Items:

How often would there be…

1. Someone to encourage you to follow a healthy diet?
2. Someone available to help you to prepare healthy meals?
3. Someone to encourage you take your medications?
4. Someone available to help you get access to your medications (getting your prescriptions filled)?
5. Someone available to actually take you or go with you to the hospitaldoctor when you are sick?
6. Someone to encourage you to exercise?
7. Someone who could participate in exercise with you?
8. Someone to encourage you to quit smoking?
9. Someone who could discuss your condition or health concerns with your doctor?
10. Someone who you can talk to about important things in your life?
11. Someone who could visit you or check up on you while you are in the hospital or at home?
12. Someone who makes you laugh?
13. Someone you can go out with just for fun (go to the movies)?
14. Someone who could make sure you get enough rest and relaxation?
15. Someone to encourage you, tell you ‘‘things will be okay,’’ or reassure you?
16. Someone (other than your doctor) you could turn to for general advice regarding your health (eating, dieting, exercise, medications)?

Response Options:
None of the time - 0
Some of the time - 1
All or most of the time - 2