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Pre-Wellness Assessment Instructions

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                                Pre-Wellness Assessment and Behavior Change Plan
                                                   Instructions
                                           GHTH 100: Personal Wellness


This assignment is due September 15

Locate and complete the Interactive Assess Yourself inventory, which can be found online in the following
manner:

      Locate the site at www.pearsoncustom.com/va/jmu_ghth100
      Two texts will appear on the screen. Click on the text to the left.
      At the top of the screen, select ‘Chapter 1’.
      To the left, click ‘Self-Assessments’.
      Click ‘Interactive Assess Yourself.’

Complete the inventory online, and print out a copy of your results upon completion. Keep a copy of your Pre-
Assessment results for comparison with the Post-Assessment. Use the results from your Pre-Assessment to
answer the following questions. On the due date, submit your responses to the questions below, as well as the
Behavior Change Contract which is attached. The assignment will not be accepted early.

   1. Type your Pre-Wellness Assessment scores in the chart.

                                      Category                     Ideal Score     Your Score
                                   Physical Fitness                    40
                                    Social Health                      40
                                  Emotional Health                     40
                                Environmental Health                   40
                                   Spiritual Health                    40
                                  Intellectual Health                  40
                        Personal Health Promotion and Disease          40
                                      Prevention
                        Pre-Wellness Assessment Total Score            280

Answer questions 2-7 based on the Pre-Wellness Assessment results. Highlight your responses on this page.

   2. The category for my Pre-Assessment overall score is:

                   a.   245-280 points – Excellent or High Level Wellness
                   b.   210-244 points – Good or Many Positives/Need Some Improvement
                   c.   140-209 points – Your Health Risks are Beginning to Show
                   d.   Less than 140 points – Needs Improvement or Choices Adverse to Health

   3. My Pre-Asessment overall score is:

                   a. A complete surprise to me
                   b. Somewhat expected
                   c. Exactly what I expect
4. Which of the following responses best reflects your feelings/thoughts about your score:

                a. I am aware of areas I do well and areas I need to change and the score accurately reflects my health
                   behaviors.
                b. I am aware of areas I do well and areas I need to change, however the score does not accurately
                   reflect my health behaviors.
                c. There is more to health than I realized and the score accurately reflects my health behaviors.
                d. There is more to health than I realized and the score still seems off in relation to how I feel about my
                   health.

5. List 5 positive health behaviors or practices that you currently engage in and plan to
   maintain.




6. List 5 negative health behaviors or practices that you currently engage in.




7. List 3 health behaviors that you will make attempts to engage in this semester. You may add positive behaviors that
you are not practicing and/or stop negative behaviors that you are practicing.
 Complete the Assess Yourself questionnaire and read the Skills for Behavior Change box describing the stages of
 change. After reviewing your results and considering the various factors that influence your decisions, choose a
 health behavior that you would like to change, starting this semester. Sign the contract at the bottom to affirm
 your commitment to making a healthy change and ask a friend to witness it.


My behavior change will be: _____________________________________________________________________________


My long-term goal for this behavior change is: _______________________________________________________________


These are three obstacles to change (things that I am currently doing or situations that contribute to this behavior or make it harder to
change):

         1.   ___________________________________________________________
         2.   ___________________________________________________________
         3.   ___________________________________________________________


The strategies I will use to overcome these obstacles are:

         1.   ___________________________________________________________
         2.   ___________________________________________________________
         3.   ___________________________________________________________


Resources I will use to help me change this behavior include:

         A friend/partner/relative:            _____________________________________
         A school-based resource:              _____________________________________
         A community-based resource:           _____________________________________
         A book or reputable website:          _____________________________________


In order to make my goal more attainable, I have devised these short-term goals

         __________________________________                       ____________                 _________________
                   Short-term goal                                  Target date                      Reward

         __________________________________                       ____________                 _________________
                   Short-term goal                                  Target date                     Reward

         __________________________________                       ____________                 _________________
                   Short-term goal                                  Target date                     Reward


When I make the long-term behavior change described above, my reward will be:

         _______________________________________________                    Target date: _________

I intend to make the behavior change described above. I will use the strategies and rewards to achieve the goals that will contribute to a
healthy behavior change.

                    __________________________________              _________________________________________
                               Signature                                               Witness

				
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