Running head: SELF-ASSESSMENT 1

Self-Assessment

Courtney Lantz

Arizona State University

 SELF-ASSESSMENT 2

Self-Assessment
Always Frequently Sometimes Rarely Never
1. On average, how often do you feel you
eat a well-balanced diet each day?
2. On average, how often do you eat at
least five cups of fruits and vegetables
each day?
3. On average, how often do you drink at
least eight cups of water per each day?
4. On average, how often do you drink
caffeinated beverages each day?
5. On average, how often do you drink
sugary drinks each day (i.e. soda, sports
drinks, juice, etc.)?
6. On average, how often do you exercise
at least 150 minutes each week (i.e. 30
minutes per day, 5 days a week)?
7. On average, how often is your weekly
exercise is a combination of aerobic,
anaerobic, strength, and flexibility?
8. On average, how often do you get at
least eight hours of sleep each night?
9. On average, how often do you get to
sleep before midnight?
10. On average, how often would you say
you feel stress-free?
11. On average, how often would you
describe yourself as feeling happy?
No Yes
12. Are you classified as overweight or
obese based on your height and weight?
13. Are you at risk for health factors such
as diabetes or cardiovascular disease?
14. Do you smoke?
15. Do you drink more than an average of
two alcoholic beverages a day?
TOTAL (add up the total number of answers in
each column)
Multiply each total by the given number X4 X3 X2 X1 X0
NEW TOTAL

Add the total from each row for a final single

number. This describes your overall health.
0-12 13-24 25-36 37-48 49-60
Poor Fair Average Good Excellent
 SELF-ASSESSMENT 3

My Self-Assessment Responses
Always Frequently Sometimes Rarely Never
1. On average, how often do you feel you X
eat a well-balanced diet each day?
2. On average, how often do you eat at X
least five cups of fruits and vegetables
each day?
3. On average, how often do you drink at X
least eight cups of water per each day?
4. On average, how often do you AVOID X
caffeinated beverages each day?
5. On average, how often do you AVOID X
sugary drinks each day (i.e. soda, sports
drinks, juice, etc.)?
6. On average, how often do you exercise X
at least 150 minutes each week (i.e. 30
minutes per day, 5 days a week)?
7. On average, how often is your weekly X
exercise is a combination of aerobic,
anaerobic, strength, and flexibility?
8. On average, how often do you get at X
least eight hours of sleep each night?
9. On average, how often do you get to X
sleep before midnight?
10. On average, how often would you say X
you feel stress-free?
11. On average, how often would you X
describe yourself as feeling happy?
No Yes
12. Are you classified as overweight or X
obese based on your height and weight?
13. Are you at risk for health factors such X
as diabetes or cardiovascular disease?
14. Do you smoke? X
15. Do you drink more than an average of X
two alcoholic beverages a day?
TOTAL (add up the total number of answers in 3 3 2 3 4
each column)
Multiply each total by the given number X4 X3 X2 X1 X0
NEW TOTAL 12 9 4 3 0

Add the total from each row for a final single 28

number. This describes your health lifestyle.
0-12 13-24 25-36 37-48 49-60
Poor Fair Average Good Excellent
SELF-ASSESSMENT 4

Reflection

After taking this self-assessment about personal health, fitness, and well-being, my

overall healthy lifestyle was on the low end of average. Honestly, I was slightly surprised that it

was not slightly worse than that. This self-assessment allows me to see several areas in which

change can (and should) be made. Most notably, this is in the areas of diet and exercise. I do tend

to eat fruits and vegetables occasionally, but my other diet choices are often poor. I tend to drink

a significant amount of soda and other caffeinated beverages. In addition to the added sugars, my

diet often consists of a high amount of sodium. It is also not well rounded because I am often

significantly under in the dairy category, among others. Exercise is another area in my life that

could use significant change. I typically do not exercise at all besides being on my feet all day

for work. It is difficult to find the time with working full-time and going to school full-time. I

plan to make a significant lifestyle change in this area after I graduate and find more time for

myself.

There are also some areas that I had strengths in, indicating positive healthy lifestyle.

These are typically dealing with lifestyle choices. For instance, many of the points I received

were because I do not smoke or drink alcohol. By not participating in these risk factors, it has

several positive benefits on my healthy lifestyle. Another strength was being happy. I finally feel

like I am on the right path in my life. Although my current lifestyle is high in stress, it leads to

increased happiness by knowing that this is where I need to be to get where I want to go. I feel

that this assessment was an overall successful indicator of my wellness, though I do think it was

slightly high.

This assessment would be great for a workplace or other community program. By starting

off with the assessment, participants would be able to have an indicator of their healthy lifestyle.
SELF-ASSESSMENT 5

We could then give participants a run-down of the results, so they had a deeper understanding of

what their results meant. Based on their specific answers, we would be able to highlight the areas

in which they are doing well as well as those in which they could make improvements. This

would allow them to keep doing what they are already doing well, but have a better

understanding of what they should do to have a healthier and more active lifestyle.