Chapter  1: Promoting Healthy Behavior Change

Self Assessment: Lifestyle Assessment Inventory

Purpose:
The purpose of this lifestyle assessment inventory is to increase your awareness of areas in your life that raise your risk of disease, injury, and possibly premature death. A key point to remember is that you have control over each of the lifestyle areas discussed. Awareness is the first step in making change.

Directions:
Place a check mark by each statement that applies to you.

Top of Form

A. Physical Fitness

I exercise for a minimum of 20 to 30 minutes at least 3 days a week.

I play sports routinely (2 to 3 times per week).

I walk for 15 to 30 minutes (3 to 7 days per week).

B. Body Fat

There is no place on my body where I can pinch more than 1 inch of fat.

I am satisfied with the way my body appears.

C. Stress Level

I find it easy to relax.

I rarely feel tense or anxious.

I am able to cope with daily stresses better than most people.

D. Car Safety

I have not been in an auto accident in the past 4 years.

I always use a seat belt when I am in a car.

I rarely drive with someone going above the speed limit.

E. Sleep

I always get 7 to 9 hours of sleep.

I do not have trouble going to sleep.

I generally do not wake up during the night.

F. Relationships

I have a happy and satisfying relationship with my friends.

I have a lot of close friends.

I have a great deal of family love and support.

G. Diet

I generally eat three balanced meals per day.

I rarely overeat.

I rarely eat large quantities of fatty foods and sweets.

H. Alcohol Use

I consume fewer than two drinks per day.

I never get intoxicated.

I never drink and drive.

I. Tobacco Use

I never smoke (cigarettes, pipe, cigars, etc.).

I am not exposed to second-hand smoke on a regular basis.

I do not use smokeless tobacco.

J. Drug Use

I never use illicit drugs.

I never abuse legal drugs such as diet or sleeping pills.

K. Safe Sex

I always practice safe sex (e.g., always using condoms or being involved in a monogamous relationship).

Bottom of Form

Scoring:

1.) Individual areas: If you have fewer than three checks in categories A through K, you can improve this area of your lifestyle.

2.) Overall lifestyle: Add up your total number of checks. Scoring can be interpreted as follows:

23 - 29 Very healthy lifestyle
17 - 22 Average healthy lifestyle
Less than 16 Unhealthy lifestyle (needs improvement)