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APPENDIX A March 2, 2010 MRS. NITA SEMPRUN, RND Nutritionist Xavier University Community Health Care Center Dear Mrs. Maulion, Greetings of Peace! We are third year BS Nursing students of Xavier University Ateneo de Cagayan. In line with our subject, Introduction to Nursing Research, we are on the process of conducting a study, which is entitled, Eating Behaviors and Lifestyle: Its Implication to Health and Wellness. 20 respondents will be given a self-administered questionnaire that aims to determine what eating behaviors and lifestyle factors affect them according to their respective classes of obesity. In line with this, we would like to ask for your help in validating our questionnaire in terms of its structure, over-all formality and suitability to our study. Attached herein is a partial copy of the questionnaire we will be administering. We are hoping for a positive response. Thank you very much and more power to you!

Respectfully Yours, Marian Vida Q. Patrimonio Team Leader

Noted by: Arlita Amapola B. Minguez, RN, MAT Introduction to Nursing Research Instructor

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Appendix B INFORMED CONSENT In signing this document, I am giving my consent to be interviewed by _____________________, a Level IV BS Nursing student of the Xavier University, Ateneo de Cagayan. I understand that I will be a part of a research study that will focus on my eating behaviors and lifestyle factors that contributes to my obesity. I understand that I will be asked on some questions about my experiences, my feelings, and the characteristics of my reactions; among others; towards my behaviors and lifestyle activities and my state of obesity. I also understand that the researcher may contact me for more information in the future. This interview was granted freely. I have been informed that the interview is entirely voluntary. However, I will not receive any benefit from my participation. I understand that the result of this research may be known to me and that ___________ is the person to contact if I have any questions about the study.

____________ Date

_______________________________________ Respondents Signature above Printed Name

Witness:

____________ Date

_______________________________________ Witness Signature above Printed Name

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Appendix C THE QUESTIONNAIRE Eating Behaviors and Lifestyle Factors: Its Implication to Health and Wellness

Dear Respondent, Greetings of peace from our Lord, Jesus Christ! We are conducting a research study regarding eating behaviors and lifestyle factors associated to obesity. May we therefore ask your cooperation by simply filling-up this set of questionnaire that may lead answers to the queries of this study. Attached to this questionnaire is the Informed Consent that enumerates the rationale and safeguards of this research. Items stipulated in the consent form shall be strictly followed. Thank you. Respectfully, Marian Vida Q. Patrimonio Team Leader

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Part I. Profile INSTRUCTION: Please supply the information requested by either writing the exact number and by checking ( / ) the appropriate box. Age: Sex: Civil Status: _____ ( ) Male ( ) Female ( ) Single ( ) Married

Part II. Eating Behaviors INSTRUCTION: This section will describe your type of Eating Behaviors associated to Obesity. Please place a check mark ( / ) on the Yes/No column for the occurrence of practice as described. Should your response to the description is YES, kindly use the scale below to rate the frequency of its occurrence for a quantifiable description. Such these two (2) responses are necessary to answer the queries in this study. 1 Never No occurrence in any given Week 2 Rare Once or Twice a Week 3 Sometimes Three to Four times in a Week Response NO YES 4 Always Five to Six times in a Week Frequency 3 2 1

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15.

Description I lost control especially eating my favorites servings of food. I do eat meals, regardless, after 6 PM I weigh more than I should have in comparison to my height (BMI=_____) I eat more than 3 to 4 cups of servings a meal, or eat more than 3 times a day even with full appetite I have high blood pressure at times I often skip meals I eat more than the usual amount of servings right when I skipped meals during breakfast or lunch I often have food cravings when I have skipped meals I have elevated blood glucose I feel hungry late at night I eat sweets when I feel down or depressed I tend to eat more servings when I feel anxious or stressed I eat more than the usual when I am alone I eat even more when I am in physical pain I eat a lot even when I am not hungry at all

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Part III. Lifestyle Factors INSTRUCTION: This section will describe your Lifestyle Factors associated to Obesity. Please place a check mark ( / ) on the Yes/No column for the occurrence of practice as described. Should your response to the description is YES, kindly use the scale below to rate the frequency of its occurrence for a quantifiable description. Such these two (2) responses are necessary to answer the queries in this study. 1 Never No occurrence in any given Week 2 Rare Once or Twice a Week 3 Sometimes Three to Four times in a Week Response NO YES 4 Always Five to Six times in a Week Frequency 3 2 1

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15.

Description I ride a vehicle as my major transport device I perform brisk walking at least 30 minutes a day or at least 5 days a week I watch TV more than 3 hours a day I enjoy eating junk foods while watching TV I exercise, other than brisk walk, at least two times a week I drink alcoholic beverages at least 1 to 2 bottles a week I eat more than the usual when I drink alcoholic beverages in large amounts I eat more than the usual when I drink alcoholic beverages in moderate amounts I lose appetite without drinking alcoholic beverages I drink alcoholic beverages during social gatherings I smoke heavily, at least 1 pack a day I smoke at least 5-10 sticks a week I do not smoke at all I lose appetite when I do not smoke I smoke to make myself more thin

Appendix D Statistical Formulas A. Sample Percentage/ Frequency Distribution

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P= Where: P as percentage f as frequency

f x100 N

N as the total number of cases 100 as constant

B. Hypothetical Mean Weight

HOM = a B Where:

HOM = hypothetical mean a = achieved desired result B = total number of items

C. Person Rho Coefficient

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D. Eigenvalue