Information For the researcher 10. Exercising (1) No exercise Exc (2) Have exercise activities (3) Type of exercise Exc1 Identify ....................................................... (4) The average exercise frequency ......................... Times/Week Exc2 (5) The average exercise duration ........................ Minutes/Times Exc3 10. Living area Area (1) City Municipal (2) Town Municipality (3) Subdistrict Municipality (4) Subdistrict Administrative Organization (SAO) 11. Do you have any chronic disease? CD (1) No (2) Yes identify……………………………... Part 2 Social capital factors Explanation : Please mark the in or fill the information that match your reality and your routine. 5 means Always do this activity. 4 means Usually do this activity. 3 means Often do this activity. 2 means Sometimes do this activity. 1 means Rarely do this activity. Information Practice Level For 5 4 3 2 1 Researcher Behavior 1. Participate in the traditional activities CSC1 in your community. 2. Help neighbor who had trouble. CSC2 3. Participate in public activities such as CSC3 cleaning the public area or join any campaign activities. 4. Participate or help neighbor in CSC4 activities such as wedding, ordination ceremony or funeral. 5. Participate in political activities and CSC5 give opinion for community in various aspects. Attitude 1. You are proud to be a part of the CSC6 community.
Information For the researcher 10. Exercising (1) No exercise (2) Have exercise activities (3) Type of exercise Identify ....................................................... (4) The average exercise frequency ......................... Times/Week (5) The average exercise duration ........................ Minutes/Times Exc Exc1 Exc2 Exc3 10. Living area (1) City Municipal (2) Town Municipality (3) Subdistrict Municipality (4) Subdistrict Administrative Organization (SAO) Area 11. Do you have any chronic disease? CD (1) No (2) Yes identify……………………………... Part 2 Social capital factors Explanation : Please mark the in or fill the information that match your reality and your routine. 5 means Always do this activity. 4 means Usually do this activity. 3 means Often do this activity. 2 means Sometimes do this activity. 1 means Rarely do this activity. Information Practice Level For Researcher 5 4 3 2 1 Behavior 1. Participate in the traditional activities in your community. CSC1 2. Help neighbor who had trouble. CSC2 3. Participate in public activities such as cleaning the public area or join any campaign activities. CSC3 4. Participate or help neighbor in activities such as wedding, ordination ceremony or funeral. CSC4 5. Participate in political activities and give opinion for community in various aspects. CSC5 Attitude 1. You are proud to be a part of the community. CSC6
8d8a8769-ec85-46e8-8cac-0e8e1b54f568.docx