Patient Motivator Questionnaire – thepublicwellnessproject.com

Many providers deliver strong treatment plans, clear education, and evidence-based care. This can make it exceptionally frustrating to still see patients struggle to maintain progress outside of clinical care.

This brief assessment is designed to help you reflect on where engagement tends to drop off and how clinical conversations can better support long-term follow-through.

There are no right or wrong answers.

Section 1

Where Do Patients Lose Momentum?

Where do you most often notice patients losing follow-through or engagement? (select up to 3)

Where do you most often notice patients losing follow-through or engagement?

When patients begin to improve Between visits or outside structured care As treatment shifts toward greater independence When progress slows or plateaus When patients are managing multiple health or life demands Around discharge or transition points It varies patient to patient

Section 2

Your Role and Practice Setting

What is your primary role?

Where do you primarily practice?

How many years have you been practicing?

0–2 3–5 6–10 10+

What population do you work with most often?

Section 3

What You See in Practice

When follow-through is low, what do you notice most often? (select up to 3)

Patients agree during visits but don’t initiate independently Home programs or recommendations are inconsistent Progress looks different in clinic versus real-world settings Patients rely heavily on provider direction Engagement drops once symptoms improve Patients feel overwhelmed by multiple priorities

When this happens, what do you find yourself doing most often?

Providing additional education or explanation Repeating instructions differently Encouraging or reinforcing adherence Modifying the plan of care Adjusting expectations Unsure what approach works best

Section 4

Professional Growth

What would be most helpful for you right now? (select up to 2)

A structured framework for guiding patient conversations Strategies to improve engagement and follow-through Approaches for patients who struggle with adherence Tools to support transitions and independence Examples of clinical language that improve buy-in

If you could improve one aspect of your patient interactions tomorrow, what would it be? (open response)

How would you rate your health?

Sleep

The following questions are about your typical sleep patterns.

Are you satisfied with your sleep?*

Do you sleep between 6 and 8 hours per night?*

Do you spend less than 30 minutes awake during the night (falling asleep + awakenings)?*

Social Connection

The following questions are about how connected you feel to others.

I feel connected to people who care about me.*

I have at least one person I can turn to in times of need.*

I regularly spend quality time with friends, family, or community.*

Stress Management

The questions in this scale ask you about your feelings and thoughts during the last month.

In the last month, how often have you felt calm and in control?*

How often have you felt confident about handling your personal problems?*

How often have you felt that you can manage unexpected challenges effectively?*

Physical Activity

Please answer these questions based on your typical week.

Do you get at least 150 minutes of moderate or vigorous activity weekly? (where your heartbeat increases and you breathe faster (e.g. brisk walking, cycling as means of transport or as exercise, heavy gardening, running or recreational sports)*

Do you do muscle-strengthening exercises at least 2 times per week?*

Nutrition

The following questions are about your typical eating patterns.

I eat at least 5 servings of fruits or vegetables most days.*

I include whole grains and plant-based proteins in my meals regularly.*

I limit ultra-processed foods and sugary drinks.*

Avoidance of Risky Substances

Please answer the following questions based on the past 12 months.

I avoid tobacco and nicotine products.*

I avoid binge drinking (more than 4 drinks in a sitting).*

I do not misuse prescription or recreational drugs.*

Based on your previous responses, what area of your health do you believe has the biggest area for improvement?

What would be the next sign of progress for you with this area of your health?

What action do you need to take to create that change?

The Patient Motivator Questionnaire