3.

Motivation (Part 1) | Types of Motivation

Treatment Self-Regulation Questionnaire for Exercise (SRQ-E)

There are a variety of reasons why people work out. Please indicate how true each reason is for
why you work out. The scale is:

1 2 3 4 5 6 7
Not at all Somewhat Very True
True True

Why do you work out?

1. Because I simply enjoy working out. 1 2 3 4 5 6 7

2. Because working out is important and beneficial for my 1 2 3 4 5 6 7

health and lifestyle.
3. Because I would feel bad about myself if I didn’t do it. 1 2 3 4 5 6 7

4. Because it is fun and interesting. 1 2 3 4 5 6 7

5. Because others like me better when I am in shape. 1 2 3 4 5 6 7

6. Because I’d be afraid of falling too far out of shape. 1 2 3 4 5 6 7

7. Because it helps my image. 1 2 3 4 5 6 7

8. Because it is personally important to me to workout. 1 2 3 4 5 6 7

9. Because I feel pressured to work out. 1 2 3 4 5 6 7

10. Because I have a strong value for being active and healthy. 1 2 3 4 5 6 7

11. For the pleasure of discovering and mastering new training 1 2 3 4 5 6 7

techniques.
12. Because I want others to see me as physically fit. 1 2 3 4 5 6 7

How to Score: For each subscale, average your responses for the specific questions.
1. External Motivation: #5, #7, #12
2. Introjected Motivation (To Avoid Guilt): #3, #6, #9
3. Identified Motivation (For Valued Outcomes): #2, #8, #10
4. Intrinsic Motivation: #1, #4, #11

A LOWER average score (1-4) indicates you are LESS motivated by that type of motivation.
A HIGHER average score (5-7) indicates you are MORE motivated by that type of motivation.

Levesque, C. S., Williams, G. C., Elliot D., Pickering, M. A., Bodenhamer, B., & Finley, P. J (2007). Validating the
theoretical structure of the treatment self-regulation questionnaire (TSRQ) across three different health behaviors.
Health Education Research, 21, 691-702.
 4. Motivation (Part 2) | Motivation Sources

Basic Psychological Needs in Exercise Scale (BPNES)

1 2 3 4 5
Totally Agree a Moderately Strongly Very Strongly
Disagree Little Bit Agree Agree Agree

Using the rating scale above, indicate how much you disagree or agree with each of the
following statements. For each item, consider the personal relevance in the context of exercise.

1. The exercise program I follow is highly compatible with my 1 2 3 4 5

choices and interests.
2. I feel very strongly that the way I exercise fits perfectly the way 1 2 3 4 5
I prefer to exercise.
3. I feel that the way I exercise is definitely an expression of myself. 1 2 3 4 5

4. I feel very strongly that I have the opportunity to make choices 1 2 3 4 5

with respect to the way I exercise.
5. I feel I have been making a huge progress with respect to the end 1 2 3 4 5
result I pursue.
6. I feel that I very effectively execute the exercises of my training 1 2 3 4 5
program.
7. I feel that exercise is an activity in which I do very well. 1 2 3 4 5

8. I feel that I can manage with the requirements of the training 1 2 3 4 5

program I am involved.
9. I feel extremely comfortable with other exercise participants. 1 2 3 4 5

10. I feel that I associate with other exercise participants in a very 1 2 3 4 5

friendly way.
11. I feel there are open channels of communication with other 1 2 3 4 5
exercise participants.
12. I feel very much at ease with other exercise participants. 1 2 3 4 5

How to Score: For each subscale, average your responses for the specific questions.
1. Autonomy: #1-4
2. Competence: #5-8
3. Relatedness: #9-12

A LOWER average score (1-3) indicates you perceive LESS of that subscale.
A HIGHER average score (4-5) indicates you perceive MORE of that subscale.

Vlachopoulos, S. P., & Michailidou, S. (2006). Development and initial validation of a measure of autonomy,
competence, and relatedness in exercise: The Basic Psychological Needs in Exercise Scale. Measurement in
Physical Education and Exercise Science, 10(3), 179-201.
 5. Motivation (Part 3) | Role of Confidence

Exercise Self-Efficacy Scale (ESES)

1 2 3 4
Not at All Rarely Moderately Always
True True True True

I am confident…

1. That I can overcome barriers and challenges with regard to 1 2 3 4

physical activity and exercise, if I try hard enough.
2. That I can find means and ways to be physically active and 1 2 3 4
exercise.
3. That I can accomplish my physical activity and exercise goals that 1 2 3 4
I set.
4. That when I am confronted with a barrier to physical activity or 1 2 3 4
exercise I can find several solutions to overcome this barrier.
5. That I can be physically active or exercise even when I am tired. 1 2 3 4

6. That I can be physically active or exercise even when I am feeling 1 2 3 4

depressed.
7. That I can be physically active or exercise even without the 1 2 3 4
support of my family or friends.
8. That I can be physically active or exercise without the help of a 1 2 3 4
therapist or trainer.
9. That I can motivate myself to start being physically active or 1 2 3 4
exercising again after I’ve stopped for a while.
10. That I can be physically active or exercise even if I had no access 1 2 3 4
to a gym, exercise, training, or rehabilitation facility.

How to Score: Average ALL your responses for the specific questions.

A LOWER average score (1-2) indicates you perceive LESS/LOW confidence.

A HIGHER average score (3-4) indicates you perceive MORE/HIGH confidence.

Note. You can also look at your response to each individual item, to see if there are particular
areas that you are more or less confident than other areas (e.g. when tired vs. without support).

Kroll, T., Kehn, M., Ho, P. S., & Groah, S. (2007). The SCI exercise self-efficacy scale (ESES): development and
psychometric properties. International Journal of Behavioral Nutrition and Physical Activity, 4(34),
https://doi.org/10.1186/1479-5868-4-34
 6. Options

Using the Compendium of Physical Activities, choose 4 options for physical activity of 3 or
more METs.

https://sites.google.com/site/compendiumofphysicalactivities/Activity-Categories

Next to each activity, provide the major BARRIER that you do/would personally face when
trying to complete that activity in the coming weeks.

For each barrier, provide at least one STRATEGY that you are confident would help you
overcome that particular barrier. Here is an example.

Physical Activity Major Barrier(s) Strategy to Overcome Barrier(s)

1. Brisk Walk It is too cold right now to walk Even though I do not like it as much,
outside, which is where I a temporary solution is to walk on
normally would walk. the treadmill at home before work.

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Physical Activity Major Barrier(s) Strategy to Overcome Barrier(s)

1.

2.

3.

4.
 7. Variation (Part 1) | Rx Basics

Please complete the following questions to assess your physical activity per week over the last
month. This is a typical way of measuring physical activity by the CDC and BRFSS.

Moderate to Vigorous Physical Activity (min/week)

MODERATE INTENSITY: You can talk, but not sing – walking briskly, water aerobics,
bicycling slowly, tennis (doubles), general dancing, general gardening.

VIGOROUS INTENSITY: You are not able to say more than a few words without pausing for a
breath – race walking, jogging, running, swimming laps, aerobic dancing, tennis
(singles), fast bicycling, hiking uphill, heavy gardening (continuous digging or hoeing).
2. How many times per week did you take part in these activities during the past month?
__ times per week
3. And when you took part in these activities, for how many minutes did you usually keep at it?
__ minutes

How to Score: Multiply the “times per week” by “minutes” to get minutes per week of
moderate-to-vigorous physical activity.

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For more detail, you can complete this recall for the past 7 days.

Day Frequency Intensity Time Type

Active this Day? Check One In Minutes What Activity?
Day 7 (Today) m Yes m No m Moderate
m Vigorous
Day 6 (Yesterday) m Yes m No m Moderate
m Vigorous
Day 5 m Yes m No m Moderate
m Vigorous
Day 4 m Yes m No m Moderate
m Vigorous
Day 3 m Yes m No m Moderate
m Vigorous
Day 2 m Yes m No m Moderate
m Vigorous
Day 1 m Yes m No m Moderate
m Vigorous
8. Variation (Part 2) | Self-Monitoring

To Do: Use a physical activity/fitness tracker to record your physical activity for 1 day.

Note. Common trackers include FitBit or Garmin. You can use your Smart Phone, alongside an
app of your choice. Your goal is to be able to record minutes of moderate and vigorous activity.

Day/Date Moderate Activity Vigorous Activity

In Minutes In Minutes

9. Variation (Part 3) | Inactivity

To Do: Either using the same physical activity monitor/tracker used above, or accessing data
from a pedometer (1) record your total steps for 1 day, (2) compare to the daily step
goals, and (3) devise your strategy to get more steps in the coming days.

Day/Date Total Steps Step Goals Per Day: Strategy to Increase Steps:
1. ≥ 5,000 steps (inactivity)
2. ≥ 7,500 steps (physical activity)
 10. Effort (Part 1) | Perceptions of Effort

The Feeling Scale

While participating in exercise, it is common to experience changes in mood. Some individuals

find exercise pleasurable, whereas others find it to be unpleasant. Additionally, feelings might
fluctuate across time. That is, one might feel good and bad a number of times during exercise.

To Do: Complete one, 30-minute exercise bout of choice – choosing an exercise you have never
done or not completed in a long time. answer the following scales BEFORE, DURING and
IMMEDIATELY AFTER the exercise bout.

BEFORE Exercise Bout: How do you feel at the present moment?

–5 –4 –3 –2 –1 0 +1 +2 +3 +4 +5
Very Bad Fairly Neutral Fairly Good Very
Bad Bad Good Good

DURING Exercise Bout: How do you feel at the present moment?

–5 –4 –3 –2 –1 0 +1 +2 +3 +4 +5
Very Bad Fairly Neutral Fairly Good Very
Bad Bad Good Good

IMMEDIATLELY AFTER Exercise Bout: How do you feel at the present moment?
–5 –4 –3 –2 –1 0 +1 +2 +3 +4 +5
Very Bad Fairly Neutral Fairly Good Very
Bad Bad Good Good

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Use the box below to describe any additional feelings or thoughts you had during the exercise
that might influence your perceptions of doing or not doing this activity in the future.

Hardy, C.J., & Rejeski, W.J. (1989). Not what, but how one feels: The measurement of affect during exercise.
Journal of Sport & Exercise Psychology, 11(3), 304-317.
11. Effort (Part 2) | Functional Fitness

Below are reasons people often give when asked why they exercise. Please read each statement
carefully and indicate, by circling the appropriate number, whether or not each statement is true
for you, or would be true for you personally if you did exercise.

1 2 3 4 5
Not at all Very True
True for Me For Me

Personally, I exercise (or might exercise) …

1. For my emotional wellness. 1 2 3 4 5

2. For my financial wellness. 1 2 3 4 5

3. For my spiritual wellness. 1 2 3 4 5

4. For social reasons, wellness. 1 2 3 4 5

5. To perform better, more well at work. 1 2 3 4 5

6. For physical wellness. 1 2 3 4 5

7. For my mind, intellectual wellness. 1 2 3 4 5

8. For aerobic/cardiovascular fitness. 1 2 3 4 5

9. For more endurance. 1 2 3 4 5

10. For more strength. 1 2 3 4 5

11. For more flexibility. 1 2 3 4 5

12. For more speed or agility. 1 2 3 4 5

13. For more balance or coordination. 1 2 3 4 5

14. For more power. 1 2 3 4 5

15. For better body composition/body weight. 1 2 3 4 5

How to Score: Examine each response to see which “function(s)” are most motivating for you.
Next, determine if your current/future exercise routine is/will be specific for the function(s).

Dimensions of Wellness: #1-7

Dimensions of Fitness: #8-15