Activity 1: Overcoming Barriers to Being Active

Instruction: Listed below are reasons that people give to describe why they do not get
as much physical activity as they think they should. Read each statement and
indicate how likely you are to say each of the following statements.

Very Somewhat Somewhat Very

How likely are you to say this?
Likely Likely unlikely Unlikely
1. My parents/guardians are so busy now, I just don’t think I
can make the time to include physical activity in my 3 2 1 0
regular schedule.
2. None of my family members or friends like to do
3 2 1 0
anything active, so I don’t have a chance to exercise.
3. I’m just too tired after work to get any exercise. 3 2 1 0
4. I’ve been thinking about getting more exercise, but I. just
3 2 1 0
can’t seem to get started.
5. I’m getting older so exercise can be risky. 3 2 1 0
6. I don’t get enough exercise because I have
3 2 1 0
never learned the skills for any sport.
7. I don’t have access to jogging trails, swimming pools,
3 2 1 0
bike paths, etc.
8. Physical activity takes too much time away from other
3 2 1 0
commitments – like work, family, etc.
9. I’m embarrassed about how I will look when I exercise
3 2 1 0
with others.
10. I don’t get enough sleep as it is. I just couldn’t get up early or
3 2 1 0
stay up late to get some exercise.
11. It’s easier for me to find excuses not to exercise that to
3 2 1 0
go out and do something.
12. I know of too many people who have hurt themselves by
3 2 1 0
overdoing it with exercise.
13. I really can’t see learning a new sport at my age. 3 2 1 0
14. It’s just too expensive. You must take a class or join a club or
3 2 1 0
buy the right equipment.
15. My free times during the day are too short to include exercise.
3 2 1 0
16. My usual social activities with family or friends do not include
3 2 1 0
physical activity.
17. I’m too tired during the week and I need the weekend to
3 2 1 0
catch up on my rest.
18. I want to get more exercise, but I just can’t seem to
3 2 1 0
make myself stick to anything.
19. I’m afraid I might injure myself or have a heart attack. 3 2 1 0
20. I’m not good enough at any physical activity to make it fun.
3 2 1 0
21. If we had exercise facilities and showers at work, then I would
3 2 1 0
be more likely to exercise.

Scoring: Enter the circled numbers in the space provided, putting the number for statement 1 on line 1,
statement 2 on line 2, and so on. Add the three scores on each line. Your barriers to physical activity fall
into one or more of the seven categories as indicated below. A score of 5 or above in any category shows
that this is an important barrier for you to overcome.

Score in Statement Total

score
1 8 15 Lack of Time
2 9 16 Social Influence
3 10 17 Lack of energy
4 11 18 Lack of Willpower
5 12 19 Fear of Injury
6 13 20 Lack of Skill
7 14 21 Lack of Resource
Activity 3: Lifestyle Evaluation

Instruction: For each question, choose the answer that best describes your behavior,
then add up your score for each section.

DESCRIPTIVE EQUIVALENT
Scores 9-10............................Excellent
Scores 6-8..............................Good but needs improvement
Scores 3-5..............................Health at risk
Scores 0-2.............................Serious and unnecessary risk with health

EXERCISE/ FITNESS Almost Always Sometimes Never

1. I engage in moderate exercise, such as brisk walking or
swimming, for 20-60 minutes, three to 4 1 0
five times a week.
2. I do exercise to develop muscular strength and
2 1 0
endurance at least twice a week.
3. I spend some of my leisure time in participating in
individual, family, or team activities, such as 2 1 0
gardening, bowling, or softball.
4. I maintain a healthy body weight, avoiding overweight
2 1 0
and underweight.
Descriptive equivalent: Score:

NUTRITION Almost Always Sometimes Never

1. I eat a variety of foods each day, including seven or
3 1 0
more serving of fruits and/or vegetables.
2. I limit the amount of total fat, saturated fat
3 1 0
and trans-fat in my diet.
3. I avoid skipping meals. 2 1 0
4. I limit the amount of salt and sugar I eat. 2 1 0
Descriptive equivalent: Score:

TOBACO USE Almost always Sometimes Never

If you NEVER use tobacco, enter a score of 10 for this
10
section and go to the next section
1. I avoid using tobacco. 2 1 0
2. I smoke only low-tar-and-nicotine cigarettes, or I smoke a
pipe or cigars, or I use smokeless 2 0
tobacco and electronic smokes.
Descriptive equivalent: Score:

ALCOHOL AND DRUGS Almost Always Sometimes Never

1. I avoid alcohol, or I drink alcohol no more than one

4 1 0
(for women) or two (for men) drinks a day.
2. I avoid using alcohol or other drugs as a way of
handling stressful situations or the problems in 2 1 0
my life.
3. I am careful not to drink alcohol when taking
medications (such as cold or allergy medications) or 2 1 0
when pregnant.
4. I read and follow the label directions when using
2 1 0
prescribed and over-the-counter drugs.
Descriptive equivalent: Score:

EMOTIONAL HEALTH Almost Always Sometimes Never

1. I enjoy being a student, and I have a job or do other
2 1 0
works that I enjoy.
2. I find it easy to relax and express my feelings freely.
2 1 0
3. I manage stress well. 2 1 0
4. I have close friends, relatives, or other whom I
can talk to about personal matters and call on for help 2 1 0
when needed.
5. I participate in group activities (such as community or
church organizations) or hobbies 2 1 0
that I enjoy.
Descriptive equivalent: Score:

SAFETY Almost Always Sometimes Never

1. I wear a safety belt while riding in a car. 2 1 0
2. I avoid driving while under the influence of alcohol or
2 1 0
other drugs.
3. I obey traffic rules and the speed limit when driving.
2 1 0
4. I read and follow instructions on the labels of
potentially harmful products or substances, such as
2 1 0
household cleaners, poisons, and electric
appliances.
5. I avoid smoking in bed. 2 1 0
Descriptive equivalent: Score:

DISEASE PREVENTION Almost Always Sometimes Never

1. I know the warning signs of cancer, heart attack, and
2 1 0
stroke.
2. I avoid overexposure to the sun and use sunscreen.
2 1 0
3. I get recommended medical screening tests (such
as blood pressure and cholesterol checks and Pap 2 1 0
tests), immunizations, and booster shots.
4. I practice monthly skin and breast/ testicle self- exams.
2 1 0
5. I am not sexually active, or I have sex with only one
mutually faithful, uninfected partner or I
2 1 0
always engage in safer sex (using condoms), and I do
not share needles to inject drugs.
Descriptive equivalent: Score:

Summary of Results
EXERCISE/ FITNESS
NUTRITION
TOBACO USE
ALCOHOL AND DRUGS
EMOTIONAL HEALTH
SAFETY
DISEASE PREVENTION