the next
three weeks.
2. Social – I will join a club at school BEFORE this week ends, and I will attend all
meetings this semester.
3. Emotional – I will journal every evening for the next two weeks as a way to reduce
stress and anxiety.
4. Academic – I will work with a study partner once a week for at least a month to help
improve my geometry grade.

Please list your goal for each category below:

1. Physical –
2. Social –
3. Emotional –
4. Academic –

Goal Reflection Question:

Which of your wellness goals is the most important to you? Explain why.

Answer:

Section 2: Target Heart Rate Chart

Use the descriptions and formulas in the chart below to calculate your personal targets.
Complete the “My Rates” column of the chart.

How Is Target Heart Rate Calculated? Formula My Rates

1. Determine your Maximum Heart Rate 220-age = MHR

How Is Target Heart Rate Calculated? Formula My Rates

(MHR) by subtracting your age from

220.

2. Determine your Resting Heart Rate Once you feel the

(radial or carotid artery). beat, begin counting
for 60 seconds.

3. Subtract your Resting Heart Rate MHR – RHR =

(RHR) from your MHR. This gives HRmax Reserve
your Heart Rate Reserve. (HRmax
Reserve).

4. To get the lower end of your target (HRmax Reserve *

heart rate (50%), multiply your Heart 0.50) + RHR = low
Rate Reserve by .50 and then add end of zone
your Resting Heart Rate to it.

5. To get the highest end of your target (HRmax Reserve *

heart rate zone (85%), multiply your 0.85) + RHR = high
Heart Rate Reserve from step 3 by end of zone
0.85, and add your Resting Heart
Rate to it.

Heart Rate Reflection Question

Were you able to maintain your workouts within your calculated target heart rate
zone? Explain which activities you enjoyed most and which best helped you stay in your
THR zone.

Answer:

Section 3: Fitness Assessments

Complete steps one and two on the chart below:

Step1
Complete the Lesson 01.03 Baseline Results column. Use the original results from your
1.03 Fitness Assessments.

Step 2
Complete the Module 1 Wellness Plan Results column.
 **Please save these results, as you will need to include them for future Wellness
Plans in the course.

Activity Lesson Module 1

01.03 Wellness
Baseline Plan Results
Results

Mile Run/Walk

Body Mass
Index

Aerobic
Capacity

Curl-ups

Push-ups

Trunk Lift

Sit and Reach

Fitness Assessment Reflection Questions:

1. Explain how your scores compare to the Healthy Fitness Zone Standards. Based on
this comparison, what should you do next?

Answer:

2. Explain how your activity routine is improving each of your health-related

components of fitness (flexibility, muscular strength and endurance, cardiovascular,
and body composition).

Answer:

Section 4: Physical Activity Log

Include all moderate and vigorous physical activity in the table below. You need at least
three different moderate to vigorous activities that add up to 420 minutes. Activities
need to add up to 420 minutes without your warm-up times. Keep adding rows to show
all of your activities. The first five rows are completed as a sample only.
Date Warm-up Physical Activity Activity Minutes
without Warm-up
12/25 5-min stretch 2-mile walk 30 min

12/26 5-min jog 4-mile run 45 min

12/27 5-min stretch Basketball practice 60 min

12/28 15-min stretch Cheerleading–state championship 180 min

12/31 5-min stretch 3-mile bike ride 20 min

 Date Warm-up Physical Activity Activity Minutes
without Warm-up

TOTAL Activity Minutes 

Remember the 420-minute minimum

Physical Activity Reflection Chart:

Using your activities as examples, reflect on your use of FITT principles by completing
the chart below:

Sample:
FITT Principle Activity Explanation

Frequency 3-mile bike ride I ride this route 2-3 times a

week.

FITT Principle Activity Explanation

Frequency

Intensity

Time

Type

Section 5: Fitness Tracker Data

You have two options to complete this section.

Choose Option A OR Option B:

A. If you have a fitness tracker, such as MOVBand, Fitbit, iPhone Health App, etc.,
please include a screen shot of your results here AND use your results to fill out the
chart:
  Average daily moves this week = Total number of physical activity minutes
for the last 7 days x 26.19
 Percent toward my goal this week = Total average daily moves ÷ 12,000
 Total moves this week = Total number of physical activity minutes for the last
7 days x 183.33

Module 1 Module 1
Wellness Plan Wellness Plan
Results

Average Daily
Moves This Week

% Toward My Goal
This Week

Total Moves This

Week

B. If you do not have a Fitness Tracker, you may complete the chart below using the
following formula:

 Average daily moves this week = Total number of physical activity minutes
for the last 7 days x 26.19
 Percent toward my goal this week = Total average daily moves ÷ 12,000
 Total moves this week = Total number of physical activity minutes for the last
7 days x 183.33

Module 1 Module 1
Wellness Plan Wellness Plan
Results

Average Daily
Moves This Week
Module 1 Module 1
Wellness Plan Wellness Plan
Results

% Toward My Goal
This Week

Total Moves This

Week

Fitness Tracker Reflection Question:

Discuss changes you can make in your workout routine to increase your activity level
and improve on your achievements. Include adjustments to completed activities and
activities you may wish to add to your routine.

Answer:

Module One Wellness Plan Grading Rubric

  Excellent Good Needs Poor

Improvement

Section 1: 9–10 points 8 points 7 points 0–6 points

Goals
All goals are Most goals are Some goals are Goals are
measurable, measurable, measurable, not measurable,
attainable, and attainable, and attainable, and attainable, and
deadline driven. deadline driven. deadline driven. deadline driven.
Reflection Reflection Reflection Reflection
question responses are responses are responses
responses are adequately complete but are incomplete
thoughtfully detailed and lacking detail and or inaccurate.
detailed and supported. support.
supported.

Section 2: 9–10 points 8 points 7 points 0–6 points

Target
  Excellent Good Needs Poor
Improvement

Heart Rate  Heart rate  Heart rate and  Heart rate and  Heart rate and
and target target heart target heart target heart
heart rate rate zone are rate zone are rate zone
zone are recorded and recorded and are not
recorded slightly moderately recorded
and inaccurate. inaccurate. and/or
accurate.  Reflection  Reflection completely
 Reflection responses are responses are inaccurate.
question adequately complete but  Reflection
responses detailed and lacking detail responses are
are thoughtf supported. and support. incomplete
ully detailed or
and inaccurate. 
supported.

Section 3: 18–20 points 16–17 points 13–15 points 0–12 points

Fitness
Assessme  Fitness  Fitness  Fitness  Fitness
nts assessment assessment assessment assessment
Results for: results are results are results are results are
Lesson recorded. recorded. recorded. recorded.
01.03  Reflection  Reflection  Reflection  Reflection
Module 1 question responses are responses are responses are
responses adequately complete but incomplete
are thoughtf detailed and lacking detail or
ully detailed supported.  and support.  inaccurate.
and
supported.

Section 4: 36–40 points 32–35 points 25–31 points 0–24 points

Physical
Activity  All exercises  Most exercise  Some exercise  Few exercises
Log are s are s are moderate are moderate
YOU ARE moderate to moderate to to vigorous to vigorous
REQUIRED vigorous vigorous intensity. intensity, or
TO LOG intensity. intensity.  At intensity is not
EACH  At  At least 350 activi indicated.
WEEK YOU least 420 ac least 385 activ ty minutes are  At
ARE IN tivity minutes ity minutes are recorded. least 315 acti
THE are recorded.  Some exercise vity minutes
COURSE recorded.  All exercises dates listed are are recorded.
 All exercises are dated as not in an  Few exercise
  Excellent Good Needs Poor
Improvement

are dated as daily or every effective dates listed

daily or other day. pattern. are in an
every other  Most exercise  At least effective
day. dates are two different pattern.
 At least listed and are exercises have  One type of
three differe not in an been logged, exercise has
nt exercises effective including been logged,
have been pattern. specific including
logged,  At least exercises when specific
including three different required. exercises
specific exercises have  Reflection when
exercises been logged, responses are required.
when including complete but  Reflection
required. specific lacking detail responses are
 Reflection exercises and support. incomplete
question when required. or
responses  Reflection inaccurate.
are thoughtf responses are
ully detailed adequately
and detailed and
supported. supported.

Section 5: 36–40 points 32–35 points 25–31 points 0–24 points

Fitness
Tracker  Average  Average daily  Average daily  One or
Data daily moves, moves, moves, percent more of the
percent percent toward toward goal, fitness tracker
toward goal, goal, and total and total data is
and total moves for the moves for the missing.
moves for week are week are  Reflection
the week are recorded recorded and responses are
recorded and at least at least incomplete
and at least 80% 70% completed or
90% complet completed. . inaccurate.
ed.  Reflection  Reflection
 Reflection responses are responses are
question adequately complete but
responses detailed and lacking detail
are thoughtf supported. and support.
ully detailed
and
supported.
  Excellent Good Needs Poor
Improvement

Presentatio 18–20 points 16–17 points 13–15 points 0–12 points

n
 Plan format  One or  Three errors in  Four or
is properly two errors in plan format. more errors in
followed. plan format.  Some respons plan format.
 All response  Most respons es are in the  Few response
s are in the es are in the form of s are in the
form of form of complete form of
complete complete sentences. complete
sentences. sentences.  Three spelling sentences.
 No spelling  One or errors.  Four or
errors. two spelling more spelling
errors. errors.

Total Points Possible: 140 points