<p>Change Plan</p><p>Student Name:</p><p>Instructions:  Use this template to document your results from the How Do I Plan to Change? section of the Change Planner.  Delete the <bracketed instructional text> from the document before submitting it to your instructor.</p><p>Page 1 of 7 Copyright©2011 Cengage Learning. All Rights Reserved. Change Plan</p><p>Wellness Area: Physical Fitness</p><p>WHAT'S YOUR READINESS STAGE IN THE AREA OF PHYSICAL FITNESS? <Pre-contemplation, Contemplation, Preparation, Action, Maintenance, or Termination></p><p>MY SELF-REFLECTION REVELATIONS: SUMMARIZED <Summarize your self-reflection revelations here  Have you engaged in any form of physical exercise in the last few days?  If not, what are some of the hindering factors?  Can you think of events that led you to engage in physical exercise in the last few days? For example, you could have walked home with a friend instead of taking the bus.></p><p>MY BEHAVIORAL CHANGE CONTRACT <Enter your My Behavioral Change Contract results below></p><p>1. I, _____, have decided to engage in a Physical Fitness Behavior Change. </p><p>2. My Goal: </p><p><Enter your goals for the wellness area here></p><p>3. The Objective(s) for my indicated Goal is/are: </p><p><Enter your objective/s for the goal here></p><p>4. I believe the following Enabling Factors will help me accomplish my Goal:</p><p>5. I believe the following Reinforcing Factors will help me accomplish my Goal: </p><p>6. I believe the following Obstacles might prevent me from achieving my Goal: </p><p>7. If I accomplish my Goal, I will reward myself with: </p><p>8. Timeline: </p><p>Page 2 of 7 Copyright©2011 Cengage Learning. All Rights Reserved. Change Plan</p><p>SUMMARIZE YOUR PLANS TO IMPROVE BEHAVIORS IN THIS WELLNESS AREA <Answer the following questions when summarizing your plans: What is your current behavior in this wellness area? What would you like to change about yourself in this wellness area? Have you previously made a similar plan that could not be followed for some reason? If yes, then identify when and under what circumstances you discontinued the plan? How optimistic are you about this plan? Is it achievable?></p><p>Page 3 of 7 Copyright©2011 Cengage Learning. All Rights Reserved. Change Plan</p><p>Wellness Area: Weight Management</p><p>WHAT'S YOUR READINESS STAGE IN THE AREA OF WEIGHT MANAGEMENT? <Pre-contemplation, Contemplation, Preparation, Action, Maintenance, or Termination></p><p>MY SELF-REFLECTION REVELATIONS: SUMMARIZED <Summarize your self-reflection revelations here  Have you been eating small portions as recommended?  Have you engaged in physical activity and maintained a nutritious diet in the past few days?  Can you think of an event or behaviors that have contributed to you forgetting about your waistline?  Have you been able to tackle the problem of weight gain over these few days? ></p><p>MY BEHAVIORAL CHANGE CONTRACT <Enter your “My Behavioral Change Contract” results below></p><p>1. I, _____, have decided to engage in a Weight Management Behavior Change. </p><p>2. My Goal: </p><p><Enter your goals for the wellness area here></p><p>3. The Objective(s) for my indicated Goal is/are: </p><p><Enter your objective/s for the goal here></p><p>4. I believe the following Enabling Factors will help me accomplish my Goal:</p><p>5. I believe the following Reinforcing Factors will help me accomplish my Goal: </p><p>6. I believe the following Obstacles might prevent me from achieving my Goal: </p><p>7. If I accomplish my Goal, I will reward myself with: </p><p>8. Timeline: </p><p>Page 4 of 7 Copyright©2011 Cengage Learning. All Rights Reserved. Change Plan</p><p>SUMMARIZE YOUR PLANS TO IMPROVE BEHAVIORS IN THIS WELLNESS AREA <Answer the following questions when summarizing your plans: What is your current behavior in this wellness area? What would you like to change about yourself in this wellness area? Have you previously made a similar plan that could not be followed for some reason? If yes, then identify when and under what circumstances you discontinued the plan? How optimistic are you about this plan? Is it achievable?></p><p>Page 5 of 7 Copyright©2011 Cengage Learning. All Rights Reserved. Change Plan</p><p>Wellness Area: Nutrition</p><p>WHAT'S YOUR READINESS STAGE IN THE AREA OF NUTRITION? <Pre-contemplation, Contemplation, Preparation, Action, Maintenance, or Termination></p><p>MY SELF-REFLECTION REVELATIONS: SUMMARIZED <Summarize your self-reflection revelations here  What are some of the foods that you have been eating in the past few days?  Are you able to determine the nutritional value of the food that you have been consuming?  Have you overeaten in the past couple of days?  Have you been able to say "No" when tempted with junk food?></p><p>MY BEHAVIORAL CHANGE CONTRACT <Enter your “My Behavioral Change Contract” results below></p><p>1. I, _____ have decided to engage in your Nutritional Behavior Change. </p><p>2. My Goal: </p><p><Enter your goals for the wellness area here></p><p>3. The Objective(s) for my indicated Goal is/are: </p><p><Enter your objective/s for the goal here></p><p>4. I believe the following Enabling Factors will help me accomplish my Goal:</p><p>5. I believe the following Reinforcing Factors will help me accomplish my Goal: </p><p>6. I believe the following Obstacles might prevent me from achieving my Goal: </p><p>7. If I accomplish my Goal, I will reward myself with: </p><p>8. Timeline: </p><p>Page 6 of 7 Copyright©2011 Cengage Learning. All Rights Reserved. Change Plan</p><p>SUMMARIZE YOUR PLANS TO IMPROVE BEHAVIORS IN THIS WELLNESS AREA <Answer the following questions when summarizing your plans: What is your current behavior in this wellness area? What would you like to change about yourself in this wellness area? Have you previously made a similar plan that could not be followed for some reason? If yes, then identify when and under what circumstances you discontinued the plan? How optimistic are you about this plan? Is it achievable?></p><p>Page 7 of 7 Copyright©2011 Cengage Learning. All Rights Reserved.</p>