Assessing Patients’ Capability in Diet and Physical Activity
| How easy is it to get to a grocery store for food shopping? |
| Are fresh fruits and vegetables for sale where you usually shop for food? |
| Can you afford to buy fresh fruits and vegetables? |
| Is there a place where you can grow food in your yard or your neighborhood? |
| Do you have time to fix your own meals? |
| Do you have family who can help you fix meals? |
| At home, are you free to eat the foods that doctors or dietitians have said you should eat? |
| Do you have the chance to be physically active? |
| It is convenient for you to be physically active several days a week? |
| Is being physically active a daily part of your job? |
| Do you have time each day to be physically active? |
| Do you have convenient places to be physically active outside [indoors]? |
| Do you have safe places to be physically active outside [indoors]? |
| Can you afford to join a health or fitness club where you can exercise? |
| Do other people help free your time to be physically active? |
| Does your spouse/partner make it easier for you to be physically active? |
| Are there people to help watch your kids while you exercise? |
| Do you have other duties [such as caring for a parent] that make it hard to be physically active? |