PART A – Exercise Participation
Please complete the following table as it relates to your exercise involvement.
Aerobics‚ Aquatics‚ Badminton‚ Basketball‚ Wrestling‚ Biking/Cycling‚ Cardio machine‚ Boxing‚ Spin class‚ Curling‚ Dance (specify type)‚ Figure Skating‚ Lacrosse‚ Pilates‚ Running/Jogging‚ Wall Climbing‚ Martial Arts/Kickbox‚ Ice Hockey‚ Gymnastics‚ Speed Skating‚ Rugby‚ Skipping‚ Ringette‚ Softball‚ Skiing–X country‚ Skiing-Downhill‚ Soccer‚ Football‚ Swimming-Laps‚ Taebo‚ Tennis‚ Volleyball‚ Weight Lifting‚ Walking‚ Training Club‚ Other
Number of Times Exercising Each Week …
Average Number of Minutes You Were Actually Exercising Each Time
Intensity: L = Light‚ M = Moderate‚ H = Heavy
PART B –Your exercise preferences
1. When I exercise with others‚ I prefer to have people I can depend on to help me if I really need it.
2. When I exercise with others‚ I prefer to have close relationships with other people.
3. When I exercise with others‚ I prefer to have someone I can turn to for guidance in times of stress.
4. When I exercise with others‚ I prefer to have people who depend on me for help.
5. When I exercise with others‚ I prefer to have people who enjoy the same social activities I do.
6. When I exercise with others‚ I prefer to have other people who view me as competent.
7. When I exercise with others‚ I prefer to feel personally responsible for the well-being of another person.
8. When I exercise with others‚ I prefer to feel part of a group of people who share my attitudes and beliefs.
9. When I exercise with others‚ I prefer to have other people who respect my skills and abilities.
10.When I exercise with others‚ I prefer to know that‚ if something went wrong‚ someone would come to my assistance.
11.When I exercise with others‚ I prefer to have close relationships that provide me with a sense of emotional security and well-being.
12.When I exercise with others‚ I prefer to have someone who I could talk to about important decisions in my life.
13.When I exercise with others‚ I prefer to have my competence and skill recognized.
14.When I exercise with others‚ I prefer to have someone who shares my interests and concerns.
15.When I exercise with others‚ I prefer to have someone who really relies on me for his/her well-being.
16.When I exercise with others‚ I prefer to have a trustworthy person I could turn to for advice if I were having problems.
17.When I exercise with others‚ I prefer to feel a strong emotional bond with at least one other person.
18.When I exercise with others‚ I prefer to have someone I can depend on for aid if I really need it.
19.When I exercise with others‚ I prefer to have someone I feel comfortable talking about problems with.
20.When I exercise with others‚ I prefer to have people who admire my talents and abilities.
21.When I exercise with others‚ I prefer to feel intimacy with another person.
22.When I exercise with others‚ I prefer to have someone who likes to do the things I do.
23.When I exercise with others‚ I prefer to have people I can count on in an emergency.
24.When I exercise with others‚ I prefer to have someone who needs me to care for them.
PART C – Your exercise experiences
1. While I was exercising with others during the last month‚ there were people I could depend on to help me if I really needed it when I exercised.
2. While I was exercising with others during the last month‚ I feel that I had close personal relationships with other people.
3. While I was exercising with others during the last month‚ there was someone I could turn to for guidance in times of stress.
4. While I was exercising with others during the last month‚ there were people who depended on me for help.
5. While I was exercising with others during the last month‚ there were people who enjoyed the same social activities I do.
6. While I was exercising with others during the last month‚ other people viewed me as competent.
7. While I was exercising with others during the last month‚ I felt personally responsible for the well-being of another person.
8. While I was exercising with others during the last month‚ I felt part of a group of people who share my attitudes and beliefs.
9. While I was exercising with others during the last month‚ I think other people respected my skills and abilities.
10.While I was exercising with others during the last month‚ if something went wrong‚ someone would have come to my assistance.
11.While I was exercising with others during the last month‚ I had close relationships that provided me with a sense of emotional security and well-being.
12.While I was exercising with others during the last month‚ there was someone I could talk to about important decisions in my life.
13.While I was exercising with others during the last month‚ my competence and skill were recognized.
14.While I was exercising with others during the last month‚ there was someone who shared my interests and concerns.
15.While I was exercising with others during the last month‚ there was someone who really relied on me for his/her well-being.
16.While I was exercising with others during the last month‚ there was a trustworthy person I could turn to for advice if I was having problems.
17.While I was exercising with others during the last month‚ I felt a strong emotional bond with at least one other person.
18.While I was exercising with others during the last month‚ there was someone I could depend on for aid if I really needed it.
19.While I was exercising with others during the last month‚ there was someone I felt comfortable talking about problems with.
20.While I was exercising with others during the last month‚ there were people who admired my talents and abilities.
21.While I was exercising with others during the last month‚ I felt intimacy with another person.
22.While I was exercising with others during the last month‚ there was someone who liked to do the things I do.
23.While I was exercising with others during the last month‚ there were people I could count on in an emergency.
24.While I was exercising with others during the last month‚ someone needed me to care for them.
Attachment (alpha 0.80)‚ reliable alliance(alpha 0.81)‚ social integration(alpha 0.85)‚ opportunity for nurturance(alpha 0.84)‚ and reassurance of worth(alpha 0.82)
1-strongly disagree‚ 2- disagree‚ 3- agree‚ 4- strongly agree
This instrument can be found online at: http://www.collectionscanada.gc.ca/obj/s4/f2/dsk3/SSU/TC-SSU-12152004201524.pdf
Watson‚ Jocelyn. Dawn. (2004). social provisions in the exercise setting. University of Saskatchewan. master of Science Thesis.
Watson‚ J. D.‚ Spink‚ K. S.‚ Wilson‚ K. S.‚ Bruner‚ M. W.‚ & Bostick‚ J. M. (October 2003). Social support in the group exercise setting: Testing the fit of Weiss’s (1974) Model of Social Provisions. Paper presented at the Annual Meeting of the Canadian Society for the Psychology of Sport and Physical Activity‚ Hamilton‚ Ontario‚ Canada.
Cutrona‚ C. E.‚ & Russell‚ D. W. (1990). Type of social support and specific stress: Toward a Theory of Optimal Matching. In B. R. Sarason‚ I. G. Sarason‚ & G. R. 78 Pierce (Eds.)‚ Social support: An interactional view (pp. 319-366). New York: John Wiley & Sons‚ Inc.
Cutrona‚ C. E.‚ & Russell‚ D. W. (1987). The provisions of social relationships and adaptation to stress. In W. H. Jones & D. Perlman (Eds.)‚ Advances in personal relationships (Vol. 1‚ pp. 37-67). Greenwich‚ CT: JAI Press Inc.
Weiss‚ R. (1974). The provisions of social relationships. In Z. Rubin (Ed.)‚ Doing unto others (pp. 17-26). Englewood Cliffs‚ NJ: Prentice Hall.