Module One Wellness Plan

GO TO FILE, then Make a copy of this to your computer!

Fill in all logs and answer the reflection questions completely with supporting details for
sections 1-5. After completing all five sections, submit this file as your Module One Wellness
Plan assignment.

Section 1: Goals

List the four wellness goals that you created earlier in Module 1 before completing the reflection
questions. Think about how you can make your goals MAD (measurable, attainable, and
deadline driven). This will help you keep your eye on the target as you work toward each goal.

Sample Goals:
1. Physical – I will walk non-stop for at least 30 minutes five days a week over the next three
weeks.
2. Social – I will join a club at school before this week ends, and I will attend all meetings this
semester.
3. Emotional – I will journal every evening for the next two weeks as a way to reduce stress
and anxiety.
4. Academic – I will work with a study partner once a week for at least a month to help
improve my geometry grade.

Please list your goal for each category below:

1. Physical –I walk 2 miles everyday with my dad at 5 so I wanna walk 3 miles now
2. Social –I would like to join a boxing class
3. Emotional –I will open up more to my best friend the same way she does with me
4. Academic –I want to work harder in school and stay on pace

Goal Reflection Question:

Which of your wellness goals is the most important to you? Explain why.

Answer: they are important to me because these are things I want to do by the end of the
year
Section 2: Target Heart Rate Chart

Complete the “My Rates” column of the chart using the THR calculator.

Target Heart Rate Data My Rates

1. Resting Heart Rate (RHR) 70bpm

2. Maximum Heart Rate (MHR) 203 bpm

3. Target Heart Rate Zone at 50% and 85% My zone is 137bpm to 183bpm

Heart Rate Reflection Question

Were you able to maintain your workouts within your calculated target heart rate zone? Explain
which activities you enjoyed most and which best helped you stay in your THR zone.

Answer: No because I have adhd and asthma which I feel like makes my heart faster

Section 3: Fitness Assessments

Complete steps one and two on the chart below:

Step1
Complete the Lesson 01.03 Baseline Results column. Use the original results from your 01.03
Fitness Assessments.

Step 2
Complete the Module 1 Wellness Plan Results column. Use the current results from your 01.03
Fitness Assessments.

**Please save these results, as you will need to include them for future Wellness Plans in the
course.
 Activity Lesson 01.03 Module 1
Baseline Wellness Plan
Results Results

Mile Run/Walk 2 3

Body Mass Index 25 to 29 bmi Same thing

Aerobic Capacity I can’t do this I could do

slightly better
now but my
asthma
messes me up

Curl-ups 20 30

Push-ups 3 3

Trunk Lift 6 7

Sit and Reach 3 3

Fitness Assessment Reflection Questions:

1. Explain how your scores compare to the Healthy Fitness Zone Standards. Based on this
comparison, what should you do next?

Answer: I feel like they slightly improved but not much

2. Explain how your activity routine is improving each of your health-related components of
fitness (flexibility, muscular strength and endurance, cardiovascular, and body composition).

Answer: well I eat a balanced diet right now while doing this I ate a salad and I work out
which helps me grow muscle
Section 4: Physical Activity Log
Include all moderate and vigorous physical activity in the table below. You need at least three
different moderate to vigorous activities that add up to 420 minutes. Activities need to add up
to 420 minutes without your warm-up times. Keep adding rows to show all of your activities.
The first five rows are completed as a sample only.

Date Warm-up Physical Activity Activity Minutes

without Warm-up

12/25 5-min stretch 2-mile walk 30 min

12/26 5-min jog 4-mile run 45 min

12/27 5-min stretch Basketball practice 60 min

12/28 15-min stretch Cheerleading–state championship 180 min

12/31 5-min stretch 3-mile bike ride 20 min

10/1/21 3 min of 2 mile walk with my dad 1 hour and 30 min

stretching my
legs

10/2/21 Stretch my Boxing bag I do this for 45 to

arms for 5 min and hour

10/3/21 Really no Biking I usually go

warm up outside now and
just bike anywhere
for 2 hours

10/4 No warm up Boxing bag An hour

10/5 No warm up Biking 45 to 1 hour

really
10/6 Stretch my Weight lifting 2 hours
arms and legs

10/7 Stretch my Weight lifting 1 hour

arm and legs

10/8 No warm up Boxing bag 30 min

10/9 No warm up Boxing bag 30 min

10/10 No warm up Boxing bag 1 hour

10/11 No warm up Boxing bag 30 min

10/12 No warm up Boxing bag 30 min

10/13 Stretch my Weight lifting 1 hour

arms and legs

10/14 Stretch my Weight lifting 2 hours

arm and legs

10/15 No warm up Biking 45 min

10/16 Stretch my Biking 2 hours

legs because
it was sore

10/17 No warm up Biking 3 hours

10/18 No warm up Biking 30 min

TOTAL Activity Minutes

1,600

Remember the 420-minute minimum

Physical Activity Reflection Chart:
Using your activities as examples, reflect on your use of FITT principles by completing the chart
below:

Sample:

FITT Principle Activity Explanation

Frequency 3-mile bike ride I ride this route 2-3 times a

week.

FITT Principle Activity Explanation

Frequency Biking I do this when im bored so a

couple times a day

Intensity Boxing I do this when im in for the

work out

Time Boxing I do this for 45 to an hour

Type Boxing Its to work out my body and

sweat a lot to lose weight
and learn to fight

Physical Activity Reflection Question:

Discuss changes you can make in your workout routine to increase your activity level and
improve on your achievements. Include adjustments to completed activities and activities you
may wish to add to your routine.
Answer:

Module One Wellness Plan Grading Rubric

 Excellent Good Needs Poor
Improvement

Section 1: 9–10 points 8 points 7 points 0–6 points

Goals
· All goals are · Most goals · Some goals · Goals are not
measurable, are measurable, are measurable, measurable,
attainable, and attainable, and attainable, and attainable, and
deadline driven. deadline driven. deadline driven. deadline driven.
· Reflection · Reflection · Reflection · Reflection
question responses are responses are responses are
responses are adequately complete but incomplete or
complete and detailed and lacking detail and inaccurate.
supported. supported. support.

Section 2: 18–20 points 16–17 points 13–15 points 0–12 points

Target Heart
Rate · Heart rate · Heart rate · Heart rate and · Heart rate and
and target heart and target heart target heart rate target heart rate
rate zone are rate zone are zone are recorded zone are not
recorded and recorded and and moderately recorded and/or
accurate. slightly inaccurate. completely
· Reflection inaccurate. · Reflection inaccurate.
question · Reflection responses are · Reflection
responses are responses are complete but responses are
complete and adequately lacking detail and incomplete or
supported. detailed and support. inaccurate.
supported.
Section 3: 36–40 points 31–35 points 25–30 points 0–24 points
Fitness
Assessments · Fitness · Fitness · Fitness · Fitness
Results for: assessment assessment assessment results assessment results
Lesson 01.03 results are results are are recorded. are recorded.
Module 1 recorded. recorded. · Reflection · Reflection
· Reflection · Reflection responses are responses are
question responses are complete but incomplete or
responses are adequately lacking detail and inaccurate.
complete and detailed and support.
supported. supported.
 Section 4: 63–70 points 54–62 points 43–53 points 0–42 points
Physical
Activity Log · All · Most · Some · Few exercises
YOU ARE exercises are exercises are exercises are are moderate to
REQUIRED moderate to moderate to moderate to vigorous intensity,
TO LOG vigorous vigorous vigorous intensity. or intensity is not
EACH WEEK intensity. intensity. · At least 350 indicated.
YOU ARE IN · At least 420 · At least 385 activity minutes are · At least 315
THE COURSE activity minutes activity minutes recorded. activity minutes are
are recorded. are recorded. · Some exercise recorded.
· All · All dates listed are not · Few exercise
exercises are exercises are in an effective dates listed are in
dated as daily or dated as daily or pattern. an effective pattern.
every other day. every other day. · At least two · One type of
· At least · Most different exercises exercise has been
three different exercise dates have been logged, logged, including
exercises have are listed and are including specific specific exercises
been logged, not in an effective exercises when when required.
including specific pattern. required. · Reflection
exercises when · At least · Reflection responses are
required. three different responses are incomplete or
· Reflection exercises have complete but inaccurate.
question been logged, lacking detail and
responses are including specific support.
complete and exercises when
supported. required.
· Reflection
responses are
adequately
detailed and
supported.

Total Points Possible: 140 points