{"id":7633,"date":"2021-04-22T17:29:39","date_gmt":"2021-04-22T22:29:39","guid":{"rendered":"https:\/\/uamscaregiving.org\/springdale\/?page_id=7633"},"modified":"2026-02-06T12:47:28","modified_gmt":"2026-02-06T18:47:28","slug":"csc3","status":"publish","type":"page","link":"https:\/\/uamscaregiving.org\/springdale\/csc3\/","title":{"rendered":"Chapter 3 Self Checks &#8211; WWE"},"content":{"rendered":"<p>All reporting of your responses will be in the aggregate; no individually identifiable information will be shared.<\/p>\n<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var 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class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_159_23_date_format gfield_description_159_23\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_159_23_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_159_23' class='gform_hidden' value='https:\/\/uamscaregiving.org\/springdale\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_159_18\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_159_18\" ><label class='gfield_label gform-field-label' for='input_159_18'>Enter your birthday<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='gfield_description' id='gfield_description_159_18'><strong><i>(MM\/DD\/YYYY)<\/i><\/strong><\/div><div class='ginput_container ginput_container_date'>\n                            <input aria-describedby='field_159_18_dmessage' name='input_18' id='input_159_18' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_159_18_date_format gfield_description_159_18\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_159_18_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_159_18' class='gform_hidden' value='https:\/\/uamscaregiving.org\/springdale\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_159_41\" class=\"gfield gfield--type-name field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_159_41\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_159_41'>\n                            \n                            <span id='input_159_41_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_41.3' id='input_159_41_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_159_41_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_159_41_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_41.6' id='input_159_41_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_159_41_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><\/li><li id=\"field_159_87\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_159_87\" ><strong>TEST YOUR KNOWLEDGE<br>\n______________________________________________________________________________________________________________________<\/strong><\/li><li id=\"field_159_91\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_159_91\" ><label class='gfield_label gform-field-label' >I know how to select appropriate equipment for walking, including shoes, socks, clothing and any aids I need.<\/label><div class='gfield_description' id='gfield_description_159_91'><i>Select your response below<\/i><\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_159_91'>\n\t\t\t<li class='gchoice gchoice_159_91_0'>\n\t\t\t\t<input name='input_91' type='radio' value='Yes'  id='choice_159_91_0'    \/>\n\t\t\t\t<label for='choice_159_91_0' id='label_159_91_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_159_91_1'>\n\t\t\t\t<input name='input_91' type='radio' value='No'  id='choice_159_91_1'    \/>\n\t\t\t\t<label for='choice_159_91_1' id='label_159_91_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_159_92\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_159_92\" ><label class='gfield_label gform-field-label' >I can describe the FITT principles of walking.<\/label><div class='gfield_description' id='gfield_description_159_92'><i>Select your response below<\/i><\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_159_92'>\n\t\t\t<li class='gchoice gchoice_159_92_0'>\n\t\t\t\t<input name='input_92' type='radio' value='Yes'  id='choice_159_92_0'    \/>\n\t\t\t\t<label for='choice_159_92_0' id='label_159_92_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_159_92_1'>\n\t\t\t\t<input name='input_92' type='radio' value='No'  id='choice_159_92_1'    \/>\n\t\t\t\t<label for='choice_159_92_1' id='label_159_92_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_159_93\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_159_93\" ><label class='gfield_label gform-field-label' >I understand the components and process for making a realistic and achievable walking plan.<\/label><div class='gfield_description' id='gfield_description_159_93'><i>Select your response below<\/i><\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_159_93'>\n\t\t\t<li class='gchoice gchoice_159_93_0'>\n\t\t\t\t<input name='input_93' type='radio' value='Yes'  id='choice_159_93_0'    \/>\n\t\t\t\t<label for='choice_159_93_0' id='label_159_93_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_159_93_1'>\n\t\t\t\t<input name='input_93' type='radio' value='No'  id='choice_159_93_1'    \/>\n\t\t\t\t<label for='choice_159_93_1' id='label_159_93_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_159_95\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_159_95\" ><strong>RATE YOUR CONFIDENCE<br>\n______________________________________________________________________________________________________________________<\/strong><\/li><li id=\"field_159_96\" class=\"gfield gfield--type-number gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_159_96\" ><label class='gfield_label gform-field-label' for='input_159_96'>I feel confident that I can apply the FITT principles to my walking program<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='gfield_description' id='gfield_description_159_96'>Please enter the number (no decimals) that best describes your confidence in the above statement<br><br>\n\n<i><strong>Zero (0) is \"not confident at all\" -- Ten (10) is \"totally confident\"<\/strong><\/i><\/div><div class='ginput_container ginput_container_number'><input name='input_96' id='input_159_96' type='number' step='any' min='0' max='10' value='0' class='medium'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_159_96 gfield_description_159_96\" \/><div class='gfield_description instruction ' id='gfield_instruction_159_96'>Please enter a number from <strong>0<\/strong> to <strong>10<\/strong>.<\/div><\/div><\/li><li id=\"field_159_99\" class=\"gfield gfield--type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_159_99\" ><label class='gfield_label gform-field-label' for='input_159_99'>I feel confident that I can use my weekly diary and my contract to set goals and keep track of my progress.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='gfield_description' id='gfield_description_159_99'>Please enter the number (no decimals) that best describes your confidence in the above statement<br><br>\n\n<i><strong>Zero (0) is \"not confident at all\" -- Ten (10) is \"totally confident\"<\/strong><\/i><\/div><div class='ginput_container ginput_container_number'><input name='input_99' id='input_159_99' type='number' step='any' min='0' max='10' value='0' class='medium'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_159_99 gfield_description_159_99\" \/><div class='gfield_description instruction ' id='gfield_instruction_159_99'>Please enter a number from <strong>0<\/strong> to <strong>10<\/strong>.<\/div><\/div><\/li><li id=\"field_159_98\" class=\"gfield gfield--type-number gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_159_98\" ><label class='gfield_label gform-field-label' for='input_159_98'>I feel confident that I can walk and exercise at my own pace, building up to at least 30 minutes on 3 days or more per week.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='gfield_description' id='gfield_description_159_98'>Please enter the number (no decimals) that best describes your confidence in the above statement<br><br>\n\n<i><strong>Zero (0) is \"not confident at all\" -- Ten (10) is \"totally confident\"<\/strong><\/i><\/div><div class='ginput_container ginput_container_number'><input name='input_98' id='input_159_98' type='number' step='any' min='0' max='10' value='0' class='medium'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_159_98 gfield_description_159_98\" \/><div class='gfield_description instruction ' id='gfield_instruction_159_98'>Please enter a number from <strong>0<\/strong> to <strong>10<\/strong>.<\/div><\/div><\/li><li id=\"field_159_97\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_159_97\" ><strong>NEXT STEPS<br>\n______________________________________________________________________________________________________________________<\/strong><br>\nCould you answer yes to the statements above?  Is your confidence level 7 or more?  If so, congratulations!  You are ready to move on.<br><br>\nEach of the statements refers to a section of this chapter.  If you answered no to any of them, you may wish to go back and review that section.  If your confidence level is low, review the sections you're not sure about.  You can also share questions or concerns with your friends who have arthritis and walk or with your health care practitioner.  If you're in a <i>Walk with Ease<\/i> group program, we recommend that you share your questions or concerns with your group leader and fellow participants.<\/li><\/ul><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_159' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_159\"]){return false;}  if( !jQuery(\"#gform_159\")[0].checkValidity || jQuery(\"#gform_159\")[0].checkValidity()){window[\"gf_submitting_159\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_159\"]){return false;} if( !jQuery(\"#gform_159\")[0].checkValidity || jQuery(\"#gform_159\")[0].checkValidity()){window[\"gf_submitting_159\"]=true;}  jQuery(\"#gform_159\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_159' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='159' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_159' value='WyJbXSIsIjFlM2IwZmFmODUyMmYyMjBjYzE2YTM0MTI1N2NkMmM5Il0=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_159' id='gform_target_page_number_159' value='0' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_159' id='gform_source_page_number_159' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"ak_\"><label>&#916;<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"ak_js\" value=\"19\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><\/form>\n                        <\/div><script type=\"text\/javascript\">\ngform.initializeOnLoaded( function() {gformInitSpinner( 159, 'https:\/\/uamscaregiving.org\/springdale\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_159').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_159');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_159').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){jQuery('#gform_wrapper_159').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_159').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_159').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/  }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_159').val();gformInitSpinner( 159, 'https:\/\/uamscaregiving.org\/springdale\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [159, current_page]);window['gf_submitting_159'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_159').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [159]);window['gf_submitting_159'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_159').text());}else{jQuery('#gform_159').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"159\", currentPage: \"current_page\", abort: function() { this.preventDefault(); 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