Background: In Canada, only 15% of adults meet the physical activity guidelines (Colley et al., 2011). As regular physical activity has been demonstrated to substantially improve physical and mental health (Naci & Ioannidis, 2013; Schuch et al., 2016), a wealth of physical activity promoting interventions have been developed and evaluated (Kahn et al., 2002; Prince et al., 2014). Physical Activity Counselling (PAC) is one of these and has been shown effective in increasing physical activity motivation and behaviour (Fortier et al., 2011). However, the active ingredients of PAC have never been reported in detail, thus limiting our potential for understanding its effectiveness and to allow for its replication. Recently, taxonomies have been published for characterizing behaviour change techniques (BCTs) and Motivational Interviewing (MI) techniques in interventions (Hardcastle et al., 2017; Michie et al., 2013). Due to its novelty, no studies to date have used the MI technique taxonomy to report interventions. Purpose: To investigate the behaviour change techniques (BCTs) and Motivational Interviewing (MI) techniques applied in PAC sessions delivered by student-counsellors. Methods: PAC 1 and PAC 2 sessions delivered by 11 student-counsellors were double coded for identification of BCTs and MI techniques, for a total of 22 video recorded sessions. Two trained coders rated the presence of BCTs and MI techniques using the Behaviour Change Technique Taxonomy v1 (BCTTv1) and the table of MI techniques. Inter coder agreement was assessed using Cohen’s kappa and the prevalence- and bias-adjusted kappa (PABAK) statistic. Results: Overall, 29 BCTs (on 93) and 27 MI techniques (on 38) were reliably coded across the sampled PAC sessions (Cohen’s k =.81, PABAK=.91). Popular BCTs included 3.1 Social support (unspecified), 1.1 Goal setting (behaviour), 1.4 Action planning, whereas OARS skills (i.e., open-ended questions, affirmations, reflective and summary statements) and 24. Emphasize autonomy were the predominating MI techniques. On average, 5.7 BCTs and 9.5 MI techniques were recorded per session. Conclusions: Findings of this study provide a first detailed report of a PAC intervention and have important implications for PAC training and replication. Future research in this area specifically looking at the quality of application of the techniques and the influence of use and quality on physical activity behaviour over time is recommended.

It is well known that physical activity can bring many benefits to people as they become older. In addition, a great deal is known about the personal and environmental motivators and barriers for older adults engaging in physical activity, yet policy imperatives have failed to deliver the change in activity levels required to even relatively modest levels of activity. This study has sought to ascertain the effect of involving older adults in the design, delivery, implementation and promotion of interventions to promote physical activity amongst their age group. Through a two phase design the study has sought to find out what the essential ingredients of a successful intervention to promote physical activity would be, before applying some of these findings to the promotion of interventions and considering their effect. The first phase of the study consisted of a qualitative study to identify older adults’ views and experiences. Some 61 older adults, aged between 49 and 87 years, were involved in 11 focus groups and 12 individual semi-structured interviews. Participants were asked why they engaged in physical activities, or what might encourage them to do so. The study was designed to identify the essential elements of a successful physical activity intervention. The second phase of the study, an action research project evolving from the qualitative study, involved older adults who were running community groups and physical activity sessions in their local areas and were keen to increase membership numbers. The Action Research Group, consisting of six older adults, two community development workers and the researcher, identified a number of problems to address as part of the study. New promotional literature for the community groups was developed, using the findings from the first study. Easy access, enjoyment, fun and affordability were highlighted on posters and leaflets that were distributed in the local communities. The studies established that there are various factors that make engaging in physical activities accessible and appealing to older adults. Participants reported that activities must be flexible; affordable; accessible; sociable; enjoyable and that engagement is seasonal. Factors relating to personality and lifestyle were also important. Not feeling the need to be active, and being unmotivated to do so, cannot be easily influenced by external promotion of physical activity. However, ensuring that activities are as easy as possible to engage in could help to encourage older adults to try activities that they might otherwise rule out. The health benefits of physical activity were far less important to the participants than the social benefits. Involving older adults in the promotion of activities, focussing on the characteristics of activities that appeal to them, had some success. Difficulties in appealing to older adults across a broad age range emerged, as many participants in both studies were put off attending any activity labelled as for ‘over 50s’. They did not identify themselves as ‘over 50’. Both studies highlighted the additional difficulty of attracting men to existing activity groups and sessions. A multilevel, social ecological model is presented, which highlights the influences on engagement in physical activity at individual and environmental levels. The future promotion of physical activity should focus on the social benefits and enjoyment that can be gained through participation, rather than on potential health benefits. How activities are labelled and promoted requires careful consideration and local older adults should be involved in local interventions. Community groups delivering interventions must receive tangible support.

People with psoriasis are known to engage in high levels of unhealthy lifestyle behaviours which may lead to poorer psoriasis outcomes and increase the risk of cardiovascular disease (CVD). Thus, helping individuals with psoriasis understand the link between behaviours and health risks, that is health risk communication, and direct support for lifestyle behaviour change (LBC) are important aspects in optimal management of psoriasis, a long-term inflammatory skin condition. There are two aspects of the literature that remain unclear. First, whether adequate support is given to patients to enable them to understand the links between lifestyle behaviours and health outcomes is part of psoriasis patient management strategies. Second, whether there is agreement around effective health risk communication techniques. This programme of research aimed to examine these gaps in the literature using four related studies. The first study used content analysis to examine general and dermatology-specific healthcare professionals’ core training competencies for evidence of skills relating to LBC. An important finding was the lack of explicit skills relating to LBC and changing understanding of health risks. There was little or no reference to recognised LBC techniques that could be used to support and facilitate LBC with patients. The second study used observational techniques to examine messages about the links between behaviour and health outcomes and LBC signposting (such as leaflets or posters about healthy living) for patients with psoriasis in primary and secondary care patient waiting areas. There was little evidence of psoriasis-specific information about healthy living. Generic information (not specifically about psoriasis) was often of poor quality and was poorly displayed, and did not conform to evidence-based recommendations for effective LBC signposting. The third study combined observational and qualitative techniques to examine how healthcare professionals communicate information about CVD risk to patients and the role of LBC in reducing risk in the context of primary care risk assessments with people with psoriasis. A key finding was that interpretation of risk information was not always linked to specific advice about how to modify each risk factor. Discussion was mostly instructional rather than a shared collaborative discussion about behaviour change and risk reductionThe fourth study used experimental methods to examine the effects of message framing theory as a health risk communication strategy on reported behavioural intentions (BIs) in people with psoriasis. An important finding was that for messages about psoriasis symptom reduction, gain-framed (positively-framed) messages were more effective in increasing BIs for alcohol reduction. Conversely, for messages about CVD risk reduction, loss-framed (negatively-framed) messages were more effective for increasing BIs to reduce alcohol consumption. The body of work presented in this thesis demonstrated that much needs to be done to increase the skill sets of healthcare professionals in order to help people with psoriasis recognise the specific links between their own health behaviours and health outcomes. In addition specific recommendations have been suggested as a way of improving risk communication strategies, such as using theory-based personally-relevant health information for people with psoriasis.

Aligning leadership behaviour to organisational values is critically important in ensuring the sustainable success of organisations. In today's fast changing world, executives are under an enormous amount of pressure to manage fierce competition and less predictability in an environment where excellence is significantly more difficult to achieve. Organisational values are the one constant in businesses today. In spite of the challenges that leaders face on a daily basis, they can increase their chance of success by ensuring that the organisational values are entrenched within the organisation. This research is focused on determining whether group coaching can have a positive impact on aligning leadership behaviour to organisational values, whether coaching can increase self-awareness and whether self-awareness correlates to an increase in the alignment of leadership behaviour to organisational values. The degree that leadership behaviour is aligned to organisational values will be assessed through 360-degree feedback assessments. / Dissertation (MBA)--University of Pretoria, 2012. / Gordon Institute of Business Science (GIBS) / unrestricted

Physical activity can have beneficial effects on post-stroke recovery, but only if it is maintained. Current evidence shows that physical activity levels of individuals with stroke do not meet recommended guidelines. This thesis investigated current programs and proposed a novel trial design to aid stroke survivors with maintaining their activity levels in free-living environments. The first study was a systematic review of the effects of current interventions in post-stroke recovery. The review reported no differences between intervention and control groups for steps walked/day at 3-month (standardized mean difference (SMD) 0.19; 95% CI -0.30 to 0.69; I2 = 47%; GRADE rating: Very Low), time spent in moderate-vigorous physical activity at 3-month (SMD -0.03; 95% CI -0.73 to 0.68; I2 = 52%; GRADE rating: Very Low), or self-reported physical activity at the 6-month follow-up (SMD 0.40; 95% CI -0.02 to 0.82; I2 = 0%; GRADE rating: Very Low). However, the pooled estimate of the self-reported physical activity at the 3-month follow-up was above the line of no-effect (SMD 0.22; 95% confidence intervals, 0.01 to 0.42; I2 = 0%; GRADE rating: Very Low). Intervention characteristics associated with physical activity maintenance could not be explored due to the low number of trials. Insights from this review were used to design an Adaptive Treatment Strategy where high-intensity interventions are sequentially tailored to participants following the identification of increased needs. A protocol of a proof-of-concept pilot Sequential Multiple Assignment Randomized Trial was outlined to assess trial feasibility, participants’ acceptability with changes in interventions, participants’ and staffs’ satisfaction with the treatment strategy, and to provide preliminary estimates of effect of physical activity and self-efficacy for physical activity. Together, these two studies provide direction about intervention design, physical activity maintenance assessment, and proposes the design of a novel pilot SMART trial. / Thesis / Master of Science Rehabilitation Science (MSc) / Physical activity can help with recovery after stroke if it is maintained. This thesis examined ways to support stroke survivors with remaining active in their daily lives. The first study was a review of existing programs to investigate their effects on the physical activity levels of individuals with stroke. Findings from this study showed that current programs produced a small improvement in physical activity that was short-lived, and no program component was better than others at promoting activity maintenance. Insights from this review were used to design a new study that provides increased support to stroke survivors in steps to cater to individual needs. This study will investigate whether this program is practical, acceptable by stroke survivors and people delivering it, and helps to improve and maintain physical activity. Together, these studies provide directions for designing future programs, assessing activity maintenance, and propose the design for a novel study.

No / Reactivity to assessment has attracted recent attention in the brief alcohol intervention literature. This systematic review sought to examine the nature of change in alcohol consumption over time in control groups in brief intervention studies. Primary studies were identified from existing reviews published in English language, peer-reviewed journals between 1995 and 2005. Change in alcohol consumption and selected study-level characteristics for each primary study were extracted. Consumption change data were pooled in random effects models and meta-regression was used to explore predictors of change. Eleven review papers reported the results of 44 individual studies. Twenty-six of these studies provided data suitable for quantitative study. Extreme heterogeneity was identified and the extent of observed reduction in consumption over time was greater in studies undertaken in Anglophone countries, with single gender study participants, and without special targeting by age. Heterogeneity was reduced but was still substantial in a sub-set of 15 general population studies undertaken in English language countries. The actual content of the control group procedure itself was not predictive of reduction in drinking, nor were a range of other candidate variables including setting, the exclusion of dependent drinkers, the collection of a biological sample at follow-up, and duration of study. Further investigations may yield novel insights into the nature of behaviour change with potential to inform brief interventions design.

Yes / Health promotion apps designed to support and reinforce health behaviours or to reduce risk behaviours are the most commonly downloaded apps. Such technologies have the potential to reach and deliver health care to new populations. But the extent to which they are successful in enabling the adoption of new and desired behaviours can vary. Some apps are more effective than others, some are free to download while others require a nominal or substantial charge. Cost alone is not indicative of quality or effectiveness. This is important because the use of health apps by the public will likely increase, as is the expectation that health care professionals understand this technology and its heuristic role in personalised health. Practitioners therefore need to be better informed regarding what makes a health app appealing to service users and successful as an intervention to facilitate behaviour change. This paper describes and discusses how the structure and content of health care apps can facilitate or inhibit behavioural change. The aim is to support practitioners in the screening and identification of suitable apps for clinical use. Method: Theory and literature review. Conclusion: App content that involved clinician input at the design stage and included internal drivers such as motivation, self-efficacy and illness understanding and external drivers such as illness information, social networking and user compatibility tend to do better in facilitating behaviour change than those that do not. Of these factors, motivation is considered to be the most important.

Food waste is an arguably increasing problem in society, with consumers being responsible for as much as half of all combined food waste. The problem needs to be tackled from all angles, but there is no all encompassing solution for all situations. One context consumers find themselves in is the kitchen at their place of work, where the shared nature of the refrigerator creates situations and problems not found in the home environment. It is for these shared kitchens that this study is focused on providing a physical solution based on The Behavioural Change Wheel (BCW), book providing methods and tools for designing with the goal of behavioural change. The intention of this study was to develop, test and later evaluate a prototype on its behavioural change capacity and potential, using the tools presented in the BCW. The developed prototype took form as an RFID activated labelling system, providing users with the current date and their name on a label to be adhered on the articles they place in the shared refrigerator. After the testing period, an online questionnaire was sent out and was answered by fourteen out of seventeen participants. The two week testing period and subsequent questionnaire provided no conclusive answers regarding detected behavioural change capacity, but the potential is considered high based on participants qualitative comments and attitudes, and their quantitative usage. No measurements of change in food waste is conducted, but the target behavioural changes would provide a positive development resulting in less food waste in the workplace kitchen, if not only a more orderly refrigerator. / Matavfall är ett påtagligt ökande problem i samhället, där konsumenter ansvarar för så mycket som hälften av allt kombinerat matavfall. Problemet bör hanteras från alla möjliga håll, men det finns ingen allmän lösning för alla situationer. Ett sammanhang som konsumenterna befinner sig i är köket på deras arbetsplats, där kylskåpets gemensamma natur skapar situationer och problem som inte återfinns i hemmiljön. Det är för dessa delade kök som denna studie riktar sig på att tillhandahålla en fysisk lösning baserad på The Behavioural Change Wheel (BCW). Den innehåller metoder och verktyg för att designa med beteendeförändring som mål. Syftet med denna studie var att utveckla, testa och senare utvärdera en prototyp angående dess beteendeförändringsförmåga och potential, med hjälp av de verktyg som presenteras i BCW. Den färdigställda prototypen tog form som ett RFID-aktiverat etikettsystem, som gav användarna det aktuella datumet och deras namn på en etikett som ska sättas på artiklarna som de placerar i det delade kylskåpet. Efter testperioden skickades ett frågeformulär ut och fjorton av sjutton deltagare svarade. En testperiod på två veckor och efterföljande frågeformulär gav inga avgörande svar angående påvisad beteendeförändringsförmåga, men potentialen anses vara hög baserad på deltagarnas kvalitativa kommentarer och attityder, och deras kvantitativa användning. Inga mätningar kring mängd matavfall utfördes, men målbeteendeförändringarna skulle ge en positiv utveckling som resulterar i mindre matavfall i arbetsplatsens kök, om inte bara ett mer ordnat kylskåp. / Smart storage solutions in the fridge of the future to reduce food waste

The first part of the report reads up on food waste and makes account for how to reduce food waste in households by documenting it. The goal of this project is to examine how a measure of method consisting of voice commands is working as compared to a classic method of measurement with paper and pen. Food waste is a big issue and to decrease food waste, it is important to document this waste in several ways. Since food waste can include different kinds of food depending on how it’s phrased, the concept of food waste is described as both food that could have been eaten but also food that could not be eaten. In studies of food waste, taking notes is a common method of measurement – but it has couple of flaws. In example subjects often forget to take notes when this is required. In this study we are investigating how voice control could be a new alternative to log food waste. The problem statement is based on whether households find easier to log something with the help of voice commands rather than writing it down with paper and pen. We have built a system that will be tested on five subjects. The subjects of the study will use voice commands with a Google Home Mini. In this study they will use voice commands while documenting food waste in each subject’s household, this will be going on in single households. To analyse the data there will be a trashcan prototype created which counts each time something is thrown in the bin. With the help of the counter there will be a possibility to examine if more food waste is thrown than being logged. Furthermore, every interaction with the voice control that is related to food waste will be saved in a spreadsheet. In the method section, an analysis of how the five subjects will be tested is done. The first week the subjects will log food waste by voice commands and will only be using the prototype that was created as the designated food waste bin. The second week, subjects will log on to paper and pen instead. Finally, the prototypes are collected to analyse the data on the microcontroller as well as the logged data collected in a spreadsheet. Qualitative data is gathered through a survey. The result indicated that the majority preferred voice control as a measurement method once it worked, deficiencies such as communication problems were a major reason why this method was not the most optimal. One subject preferred the measurement method with paper and pen over voice control. Several test subjects thought it was difficult to keep track of paper and pencil but appreciated that it was a safe method of measurement in which they could see what was on the paper. This study is of interest to systems where voice control is used in, for example smart homes but also a contribution to the development of measurement methods. One conclusion in the study is that voice control is a possible measurement method but that more studies are needed in the subject. / Matsvinn är ett stort problem och för att minska matsvinn är det viktigt att öka medvetenhet och kunskap om vad som slängs och varför. Eftersom matsvinn kan omfatta olika typer av livsmedel definieras begreppen matsvinn som mat som hade kunnat ätas och matavfall definieras som matsvinn samt oundvikligt matavfall. Vid forskning om matsvinn är anteckningar en vanlig datainsamlingsmetod, men den lider av brister där exempelvis testpersoner glömmer bort att anteckna. I denna studie undersöker vi möjligheterna att använda röststyrning som ett nytt alternativ till att logga matsvinn. Problemformuleringen grundar sig i att undersöka om hushåll anser att det är enklare att logga något med hjälp av röstkommandon jämfört med att skriva ned det med papper och penna. Vi har byggt ett system som testas på fem testpersoner. För att använda sig av röststyrning blev testpersonerna i studien tilldelade varsin Google Home Mini. I denna studie appliceras denna mätmetod på att mäta matsvinn i singelhushåll. För att analysera datan byggde varsin kompostpåsehållare som räknar varje gång svinn slängs i papperskorgen. Genom räknaren kan det undersökas om det slängs mer än det antecknas. Dessutom loggas allt testpersonerna säger till röstassistenten som har med matsvinn att göra. Första veckan under undersökningen loggades deltagarna allt de slängde med röstkommandon samt använder sig enbart av den givna prototypen för att slänga matsvinn. Andra veckan loggade deltagarna istället på papper och penna. Slutligen samlades prototyperna för att analysera datan på mikrokontrollern samt den loggade datan som samlades i ett kalkylark. Kvalitativ data samlades genom en enkät. Resultatet tyder på att majoriteten föredrog röststyrning som mätmetod när det väl fungerade, brister som kommunikationsproblem med röstassistenten var en stor anledning till varför denna metod inte var den mest optimala. En testperson föredrog mätmetoden med papper och penna framför röststyrning. Flera testpersoner tyckte att det var jobbigt att ha koll på papper och penna men uppskattade att det var en säker mätmetod då de kunde se vad som stod på pappret. Studien är av intresse för system där röststyrning används i exempelvis smarta hem men även ett bidrag till utveckling av mätmetoder. En slutsats i studien är att röststyrning är en möjlig mätmetod men att fler studier behövs göras i ämnet.

The purpose of this study was to understand the factors that encourage midlife women to make exercise and dietary changes, the prevalence of those changes, the process by which women make them, the factors that support or impede them, and how we can enhance women’s capacity to make health behaviour changes in midlife. Since the literature highlighted the importance of self-efficacy in changing health behaviour, and of health-related quality of life as a widely recognized measure of women’s mental and physical wellbeing, the study sought to understand the relationship between exercise and dietary self-efficacy, health behaviour change and health-related quality of life (SF-36), by testing a modified version of Bandura’s 1977 and 2002/2004b models of self-efficacy. The methodology involved postal surveys as well as semi-structured interviews with a subsample of the women who completed the survey. Surveys were sent to 866 women aged 51-66 years from rural and urban locations in Queensland, Australia. Five hundred and sixty-four (69%) were completed and returned. Survey data was analysed using descriptive and bivariate statistics and structural equation modeling. Thematic analysis was used to analyse interviews. The results confirmed that midlife is a significant time for women to make positive health behaviour changes. Almost 40% of women made a change to their exercise and around 60% made a dietary change since turning 40. The main exercise change was doing more walking and the most common dietary change was reducing fat intake. Self-efficacy was shown to be a key influence on whether women made positive changes to their health in midlife. In the relationship between health behaviour change and health-related quality of life, making a positive change to exercise was significantly related to physical but not mental health, and making a dietary change was not related to either physical or mental health. Body mass index was shown to be an important influence on both self-efficacy and health-related quality of life (particularly physical health). Interviews were conducted with 29 of the participants. Interview data reinforced that the main motivations to make a positive health behaviour change among midlife women were being overweight, having an injury or being diagnosed with an illness or health condition. Witnessing the hardship experienced by others with a degenerative disease could also prompt a positive behaviour change. Successful changes mainly involved modifying existing practices and repeating new behaviours until they became part of the daily routine. The main facilitators of health behaviour change were having positive role models, having more time due to retirement, and having support from significant others (such as husbands), health professionals and organizations such as Weight Watchers. The main obstacles to making changes were work, care giving, illness and injury. Bandura’s (1977, 2000/2004b) model was partially supported, but the cross-sectional nature of the study may have been a limitation in demonstrating all aspects of the self-efficacy process. In summary, women are willing to make positive health behaviour changes in midlife, but they need education and support to have those changes be effective. It is anticipated that this research will lead to a greater understanding of the significance of midlife as a time for making healthy lifestyle changes that have the potential to improve women’s health and quality of life in later years.