The failure to maintain a healthy lifestyle (particularly consuming a healthy diet and engaging in regular physical activity) is a significant contributor to overweight and obesity and the resulting detrimental effects on individual and public health. Using Social Cognitive Theory and the Health Action Process Approach to inform the theoretical framework, this research examined whether maintaining a healthy lifestyle is influenced by different factors in overweight or obese and normal weight groups. Participants were 374 University students, categorized as overweight or obese and normal weight based on BMI determined by self-reported height and weight. They were assessed on measures of healthy eating and physical activity (at three-month intervals, to determine the maintenance of those behaviours over time) and variables predicted to influence those behaviours including: action self-efficacy, outcome expectations, intentions, planning, recovery self-efficacy, facilitators (i.e., consideration of future consequences, perceived social support and perceptions of general health) and impediments (i.e., depression, perceived stress and shame). Structural Equation Modeling was used to determine the fit of the predicted model for the total sample and for the overweight and obese and normal weight subgroups. The results demonstrated that a revised model predicting exercise behaviour (but not healthy diet) was able to adequately explain the data for the overall sample and for the normal weight subsample, but not for the overweight and obese subsample. Outcome expectations about exercise, self-efficacy and planning made important contributions to the prediction of exercise behaviour, but not diet. Implications of these findings will be discussed.

The failure to maintain a healthy lifestyle (particularly consuming a healthy diet and engaging in regular physical activity) is a significant contributor to overweight and obesity and the resulting detrimental effects on individual and public health. Using Social Cognitive Theory and the Health Action Process Approach to inform the theoretical framework, this research examined whether maintaining a healthy lifestyle is influenced by different factors in overweight or obese and normal weight groups. Participants were 374 University students, categorized as overweight or obese and normal weight based on BMI determined by self-reported height and weight. They were assessed on measures of healthy eating and physical activity (at three-month intervals, to determine the maintenance of those behaviours over time) and variables predicted to influence those behaviours including: action self-efficacy, outcome expectations, intentions, planning, recovery self-efficacy, facilitators (i.e., consideration of future consequences, perceived social support and perceptions of general health) and impediments (i.e., depression, perceived stress and shame). Structural Equation Modeling was used to determine the fit of the predicted model for the total sample and for the overweight and obese and normal weight subgroups. The results demonstrated that a revised model predicting exercise behaviour (but not healthy diet) was able to adequately explain the data for the overall sample and for the normal weight subsample, but not for the overweight and obese subsample. Outcome expectations about exercise, self-efficacy and planning made important contributions to the prediction of exercise behaviour, but not diet. Implications of these findings will be discussed.

Revised; Originally published: 12/2008 / Food labels are designed to help consumers to make healthy food choices. Yet the Nutrition Facts label is not always easy to understand, due to a lot of technical information. The step-by-step approach in this publication is easy to follow, and may help consumers to build skills how to read and use the information on a Nutrition Facts label more easily and effectively for their needs. This two page information sheet is useful, especially when a nutrition educator teaches a lay person those tricky foods labeling terms and recommends healthy alternative in his/her diet.

A adoção de hábitos saudáveis como a prática de atividades físicas, alimentação equilibrada, sono saudável e a cessação do tabagismo tem sido apontada como importante medida para melhorar a saúde, a qualidade de vida e facilitar a prevenção e controle de algumas doenças crônicas na população. Assim, intervenções em saúde que visam orientar e facilitar a adoção de tais hábitos são componentes importantes e necessários no planejamento de programas de promoção da saúde. Mesmo que desconsiderássemos qualquer outro benefício além do financeiro, este já seria suficiente para justificar ações voltadas para a promoção da saúde por possibilitarem otimização dos recursos materiais e humanos nas intervenções em saúde . Visando ampliar ainda mais este benefício, novas tecnologias capazes de reduzir custos e manter qualidade de atendimento têm sido pesquisadas. É neste contexto que a abordagem telefônica para promover saúde surge como uma opção. Este estudo tem a finalidade de avaliar a efetividade da abordagem telefônica na promoção da saúde. O estudo foi realizado no Centro de Promoção da Saúde da Faculdade de Medicina da Universidade de São Paulo, com 46 indivíduos. Foram feitos de 3 a 5 contatos por pessoa, por meio dos quais foram feitas orientações e intervenções baseadas nos preceitos da Terapia Cognitivo-Comportamental e do Modelo Transteórico. Os resultados mostraram que, após a intervenção, os clientes que receberam cinco contatos telefônicos, mudaram o comportamento, passando a praticar alguma atividade física com regularidade e melhorando a qualidade do sono, esta mudança foi estatisticamente significativa. Os outros comportamentos estudados não apresentaram mudança estatisticamente significativas após 3 ou 5 contatos, apesar de alguns clientes apresentarem mudanças favoráveis em seu comportamento, principalmente no grupo que recebeu 5 contatos. Concluindo, a abordagem telefônica favoreceu a adoção de hábitos saudáveis, mostrando-se, portanto, como uma estratégia de apoio favorável à promoção da saúde. / The adoption of healthy habits such as physical activities, balanced diet, healthy sleep, and the cessation of smoking have been pointed out as important measures to improve health, quality of life and further the prevention and control of some chronic diseases in our population. As such, healthy interventions aiming to guide and further the adoption of these habits are important and necessary compounds in the planning of programs dedicated to promoting healthy lifestyles. Even if we do not consider any other benefit, aside from the financial benefit, this would already be enough to justify actions taken for promoting a healthy lifestyle since this could optimize material and human resources in the areas dedicated to health. Aiming to extend even more this benefit, research is being done to find new technologies capable of reducing costs and maintaining the quality of attendance. It is in this context that the telephonic approach for healthy lifestyle promotion appears as an option. This study intended to evaluate the effectiveness of the telephonic approach for healthy lifestyle promotion. This study was performed at the Healthy Lifestyle Promotion Center of the University of São Paulo Medical School, with 46 individuals. Each individual received 3 to 5 telephone calls through which guidance and interventions were made based on Cognitive-Behavioral Therapy and Transtheoretical Model norms. The results pointed out, that after this intervention the clients, who had received 5 telephone calls, changed their behavior, They started to practice some form of regular physical activity and changed their quality of sleep, this change was statistically significant. The remaining behaviors studied showed no statistically significant changes after the 3 to 5 telephone calls, although some clients presented favorable behavior changes, principally in the group that had received the 5 telephone calls. In conclusion, the telephonic approach indeed has furthered the adoption of healthy lifestyle habits, and thus has shown to be an favourable strategy in the promotion of healthy lifestyles.

abstract: Two studies were conducted to test a model to predict healthy lifestyle behaviors, physical activity, and body mass index (BMI) in Taiwanese adolescents by assessing their physical activity and nutrition knowledge, healthy lifestyle beliefs, and perceived difficulty in performing healthy lifestyle behaviors. The study drew upon cognitive behavioral theory to develop this study. The pilot study aimed to test and evaluate psychometric properties of eight Chinese-version scales. The total sample for the pilot study included 186 participants from two middle schools in Taiwan. The mean age was 13.19 for boys and 13.79 for girls. Most scales including Beck Youth Inventory self-concept, Beck Youth Inventory depression, Beck Youth Inventory anxiety, healthy lifestyle beliefs, perceived difficulty, and healthy lifestyle behaviors scales Cronbach alpha were above .90. The Cronbach alpha for the nutrition knowledge and the activity knowledge scale were .86 and .70, respectively. For the primary study, descriptive statistics were used to describe sample characteristics, and path analysis was used to test a model predicting BMI in Taiwanese adolescents. The total sample included 453 participants from two middle schools in Taiwan. The mean age of sample was 13.42 years; 47.5% (n = 215) were males. The mean BMI was 21.83 for boys and 19.84 for girls. The BMI for both boys and girls was within normal range. For path analysis, the chi-square was 426.82 (df = 22, p < .01). The CFI of .62 and the RMSEA of .20 suggested that the model had less than an adequate fit (Hu & Bentler, 1999). For alternative model, dropping the variable of gender from the model, the results indicated that it in fact was an adequate fit to the data (chi-square (23, 453) =33.75, p> .05; CFI= .98; RMSEA= .03). As expected, the results suggested that adolescents who reported higher healthy lifestyle beliefs had more healthy lifestyle behaviors. Furthermore, adolescents who perceived more difficulty in performing healthy lifestyle behaviors engaged in fewer healthy lifestyle behaviors and less physical activity. The findings suggested that adolescents' higher healthy lifestyle beliefs were positively associated with their healthy lifestyle behaviors. / Dissertation/Thesis / Ph.D. Nursing and Healthcare Innovation 2012

2 pp. / Food labels are designed to help consumers to make healthy food choices. Yet Nutrition Facts label is not always easy to understand due to a lot of technical information. The step-by-step approach in this publication is easy to follow, and may help consumers to build skills how to read and use the information on a Nutrition Facts label more easily and effectively for their needs. The 2-pages information sheet is useful, especially when a nutrition educator teaches a lay person those tricky foods labeling terms and recommends healthy alternative in his/her diet.

Magister Public Health - MPH / Introduction: The control of type 2 diabetes mellitus (T2DM) is pivoted on adherence to a healthy lifestyle (healthy diet, physical activity and non-smoking). Zimbabwe reports a high burden of T2DM related complications suggesting an increased inability by patients to control their blood glucose levels. This study, therefore, sought to describe the healthy lifestyle practices of T2DM patients in Harare, Zimbabwe and associate these practices with their glycated haemoglobin (HBA1C) levels, a marker for the control of diabetes. Methodology: A descriptive cross-sectional study was done. Participants were T2DM patients who were 18 years and older from two tertiary hospital diabetes clinics in Harare. Data collection was done using a structured questionnaire which was interviewer-administered along with height, weight and HBA1C measurements. Descriptive statistics were used to describe the study populations. Chi square test was used to calculate statistically significant associations between healthy lifestyle behaviours and demographics or HBA1C levels at the significant level of 0.05%.

Over a quarter of children and two thirds of adults in Australia are overweight, with these estimates reflecting global trends. The literature review in Chapter 1 highlights that treatment of childhood overweight is an important part of the public health approach required to address the obesity epidemic. Energy moderation, behaviour modification and family support are the cornerstones of treatment of childhood overweight. However the evidence to guide best practice is limited, with a call being made for well designed studies to inform age-appropriate effective, long term child weight management. Studies are needed in a range of populations and to assess a range of health outcomes. This thesis tested the hypothesis that, pre-pubertal children whose parents participate in a parent-led, family-focused child weight management intervention comprising parent skills training and intensive lifestyle education will have adiposity, metabolic profiles and indicators of physical and psychosocial functioning after 12 months that are a) improved compared to children wait listed for intervention and b) no different to children whose parents participate in parenting skills training alone (without intensive lifestyle education). Methods of the randomised controlled trial undertaken with 111 overweight, pre-pubertal 6-9 year olds to test this hypothesis are detailed in Chapter 2. Parents were defined as the agents of change, responsible for attending intervention sessions and implementing family-focused lifestyle change to support child weight management. Two interventions, both utilising parenting skills training, but differing in the presence or absence of intensive lifestyle eduction were compared to a group waitlisted for intervention with a brief pamphlet. Program effectiveness was defined in terms of adiposity together with broader health and evaluation outcomes. Chapter 3 describes the study population, their flow through the study, the primary outcome BMI z score and waist circumference z score. With parenting plus intensive lifestyle education there was a 10% reduction in BMI z score over 12 months. However this was not statistically different to the 5% reduction observed with parenting alone or intervention waitlisting. There was a significant reduction in waist circumference between baseline and 12 months with parenting alone and parenting plus lifestyle education, but not waitlisting. There was a group, time and gender interaction, with boys receiving intervention having greater reductions in adiposity. In determining intervention effectiveness, growth, metabolic profile and psychosocial outcomes are presented in Chapter 4. While there were limited improvements in metabolic profile and body dissatisfaction, significant improvements were observed in parent-perceived HR-QOL relating to psychosocial and family functioning. Improvements were confined to the intervention groups, parenting plus lifestyle education more than parenting alone. Chapter 5 presents the study process and impact evaluation. Parents were satisfied with the program and reported that it provided the type of help they wanted. Personal, rather than program factors such as work and family commitments limited intervention attendance to 60%. Child health behaviours and parental weight status show positive change in all groups, but favour intervention. Chapter 6 highlights key findings, study strengths/limitations and areas for further research. In conclusion, a parent-led family-focused intervention utilising parenting skills training and healthy family lifestyle is a promising intervention for young overweight children.

Parents of children with disabilities need accurate information to help them provide tailored services and supports to their families. This is especially true for immigrant Latino families who tend to experience poor overall health and who tend to avoid formal services and supports. Based on input gathered from Latino parents of children with disabilities, a three module curriculum, 'Empowering Families,' was developed. Following a cultural appropriateness review of the curriculum and associated measurement instruments, revisions were made to the content and presentation procedure. This was followed by a field test of the curriculum with two groups of Latino parents/caregivers of children with developmental disabilities. Results from the training sessions with both groups indicate that the training resulted in moderate knowledge gains and that self-reported healthy lifestyle behaviors experienced minimal improvement. Overall health status was essentially unchanged. Participants rated the content very highly in terms of cultural appropriateness and usefulness.

Syfte: Att beskriva föräldrars upplevelser av att ha ett barn med övervikt samt beskriva upplevda hinder och strategier för att hjälpa dem till en sundare livsstil. Syftet var även att granska artiklarnas kvalité gällande datainsamlingsmetod. Metod: Studien var en beskrivande litteraturstudie. Femton vetenskapliga artiklar inkluderades utifrån syftet som sedan granskades och sammanställdes. Resultat: Föräldrarna upplevde stor oro över sitt barns övervikt och välmående. Flera föräldrar kände svårigheter över att prata om övervikten med sitt barn. Den största oron som uppstod hos föräldrarna berodde på barnets psykiska ohälsa. De föräldrar som kontaktade skolan eller vården för att få hjälp med sitt barns övervikt upplevde att de inte blev tagna på allvar och att de blev skuldbelagda för barnets övervikt. Dock framkom även positiva upplevelser då barnet fått både psykiskt och fysiskt stöd samt individanpassade råd. Föräldrarna upplevde hinder som ekonomi, tidsbrist, bristande intresse för fysisk aktivitet samt okunskap gällande sunda levnadsvanor. Slutsats: Att vara förälder till ett överviktigt barn skapade ofta känslor av oro och skuld hos föräldrarna, de upplevde även svårigheter med att stödja barnet till sunda levnadsvanor. Därför var föräldrarna ofta i behov av stöd men även undervisning, individanpassad rådgivning och hjälp med att uppnå en sundare livsstil för barnet. / Purpose: To describe parents' experiences of having an overweight child, as well as to describe the experienced obstacles faced and strategies used to achieve a healthier life style. The purpose is also to examine the quality of the examined articles' in regards to their data gathering methods. Method: This was a descriptive literature study. Fifteen academic articles were chosen based on the study's purpose and then reviewed and compiled. Findings: The parents experienced strong concern for their overweight children's health. Several parents felt it difficult to talk with their children about weight. The largest concerns amongst parents were related to their child's mental health. The parents that contacted the school or health care practitioners in order to ask for help regarding their child’s weight issues felt that they were not taken seriously and felt blamed for their child's weight issues. However, there were also positive experiences in which the child received individualized physical and mental support. The parents experienced obstacles such as; financial issues, lack of time, lack of interest in physical activities, and a lack of knowledge in regards to a healthy life style. Conclusion: Parents of overweight children often experienced concern and guilt. They found it difficult to support their child in living healthy. Because of this, the parents were often in need of support as well as education, individualized counseling and help to encourage a healthier life style for their child.