Power to Prevent - National Diabetes Education Program - National ...

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Pre-Session 11 Questionnaire (Fill in this questionnaire at the beginning of session 11) Name or other identifer (such as initials with day and month of birth): ______________________ Emotion-Related Lessons Please circle one number to indicate the answer closest to how you feel. (Check “Don’t know or refused” if you do not know or do not want to answer.) 1. I am aware of things that are bad for my health (for example, overeating or binge drinking of alcohol) that I might do when I feel bad. 2. I understand how negative feelings (for example, feeling that I am a weak or bad person or that I always fail) can lead to poor eating habits and less physical activity. 3. I am confdent I can “talk back” to negative thoughts to improve my mood. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 Don’t know or refused Please put your name (or your initials with day and month of birth) on this questionnaire and give it to your program leader. NDEP Power to Prevent Appendices 57
Post-Session 11 Questionnaire (Fill out this questionnaire at the end of session 11) Name or other identifer (such as initials with day and month of birth): ______________________ Emotion-Related Lessons Please circle one number to indicate the answer closest to how you feel. (Check “Don’t know or refused” if you do not know or do not want to answer.) 1. I am aware of things that are bad for my health (for example, overeating or binge drinking of alcohol) that I might do when I feel bad. 2. I understand how negative feelings (for example, feeling that I am a weak or bad person, or that I always fail) can lead to poor eating habits and less physical activity. 3. I am confdent I can “talk back” to negative thoughts to improve my mood. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 Don’t know or refused Please put your name (or your initials with day and month of birth) on this questionnaire and give it to your program leader. NDEP Power to Prevent Appendices 58
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Power to Prevent A Family Lifestyle
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Credits and Acknowledgments NDEP Af
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Table of Contents Foreword. . . . .
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Appendix Materials and Resources Th
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Additional Resources for Program Le
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Organizations Black Women’s Healt
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in the Forward/Introduction section
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NDEP GAME PLAN Food and Activity Tr
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Session No. and Title Session 10 Pa
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Session Duration Each session is de
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Session Preparation As program lead
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Refreshments and healthful snacks,
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Conducting the Session NOTE: Times
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Say: “Let’s fll in our Individu
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The program leader ends the session
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NOTE: You could choose other sticke
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NDEP Power to Prevent Program Leade
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Getting Started Getting started wit
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NDEP Power to Prevent Program Leade
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Key to Icons Used in Power To Preve
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At least two helpers to assist peop
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Say: “The objectives for today’
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What are some of the Complications
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Pledge Possible Improvements I’ll
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NDEP Power to Prevent Session 0
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Purchase stickers (stars, smiling f
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Discussion Points Say: “Small Ste
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Preparation and Reminders for the N
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Advance Preparation NOTE: The NDEP
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Discussion Points Say: “Healthy e
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Activity Take a 5- to 0-minute brea
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Tips for Inviting a Registered Diet
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NDEP Power to Prevent Session 3 0
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Appendix U: Why Physical Activity I
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in silence. Suggest that if partici
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Ask participants to name ways that
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Optional Activities 4.1 Visit an At
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also be downloaded from the NDEP We
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Say: “Cooking can be a fun activi
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Brochure 7 Principles for Controlli
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Conducting the Session Welcome Welc
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List answers on a fipchart, and mak
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Conducting the Session Welcome Welc
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Activity Take a 5- to 0-minute brea
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Advance Preparation In addition to
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Further Information on Diabetes Pre
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Obtain copies of Appendix Q: Energi
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Review of Discussion Points Say:
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My Pyramid Some people in your grou
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Bring copies of menus from several
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Example of better “I statement”
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If you plan do to the Optional Acti
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It is recommended that people with
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Optional Activities 1.1 Review the
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Discussion Points Say: “Making ch
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Pledge Have participants make an in
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Advance Preparation for Session 12
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Make photocopies of the Post-progra
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Review of Discussion Points Say:
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NDEP Power to Prevent Appendices 2
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Sample Letter to Potential Partners
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Page 147 and 148: Black Women’s Health Imperative w
Page 151 and 152: Community newspaper organizations S
Page 153 and 154: Selecting and Securing a Regular Me
Page 155 and 156: Reward participants for fnishing th
Page 157 and 158: People bring their children to the
Page 161 and 162: “I can accept failure. Everyone f
Page 171 and 172: Session Questionnaire Intent 1 Pre-
Page 173 and 174: Where Am I Right Now? Thinking abou
Page 175 and 176: The next questionnaire is an option
Page 177 and 178: Feelings About Having Diabetes Plea
Page 179 and 180: Pre-Session 3 Questionnaire (Fill o
Page 181 and 182: Post-Session 3 Questionnaire (Fill
Page 183 and 184: Pre-Session 4 Questionnaire (Fill o
Page 185 and 186: Post-Session 5 Questionnaire (Fill
Page 187 and 188: Please answer the following. (Check
Page 189 and 190: Check Ups Please check “Yes” or
Page 191: How confdent are you now? Please ci
Page 195 and 196: Where Am I Right Now? Thinking abou
Page 199 and 200: 1 Start Here 2 Check Calories 3 Lim
Page 213 and 214: The Plate Method The Plate Method c
Page 223 and 224: Spotting Denial Denial has a few ca
Page 225 and 226: If you have three or more of these
Page 227 and 228: Let Anger Be Your Ally The goal is
Page 229 and 230: Learning to Relax There are many wa
Page 237 and 238: Si Usted Tiene Diabetes, ¡Sepa los
Page 239 and 240: Small Steps. Big Rewards. Prevent T
Page 241 and 242: Publications and Resources for Chil
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Team Care: Comprehensive Lifetime M
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Team Care: Comprehensive Lifetime M
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New Beginnings: A Discussion Guide
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