Diabetes Initiative Logo  
Home bullet What is Self Management bullet Build A Program bullet Support Your Program bullet Program Models bullet Resources bullet Lessons Learned bullet Search
Resources




Record of Grantee Meetings
iamge

Resources

Assessment Materials, Forms & Instruments

Summary

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

Related Links

  • For other tools on multiple self management behaviors: Click here
  • For more assessment tools: Go back

The Diabetes Initiative was a national program of the Robert Wood Johnson Foundation from 2002 to 2009.
Archived in 2009, this site is a repository for information and resources gathered over the course of the Initiative.
© 2002-2009 The Diabetes Initiative, a national program of the Robert Wood Johnson Foundation®
Home • Build a program • support your program • programs • resources • lessons learned • SEARCH • CONTACT • TERMS