Assessment Materials, Forms & Instruments
Behavior Worksheet (PDF)
The two-page assessment instrument is designed to be completed by patients. It assesses patient readiness to make specific self management behavior changes related to healthy eating, being active, monitoring blood sugar, taking medication, problem solving, healthy coping, and reducing risks. It is based on the Transtheoretical Model (TTM) for behavior change.
Author site: Galveston County Health District I 2004
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