Southern Africa has the highest prevalence of Human Immunodeficiency Virus (HIV) infection in the world. With a high prevalence of HIV, as well as a rising incidence of chronic diseases of lifestyle (CDLs), South Africa is faced with the dual burden of infectious diseases and CDLs. Health promoting behaviours (HPBs), including physical activity (PA), maintaining good nutrition and taking responsibility for personal health, play an important role in managing the symptoms of HIV infection and the side effects of antiretroviral (ARV) use. Additionally HPBs improve health-related quality of life (HRQOL) in people living with HIV (PLWHIV). Furthermore, research indicates that HPBs should be encouraged among university students as they will become the future decision and policy makers in their places of employment. This study sought to determine the PA levels, HPBs and HRQOL of university students living with HIV, in order to better promote PA participation and HPBs in this population. Additionally, participants‘ perceptions of and attitudes towards exercise participation were investigated, as were barriers that mitigated against PA participation and HPBs. This study was exploratory-descriptive in nature and utilised a mixed methods design. The University Campus Health Clinic (CHC) staff recruited 29 HIV positive students (HIVPS) between the ages of 18 and 25 through purposive sampling. In the quantitative portion of the study the HIVPS completed a demographic questionnaire as well as three self-administered questionnaires, namely: the International Physical Activity Questionnaire (IPAQ), the Health-promoting Lifestyle Profile (version 2, HPLP-II) and the World Health Organisation Quality of Life Brief Questionnaire (WHOQOL-HIV-BREF) to determine PA levels, health-promoting lifestyle behaviours and HRQOL, respectively. Height and weight, as well as the most recent CD4 count were also recorded.

Research applications in the field of positive organisational behaviour are developing as part of the paradigm of fortology. Both psychofortology and positive psychology support the development of the strengths (fortology) of human behaviour. Health and wellness research in working contexts build theory in the field of Industrial Psychology. The objective of the present research is to develop and test a holistic work-wellness model for employees of a life insurance organisation in South Africa. Holistic work-wellness research requires that wellness, organisational factors and individual dispositions be treated as part of an integrated and dynamic system. The relationship between these constructs provides some understanding of total work wellness. A cross-sectional survey designed was used with a sample of 673 participants. The 5 Factor Wellness Survey, the Maslach Burnout Inventory – General Survey, Utrecht Work Engagement Scale and the Job Diagnostics Survey were administered. The empirical research results have shown that a positive relationship exists between motivational job characteristics, sense of coherence, engagement and wellness. A somewhat negative relationship exists between burnout and wellness in the holistic work-wellness model. The structural equation modelling statistics provided reasonable goodness of fit indices with some room for modification. According tot the Root Mean Square Error of Approximation criterion, the results support the acceptance of the holistic work-wellness model. A path diagram, in which cause and effect arrows flow from the exclusive latent variable back to the primary factors, was developed. The development of this holistic work-wellness model addresses the research problem and builds theory with which to holistically understand work wellness. It can be concluded that the development of this particular model can be used in the insurance organisation to implement employee health and wellness care. The Indivisible Self: An Evidence-Based Model of Wellness that consists out of 17 wellness and 4 contextual factors were successfully applied as a clinical wellness model in an organisational context (Myers and Sweeney, 2005). A principle factor analysis confirmed the factor structure of previous wellness research for the first time in a South African study. Structural equation modelling statistics on the wellness model confirmed the 19-factor model with adequate goodness of fit indices. The empirical research data confirms The Indivisible Self: An Evidence-Based Model of Wellness for the insurance organisation. This wellness model can therefore be used as an independent wellness model to explain wellness from the theory and from the present empirical study. From the literature it is clear that research on wellness in relation to motivational job characteristics are developing as a research topic. The empirical research in the present study confirmed that a positive relationship exist between these two phenomena. Goodness of fit indices confirm that the six-factor motivational job characteristics model cannot be used as an independent model in the insurance organisation. Subsequently this did not validate the practically significant positive relationships in the independent job model. However these findings were still useful in an explorative study that focused on the development of a holistic work-wellness model. A strong sense of coherence can therefore be hypothesised to help employees to face stressful situations and to handle complex tasks because demands from the environment are understood and believed to be under their personal or significant others’ control. They are likely to regard the tasks as challenging enough to spend energy on. It can be described as the characteristic inherent to individuals, which assists them in their interaction with their work-environment and situations that might arise as a consequence thereof. Empirical statistical results indicated that the three factors meaning, comprehension and manageability are confirmed for the sense of coherence construct. A principle factor analysis confirmed reliable Cronbach alphas for meaning and comprehension in the present research. Structural equation modelling proves that the sense of coherence model cannot be used independently due to poor goodness of fit statistics. However, sense of coherence is still useful in the development of a holistic work-wellness model. The research results also showed that engagement could be considered a positive indicator of employee wellness. Findings validated and confirmed the factorial validity of vigour and dedication. Goodness of fit statistics produced goodness of fit indices of intermediate quality. Empirical statistics verified and validated burnout as a four-factor model. Researched statistics showed internally consistent results for the four-burnout subscales (exhaustion, cynicism, professional efficacy and cognitive weariness). It can be concluded that these factors are reliable and valid factors. Results from the structural equation modelling proposed good fit (RMSEA) for the four-factor burnout model, with some modification required to improve the other indicators. Conclusions and recommendations in terms of the implementation of managed health and wellness care for employees in the insurance organisation are based on the development of the holistic work-wellness model. Health and wellness programmes should be researched to develop the empirical application of the holistic work-wellness model. / Prof. R.P. De la Rey

A thesis submitted to the Faculty of Humanities University of Zululand in partial fulfillment of the requirements for the degree of Doctor of Philosophy: Community Psychology in the Department of Psychology, 2006. / This investigation was contextualised within the community psychological model of mental health promotion and Zimmerman's empowerment theory (1995) and psychological intervention being conceptualized as a positive component with a view to enhancing psychological well-being. This study investigated psychological intervention as a strategy for the promotion of well-being among caregivers in a children's home. The primary focus was the caregivers in children's homes in the greater Durban area and the secondary consideration was the positive cascade effect it had on the children under then-care. The research design comprised an experimental and control group. A psychological intervention was implemented and the Maslach burnout inventory (1986) was used to measure the well-being outcomes. This was complemented with qualitative techniques that included a needs assessment questionnaire, intervention, consultation, focus group, appreciative enquiry, children's behaviour profile and the principal's pre and post intervention evaluation. The improvement in caregivers' well-being was also evaluated in the positive behaviour changes of selected children assessed by the Conners rating scale (1979). The SPSS findings indicated negligible change in the pre and post test MBI scores for caregivers. There was no significant differences in the pre and post test scores on the Conners rating scale. However, the descriptive qualitative measures indicated significant levels of improved psychological well-being by caregivers which generated a positive cascading effect on selected children under their charge. These descriptive improvement trends are attributed to the comprehensive treatment or intervention. / National Research Foundation (NRF)

A thesis submitted in fulfillment of the requirements of the degree of Doctor of phisophy in the Faculty of Arts, in the Department of IsiZulu naMagugu at the University of Zululand, 2004. / Lolu cwaningo luwumzamo wokuphonsa itshe esivivaneni sokushicilelwa nokulondolozwa kwalokho okungamagugu esizwe. Isizwe esingalondolozi amagugu nefa laso sinjengomuntu ovunule akangapheleia. Iqhaza lezimila emithini nasekudleni komdabu kumaZuiu kuyinto ebalulekile neyigugu. Kumele kubhekwe ngamehlo abanzi ukuze nezizukulwane ezizayo zilithole lela gugu zilisebenzise, kusimame isizwe. Uma isizwe sesibizwa ngesithuthukile leso sizwe sisuke kokuningi sikwazi ukuziphilisa ngalokho okuyifa namagugu aso. Izimila zingelinye lamafa amaZulu ngoba ngaphandle kokudla okuyisidingongqangi, nokwelapha kubalulekile. Kulezi zinsuku zanamuhia kubhoke indlala nezifo ezingomashayabhuqe, abantu bakhathazekile isizwe siyaphela. Inselelo le ebhekene nesizwe okumele siyihlangabeze ngolwazi nangesibindi. Bekungamele siqaiaze kude kodwa bekufanele sibheke esinakho sisebenzise khoaa kuxazululeke inkinga esikhungethe. Umcwaningi ubona sengathi iqhaza lezimila ekudleni nasemithini yomdabu lithanda ukushabalala. Impucuko yaseNtshonalanga yenza abantu abaningi babone sengathi ukudla komdabu kuyinto ephansi futhi kungukudla okungenamsoco. Umsoco bekucatshangwa ukuthi utholakala ekudleni kwesilungu kuphela. Iqhaza lezimila emithini yomdabu nalo futhi belibukelwa phansi. Bekubonakala sengathi imithi yesilungu yodwa engasetshenziswa ukwelapha abantu kulezi zinsuku, ngoba mhlawumbe kube nomuntu mumbe ongenalwazi ngemithi yesintu. Ukudla okunomsoco kugcina umuntu ephilile enamandla. Ukudla ukudla okungenamsoco kudala isizwe esingondlekile nesintekenteke. Uma kubhekwa lezi zimila zomdabu kubonakala kusuka izizwe phesheya kwezilwandle zizokwenza ucwaningo lapha kwaZulu-Natali zibuyele emuva ziyokwenza amaphilisi nemithi ngazo lezi zimila zethu. Lokho kufakazela iqiniso lokuthi, sicebile, sinefa, okumele siligcine silisebenzise ngokuyikho ukuxazulula tzinkinga esinazo njengesizwe samaZuIu. Ucwaningo luyindlela yokufika ekuxazululweni kwezinkinga ezisikhungethe. Inhlosongqangi yalolu cwaningo bekuwukucwaninga ngeqhaza lezimila ekudleni nasemithini yomdabu esizweni samaZulu. Inhloso exhanteleyo yona kuwukucwaninga ukuthi lungakanani ulwazi ngeqhaza lezimila ekudleni nasemithini yomdabu yesizwe samaZulu kotbisha abachibiyela izifundo zabo zokufundisa. Kusetshenziswe uhlelo nohiu lwemibuzo ukufeza ie nhloso. Kube sekubhekwa nalokho osekuke kwabhalwa ngeqhaza lezimila ekudleni nasemithini yomdabu. Kucwaningwe ngezimila ezinhlobonhlobo, ezidliwayo, ezinobuthi nalezo ezeiaphayo. Imfuyo nayo ayisalanga ngaphandle, kubukwe izhnila ezelapha imfuyo kanye nalezo eziyingozi emfuyweni. Imiphumela etholakele ibe isihlaziywa kwenziwa izincomo, kwaba isiphetho emva kwalokho.

The oral health knowledge, attitudes and practices of primary school children and teachers in Mofolo, Soweto were determined. The enabling and inhibiting factors for oral health promotion in the school environment were also assessed. The aim of the study was to determine if there was any difference in knowledge, attitudes and, practices in learners and teachers and their environment at schools that were exposed to a preventive, educational and tooth brushing programme and those learners and teachers that were not exposed to the programme. Three hundred and thirty-six primary school children six to twelve years of age from four primary schools in Mofolo, i.e. Itekeng, Vukani, Emsebeni and Tshedimoso completed questionnaires. Itekeng and Vukani primary schools were part of an existing tooth brushing, educative and preventive programme, and Emsebeni and Tshedimoso primary schools were not. Four focus group discussions (one from each school) were held with regard to knowledge of oral health and hygiene and the school environment. Seven teachers from two of the four schools and eight teachers from each of the other two schools attended the discussions. Both the learners and teachers at all the schools had little knowledge of dental care, like tooth brushing with fluoridated toothpaste. Frequency of brushing was poor. Most of the learners (61 percent) for the exposed learners and 50 perecent from the unexposed learners reported brushing their teeth once a day. Dietary habits of the learners revealed a high consumption of sugary snacks in between meals and sugar. Fifty-five percent of the exposed learners bought sweets and cakes and 56 percent of the unexposed learners bought fizzy drinks and fruit juices at school. Forty-six percent of the exposed and 58 percent of the unexposed learners said they took more than three spoons of sugar with their breakfast. . Utilisation of primary dental health services in the community by both teachers and learners was poor. More learners from the exposed schools (97 percent) than the unexposed (82 percent) had been to a dentist because they had a toothache. Only 1 percent from the exposed schools and 8 percent from the unexposed had been for a routine check up. Learners from both school categories and teachers had no knowledge of fluoride or benefits of water fluoridation. Over 98 percent of learners from both school categories had never heard of fluoride. The teachers believed it was their responsibility to teach learners and parents about oral health and showed willingness to participate in oral health promotion programmes. The main source of oral health knowledge among the learners was home. Several inhibiting factors to oral health promotion like poverty, lack of adequate oral health knowledge and poor school environment were identified in all the schools.There was no school policy regarding oral health promotion In conclusion, there were no significant differences in the reported knowledge, attitudes and practices between the learners and teachers from the two schools that were part of the preventive, educational and brushing programme and those from the other schools that were not part of the programme. This therefore shows that while preventive and educational programmes are an important component of oral health promotion, they are not adequate in changing knowledge, attitudes and oral health practices.

Engström, M. Hälsopromotion i öppenvården. En litteraturstudie om effekter av olika metoder för att främja fysisk aktivitet. Examensarbete i omvårdnad 10p. Malmö högskola: Hälsa och samhälle, utbildningsområde omvårdnad, 2007.Syftet med denna litteraturstudie var att belysa de olika metoder som används i öppenvården för att främja fysisk aktivitet och om dessa har någon långvarig effekt. Metoden baseras på en systematisk granskning och analys av åtta vetenskapliga artiklar med kvantitativ ansats. Resultatet belyser de metoder som används: rådgivning, teoribaserad rådgivning, handledd gruppträning eller individuellt anpassat träningsprogram. Den långsiktiga effekten visar sig framförallt i metoder som baseras av en teoribaserad rådgivning och handledd gruppträning/individ anpassat träningsprogram.Nyckelord: fysisk aktivitet, hälsopromotion, rådgivning, teoribaserad rådgivning, handledd gruppträning/ individanpassat träningsprogram. / Engström, M. Health promotion in primary care. A literature review about the effects of different methods which promote physical activity. Degree project 10 credit points. Nursing program. Malmö university; Health and society, Department of Nursing, 2007. The purpose of this review was to describe the methods which are used in primary care to promote physical activity and to find out if it have any long lasting effects. The review is based on a systematic analysis of eight scientific articles with quantitative data. The result presents methods as counseling, theory based counseling, supervised exercise group or individual based exercise program. The long lasting effects are shown in methods as theory based counseling and supervised exercise group/individual based exercise program.Keywords: physical activity, exercise, health promotion, counseling, theory based counseling, supervised exercise group/ individual based exercise program.

This formative research examines the effects of health promotion on girls' and young women's health behaviours. Health promotion campaigns targeting women have previously had variable success. Some have been criticised for containing unhelpful values and messages, for example, those that were seen to cause harm to women outside the target population or use of stereotypical symbolism to support the message. Within this study these are called 'unintended consequences'. The Young Women and Health Promotion (YW&HP) study examines the potential for unintended consequences (both negative and positive) of health promotion in general. The focus is then narrowed to examine in more detail whether the use of specific methodologies (such as social marketing), contribute to unintended consequences when promoting physical activity, nutrition and non- smoking messages to girls' and young women. These health behaviours were specifically targeted as they are known to be the major modifiable risk factors for women in the prevention of many chronic illnesses. / This formative research involved the collection and analysis of qualitative and quantitative data from 132 girls and young women across three age categories. These were Year 7 girls (Children - 11-12 years), Year 10 girls (Adolescents - 14-15 years) and young adults (18-25 years). Eighteen focus groups and 15 in-depth interviews were conducted to elicit responses to examine the effects of health promotion on girls' and young women's health behaviours, with particular focus on unintended effects. Current and past health promotion materials, plus a selection of commercial campaigns were utilized to prompt discussion within the groups. The discussion allowed the exploration of girls' and young women's motivators (enabling and reinforcing factors) for personal health behaviours, attitudes and responses to health promotion materials, and the longer-term impacts of health promotion campaigns. A self-administered questionnaire was distributed at the commencement of each focus group, which provided additional information and was later triangulated with the qualitative data. Limitations due to the cross-sectional nature and sampling process of the study mean the results cannot be generalized beyond the study population. However the findings demonstrated that young women are motivated by a complex set of factors. The most common factors influencing the study groups were body image, self-esteem, media and role models. / In addition young women of all age groups had a high awareness of the available messages in the areas studied. All groups discussed the increasing volume of health information available that is targeted at women. Participants noted much of the information originated from commercial sources. This in addition to public health initiatives resulted in increased 'health noise' to which they 'switched off. Furthermore the YW&HP study revealed the importance of written media for women. The young women in this study appreciated the need for mass media advertising, however, preferred to have take-home advice to process at their own time. Discussion of how women process information revealed these young women to be a critical and analytical audience that are often skeptical of health information. Prior to making a decision, therefore, most of the women underwent a process of internal and external validation which included cross referencing information with peers, friends, family and health professionals to establish its accuracy, credibility and validity. Hence the findings of this study would support the need for further exploration of media such as women's magazines to promote health to young women which may in turn prompt discussion with peers and therefore expedite the validation process. / Due to study limitations, results from this formative research need to be interpreted with caution. The results, however, would indicate the area of health promotion and how it communicates health information to young women would benefit from further investigation. The findings suggest many types of media currently being used to communicate health information to young women were useful and appropriate, specifically the use of social marketing media, which, was seen as a worthwhile and necessary strategy for this target group. Methods routinely used by commercial companies were also viewed as effective especially the use of women's magazines. As part of a comprehensive health promotion approach, this is a strategy, which may be an equally useful vehicle for public health messages. In conclusion, discussion with participants revealed a number of negative and positive unintended consequences. This would, therefore, support the need for further research in this area. Furthermore, the research has highlighted the importance of a comprehensive approach to the delivery of health information to young women. Best practice suggests this approach should adhere to ethical communication principles, which would enhance the intended outcomes of the communications whilst also assisting to maximize positive unintended consequences and minimize negative unintended consequences.

Objective To conduct an evaluation of the pilot implementation of the World Health Organization Health Promoting Hospitals initiative and its self-assessment tool in public hospitals in KwaZulu-Natal in 2004/2005 Study design This evaluation utilised a cross-sectional design that incorporated both qualitative and quantitative research methods. Main measures Throughout the Health Promoting Hospital pilot project the opinions and responses of those with a legitimate interest in the initiative were monitored. Data collection methods utilised in this evaluation included participant observation, the World Health Organisation metaevaluation questionnaire, records of workshops and feedback meetings and secondary analysis of all data collected by the six pilot hospitals during the implementation of the project in KwaZulu-Natal. Results Major constraints were found to be time, human and financial resources, lack of training and expertise and insufficient support for the project. The self-assessment tool was found to be insufficiently adapted and not all outcomes were found to be reliable and useful. Despite this, institutional staff found the Health Promoting Hospital project to be capacity building and morale boosting. Relationships between health service levels improved. All hospitals who participated recommended that other hospitals become Health Promoting Hospitals. Conclusion If the World Health Organisation Health Promoting Hospital initiative with its selfassessment tool is to be rolled out to the rest of KwaZulu-Natal province, then substantial changes have to be made to the process. Amongst these are: further adaptation of the selfassessment tool, improved methods of data collection, provision of sufficient resources and increased and sustained provincial support for the project. In addition it is imperative that outcome and impact evaluations be done. / Thesis (M.Med.)-University of KwaZulu-Natal, 2008.

Studien handlar om hälsofrämjande arbete i en organisation kallad organisation X. Syftet med denna studie är att utifrån Antonovskys begrepp känslan av sammanhang (KASAM) utveckla kunskap om hur en organisations hälsofrämjande insatser stämmer överens med hur personalen uppfattar det hälsofrämjande arbetet. En eventuell skillnad mellan organisationens insatser och personalens uppfattning är viktig att uppmärksamma, då de insatser som görs från organisationens sida är tänkt att främja medarbetarnas deltagande i det hälsofrämjande arbetet och utifrån de förutsättningar som finns i organisationen. Jag utgår från Antonovskys KASAM och använder mig av begrepp som KASAM, hanterbarhet, begriplighet och meningsfullhet, stressorer, salutogenes, patogenes och hälsofrämjande ledarskap.  Empirin består av intervjuer med anställda i organisation X. Resultatet har delats in i två delar, en del som handlar om personalavdelningens uppfattning om det hälsofrämjande arbetet i organisation X och en del om de anställdas uppfattning om organisationens hälsofrämjande arbete.  Själva analysen som genomförs är indelad i olika rubriker. Den slutsats som dras i studien är bl. a att ett hälsofrämjande arbete i organisation X inte bara består av hälsofrämjande aktiviteter i form utav fysiska aktiviteter utan att det handlar även om socialt stöd i form av gemenskap, delaktighet och lärande samt att även om organisationen jobbar med att erbjuda olika hälsofrämjande aktiviteter tycks detta inte räcka. Ytterligare en slutsats som kan dras är hur organisationens insatser stämmer överens med hur personalen uppfattar det hälsofrämjande arbetet.

This study was designed to answer the following research questions: "To what extent do undergraduate health education programs offer a worksite health promotion course?" "What are the components included in the worksite health promotion courses offered by colleges and universities?" "Does program approval or accreditation impact whether or not a program offers a worksite health promotion course?" and "Does CHES preparation of students impact whether or not a program offers a worksite health promotion course?"Data were collected from colleges/universities across the nation using a written, mailed questionnaire. From the analysis of the data it was found that 24.7% of the undergraduate health education programs surveyed offer a worksite health promotion course, none of the components on the checklist were present in all WHP course syllabi, there does not appear to be a statistically significant relationship between a program having SABPAC approval or having NCATE accreditation and the offering of the WHP course, and there does not appear to be a statistical significant relationship between a program preparing it students for the CHES examination in the offering of a WHP course. / Department of Physiology and Health Science