N3335 Promoting Healthy Lifestyles Health Risk Assessment and Health Promotion Contract

Health Risk Assessment and Health Promotion Contract

Overview: Health Risk Assessment and Health Promotion Contract

For each section of the HealthSelf-Assessment in the document below, provide a substantial summary of your current health status.In each section’s summary, be sure to include any information regarding your health and lifestyle that might play a role in your overall wellness.

You will contract to change/improve one health behavior during this course. Your HealthRisk Assessment can give you guidance on your choice, but ultimately the choice is yours.

Part of the contract requires you to evaluate your current “stage of change” according to the stages described by Zimmerman, Olsen, and Bosworth in the article, “A ‘Stages of Change’ Approach to Helping Patients Change Behavior.” http://www.aafp.org/afp/2000/0301/p1409.html

You will be tracking your progress toward the goals in your contract by completing journal entries for four weeks, then analyzing your motivation, successes, and obstacles in the final week of the course.

Objectives: 

• Devise a personal Health Promotion contract to be used for the duration of the course.
• Discuss the Stages of Change model in relation to health behavior changes for others and self.

Rubric

Use this rubric to guide your work on the assignment, “Health Risk Assessment and Health Promotion Contract.”

Task	Accomplished	Competent	Needs Improvement
Health Risk Assessment (Total 50 points)	All sectionsinclude thorough and substantial summaries of your current health status, with details of your health and lifestylethat might play a role in your overall wellness (ie. “I don’t drink or smoke” is not considered a substantial explanation. If you don’t drink or smoke, include how this will help prevent certain illnesses.) (50 points)	At least 5 sections completed thoroughly, with substantial summaries and details, but not all sections completed thoroughly with substantial detail. (35 points)	At least 2 sections completed thoroughly, with substantialsummaries and details, or no sections completed thoroughly.   (15 points)
Health Promotion Contract (Total 50 points)	All 5 sections completed, including measurable goals, correct target dates, and reasonable rewards, etc… Each item inserted in the correct field on the template (goals, dates, rewards, etc…) (50 points)	All sections completed, but not all goals are measureableor inalignment with final goal, dates are missing or all not inserted in the template, missing some or all rewards   (35 points)	Minimal sections addressed completely or correctly, or no sections addressed        (15points)

Health Risk Assessment

Summarize your current health status, including any other information about your own health and lifestyle that may play a role in your overall wellness, in each section below. Summary of each section must be substantial and include details to receive credit.Please note that only your Coach and Faculty will be reading your entries. If there is any information that you do not feel comfortable sharing you do not need to include that particular information but still need to make your entry substantive as directed above.

Blood Pressure/Cholesterol/Diabetes

Weight/BMI

Food Intake/Diet

Tobacco and Alcohol

Well Being

Activity/Exercise

Health Promotion Contract

Your goals should be written in SMART goal format, meaning they should be Specific, Measurable, Attainable, Realistic, and Timely. Please go to this website for more detailed information on SMART goal format: Smart Goal Format article

Identify one goal to work toward during this course, knowing that you will be journaling about your progress in your journaling assignment, four times a week for four weeks.

An example of a goal that is NOT in SMART goal format is: I will walk more often.

An example of a properly formatted SMART goal is:

I, (student name), agree to walk for 30 minutes, four times a week (goals can be daily but need to be for at least 4x per week since you will be journaling on the goal 4x a week) by 8/3/20. (The date inserted here should be the Saturday of Module 4 for your course.)

Your SMART goal:

 

1.         I,                                                                                       [Name]

            agree to

insert month/day/year

            by [date:    [Saturdayof Module 4]

2.         I will use the following tools to monitor my progress:

The weekly assignment Journal and (at least one other tool)-

            [chart, graph, scales, etc., as appropriate for your goal]

3.         To reach my final goal I have devised the following schedule of goals and

rewards [Need two mini-goals and your final goal (as written above in #1) and also list rewards for all. Be sure that your mini goals match your final goal, meaning they are in alignment with and will help you achieve your final goal.As in the example goal of walking, then both mini goals should address walking – see highlighted area below].

You should have a total of 3 goals, 3 dates, and 3 rewards in the template below.

GOALS	TARGET DATE	REWARD
Mini goal example: I will walk 10 minutes twice a week		Take time to get a manicure
Mini goal #1:write your specific measurable mini goal here-		Write your reward here:
Mini goal #2:write your specific measurable mini goal here-		Write your reward here:
Final Goal(exactly as written in #1 above in the SMART goal organizer,see the highlighted example below): write your specific measureable Final Goal here-		Write your reward here:

Example of how your Final Goal should be written/formatted in the Final Goal box above:

4.         I amcurrentlyin the _______________________ Stage of Change(Must be a stage of change from the six stages of change in the article read this week) because:

[Concisely, but with substance, discuss why you think you are in this stage]

5. ____________________________________________                  ______________

[Your MyMavsemail address indicates your signature]                     [Date]