Abstract Behavior change support systems (BCSSs) help people to achieve personal goals that they cannot necessarily achieve on their own. Typical BCSSs include health-related systems and applications. Significant policy and research attention has been aimed at information technologies that enable behavior change in regard to individuals’ health and wellbeing activities. The aim of this dissertation is to build a comprehensive view of health BCSSs, ranging from technology adoption to engagement, persuasion, and habit formation. As its main research question, the present thesis asks: What can user experiences of health BCSS reveal about behavior change? In addition, it proposes a framework for different approaches, which can help developers solve ethical issues in their BCSS design. This dissertation comprises four qualitative studies and one conceptual study. Hermeneutics has been the most influential research method in conducting these studies. Ontologically, hermeneutics leans toward socially constructed reality. The primary conceptual lenses for interpreting the data are the BCSS framework and Persuasive Systems Design model. This thesis extends prior research on eHealth, including non-adoption, flow esperience, use adherence, habit formation, and ethics. The results emphasize that persuasive systems design can affect user experience in different stages of system adoption and learning a new, healthier lifestyle. The presented work addresses health behavior change as a complex issue. Many individuals regard system usefulness in terms of perceived value for themselves rather than in terms of the system’s instrumental value. People are less likely to use the systems if they do not fit into their daily routines. Flow experience appears not to play as fundamental part in the BCSS use experience as is expected. The results suggest that self-monitoring, reminders and tunneling can help users to achieve better outcomes. These persuasive features can help increasing subject’s compliance and commitment, which in turn can help individuals to achieve better habits. Additionally this thesis presents a framework where different ethical approaches are divided to three distinct categories. / Tiivistelmä Käyttäytymismuutosta tukevat tietojärjestelmät auttavat ihmisiä saavuttamaan henkilökohtaiset tavoitteensa, joita he eivät välttämättä yksin saavuttaisi. Tyypillisesti tällaiset järjestelmät ja applikaatiot liittyvät terveyteen. Sekä tutkimuksessa että julkishallinnossa on kiinnitetty huomiota, kuinka yksilöiden terveyttä ja hyvinvointia voidaan edistää informaatioteknologian avulla. Tämän väitöskirjan tarkoituksena on rakentaa kokonaisvaltainen näkemys terveyttä edistävistä käyttäytymismuutosta tukevista tietojärjestelmistä lähtien järjestelmän käytöstä ja osallistavuudesta, suostuttelevuuteen ja tapojen muodostumiseen. Väitöskirjan keskeisin tutkimuskysymys on: mitä käyttäjien kokemukset terveyttä edistävistä käyttäytymismuutosta tukevista tietojärjestelmistä paljastavat mitattavasta käyttäytymismuutoksesta? Lisäksi tämä väitöskirja tarjoaa viitekehyksen, joka voi auttaa suunnittelijoita ratkaisemaan eettisiä ongelmakohtia, kun he suunnittelevat käyttäytymismuutosta tukevia tietojärjestelmiä. Väitöskirja pitää sisällään neljä kvalitatiivista osajulkaisua ja yhden konseptuaalisen osajulkaisun. Hermeneutiikka on osajulkaisujen kannalta keskeisin tutkimusmenetelmä. Ontologisesti hermeneutiikka nojaa sosiaalisesti konstruoituun todellisuuteen. Aineiston tulkitsemisen kannalta keskeisimmät konseptuaaliset viitekehykset ovat olleet BCSS framework ja Persuasive Systems Design model. Väitöskirja laajentaa aiempaa tutkimuksellista näkökulmaa eHealth-teemasta pitäen sisällään näkökulmat järjestelmän hylkäämisestä, flow-kokemuksesta, järjestelmän käyttöön sitoutumisesta, elintapojen muodostumisesta ja eettisyydestä. Väitöskirjan tulokset korostavat, että suostuttelevien järjestelmien suunnittelumenetelmät voivat vaikuttaa käyttäjäkokemukseen eri vaiheissa järjestelmän käyttöönotosta uuden terveellisemmän elintavan omaksumiseen. Väitöskirjassa esitellyt osajulkaisut osoittavat, että terveyttä edistävä käyttäytymismuutos on monimutkainen kokonaisuus. Moni haastatelluista koki järjestelmän hyödyllisyyden liittyvän enemmän itsensä kehittämiseen kuin välineelliseen hyötyyyn. Ihmiset olivat vastentahtoisia käyttämään järjestelmää, jos se ei sopinut heidän arkielämäänsä. Väitöskirjan tulokset antavat ymmärtää, että itsemonitorointi, muistutukset ja tunnelointi auttavat käyttäytymismuutosta tukevien tietojärjestelmien käyttäjiä saavuttamaan parempia lopputuloksia. Nämä suostuttelevat elementit voivat helpottaa käyttäjiä noudattamaan ohjeita ja sitoutumaan muutosprosessiin kohti terveellisempiä elämäntapoja. Väitöskirja tarjoaa lisäksi viitekehyksen, jossa erilaiset eettiset lähestymistavat on jaotelty kolmeen eriteltävään kategoriaan.

Magister Scientiae (Occupational Therapy) - MSc(OT) / Children with autism typically present with sensory processing difficulties that affect their ability to relate to people. This qualitative study focused on exploring the sensory processing of children with autism and their mothers, using a frame of reference of sensory integration theory. The purpose of the study was to help mothers gain knowledge and understanding into their own sensory processing so that they could develop a better understanding of their child's sensory processing in order to facilitate better mother-child relationships. An evaluation tool, the Sensory Profiles by Dunn (1999) and the Adolescent/Adult Sensory Profile by Brown & Dunn (2002) was used as the instrument for gathering information on sensory processing. The population consisted of ten sets of mothers and their children with autism who attend Vera School for Learners with Autism. The Sensory Profiles was completed to investigate the phenomenological issues regarding the sensory modulation aspects of the parent-child relationship. Each mother received individual feedback on their own and their child's sensory processing. Two focus groups were then conducted with the mothers to determine the value of the information gained from the profiles. Data consisted of two audio taped feedback from the focus group. Data was analysed for emerging themes. The three major themes that emerged were, (a) You realize how similar you are to your child, (b) I also have needs (c) They walk away and leave you with this wreck of a child. The findings of the study suggest that an understanding of sensory processing can influence the mother-child relationship positively. / South Africa

The author applies marketing research methods, in order to work out a recommendation for sales growth on the background of an IT services company looking for expansion in the hotel sector in the Czech Republic. Through the application of qualitative and quantitative research methods it is established that the anonymized company needs to focus on the segment of three to five star hotels in Prague that do not have their HQ outside of the Czech Republic. Furthermore, a clear product focus on cost saving utilisation of product like virtualization and office automatization is advised, whilst expanding the portfolio on basic hotel needs like camera and entertainment systems. Finally, the analysis recommends to establish professional behaviour and appearance guidelines for in the field service technicians.

Today over 1.1 million people are living with HIV/AIDS in the United States; over the last 4 decades mortality rates have decreased largely made in part because of advancement in awareness and treatment options. Treatment adherence has long been considered a vital component in decreasing HIV/AIDS related mortality and has proven to reduce the risk of transmission. However not all patients take their medicine as prescribed. This research study, sponsored by The North Central Texas HIV Planning Council explored how Patient and Provider communication impacted treatment adherence. By utilizing a mixed-methods approach survey data and semi-structured interviews were used to collect insights from both Patients and Providers. Data gleaned through the interview process provided a perspective that could not be captured by using quantitative methods alone. The results from this research yielded multiple themes related to patient and provider communication with recommendations as to how The North Central Texas HIV Planning Council could address treatment adherence, such as Providers focus on Patients perceived severity based on their understanding of disease and illness; that side-effects remain a concern for patients and should not be dismissed; and finally that the word AIDS is perceived to be more stigmatized and as such organizations providing HIV/AIDS related services should explore alternative names where the word AIDS in not included.

À partir de campagnes d’entretiens réalisés auprès d’acteurs publics répondant à la droite radicale en Allemagne et en France, je propose d’expliquer comment les acteurs publics de ces deux Etats participent à la régulation de l’expression du radicalisme de droite. J’ai choisi pour ce faire d’explorer deux pays voisins ayant cadré différemment la place de la lutte contre le radicalisme de droite : les acteurs politiques et administratifs allemands ont construit une politique publique luttant contre le radicalisme politique, ce qui n’est pas le cas de la France où le traitement de la droite radicale se fait avant tout au sein de l’arène politique. L’approche comparée souligne que la gouvernance de la droite radicale par les services de l’Etat fait l’objet d’une construction constante reposant sur une diversité d’acteurs ayant leurs propres cadres de références basés sur des jugements normatifs, des intérêts et expériences institutionnelles. Ce sont les constellations d’acteurs avec différents cadres de référence et la nature de leurs interactions qui permettent d’expliquer les conditions de l’utilisation des instruments de politique publique répondant au radicalisme de droite. Les différences dans la gestion du radicalisme de droite en Allemagne et en France illustrent les rapports que ces sociétés libérales et démocratiques entretiennent avec la politique. / Based on research fieldwork conducted in France and Germany with semi-directed interviews split between different institutional actors responding to right-wing radicalism, this study seeks to explain how public actors have taken part in the regulation of the expression of right-wing radicalism. I thereby chose to compare neighbouring countries, which have framed the struggle against right-wing radicalism differently: German political and state actors have constructed a public policy responding to political radicalism, whereas it has hardly been the case in France where the radical right is primarily handled in the political arena. The comparative approach outlines that the governance of the radical right by state authorities is the object of a continuous political construction undertaken by a variety of actors with distinctive policy frames. These are based on normative judgements, personal interests, and institutional experiences. The constellations of actors with different policy frames and their interactions during the decision-making process enable to explain the modalities of the use of policy instruments that are used to respond to right-wing radicalism. Differences in the handling of right-wing radicalism in France and Germany illustrate the relationships that these liberal and democratic societies have had with politics.

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Due to the COVID-19 pandemic, the world faced lockdown and quarantine restrictions that encouraged or forced people to stay home. Along with the rest of the world, Brazil faced many difficulties during this period and it became one of the countries that lost more lives due to the Coronavirus infection worldwide. This study focuses on showing how people in Brazil coped with the challenges brought by the pandemic. It also focuses on showing if and how participants used media as a coping mechanism. The research was done through qualitative methods with semi-structured interviews with 25 adults who were living in Brazil during the pandemic and the lockdown restrictions. This study shows that participants did use media as a coping mechanism and even though they have encountered negative consequences, they have also faced and mentioned several positive effects during this period. Participants mentioned other coping mechanisms that made a difference for them during the darkest moments in the pandemic like, having interpersonal communication with family and friends, religion, gaming, and others.

Growth and development are central constituents of the human experience. Although the American Psychological Association aims to understand change and behavior in ways that embrace all aspects of experience (APA, 2008), sudden, life-altering or quantum transformation has been disregarded throughout the history of psychology until recently (see Miller & C' de Baca, 1994, 2001). Quantum transformation is similar to self-surrender conversion (James, 1902), but different from peak experiences (Maslow, 1964) and near death experiences (Lorimer, 1990) because quantum transformation, by definition, involves lasting change. Quantum transformation contains epistemic qualities, which refer to the content and process of knowing (Miller & C' de Baca, 2001), but little is known about these qualities. The current study employed a qualitative method to better understand the epistemic qualities of quantum transformation. Fourteen participants were extensively interviewed about their experience. Analysis involved hermeneutic methods (Kvale, 1996) and phenomenological description (Giorgi & Giorgi, 2003). Quantum transformation is essentially a process of knowing that unfolded in the form of Disintegration, Insight, and Integration in the present study. First, Disintegration is presented by themes of Overwhelming stress, Relational struggle, Hopelessness, Holding-on, Control, Psychological turmoil, Self-discrepancy, and Guilt. Second, Insight is presented by the Content and Tacit knowing of the experience. Third, Integration is presented by Changes in values, Other-orientation, and A process of development. The results suggest that the disintegration and the suffering that characterizes the pre-transformation milieu inform how quantum transformation relates to lasting change. Therapists that automatically aim to alleviate moral-emotional sorrow or guilt should consider whether the emotional experience can bring about positive transformation. Overall, quantum transformation has potentially major implications for our understanding of personality change and moral development.

L’atteinte d’un soulagement adéquat de la douleur garantissant aussi une utilisation sécuritaire des opioïdes et répondant aux attentes des patients s’est beaucoup complexifiée dans le contexte d’une attention accrue à l’utilisation et aux effets néfastes des opioïdes. Cette attention a remis en question les pratiques de prescription et distribution de médicaments visant le soulagement de la douleur. En tant que dispensateurs de médicaments, les pharmaciens assument un rôle central pour en assurer leur utilisation sécuritaire et appropriée. L’objectif général de ce travail est de décrire les pratiques pharmaceutiques portant sur le soulagement de la douleur dans le contexte actuel en Amérique du Nord en général et au Québec en particulier, et mieux comprendre les facteurs facilitants et les barrières à l’amélioration de ces pratiques au Québec. Ce projet a été mené en deux parties. Tout d’abord, une revue de la littérature a été effectuée pour recenser les publications examinant les pratiques pharmaceutiques visant le soulagement de la douleur et la gestion des opioïdes en lien avec une préoccupation généralisée sur l’usage des opioïdes. Les objectifs étaient d'identifier ces pratiques et d'évaluer si elles avaient été amenées à évoluer suite à ces préoccupations. Pour la deuxième partie du projet, qui visait à approfondir les perceptions des pratiques pharmaceutiques portant sur la douleur au Québec, des entrevues semi-structurées ont été menées avec des pharmaciens (n = 8) oeuvrant dans divers milieux cliniques (pharmacie communautaire, pharmacie en établissement de santé et groupe de médecine de famille). Alors que les pharmaciens ont exprimé le désir de jouer un rôle central dans l'atteinte des objectifs de traitement de la douleur tout en assurant l’utilisation sécuritaire des opioïdes, ils ont rapporté plusieurs obstacles dans leur pratique. De plus, la prestation des soins pharmaceutiques visant le soulagement de la douleur pourrait être améliorée en tirant parti des facilitateurs de chaque milieu de pratique et en favorisant les partenariats intraprofessionnels à travers les différents milieux de pratique. / Providing adequate pain relief while ensuring safe opioid use and managing patient expectations has become an intricate endeavor in the context of increased attention to opioid use and its harms. This attention has put into question the practices of prescribing and dispensing medications for pain relief. As the dispensers of medications, pharmacists play a crucial role in ensuring their safe and proper use. The general objective of this work is to describe the pharmaceutical practices encompassing pain relief in the current context in North America in general, and in Quebec in particular, and to better understand the facilitating factors and the barriers to the improvement of these practices in Quebec.This project was conducted in two parts. First, a scoping review of the literature was conducted for publications examining pharmaceutical practices aimed towards pain relief and opioid management in the context of widespread concern about opioid use. The objectives were to identify these practices and assess whether they had been called on to evolve as a result of these concerns. For the second part of the project, which aimed to deepen the perceptions of pharmaceutical practices relating to pain in Quebec, semi-structured interviews were conducted with pharmacists (n = 8) working in various clinical settings (community pharmacy, health facility pharmacy and family medicine group). While pharmacists have expressed a desire to play a central role in achieving pain treatment goals while ensuring the safe use of opioids, they reported several barriers in their practice. Lack of time to perform adequate follow-ups, gaps in pain assessment and pharmacotherapy knowledge, and communication skills tailored to patients who suffer were the main barriers mentioned by pharmacists. Adjustments to teaching and practice curricula, standardized assessment and monitoring tools, and increased patient involvement in decision-making could prove beneficial. In addition, delivery of pharmaceutical care for pain relief could be improved by leveraging facilitators from each practice setting and fostering intraprofessional partnerships across different practice settings.