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
01.03 Fitness Assessments.

Step 2
Complete the Module 1 Wellness Plan Results column. Use the current results from
your 01.03 Fitness Assessments.
 **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 OR use your results to fill out the
chart:
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

% 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, attainable, and attainable, and , attainable,
and deadline deadline driven. deadline driven. and deadline
driven. Reflection Reflection driven.
Reflection responses are responses are Reflection
question adequately complete but responses
responses are detailed and lacking detail are incomplete
thoughtfully supported. and support. or inaccurate.
detailed and
supported.

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

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

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

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

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

Physical
Activity  All exercis  Most exercis  Some exerci  Few exercis
Log es are es are ses are es are
YOU ARE moderate moderate to moderate to moderate to
REQUIRED to vigorous vigorous vigorous vigorous
TO LOG intensity. intensity. intensity. intensity, or
EACH  At  At  At intensity is
WEEK YOU least 420  least 385 ac least 350 acti not
ARE IN activity tivity minutes vity minutes indicated.
THE minutes are are recorded.  At
COURSE are recorded.  Some exerci least 315 ac
recorded.  All exercises se dates tivity
 All exercis are dated as listed are not minutes are
es are daily or in an recorded.
dated as every other effective  Few exercis
daily or day. pattern. e dates
every  Most exercis  At least listed are in
other day. e dates are two different an effective
 At least listed and exercises pattern.
three diffe are not in an have been  One type of
rent effective logged, exercise has
exercises pattern. including been
 have been  At least specific logged,
logged, three differe exercises including
including nt exercises when specific
specific have been required. exercises
exercises logged,  Reflection when
when including responses required.
required. specific are complete  Reflection
 Reflection exercises but lacking responses
question when detail and are
responses required. support. incomplete
are thoug  Reflection or
htfully responses inaccurate.
detailed are
and adequately
supported detailed
. and
supported.

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

Fitness
Tracker  Average  Average  Average daily  One or
Data daily daily moves, moves, more of the
moves, percent percent fitness
percent toward goal, toward goal, tracker data
toward and total and total is missing.
goal, and moves for moves for the  Reflection
total the week are week are responses
moves for recorded recorded and are
the week and at least at least incomplete
are 80% 70% complet or
recorded completed. ed. inaccurate.
and at  Reflection  Reflection
least responses responses
90% comp are are complete
leted. adequately but lacking
 Reflection detailed detail and
question and support.
responses supported.
are thoug
htfully
detailed
and
supported
.
Presentatio 18–20 points 16–17 points 13–15 points 0–12 points
n
 Plan  One or  Three errors  Four or
format two errors in in plan more errors
is properl plan format. format. in plan
y followed.  Most respon  Some respon format.
 All respon ses are in ses are in the  Few respon
ses are in the form of form of ses are in
the form of complete complete the form of
complete sentences. sentences. complete
sentences.  One or  Three spellin sentences.
 No spellin two spelling g errors.  Four or
g errors. errors. more spellin
g errors.

Total Points Possible: 140 points