5 Principles of Healthy Living Assessment

Courtesy of Dr Brad Jacobs (bradlyjacobs@gmail.com), I am able to present you here with a great questionnaire that will give you an insight into your HEALTH! Take 5 minutes out of your busy busy life and score the questions below - then you can devote a little time over the busy holidays coming up on YOU and improving that score :-)

Over to Dr. Brad!



Modern life keeps us so busy that we often find ourselves over-committed, juggling multiple priorities and feeling out of control. This lifestyle is often exhausting, not sustainable, and associated with harmful health effects.

This 5 Principles of Healthy Living Assessment can help you take control of your life and your health.
The below assessment will help you identify which areas you need to focus on to improve your overall health.

INSTRUCTIONS: How much do you agree with each of the following statements? Write down the title of each section and your scores behind each title. Add up per section at the end of the assessment and see the ACTION plan below once you have completed the assessment and totalled your scores!

Answer options:
1: Do not agree at all
2: Partially agree
3: Modestly agree
4: Mostly agree
5: Strongly agree

Finding Passion and Purpose:
1. I devote as much time as I would like to what matters most to me.
2. If I were to die today, I would die feeling that I have lived the life I wanted.
3. I regularly engage in a passion outside of work and parenting.
4. I have the power and control to make the changes in my life that I want to make.
5. I donʼt hold back on life (including career choices and personal decisions) out of fear.

1. Iʼm happy with my ability to forgive others.
2. I make time to take care of myself emotionally and to align myself with my personal life goals as much as Iʼd like.
3. I have a satisfying network of friends, family and/or a religious/spiritual community.
4. The busyness of my work does not interfere with my ability to interact with this support network as often as Iʼd like.
5. My work and home environments are conducive to helping me live a healthy and fulfilling life.

Training Your Mind for Stress Reduction
1. I have enough time in my day to get the work done that needs to get done each day.
2. I rarely feel worry or regret.
3. I feel comfortable in my ability to manage my stress level.
4. I wake up most mornings feeling refreshed.
5. My mind rarely wanders to think about things other than what Iʼm doing.

Healthy Eating
1. I eat about five servings of fruits and vegetables most days of the week.
2. I rarely feel sluggish in the afternoon.
3. I usually have bowel movements that are well-formed without the need to use laxatives or strain.
4. I do a good job at keeping those extra pounds off.
5. I know a lot about how to use food to improve my health.

Active Living
1. I move my body about 30 minutes over the course of the day most days of the week.
2. I find time to stretch my body most days of the week.
3. Iʼve been able to maintain or improve my posture over time.
4. I donʼt have chronic injuries or health problems that prevent me from living a physically active life.
5. I spend less than 2 hours watching television most days.

Instructions on scoring your results:
You can score 1 to 5 points on each question depending on how you answer the question.
For example, if you note down ʻ3ʼ then you receive 3 points for that question. Since there are 5 questions for each Principle, you can score 5 to 25 points for each Principle. For example, if you wrote down ʻ3ʼ, ʻ2ʼ, ʻ4ʼ, ʻ1ʼ, ʻ5ʼ for the 5 questions in one Principle then your total score for that Principle is 15 points since 3 + 2 + 4 + 1 + 5 = 15.
Write down the score for each Principle next to the title for that Principle then read the “Interpretation of Results” section below to learn what this means for you.

Interpretation of Results:
A score of 21-25 points means that you are doing outstanding in this Principle, without need for improvement.
A score of 16-20 points suggests that you doing very well in this Principle, and have minor need for improvement.
A score of 11-15 suggest that you are doing modestly well, and have room for improvement in this Principle.
A score of 10 or less suggests you have significant room for improvement.

YOUR ACTION PLAN: Focus attention on the Principle(s) for which you scored 16-20, then focus attention on those Principles with scores of 11-15. Finally, focus attention on Principles where you scored 10 or less last. The rationale is that you will find that improvement in one principle will result in improvements in other principles.

Copyright 2009 Bradly Jacobs MD, Inc.

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