Getting Started

This section asks questions about your current levels of physical activity (gardening, walking, vacuuming, etc.) and healthy eating. Please check the boxes that best answer each question.

Questions to Answer: Physical Activity

1. List your current physical activities. (Check all that apply.)
   • Housecleaning, shopping, climbing stairs
   • Yard work or gardening
   • Active work (e.g., farm work, pushing/pulling/lifting,digging, carrying boxes)
   • Walking, hiking, or running
   • Playing sports
   • Playing actively with children (e.g., tag, ball games, jumping rope)
   • Ice skating, skiing
   • Swimming, riding horses
   • Working out with a treadmill, step machine, orexercise videos
   • Doing sit-ups or lifting weights
   • Others: ____________________________________

2. How much time are you physically active on a typical day?
   • More than 30 minutes
   • 20-30 minutes
   • Less than 20 minutes
   • I am active for 10-minute periods throughout the day for a total of ____ minutes. (Fill in the blank)
   • Less than 10 minutes

3. How many days a week are you physically active?
   • 7 days
   • 5-6 days
   • 3-4 days
   • 1-2 days
   • Less than 1 day

4. What are some of the reasons that keep you from being physically active? (Check all that apply.)
   • Lack of time.
   • Lack of energy/too tired.
   • Don't know how to get started.
   • Don't enjoy physical activity.
   • Lack of transportation.
   • Don't have/can't afford a place to be physically active.
   • Child care is not available.
   • Have a physical problem, pain, or disability.
   • Others: ______________________________________

Section 3, Tools for Reaching My Physical Activity Goals, has tips to help you find solutions to some of these issues.

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