This thesis aimed at developing and evaluating a tailored behavioural sleep medicine intervention for enhanced physical activity and healthy eating in patients with obstructive sleep apnea syndrome (OSAS) and overweight. Participants with moderate or severe OSAS (apnea-hypopnea index ≥15) and obesity (Studies I-II) or overweight (Studies III-IV), treated with continuous positive airway pressure (CPAP) (Studies I-II) or admitted to CPAP treatment (Studies III-IV), were recruited from the sleep clinic at Uppsala University Hospital, Sweden. Semi-structured individual interviews were analysed using qualitative content analysis (Study I). Data on moderate-to-vigorous physical activity (MVPA) and sedentary time were collected with three measurement methods and analysed regarding the level of measurement agreement (Study II). Potential disease-related and psychological correlates for the amount of MVPA, daily steps and sedentary time were explored using multiple linear regression (Study III). Physical activity and eating behaviour changes were examined after a six month behaviour change trial (Study IV). A tailored behavioural sleep medicine intervention targeting physical activity and healthy eating in combination with first- time CPAP treatment was compared with CPAP treatment and advice on the association between weight and OSAS. According to participants’ conceptions, a strong incentive is needed for a change in physical activity and bodily symptoms, external circumstances and thoughts and feelings influence physical activity engagement (Study I). Compared with accelerometry, the participants overestimated the level of MVPA and underestimated sedentary time when using self-reports (Study II). The participants spent 11 hours 45 minutes (71.6% of waking hours) while sedentary. Fear of movement contributed to the variation in steps and sedentary time. Body mass index was positively correlated to MVPA (Study III). The experimental group increased intake of fruit and fish and reduced more weight and waist circumference compared with controls. There were no changes in physical activity (Study IV). The novel tailored behavioural sleep medicine intervention combined with first-time CPAP facilitated eating behaviour change, with subsequent effects on anthropometrics, but it had no effects on physical activity and sedentary time. Fear of movement may be a salient determinant of sedentary time, which has to be further explored in this population. The results confirm sedentary being a construct necessary to separate from the lower end of a physical activity continuum and highlight the need of developing interventions targeting sedentary behaviours specifically.

Objectives This thesis aimed to explore psychological factors associated with walking behaviour in patients with Peripheral Arterial Disease, within the framework of Leventhal et al’s (1998) Common-sense Model of Self-regulation of Health and Illness. The objective was to identify psychological factors which could be modified to increase walking behaviour in these patients. Method A series of three studies were conducted to achieve these aims. The first study was an exploratory qualitative study, to explore the illness and treatment beliefs and walking behaviour of patients with intermittent claudication. The second study was a cross-sectional postal questionnaire to a cohort of patients with intermittent claudication, which tested the influence of the psychological factors identified in the qualitative study, in a larger sample. The final study was a randomised controlled trial of a brief psychological intervention designed to modify the illness and walking beliefs of patients with intermittent claudication, in order to increase walking behaviour. Results Beliefs about intermittent claudication, and beliefs about walking were both found to be associated with walking behaviour in the qualitative study. The results from the cross-sectional postal questionnaire confirmed this relationship – taken as a set, illness and walking beliefs accurately predicted adherence to minimum walking levels for 93.4% of the sample. The brief psychological intervention successfully modified illness and treatment beliefs and increased walking behaviour in patients newly diagnosed with intermittent claudication. Conclusion This thesis highlights the importance of illness and walking beliefs to the walking behaviour of patients with intermittent claudication. The thesis has added to the body of knowledge about intermittent claudication, and the findings of this thesis have implications for the treatment of patients with intermittent claudication within the health service. Theoretical and clinical implications of this research are discussed.

Adopting more sustainable consumption habits has been identified as a necessary step in the progression towards a sustainable society. In the area of sustainable consumption, personal food behaviour represents a strong leverage point. University students have been identified as a strategic audience; habits established during this transformative period can track forward into later life. This study seeks to identify the barriers inhibiting students from eating more sustainably. Perceived benefits of eating more sustainably, student food preferences, and student definitions of sustainable food are also identified. Focus groups, surveys, and interviews were carried out at universities in Europe, North America and Australia. Results show that perceived cost of sustainable food and a lack of knowledge, time and availability were ubiquitous barriers preventing students from adopting more sustainable eating habits. In addition to gathering the perceptions of others, the authors’ understanding of the challenges and benefits of eating more sustainably was augmented by a month-long self-study. Results from the self-study show that it is feasible to eat more sustainably without incurring additional costs. Recommendations informed by the focus groups, surveys, interviews and self-study are made to help students overcome the barriers to eating more sustainably.

This thesis is an investigation of the self-reported health behaviour changes made by adults in the Canadian Community Health Survey 2007, categorized by BMI category. Descriptive analyses and forward stepwise regression were performed to determine variables associated with HBC. The final sample n = 111,449. Overall, 58% of individuals had made a HBC in the past year. Increased exercise was the most common HBC (29%), followed by improved eating habits (10%) and losing weight (7%). Only 51% experienced barriers to HBC; lack of will power was most commonly cited. Overweight and obese individuals were more likely to undertake HBC. In the regression model, opinion of own weight was the strongest predictor of HBC, followed by fruit and vegetable consumption, number of consultations with doctor, smoking status, and perceived health.

Based on a previous empirical study of the effect of a residential demand response program in Sala, Sweden, this project  investigated the economic consequences of consumer behaviour change after a demand-based time of use distribution tariff was employed. The economic consequences of consumers were proven to be disadvantageous in terms of unit electricity price. Consumers could achieve more electricity bill saving through stabilising their electricity consumption during peak hours, and this way bring least compromising of their comfort level. In order to estimate the price elasticity of the studies demand response program, a new method of estimation price elasticity was proposed. With this method, the intensity of demand response of the demand response program was estimated in terms of price elasticity. Regression analysis was also applied to find out the price incentives of consumer behaviour change. And the results indicated that the rise in electricity supply charge hardly contributes to load reduction, while the demand-based tariff constituted an advantageous solution on load demand management. However stronger demand response still requires better communication with customers and more incentives other than the rise in distribution tariff.

This thesis is an ethnographic study of the lives of thirty community HIV educators in KwaZulu-Natal, South Africa. Compared to quantitative studies this is a small number, but by keeping the number of participants small it has been possible to obtain an extensive understanding of the lives of each individual, which helps to explain why they make the decisions they do. The reason for choosing community HIV educators as the participants in this study is because it could be stated from the outset that they are well-informed about HIV prevention and, depending on the specific NGO they work for, they have been recipients of either ‘female empowerment’ or ‘responsible masculinity’ programmes. This is significant because early HIV prevention interventions have assumed that providing individuals with HIV awareness and gender equality programmes would lead to the implementation of HIV preventative behaviour. Studying the willingness and ability to implement HIV prevention practices of these particular individuals could therefore help to answer the question whether HIV awareness and gender-related programmes are indeed sufficient to create HIV preventative behaviour change. Furthermore, it was useful to hear from these participants what they experience as enabling and restricting factors when it comes to implementing HIV preventative behaviour. The core research question is: How do community HIV educators in KwaZulu-Natal negotiate HIV prevention in their everyday intimate relationships? The data presented in this thesis was collected during ten months of participant observation amongst community HIV educators whilst they were at work, at home, or out with their peers. To further aid the general understanding of Zulu culture, the researcher lived as part of a Zulu family for six months. The thesis presents several examples of community HIV educators who do not consistently use condoms in their everyday lives despite the fact that they promote the use of condoms. How is it possible that those who speak of being transformed as a result of HIV awareness and female empowerment or responsible masculinity programmes, and who promote condom use in their communities, do not always consistently use condoms in their personal lives? This thesis is concerned with trying to resolve this apparent illogicality. It argues that when individual interventions fail to lead to behaviour change it is because individuals act in relation to other people instead of in isolation. The thesis draws on the work of Bourdieu, particularly his concepts of habitus, field, and capital, to explain how structural factors influence individual practice. This means that the negotiation of HIV prevention is affected by what is generally considered appropriate in terms of existing dispositions. Hence the perception of a particular HIV prevention practice as either appropriate or inappropriate affects the ability of an individual to implement this practice. Examples are provided of how, when it comes to the practice of condom use, which has generally been perceived as inappropriate, structural factors have a restricting effect on HIV prevention. This thesis also provides examples of how, when it comes to the practice of medical male circumcision and virginity testing, which have generally been perceived as appropriate, structural factors actually have an encouraging effect on HIV prevention. As a result this thesis argues that instead of addressing individuals, HIV prevention interventions should address the collective. However, this thesis also argues that an increase in economic, cultural, social, and symbolic capital can suppress the effect of structural factors. To support this argument the thesis attends to individuals who, when they can afford to do so as a result of having capital at their disposal, deviate from collectively determined ideal practice, for example by discreetly negotiating HIV counselling and testing with their sexual partners.

The purpose of this research was to explore how post-visit action resources, such as printed handouts and email updates, impact environmental free-choice learning and sustainable behaviour after a visit to an environmental free-choice learning centre. Free-choice learning, which occurs in places like zoos, is an increasingly popular and effective experience to communicate environmental sustainability and climate change issues to the public. This research specifically explored how post-visit resources provided after a visit to the International Polar Bear Conservation Centre in Winnipeg’s Assiniboine Park Zoo in Manitoba, Canada affected environmental learning and sustainable behaviour change over a two-month period. Questionnaire and personal meaning mapping interview responses revealed that post-visit resources can be an effective way to improve environmental learning, increase awareness, and encourage some sustainable behaviour change. The implications for environmental free-choice learning experiences are discussed and recommendations for future practices explained.

Abstract Nature-based tourism and wildlife tourism are becoming increasingly popular worldwide and are often promoted as a means of protecting and preserving environmental resources. These forms of tourism are usually accompanied by interpretation such as signs, presentations and activities specifically designed to raise visitors‟ awareness of, and concern for, environmental issues. The rationale behind this approach is that enhancing visitors‟ environmental knowledge, understanding and attitudes prompts the adoption of environmentally responsible behaviours. This is supported by a growing body of research that suggests that environmental interpretation has considerable potential to impact upon visitors‟ conservation knowledge and attitudes, and that well-designed interpretive experiences and messages are an effective means of reducing a range of negative „on-site‟ behaviours such as littering, straying from walkways and feeding wildlife. However, there has been little exploration of whether environmental interpretation influences the uptake of conservation practices „off-site‟ or how the positive impacts of nature-based tourism can be maintained over time. Until recently, tourism research exploring post-visit behaviour has used visitors‟ immediate post-visit intentions as a measure of behaviour change. There is increasing evidence, however, that stated intentions to engage in conservation behaviours rarely manifest as actual behaviour, and that visitors‟ on-site enthusiasm and commitment tends to wane following their visit. The current research aimed to investigate whether providing visitors with post-visit support in the form of learning materials and reminders would prevent this decline and enhance long-term conservation learning (hereby defined as knowledge, attitudes and behaviour). This research explores short and long-term changes in families‟ conservation knowledge, attitudes and behaviour following their visit to Mon Repos Conservation Park, a world renowned turtle rookery in Queensland, Australia. Stage one of the study involved surveying 100 Australian families to identify barriers and benefits associated with six conservation practices (re-using containers, buying minimal packaging, reducing use of plastic bags, picking up litter, recycling and composting). Using Community-based Social Marketing theory, responses informed the development of printed and online post-visit action resources specifically designed to reinforce the wildlife tourism experience and support families‟ conservation learning. Resources focused on the six conservation behaviours outlined above but also included other environmental activities and conservation information of relevance. v In stage two, two hundred Australian families visiting Mon Repos in December 2007 and January 2008 were sampled and assigned to either a treatment group (provided with post-visit action resources and regular contact) or the control group (no post-visit support). All families were asked to complete pre-visit, post-visit and follow-up questionnaires to enable the researcher to ascertain short-term and long-term changes in their conservation knowledge, attitudes and behaviour and to identify factors contributing to the uptake of off-site conservation practices. The final sample comprised the one hundred families who completed all three questionnaires. Comparisons between responses of the control and treatment groups revealed that post-visit action resources reinforced respondents‟ knowledge of threats to turtles and enhanced their attitudes towards protecting wildlife and the natural environment. Families who received post-visit support were also significantly more likely to pick up litter and introduced more conservation actions than those who did not receive this support. Aspects of the post-visit action resources that were particular effective were updates of turtle activity at Mon Repos, emails, fact sheets and the newsletter. Other factors that prompted the adoption of conservation practices included Mon Repos‟ interpretation and the opportunity to view wildlife in its natural surroundings. The influence of other family members and pre-visit knowledge and interest were also found to be associated with subsequent uptake of conservation behaviours. Implications for wildlife interpretive practice and the design and delivery of post-visit support are discussed and recommendations for future research presented.

Abstract Nature-based tourism and wildlife tourism are becoming increasingly popular worldwide and are often promoted as a means of protecting and preserving environmental resources. These forms of tourism are usually accompanied by interpretation such as signs, presentations and activities specifically designed to raise visitors‟ awareness of, and concern for, environmental issues. The rationale behind this approach is that enhancing visitors‟ environmental knowledge, understanding and attitudes prompts the adoption of environmentally responsible behaviours. This is supported by a growing body of research that suggests that environmental interpretation has considerable potential to impact upon visitors‟ conservation knowledge and attitudes, and that well-designed interpretive experiences and messages are an effective means of reducing a range of negative „on-site‟ behaviours such as littering, straying from walkways and feeding wildlife. However, there has been little exploration of whether environmental interpretation influences the uptake of conservation practices „off-site‟ or how the positive impacts of nature-based tourism can be maintained over time. Until recently, tourism research exploring post-visit behaviour has used visitors‟ immediate post-visit intentions as a measure of behaviour change. There is increasing evidence, however, that stated intentions to engage in conservation behaviours rarely manifest as actual behaviour, and that visitors‟ on-site enthusiasm and commitment tends to wane following their visit. The current research aimed to investigate whether providing visitors with post-visit support in the form of learning materials and reminders would prevent this decline and enhance long-term conservation learning (hereby defined as knowledge, attitudes and behaviour). This research explores short and long-term changes in families‟ conservation knowledge, attitudes and behaviour following their visit to Mon Repos Conservation Park, a world renowned turtle rookery in Queensland, Australia. Stage one of the study involved surveying 100 Australian families to identify barriers and benefits associated with six conservation practices (re-using containers, buying minimal packaging, reducing use of plastic bags, picking up litter, recycling and composting). Using Community-based Social Marketing theory, responses informed the development of printed and online post-visit action resources specifically designed to reinforce the wildlife tourism experience and support families‟ conservation learning. Resources focused on the six conservation behaviours outlined above but also included other environmental activities and conservation information of relevance. v In stage two, two hundred Australian families visiting Mon Repos in December 2007 and January 2008 were sampled and assigned to either a treatment group (provided with post-visit action resources and regular contact) or the control group (no post-visit support). All families were asked to complete pre-visit, post-visit and follow-up questionnaires to enable the researcher to ascertain short-term and long-term changes in their conservation knowledge, attitudes and behaviour and to identify factors contributing to the uptake of off-site conservation practices. The final sample comprised the one hundred families who completed all three questionnaires. Comparisons between responses of the control and treatment groups revealed that post-visit action resources reinforced respondents‟ knowledge of threats to turtles and enhanced their attitudes towards protecting wildlife and the natural environment. Families who received post-visit support were also significantly more likely to pick up litter and introduced more conservation actions than those who did not receive this support. Aspects of the post-visit action resources that were particular effective were updates of turtle activity at Mon Repos, emails, fact sheets and the newsletter. Other factors that prompted the adoption of conservation practices included Mon Repos‟ interpretation and the opportunity to view wildlife in its natural surroundings. The influence of other family members and pre-visit knowledge and interest were also found to be associated with subsequent uptake of conservation behaviours. Implications for wildlife interpretive practice and the design and delivery of post-visit support are discussed and recommendations for future research presented.

Abstract Nature-based tourism and wildlife tourism are becoming increasingly popular worldwide and are often promoted as a means of protecting and preserving environmental resources. These forms of tourism are usually accompanied by interpretation such as signs, presentations and activities specifically designed to raise visitors‟ awareness of, and concern for, environmental issues. The rationale behind this approach is that enhancing visitors‟ environmental knowledge, understanding and attitudes prompts the adoption of environmentally responsible behaviours. This is supported by a growing body of research that suggests that environmental interpretation has considerable potential to impact upon visitors‟ conservation knowledge and attitudes, and that well-designed interpretive experiences and messages are an effective means of reducing a range of negative „on-site‟ behaviours such as littering, straying from walkways and feeding wildlife. However, there has been little exploration of whether environmental interpretation influences the uptake of conservation practices „off-site‟ or how the positive impacts of nature-based tourism can be maintained over time. Until recently, tourism research exploring post-visit behaviour has used visitors‟ immediate post-visit intentions as a measure of behaviour change. There is increasing evidence, however, that stated intentions to engage in conservation behaviours rarely manifest as actual behaviour, and that visitors‟ on-site enthusiasm and commitment tends to wane following their visit. The current research aimed to investigate whether providing visitors with post-visit support in the form of learning materials and reminders would prevent this decline and enhance long-term conservation learning (hereby defined as knowledge, attitudes and behaviour). This research explores short and long-term changes in families‟ conservation knowledge, attitudes and behaviour following their visit to Mon Repos Conservation Park, a world renowned turtle rookery in Queensland, Australia. Stage one of the study involved surveying 100 Australian families to identify barriers and benefits associated with six conservation practices (re-using containers, buying minimal packaging, reducing use of plastic bags, picking up litter, recycling and composting). Using Community-based Social Marketing theory, responses informed the development of printed and online post-visit action resources specifically designed to reinforce the wildlife tourism experience and support families‟ conservation learning. Resources focused on the six conservation behaviours outlined above but also included other environmental activities and conservation information of relevance. v In stage two, two hundred Australian families visiting Mon Repos in December 2007 and January 2008 were sampled and assigned to either a treatment group (provided with post-visit action resources and regular contact) or the control group (no post-visit support). All families were asked to complete pre-visit, post-visit and follow-up questionnaires to enable the researcher to ascertain short-term and long-term changes in their conservation knowledge, attitudes and behaviour and to identify factors contributing to the uptake of off-site conservation practices. The final sample comprised the one hundred families who completed all three questionnaires. Comparisons between responses of the control and treatment groups revealed that post-visit action resources reinforced respondents‟ knowledge of threats to turtles and enhanced their attitudes towards protecting wildlife and the natural environment. Families who received post-visit support were also significantly more likely to pick up litter and introduced more conservation actions than those who did not receive this support. Aspects of the post-visit action resources that were particular effective were updates of turtle activity at Mon Repos, emails, fact sheets and the newsletter. Other factors that prompted the adoption of conservation practices included Mon Repos‟ interpretation and the opportunity to view wildlife in its natural surroundings. The influence of other family members and pre-visit knowledge and interest were also found to be associated with subsequent uptake of conservation behaviours. Implications for wildlife interpretive practice and the design and delivery of post-visit support are discussed and recommendations for future research presented.