Sample Rubric for Evaluating the Elements of a Body Image
Element of Less Effective Somewhat Effective More Effective
Action Plan Rating of 1 Rating of 2 Rating of 3
Who Plan includes name of one Plan includes name of adult Plan includes name of adult
support person. tutor, Wellness 10 tutor, or tutor, Wellness 10 tutor, or
teacher as well as name of teacher as well as name of
peer support person. peer support person and
name(s) of others the student
intends to involve in the
What Plan includes a statement Plan includes a goal Plan includes a goal
of what is to be done. statement that is clear, statement that is clear,
specific, measurable, and specific, measurable, and
attainable. attainable. Also included is a
statement of purpose that
this is about body image and
affirming standards. A
statement clarifies whether
the plan is to improve or
maintain body image.
How Plan includes a vague Plan includes some details Plan includes a step-by-step
outline of what is to be about what is to be done. outline of what is to be done.
done. Precise physical activities are
identified and/or precise food
groups and servings are
Why Plan includes a vague Plan includes some detail Justification is provided for
explanation about why about why some steps are in why specific steps are
particular steps are in place. included to meet the goal.
place. Plan lists possible barriers or
obstacles and how they might
When Plan includes start date Plan includes start date, end Plan includes start and end
and end date. date, first check-in date, and dates as well as check-in
some details about time of dates and celebration dates.
day or which daily meal(s). Details are included about
dates and times for each step
of the action plan.
Where Plan includes no indication Plan includes scant details Plan includes specific
of where the action plan is about where the action plan indication of exactly where
to be carried out. is being carried out. each step of the action plan is
to be carried out (e.g., swim
lanes at the recreation
centre, eat 2 servings at
school during lunch hour,
roller blade in the park).