Assessment of Physical Activity, Overall Well-being, and Personality

Part 1: Begin by filling in your sex and age in the appropriate sections of the scantron. Then
please continue with the following questions and fill in the spaces with the most suitable answer.
For questions that do not apply to you, leave the scantron space blank.
1. What year in school are you?
A=Freshman, B=Sophomore, C=Junior, D=Senior/Super Senior
2. Within the last year have you competed in a sport?
A=Yes, B=No
3. If YES, was the sport more directed toward a team performance or an individual
performance?
A=Team, B=Individual
a. If YES, what sports, or sport, have you competed in? (Please complete the pink
form attached).
4. Are you currently in an organized sport? (e.g., school sport team or community sport team)
A=Yes, B=No
5. If YES, is the sport directed toward a team performance or an individual performance?
A=Team, B=Individual
6. At what level do you compete for your sport?
A=Elite, B=Recreational, C=Social
7. Will you be trying out for a sport within the next year? (e.g., intramural or official UWPlatteville sport team)
A=Yes, B=No
8. If YES, will the sport be directed toward a team performance or an individual performance?
A=Team, B=Individual

Part 2: If you ARE currently in a sport, or were, for what reasons did you decide to join? (Rate
accordingly.)
A = Strongly Disagree, B = Slight Disagree, C = Neutral, D = Slight Agree, E = Strongly Agree
9. To be competitive (a drive for success)
10. To meet new people

11. To socialize further with current friends

12. To occupy free time

Part 3: If you are NOT, or were not, in a sport, for what reasons did you choose not to join?
(Rate accordingly.)
A = Strongly Disagree, B = Slight Disagree, C = Neutral, D = Slight Agree, E = Strongly Agree
13. Afraid of failure or to embarrass oneself
14. Would rather work out on own time
15. Other personal reasons or lack of interest
16. Not enough time
17. Do you work out regularly?
A=Yes, B=No
18. If YES, do you typically work out in a group or individually?
A=Group, B=Individual
19. Do you work out at a gym or in your own home?
A=Gym, B=Home
20. On average how many times a week do you work out?
A=Not at all, B=Everyday, C=Once or twice, D=Three to five days
21. Do you smoke cigarettes?
A=Yes, B=No
22. On average how many days a week do you drink alcohol?
A=Not at all, B=Everyday, C=Once or twice, D=Three to five days
23. On average how many days a week do you eat fast food or go to a restaurant to eat?
A=Not at all, B=Everyday, C=Once or twice, D=Three to five days

Part 4: In regard to your diet, do you get an adequate amount of each of the following food
choices? (Indicate which is most applicable):
A=Not enough, B=Just right, C=Too much
24. Protein
25. Fruit

26. Vegetables
27. Dairy
28. Carbohydrates
29. Poultry
30. Salt
31. Sugar
32. Do you have a well-balanced diet?
A=Yes, B=No
33. Do you typically wear your seatbelt while driving?
A=Yes, B=No

Part 5: Please answer the following questions to be best of your knowledge and abilities. If you
do not know an answer or do not feel comfortable answering, please leave the answer blank and
move onto the next question. Please use the following scale to answer the questions:
A = Strongly Disagree, B = Slight Disagree, C = Neutral, D = Slight Agree, E = Strongly Agree
34. I tend to be influenced by people with strong opinions.
35. In general, I feel I am in charge of the situation in which I live.
36. I think it is important to have new experiences that challenge how you think about yourself
and the world.
37. Maintaining close relationships has been difficult and frustrating for me.
38. I live life one day at a time and dont really think about the future.
39. When I look at the story of my life, I am pleased with how things have turned out.
40. I have confidence in my opinions, even if they are contrary to the general consensus.
41. The demands of everyday life often get me down.
42. For me, life has been a continuous process of learning, changing and growth.
43. People would describe me as a giving person, willing to share my time with others.
44. Some people wander aimlessly through life, but I am not one of them.
45. I like most aspects of my personality.

46. I judge myself by what I think is important, not by the values of what others think is
important.
47. I am quite good at managing the many responsibilities of my daily life.
48. I gave up trying to make a big improvements or changes in my life a long time ago.
49. I have not experienced many warm and trusting relationships with others.
50. I sometimes feel as if Ive done all there is to do in life.
51. In many ways, I feel disappointed about my achievements in life.

Part 6: Below are some questions concerning the way you behave, feel, and act. Indicate
whether YES or NO applies to you in regards to the question by circling one or the other. Work
quickly and try not to overthink the question. We want your initial reaction.
A=Yes, B=No
52. Do you often long for excitement?
53. Are you usually carefree?
54. Do you stop and think things over before doing anything?
55. Do you generally do and say things quickly without stopping to think?
56. Would you do almost anything for a dare?
57. Do you often do things on the spur of the moment?
58. Generally do you prefer reading to meeting new people?
59. Do you like going out a lot?
60. Do you prefer to have few but special friends?
61. When people shout at you do you shout back?
62. Can you usually let yourself go and enjoy yourself a lot at a lively party?
63. Do other people think of you as being very lively?
64. Are you mostly quiet when you are with other people?
65. If there is something you want to know about, would you rather look it up in a book than talk
to someone about it?

66. Do you like the kind of work that you need to pay close attention to?
67. Do you hate being with a crowd who play jokes on one another?
68. Do you like doing things in which you have to act quickly?
69. Are you slow and unhurried in the way you move?
70. Do you like talking to people so much that you never miss a chance of talking to a stranger?
71. Would you be very unhappy if you could not see lots of people most of the time?
72. Would you say that you were fairly self-confident?
73. Do you find it hard to really enjoy yourself at a lively party?
74. Can you easily get some life into a dull party?
75. Do you like playing pranks on others?