1. Are people living with HIV more likely to have other chronic diseases? |
(1) Yes (2) No (3) Do not know |
2. Do you think chronic diseases are lifelong? |
(1) Yes (2) No (3) Do not know |
3. Are diabetes, high blood pressure, lung disease and cancer chronic diseases? |
(1) Yes (2) No (3) Do not know |
4. Does maintaining proper body weight help prevent or control chronic disease? |
(1) Yes (2) No (3) Do not know |
5. Does cutting down on salt in food and eating healthy help prevent or control diabetes and heart disease? |
(1) Yes (2) No (3) Do not know |
6. Is physical exercise at least three times a week essential for a healthy life? |
(1) Yes (2) No (3) Do not know |
7. Is it important to avoid smoking, alcohol and other drugs to prevent heart disease, lung disease and cancer? |
(1) Yes (2) No (3) Do not know |
8. Can reducing everyday stress help you have a healthier lifestyle? |
(1) Yes (2) No (3) Do not know |
9. Is taking antiretroviral drugs every day, as prescribed, important for your health? |
(1) Yes (2) No (3) Do not know |
10. Is taking medication for chronic diseases (if any) every day, as prescribed by a doctor, important for your health? |
(1) Yes (2) No (3) Do not know |
ATTITUDE ASSESSMENT - 1. Adequate (%): _____ 2. Inadequate (%): _____
|
1. Am I interested in performing routine exams according to medical advice? |
(1) Yes (2) No |
2. Do I intend to maintain my proper body weight? |
(1) Yes (2) No |
3. Do I think about reducing the salt in food to avoid chronic diseases? |
(1) Yes (2) No |
4. Am I interested in having a healthier diet? |
(1) Yes (2) No |
5. Do I feel like exercising at least three times a week? |
(1) Yes (2) No |
6. Do I want to quit smoking? |
(1) Yes (2) No (3) Do not smoke |
7. Do I intend to stop consuming alcoholic beverages? |
(1) Yes (2) No (3) Do not drink |
8. Do I want to stop using illicit drugs (marijuana, cocaine, crack, etc.)? |
(1) Yes (2) No (3) Do not use |
9. Do I want to be less stressed or lessen my sources of stress? |
(1) Yes (2) No (3) Do not have |
10. Do I want to take all my meds daily without forgetting? |
(1) Yes (2) No |
PRACTICE ASSESSMENT - 1. Adequate (%): ____ 2. Inadequate (%): _____
|
1. Am I performing routine exams according to medical advice? |
(1) Yes. How often? |
(2) No |
2. Is my blood pressure and blood glucose controlled? |
(1) Yes (2) No (3) Do not know |
3. Am I worried about my weight? |
(1) Yes (2) No (3) Do not know |
4. Have I been able to reduce or avoid the use of salt in food? |
(1) Yes (2) No |
5. Do I eat more fruits and vegetables and less fried foods in my daily life? |
(1) Yes (2) No |
6. Do I exercise at least three times a week? |
(1) Yes. Which one? |
(2) No |
7. Did I quit smoking to preserve my health? |
(1) Yes (2) No. Cigarettes/day? |
(3) Never smoked |
8. Do I still drink alcohol? |
(1) Yes. How often? |
(2) No (3) Never consumed |
9. Do I still use illicit drugs (marijuana, cocaine, crack, etc.)? |
(1) Yes. Which one and how often? |
(2) No (3) Never used |
10. Was I able to reduce my stress and avoid stressful situations? |
(1) Yes. What do you do? |
(2) No |
11. Do I take all the medicines I need daily? |
(1) Yes (2) No |