health behavior final report
rqp
BEHAVIORCHANGECONTRACT-FINALREPORT1.docx
HEALTH BEHAVIOR CHANGE CONTRACT- FINAL REPORT
Purpose: To use information, theories, and resources from class to attempt to change one health behavior
Instructions:
Directions
Please answer the questions provided for you below. Summarize the progress you have made to date plus your plan for the future. When restating your goal, make sure it is a complete set up statement that has your target behavior AND goal listed. Do not write a vague goal, it should be specific. For example, if your goal was to exercise 3-4 days a week for a min of 30 min in order to lose 5 lbs., make sure you answer ALL components.
Accomplishment: Describe briefly the progress you made towards your goal. Be specific. For example, if your goal had to do with weight loss, don’t just indicate that you lost weight; include how much weight you lost. If you did not make any progress, state that.
Successful Strategies: List at least 3 strategies that you have found useful to you as you worked towards your goal.
Obstacles: List either of the following:
at least 2 obstacles that you successfully overcame as you worked towards achieving your goal and how you overcome them; OR
at least 2 obstacles you encountered, but were not able to overcome and how you could overcome them in the future
Maintenance: Describe briefly what you plan to do from now on to either achieve your goal, or maintain your successful attainment of the goal.
Health Behavior Change Contract
My goal was:
2. Accomplishment and Progress with my goal:
3. What were 3 successful strategies that helped you ?
1.
2.
3.
4. List 2 Obstacles you overcame and how you overcame them OR list 2 obstacles that you encountered that you did not overcome and what you can do differently in the future to overcome them
Obstacle 1:
Obstacle 2:
5. Maintenance:
