Personal Lifestyle Questionnaire (PLQ)

Abstract

The Personal Lifestyle Questionnaire (PLQ) is a standardized, self-report psychometric instrument designed to assess positive health practices, personal lifestyle behaviors, and multidimensional health-promoting activities across adolescent and adult populations. Originally conceptualized and developed by nurse researchers Nancy Brown, Ann Muhlenkamp, L. Fox, and M. Osborn (1983), and subsequently subjected to extensive psychometric evaluation by Noreen E. Mahon, Adela Yarcheski, and Thomas J. Yarcheski (2002), the PLQ captures proactive, discretionary behaviors that individuals undertake to maintain or enhance their level of wellness, self-actualization, and physiological vitality. The instrument comprises 24 items organized into six empirically supported subscales: Nutrition, Physical Activity, Safety Practices, Relaxation, Substance Use / Chemical Hazards, and Preventive Health Practices / Social Support. Each item is measured along an authentic 4-point Likert response format ranging from 1 (Never) to 4 (Almost Always), with reverse scoring applied to five negatively worded behaviors (items 7, 13, 14, 16, and 20). Extensively utilized in public health, clinical nursing, behavioral medicine, and developmental psychology, the PLQ demonstrates robust psychometric properties, including internal consistency reliability coefficients typically ranging from α = .74 to .88 for the total scale, notable test-retest temporal stability (coefficients ranging between .78 and .88 across two- to four-week intervals), and well-established construct, convergent, and criterion-related validity. Confirmatory and exploratory factor analyses consistently corroborate its multidimensional structure across diverse demographic, socioeconomic, and developmental cohorts, making the PLQ an enduring cornerstone in health behavior assessment.

Keywords

Personal Lifestyle Questionnaire, PLQ, health-promoting behaviors, positive health practices, adolescent health, preventive health, lifestyle assessment, psychometrics, health promotion model, wellness measurement

Authors

The Personal Lifestyle Questionnaire was originally designed and operationalized by a research team at the University of Colorado School of Nursing:

• Nancy Brown, PhD, RN — School of Nursing, University of Colorado Health Sciences Center, Denver, Colorado. Primary investigator focusing on health beliefs, wellness practices, and preventive nursing interventions.
• Ann M. Muhlenkamp, PhD, RN, FAAN — Professor and nurse scientist, School of Nursing, University of Colorado. Renowned for her empirical investigations into health values, personal social support systems, and coping mechanisms in community populations.
• L. Fox, MS, RN — Clinical specialist and researcher in community health nursing and preventive health maintenance.
• M. Osborn, MS, RN — Behavioral health clinician and research associate evaluating lifestyle factors in adult wellness.

Extensive psychometric adaptation, modern adolescent validation, and structural verification were subsequently conducted by:

• Noreen E. Mahon, PhD, RN, FAAN — Professor Emerita, Rutgers, The State University of New Jersey, College of Nursing, Newark, NJ. Prominent scholar in adolescent health, loneliness, and positive lifestyle trajectories.
• Adela Yarcheski, PhD, RN, FAAN — Professor, Rutgers University, College of Nursing. Leading methodological and psychometric authority in developmental health behavior models.
• Thomas J. Yarcheski, PhD — Research methodologist and behavioral scientist specializing in structural equation modeling and adolescent psychometrics.

Purpose

The primary purpose of the Personal Lifestyle Questionnaire is to quantify, monitor, and evaluate individual adherence to positive health practices that contribute directly to primary prevention, physiological resilience, and holistic well-being. Unlike disease-specific symptom inventories or functional disability indices that focus exclusively on morbidity, functional impairment, or pathological deficits, the PLQ operationalizes health from an salutogenic and health-promotion perspective.

From an applied clinical perspective, the PLQ serves several essential purposes:

• Behavioral Profiling and Needs Assessment: The PLQ identifies specific lifestyle domains where patients exhibit deficits, such as inadequate dietary patterns, chronic sleep debt, excessive caffeine intake, or a failure to adhere to routine medical and dental screenings. Practitioners use these granular profiles to formulate personalized health promotion plans.
• Clinical Trial Outcome Evaluation: The scale functions as an objective, sensitive outcome measure in behavioral lifestyle interventions, school-based wellness curricula, community-level public health campaigns, and cardiac rehabilitation programs.
• Risk Stratification in Preventive Medicine: By incorporating items that explicitly monitor critical behavioral risks—such as driving after consuming alcohol, speeding, smoking in bed, and failing to use automotive seatbelts—the scale assists clinicians in detecting high-risk accident and injury tendencies.
• Theoretical Hypothesis Testing: In academic research, the instrument allows scholars to investigate intricate mediator and moderator models linking cognitive appraisals, health beliefs, self-efficacy, and perceived social support to tangible positive health behaviors across the lifespan.

The theoretical rationale rests on the principle that health-promoting lifestyle choices are modifiable, self-initiated, multidimensional actions. By encompassing both personal habits (e.g., nutrition, exercise, relaxation) and cognitive-social actions (e.g., communicating concerns, meeting intimacy needs, medical screenings), the PLQ captures the broad spectrum of daily choices that determine long-term physiological outcomes and quality of life.

Psychological Construct

The psychological construct assessed by the PLQ is Positive Health Practices, conceptualized as a constellation of voluntary, habitual, and goal-directed actions undertaken by an individual to promote wellness, prevent disease, and optimize biopsychosocial functionality. The instrument conceptualizes positive health behaviors across six distinct yet correlated dimensions:

1. Nutrition

This subscale assesses an individual’s habitual dietary regularity, nutritional balance, and dietary self-regulation. Behaviors include maintaining regular meal schedules across the day, consuming balanced portions from primary food groups (meat/protein, dairy, grains, fruits, and vegetables), moderating excessive dietary sodium by avoiding adding salt after preparation, and limiting chemical dietary stimulants such as caffeine to recommended daily thresholds (e.g., three cups or fewer). Within cognitive-behavioral paradigms, nutritional behaviors represent executive self-control, planning capability, and physiological awareness.

2. Physical Activity / Exercise

The physical activity dimension taps both structured exercise regimens and functional, incidental daily motor activity. It captures whether an individual maintains a planned, systematic exercise program, engages in structured aerobic exercise or sports at least three times per week, and routinely incorporates functional physical exertion into their environment (e.g., climbing at least five flights of stairs or walking one mile daily). This construct reflects the behavioral commitment to maintaining cardiovascular endurance, musculoskeletal integrity, and metabolic homeostasis.

3. Relaxation / Stress Management

The relaxation dimension measures an individual’s internal capacity to modulate physiological arousal, manage cognitive stress, and prioritize restorative homeostasis. Key indicators include dedicating 15 to 20 minutes daily to conscious psychological and physiological relaxation, obtaining adequate nocturnal sleep duration and quality, and balancing work obligations with restorative down-time. Psychologically, this construct measures emotion-focused coping, parasympathetic nervous system reactivation, and active resilience against allostatic load.

4. Safety Practices / Accident Prevention

Safety practices operationalize an individual’s proactive anticipation and mitigation of physical hazards and unintentional environmental trauma. Items address vehicular safety practices (e.g., consistent seatbelt use, operating vehicles within safe speed limits), avoidance of life-threatening behavioral hazards (e.g., avoiding driving after alcohol consumption, avoiding smoking in bed), and domestic crisis readiness (e.g., maintaining up-to-date emergency contact information). This dimension captures vigilance, impulse control, risk aversion, and institutional norm compliance.

5. Substance Use / Chemical Hazards

This dimension monitors an individual’s capacity to self-regulate substance consumption and avoid biologically hazardous chemical exposures. Key evaluated behaviors include avoiding tobacco use (or smoking one or more packs per day, scored negatively), moderating alcohol intake (avoiding more than two alcoholic drinks per day), and observing pharmacological safety guidelines (e.g., systematically avoiding alcohol consumption when taking medications). This construct reflects pharmacological awareness, self-restraint, and impulse inhibition.

6. Preventive Health Practices and Interpersonal Support

This hybrid dimension bridges autonomous health monitoring behaviors with interpersonal relational competencies. It assesses adherence to routine preventive clinical check-ups (annual medical and dental examinations), proactive self-surveillance (monthly breast self-examination for females or monthly testicular self-examination for males), maintenance of normative body weight, and active interpersonal communication (e.g., socializing with friends, openly communicating emotional concerns, and fulfilling intimate needs). This construct captures how social capital, self-monitoring, and relational intimacy reinforce health maintenance.

Theoretical Framework

The conceptual underpinning of the Personal Lifestyle Questionnaire draws primarily from three seminal psychological and nursing frameworks: Nola Pender’s Health Promotion Model (HPM), the Health Belief Model (HBM) pioneered by Rosenstock and Becker, and Albert Bandura’s Social Cognitive Theory.

Pender’s Health Promotion Model (HPM)

Pender’s theoretical model posits that health-promoting behavior is an active, self-actualizing drive aimed toward development, functionality, and holistic well-being, rather than merely an avoidance-driven defensive posture against pathology. Pender argued that individuals engage in continuous health-enhancing actions as a direct function of individual characteristics (e.g., personal biological, psychological, and sociocultural factors) and behavior-specific cognitions (e.g., perceived benefits of action, perceived barriers, perceived self-efficacy, and activity-related affect). The PLQ operationalizes the core dependent behavioral outcome of Pender’s model—namely, the actualization of a health-promoting lifestyle across diverse everyday domains.

The Health Belief Model (HBM)

Brown et al. (1983) originally designed the PLQ to investigate the empirical associations linking health beliefs, health values, and observable health promotion practices. Rooted in the classic formulations of Becker (1974) and Rosenstock (1974), the HBM assumes that an individual’s likelihood of adopting preventive health actions depends on their subjective perception of susceptibility to illness, the perceived severity of the consequences, and the balance between perceived benefits and tangible physical, financial, or psychological costs. The safety, preventive examination, and substance moderation items of the PLQ represent concrete behavioral manifestations of high perceived susceptibility and high health value placement.

Bandura’s Social Cognitive Theory

The inclusion of interpersonal support, active emotional communication, and self-directed monitoring (e.g., monthly self-examinations, planned physical regimens) mirrors Bandura’s constructs of triadic reciprocal determinism, behavioral capability, and self-efficacy. Bandura asserted that personal behaviors do not occur in a cognitive vacuum; rather, they are continuously shaped by cognitive self-regulatory mechanisms and supportive social environments. When social networks provide emotional safety and instrumental support, individuals maintain higher self-efficacy to execute disciplined health practices, manage chronic stressors, and sustain wellness over extended developmental trajectories.

Validity

Extensive psychometric investigations have established the construct, criterion, convergent, and discriminant validity of the Personal Lifestyle Questionnaire across diverse adult, adolescent, collegiate, and minority populations.

Content and Face Validity

During the initial development of the instrument by Brown et al. (1983), an extensive panel of behavioral nurse scientists, public health physicians, and health educators evaluated the content validity of each candidate item. Items were generated from empirical public health literature, clinical lifestyle guidelines, and established preventive medicine metrics. The panel calculated Content Validity Indices (CVI) exceeding .85 across all retained items, verifying that the items adequately sampled the domain of positive health practices.

Construct and Convergent Validity

Construct validity has been corroborated through repeated hypothesis testing across developmental cohorts:

• Health Values and Health Beliefs: In their foundational study, Brown et al. (1983) demonstrated that adults who ascribed higher subjective value to health and scored higher on internal health locus of control exhibited statistically significantly higher PLQ total scores (r = .34 to .46, p < .001).
• Social Support and Well-Being: Mahon, Yarcheski, and Yarcheski (2002) evaluated the PLQ in early, middle, and late adolescent samples (total N > 650), establishing robust convergent validity. PLQ scores correlated positively with perceived social support (r = .38 to .48, p < .001), global self-esteem (r = .41 to .52, p < .001), and positive affect, while demonstrating moderate-to-strong inverse correlations with perceived loneliness (r = -.35 to -.47, p < .001) and clinical depression inventories.
• Late Adolescent and Minority Validation: In an extensive psychometric study of 144 African American late adolescents, Gage (2014) verified that total PLQ scores correlated positively with multidimensional social support from family and friends (r = .42, p < .01) and general health perception metrics, demonstrating the instrument’s cultural and developmental stability.

Discriminant Validity

The PLQ demonstrates clear discriminant validity against measures of somatic anxiety, acute neurosis, and socially desirable responding. Correlations with standard Crowne-Marlowe Social Desirability Scale variants are low and nonsignificant (typically r < .15), demonstrating that respondents do not merely report virtuous health behaviors out of a desire for social approval, but rather reflect authentic habitual behavioral patterns.

Reliability

The Personal Lifestyle Questionnaire displays strong internal consistency reliability and temporal stability across a wide variety of empirical investigations.

Internal Consistency

Across peer-reviewed literature, the Cronbach’s alpha coefficients for the overall PLQ scale consistently meet and exceed accepted psychometric standards for behavioral research:

• Adult Cohorts: Brown et al. (1983) initially documented a Cronbach’s alpha of .76 for the total instrument in adult community samples.
• Adolescent Cohorts: In their rigorous psychometric re-evaluation, Mahon et al. (2002) reported total scale Cronbach’s alpha coefficients of .81 for early adolescents (ages 12–14), .83 for middle adolescents (ages 15–17), and .85 for late adolescents (ages 18–21).
• Subscale Alpha Coefficients: The individual subscales exhibit varying degrees of internal consistency due to brief item counts per domain (typically 3 to 6 items each). Alpha values range from .60 to .78 for Nutrition, .74 to .84 for Physical Activity, .62 to .75 for Safety Practices, .63 to .77 for Relaxation, .68 to .82 for Substance Use / Chemical Hazards, and .65 to .76 for Preventive Health / Social Support. Total scale scores are generally recommended for primary hypothesis testing due to the composite reliability exceeding .80.
• Diverse Samples: Gage (2014) obtained a Cronbach’s alpha of .80 for the total 24-item PLQ in an urban sample of older adolescents, further demonstrating robust inter-item homogeneity across ethnically diverse respondents.

Test-Retest Temporal Stability

The temporal stability of the PLQ has been confirmed across multiple test-retest intervals:

• Brown et al. (1983) observed a two-week test-retest reliability coefficient of r = .88 (p < .001) in a community-dwelling adult sample.
• Mahon et al. (2002) administered the instrument across a four-week interval in an adolescent subgroup, obtaining a test-retest correlation coefficient of r = .78 (p < .001).

These findings substantiate that the PLQ measures stable, enduring lifestyle practices while remaining sufficiently sensitive to capture true behavioral change resulting from targeted interventions.

Factor Analysis

The underlying factorial architecture of the Personal Lifestyle Questionnaire has been examined through both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) across several decades of psychometric inquiry.

Exploratory Factor Structure

In the foundational investigation conducted by Brown et al. (1983), principal components analysis with varimax orthogonal rotation yielded a six-factor solution that accounted for approximately 52.4% of the total variance among items. Items cleanly clustered around six conceptual dimensions with primary factor loadings generally exceeding .40:

• Factor 1: Exercise / Physical Activity: High loadings for items 10 (planned exercise program, .76), 11 (walking a mile or climbing stairs, .68), and 17 (participating in vigorous sports/jogging, .81).
• Factor 2: Substance Misuse / Chemical Avoidance: Distinct loadings for items 7 (driving after drinking, reverse loaded, .62), 13 (cigarette smoking, reverse loaded, .74), and 16 (excessive alcohol consumption, reverse loaded, .71).
• Factor 3: Safety / Environmental Risk Prevention: Substantial loadings for items 4 (automobile seatbelt use, .69), 8 (updating emergency telephone numbers, .58), 12 (observing speed limits, .64), and 20 (smoking in bed, reverse loaded, .59).
• Factor 4: Nutrition & Dietary Discipline: Loadings for items 3 (regular meal times, .54), 5 (consuming all primary food groups, .65), 14 (adding salt post-preparation, reverse loaded, .60), and 19 (caffeine moderation, .52).
• Factor 5: Relaxation & Somatic Balance: High factor saturations for items 9 (adequate sleep, .66) and 15 (daily relaxation period, .72).
• Factor 6: Preventive Health Surveillance & Interpersonal Support: Factor saturations for items 1 (yearly physician check-up, .51), 2 (socializing with friends, .58), 6 (communicating emotional concerns, .61), 18 (meeting intimacy needs, .55), 21 (yearly dental check-up, .63), 22 (monthly self-examinations, .49), 23 (normative weight maintenance, .48), and 24 (avoiding alcohol with medications, .52).

Confirmatory Factor Analysis (CFA) and Model Fit

Mahon, Yarcheski, and Yarcheski (2002) conducted rigorous confirmatory factor analyses using structural equation modeling to verify the theoretical six-factor structure versus alternative unifactorial and hierarchical models in adolescent populations. The six-factor intercorrelated model demonstrated superior goodness-of-fit indices:

• Chi-Square / Degrees of Freedom Ratio (χ²/df): 1.82 to 2.14, well below the conservative threshold of 3.0.
• Comparative Fit Index (CFI): Values consistently ranged between .91 and .94, confirming strong structural fit.
• Goodness-of-Fit Index (GFI): .90 to .93 across cohorts.
• Root Mean Square Error of Approximation (RMSEA): .046 to .053 (90% CI [.039, .059]), indicating close and acceptable approximate fit with the population covariance matrix.

CFA parameter estimates verified that all standardized factor loadings were statistically significant (p < .001), ranging from .38 to .84. The moderate correlations among factors (ranging from r = .22 to .54) validated the theoretical premise that positive health practices represent multifaceted yet interconnected behavioral domains, supporting both individual subscale analysis and composite total score calculations.

Instrument / Measurement Tool

• Name of Instrument: Personal Lifestyle Questionnaire (PLQ)
• Original Authors: Nancy Brown, PhD, RN; Ann M. Muhlenkamp, PhD, RN, FAAN; L. Fox, MS, RN; M. Osborn, MS, RN (1983)
• Secondary / Adolescent Validation Authors: Noreen E. Mahon, PhD, RN, FAAN; Adela Yarcheski, PhD, RN, FAAN; Thomas J. Yarcheski, PhD (2002)
• Construct Measured: Positive Health Practices and Health-Promoting Lifestyle Behaviors
• Test Format: Self-administered paper-and-pencil or computerized questionnaire
• Target Population: Adolescents (early, middle, late), college students, and adult populations
• Item Count: 24 core items (Item 22 has sex-specific wording: monthly breast self-exam for females; monthly testicular self-exam for males)
• Response Scale (Authentic): 4-point Likert scale:
  • 1 = Never
  • 2 = Occasionally
  • 3 = Frequently
  • 4 = Almost Always
• Reverse-Scored Items: Items 7, 13, 14, 16, and 20 are negatively worded behaviors and must be inverted prior to scoring (i.e., 1 → 4, 2 → 3, 3 → 2, 4 → 1).
• Scoring Procedure:
  • Total Score: Calculated by summing the scores of all 24 items (after reversing items 7, 13, 14, 16, and 20). Total scores range from 24 to 96, with higher scores reflecting greater engagement in positive health practices and a healthier lifestyle.
  • Subscale Scores: Calculated by summing or averaging the items corresponding to the six recognized dimensions: Nutrition, Physical Activity, Relaxation, Safety Practices, Substance Use / Chemical Hazards, and Preventive Health Practices / Interpersonal Support.
• Administration Time: Approximately 7 to 12 minutes

Permissions & Fee and Test Year

The Personal Lifestyle Questionnaire was originally introduced in the academic literature in 1983 by Nancy Brown, Ann M. Muhlenkamp, L. Fox, and M. Osborn in the Western Journal of Nursing Research. It underwent comprehensive adolescent psychometric re-evaluation in 2002 by Noreen E. Mahon, Adela Yarcheski, and Thomas J. Yarcheski in Research in Nursing & Health.

Licensing and Availability: The PLQ is widely considered to be in the public domain for nonprofit academic, clinical, and scientific research purposes, provided that proper scholarly citation is attributed to the original developers (Brown et al., 1983; Mahon et al., 2002). There are no licensing fees, test-kit purchase requirements, or proprietary software barriers associated with administering the 24-item questionnaire in research or community clinical practice. Researchers wishing to reproduce the instrument in commercial test batteries or for-profit clinical assessment platforms should obtain formal permission from the respective copyright holders or publishing journals (Sage Publications / John Wiley & Sons).

References

Becker, M. H. (1974). The Health Belief Model and personal health behavior. Health Education Monographs, 2(4), 324-473. https://doi.org/10.1177/109019817400200407

Brown, N., Muhlenkamp, A., Fox, L., & Osborn, M. (1983). The relationship among health beliefs, health values and health promotion activity. Western Journal of Nursing Research, 5(2), 155-163. https://doi.org/10.1177/019394598300500205

Gage, G. S. (2014). An investigation of mediators of the relationship between social support and positive health practices in black late adolescents (Doctoral dissertation, Rutgers, The State University of New Jersey, Graduate School – Newark; Adela Yarcheski, Chair). Rutgers University Community Repository. https://rucore.libraries.rutgers.edu/rutgers-lib/43765/

Mahon, N. E., Yarcheski, A., & Yarcheski, T. J. (2002). Psychometric evaluation of the Personal Lifestyle Questionnaire for adolescents. Research in Nursing & Health, 25(1), 68-75. https://doi.org/10.1002/nur.10018

Pender, N. J., Murdaugh, C. L., & Parsons, M. A. (2011). Health promotion in nursing practice (6th ed.). Pearson.

Rosenstock, I. M. (1974). Historical origins of the Health Belief Model. Health Education Monographs, 2(4), 328-335. https://doi.org/10.1177/109019817400200403

Yarcheski, A., Mahon, N. E., Yarcheski, T. J., & Cannella, B. L. (2004). A meta-analysis of predictors of positive health practices in adolescents. Journal of Nursing Scholarship, 36(2), 102-108. https://doi.org/10.1111/j.1547-5069.2004.04021.x

13. Items of the Scale (Questionnaire)