Victoria Langley

2/24/16
PUBH 481*01
Dr. Thompson
Theory of Reasoned Action Survey

Reducing Obesity Survey

Thank you for taking the time out to complete this survey. The purpose of this survey is to get
feedback on your attitudes and beliefs about increasing physical activity and what you think you
could do to prevent obesity. Please answer the following questions below. Circle the one that
most apply to you.

Behavior Intentions
Do you intend on increasing your physical
-3
-2
-1
activity to reduce obesity by the end of
2016?

Unlikely

Behavior Belief
Regarding obesity, how
Go to the gym if
obesity?
Eat healthier
reduces obesity?
Take dietary
body fat?
Feel confident
exercise?

-3

-2

-1

Unlikely likely are you to;

2Likely3

-3

-2

-1

-3

-2

-3

-3

-2

-1

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-1

you believe it reduces

foods if you believe it
supplements to reduce
going to the gym to

To buy fruits and vegetables if you believe that

it reduces the pleasure of junk food?

Evaluation of Behavioral Outcomes

Preventing obesity
physical
activity is
Eating healthier
is
Taking dietary
body fat is

Bad
Good

-3

-2

-1

-3

-2

-1

-3

-2

-1

through the use of

foods to reduce obesity
supplements to reduce

-3

-2

-1

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-2

-1

Building my self-confidence to go to the gym is

Buying junk food instead of fruits
and vegetables
is
Subjective
Norm

My doctor
should increase
my physical
prevent obesity.

My teacher
build my selfto go to the gym

My parents
should intake
foods rather than

-3

-2

-1

Disagree
1 Agree
2
3

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-2

-1

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-2

-1

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-2

-1

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-2

-1

My brother/sister
should increase
physical activity
gym.

My friend thinks I should start a workout plan

to reduce my chances of obesity.

believes that I
activity level to

believes that I can

esteem
through counseling.
believes that I
healthier
junk food.
believes that I
my
level by going to a

Motivation to Comply
Unlikely

Regarding obesity, I would do what my;

Doctor thinks I

should do.

Teacher thinks I

should do.

Parents thinks I

should do.

My
should.

brother/sister thinks I

My friend think

I should do.

Control Belief
Are you likely to increase physical activity to reduce
obesity if:

Gym
free?

-3

-2

-1

Unlikely
Likely

3
memberships were

-3

-2

-1

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-2

-1

Transportation

If you felt
the gym?

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-2

-1

If you had a

-1

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-1

You had the

friends

to gyms was easier?

confident going to

workout partner?
motivation from

and family?

Perceive Power
Difficult

Easy

If gym
it would make

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-2

-1

memberships were free

physical activity

Access to
would
make

-3

-2

-1

transportation to gyms

Feeling
the to the gym
makes
Having a
exercising

exercising
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-2

-1

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-2

-1

confident about going

exercising
workout partner makes

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-2

-1

Motivation from friends and family makes

increasing physical activity

Self-Efficacy
Uncertain
Certain

If there were
memberships, I
attend.

-3

-2

-1

free gym
am certain I will

If there were
gyms,
I am certain I
my fitness

-3

-2

-1

transportation to

would increase
level.

If I was more
myself, I am
certain that I
my physical

-3

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-1

confident about
-3

-2

-1

would increase
activity.

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-2

-1

partner, I am
increase my
activity.

If I had a gym
certain I would
physical

If I could build self-esteem from friends and

family to go to the gym, I am certain that I
would feel better about going.