SOCIAL SUPPORT QUESTIONNAIRE

Social support is defined as having a network of people that support your endeavors, contribute positively to your decision-making process, and are there for you when you need help. Scientists have suggested that people with this kind of network around them can transcend even the worst environments and accomplish great things. Unfortunately, people who don't have this type of network have a harder time accomplishing even modest goals. Remember this: who you are today and who you become in the future has a lot to do with whom you choose to spend your time. 

The following questions are designed to assess your level of social support, which strongly influences how well you follow any nutrition or exercise program. Simply answer these questions below by selecting the response most appropriate to your situation.  And remember, be honest. You're doing this exercise to find the areas of your life that might present challenges to your progress. 

A word of caution: once you recognize your challenges, it's easy to blame them for your outcomes. Don't do this. Outside factors can affect you- if you let them. But you're in control. You have the power to place yourself in the right environment, so use it!

Name *
Name
Date *
Date
1. Do the people with whom you spend each day (at work or at home) follow healthy lifestyle habits such as exercising regularly, watching what they eat, and taking nutritional supplements?
2. Does your spouse or partner follow healthy lifestyle habits such as exercising regularly, watching what s/he eats, and taking nutritional supplements?
3. When you want to perform some physical activity such as going for a workout or taking a hike, is it easy for you to find a partner to go with you?
4. At your workplace, do your coworkers regularly bring in treats like cookies, donuts, and other snacks?
5. If you go out to eat more than once per week, do the people you dine with order healthy selections?
6. Do you belong to any clubs, groups, or teams that meet at least twice per week and do some physical exercise (this does not include a health club membership)?
7. Do you belong to a health club and attend, on average, at least three times per week?
8. When discussing your nutrition and exercise goals with friends, do they seem interested in getting on board, or do they think you're crazy?
9. Do the people you live with bring home foods that aren't considered healthy or good for you?
10. Do the people you live with or work with schedule activities for you that interfere with your pre-established exercise time?
11. Do those around you bring nutrition, exercise, or supplemental information to your attention so that you can stay informed about these topics?