College of St.

John - Roxas College Of Nursing Banica, Roxas City Dear Respondent, We are conducting a study that will determine the Health Practices of Selected Members of a Community at Roxas City. Basically, the community selected is the Seventh-Day Adventist group within the age group 40 to 64 years old because it has been observed that the health conditions of your church members have been declared as healthy with ideal health practices. Your honest response to the items in this questionnaire is of utmost importance to get reliable information about your health practices. Rest assured that no personal information will be included in the discussion except for those covered by the study objectives. Thank you. The Researchers

Part I. Demographic Profile 1. 2. 3. 4. 5. 6. Name: ______________________________(optional) Sex:___ M ___ F Age ______ Marital status: ___ single ___ married ___ widow ___separated Educational level: ___Elementary ___high school ___vocational Monthly Income ( total combined family income a month)_____________

Part II. Health Practices Questionnaire Instructions: Please check the box whether the questions listed below is part of your usual practices according to the frequency in which you perform such activities. Dietary Habit I prefer fresh food than frozen goods I check nutritional value of foods I exert effort to make eating enjoyable I take food supplements in place of meals I eat fruits and vegetables I eat whenever I am hungry. I buy any food I like to eat. I prefer to eat at fast food chains than at home Always Most times Sometimes Seldom Never

Physical Activities I engage in activities like hiking, caving, nature walks, etc. I find a class or activity that fits my size and fitness level I need to have proper equipment in order to exercise/work out I do physical workout/exercise I conserve strength by selecting light activities only. I prefer to walk going to work and errands I prefer home activities over sports or outdoor exercises I do not exercise because I am tired from work.

Always

Most times

Sometimes

Seldom Never

Always Sleeping Pattern I sleep at least 7 to 8 hours a night. I invest in good bed and pillows for sleeping I experience insomnia I sleep terribly having a lot of problems on my head I cannot sleep early because of work I still feel tired even after a nights sleep. I drink milk or take medications in order to sleep. I have a regular sleeping time. Always Health-Seeking Behaviors I have regular screening exams. (Eg. papsmear, mammogram, etc) I follow medical advice completely. I have dental check up every year I do not go for medical check-up unless I am ill I do not smoke or drink alcohol I use over the counter drugs/natural herbs even when not advised I use generic drugs instead of the one prescribed by the doctor I lower my medication dose when I am better.

Most times

Sometimes

Seldom Never

Most times

Sometimes

Seldom Never