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1. Do the people with whom you spend each day(at work or at home) follow healthy lifestyle habits such as exercising regularly, watching what they eat, and taking nutritional supplements?

a) Yes, most of them do. (+3)b) About half do and half don't. (0)c) No, most of them don't. (-3)


2. Does your spouse or partner follow healthy healthy lifestyle habits such as exercising regularly, watching what s/he eats, and taking nutritional supplements?

a) Yes, my spouse/partner does. (+5)b) No, my spouse/partner doesn't. (-5)c) I don't have a spouse or partner. (-3)


3. When you want to perform some physical activity such as going for a workout or taking a hike, is it easy for you to find a partner to go with you ?

a) Yes, It's easy to find a partner. (+2)b) Yes, but very infrequently. (0)c) No, they never do. (-4)


4. At your workplace, do your coworkers regularly bring in treats like cookies, donuts, and other snacks?

a)Yes, they often do. (+4)b)Yes, but I typically don't indulge. (0)c) No, they don't. (+5)


5. If you go out to eat more than once per week, do the people you dine with order healthy selections?

a)Yes, they always do. (+2)b)Only about half of the time. (0)c) No, they never do. (-2)


6. Do you belong to any clubs, groups, or teams that meet at least twice per week and do some physical exercise( this does not include a health club membership)?

a) Yes, I have been a member for years.(+5)b) Yes, I have just started.(+2)c) No, I don't (0)


7. Do you belong to a health club and attend, on average, at least three time per week?

a) Yes, I've been doing this for at least 1 year.(+2)b) Yes, I've just joined.(+1)c) No, I don't. (0)


8. When discussing your nutrition and exercise goals with friends, do they seem interested in getting on board, or do they think you're crazy?


a) They're very interested. (+2)b) They're not interested. (0)c) They think I'm crazy. (-2)


9. Do the people you live with bring home foods that aren't considered healthy or good for you ?


a)Always (-5)b)Sometimes (-3)c) Never (0)


10. Do the people you live with bring home foods that are considered healthy or good for you?


a)Always (+5)b)Sometimes (0)c) Never (-5)


11. Do the people you live with or work with schedule activities for you that interfere with your pre-established exercise time?


a) Always; they don't respect my time. (-3)b) Sometimes;they don't think about it. (-1)c) Never; they respect this time. (+3)


12. Do those around you bring nutrition, exercise, or supplement information to your attention so that you can stay informed about these topics?


a)Always (+5)b)Sometimes (+2)c) Never (0)


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