DISEASE PREVENTION EFFORTS
How Do You Rate?
Directions: Number a sheet of paper from 1 through 20. Read each item below
and respond by writing True if the statement describes you most of the time,
Maybe if the statement describes you some of the time, and False if the
statement never applies to you.
Total the number of each response and proceed to the next section of the
1. I keep my immunization records up-to-date.
2. I stay away from people who currently have a cold or the flu.
3. I do not smoke.
4. I avoid using towels others have used.
5. I eat a balance diet daily.
6. I take a few minutes each day to relax.
7. I get at least eight hours of sleep each night.
8. I exercise aerobically 20 minutes at least three times a week.
9. I stay home at least the first day that symptoms of an illness appear.
10. I avoid using other people’s combs and brushes.
11. I shower or bathe regularly.
12. I put food waste in closed containers.
13. I listen and respond to my body’s message that it is tired or something is
14. I do not eat or drink after other people, nor do I share eating utensils.
15. I wash my hands before every meal, before preparing food, and after
using the bathroom.
16. I cover my mouth before I cough or sneeze.
17. I advise my parents to make sure that our pets have their shots.
18. I avoid walking barefoot in locker rooms or shower rooms.
19. I avoid eating dairy products and poultry that might not have been
20. I support efforts to enforce public health laws for immunization and for
reporting communicable diseases.
How Did You Score?
Give yourself 4 points for each True answer, 2 points for each Maybe answer
, and 0 points for each False answer. Find your total, and read below to see
how you scored, then proceed to the next section.
60 to 80
Excellent. Your disease prevention efforts are outstanding. Congratulations.
40 to 59
Good. You are doing very well in your efforts to prevent communicable
20 to 39
Fair. Disease prevention is not important enough to you. Some efforts will
be beneficial to you and others.
Needs Improvement. Be careful. You may be spreading communicable
diseases to yourself and to others. Now is a good time to start taking better
care of yourself.
What are your goals?
If you received an excellent or good score, complete the statements in Part A.
If your score was fair or needs improvement, complete Parts A and B.
1. I plan to learn more about disease prevention by ____________.
2. My timetable for accomplishing this is ____________.
3. I plan to share my information with others by ___________.
4. The behavior I would most like to change is ___________.
5. The steps involved in making this change are ___________.
6. The people or groups I will ask for support and assistance are
7. My rewards for making this change will be __________.