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t2( TOOLS WHAT ARE WE DOING NOW?
What are your family's needs now? Start to answer this important question by taking a look at your family's current behavior and attitudes.
Print and complete this survey for each child in your family;
1. My family eats __# of meals together, at home, each week
2. My child eats __# of meals at school or out of the house each week
3. My child eats __# of vegetables every day
4. My child eats __# pieces of fruit every day
5. My child gets __minutes of exercise per day
6. My child’s favorite activity or hobby is ___and they spend __hours a week doing it
7. My child spends __hours a day watching TV, playing video games or on the computer
8. Right now I believe Type 2 Diabetes is;
__No big Deal
__Overwhelming
__Scary and depressing
__Unavoidable since it runs in my family
__Controllable with good health habits
9. Right now this is how my child feels;
__They don’t believe they have or are at risk for Type 2 Diabetes
__They are wondering what they can do to take control of their
diabetes
__They have already started to make some changes,
like (this)________________________________________
__They believe they have the power to take control of Diabetes.
10. This is what bothers them about being diagnosed with (or at risk
for T2DM__________________________________________
11. This is what I would like to change about my child’s health:
__________________________________________________
12. If my child and I had three wishes, this is what we would wish for:
1. _________________________________________________
2. _________________________________________________
3. _________________________________________________
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