Caregivers play an integral role in the cancer care system in Canada as they provide unpaid care and support for millions of adults living with and beyond cancer. Although caregiving can be a positive experience for some, assuming a caregiving role can be detrimental to caregivers’ own physical and mental health. Research over the past decade has highlighted the negative impacts of caregiving and called for more efforts focused on improving caregivers’ wellbeing. Most interventions targeting caregivers are largely designed to support them in providing care, with little emphasis placed on specifically promoting self-care behaviours. To address this gap, we designed a brief 4-week self-determination theory-based intervention to improve two self-care behaviours (i.e., physical activity and fruit and vegetable consumption) among cancer caregivers. The primary objective of the mixed-methods research presented in this thesis was to assess the feasibility and acceptability of the intervention. Exploratory objectives included understanding participants’ experiences within the intervention. The single-arm intervention was delivered via four weekly video calls to 13 caregivers (mean age=57.6 [15.4 years]) across Canada. The enrollment rate was 62% and the retention, adherence, and fidelity rates ranged from 90 to 99%. The intervention was generally deemed acceptable by participants; however, modifications such as adding psychological support were suggested. Participants’ experiences participating in the intervention were captured within three themes: (1) (Re)prioritizing self-care behaviours; (2) Finding support for self-care behaviours within the caregiving context; and, (3) Becoming a better caregiver through self-care behaviours. Although promising, modifications to the intervention methods are needed to improve enrolment and better meet caregivers’ needs. This study highlights the importance of self-care behaviours for caregivers and provides valuable information on how to foster these behaviours among this population.

Bakgrund: Fysisk aktivitet har ett flertal goda hälsoeffekter samt positiv inverkan på, kognition, prestation i skolan och motorisk utveckling. I dagens Sverige rör sig barn och ungdomar allt mindre och få uppnår rekommendationerna för fysisk aktivitetsnivå. Fysioterapeuter har god kunskap om fysisk aktivitet och rörelse och nyttjas i andra länder inom skolans värld, i dagsläget är detta dock mycket ovanligt i Sverige. Syfte: Utforska hur fysioterapeuter verksamma inom skolans värld i Sverige upplever sin möjlighet och handlingsutrymme att påverka barns rörelsebeteende. Metod: Studien bygger på kvalitativ metod och tre semikonstruerade intervjuer genomfördes med fysioterapeuter verksamma inom elevhälsan. Intervjuerna spelades in och transkriberades. Materialet analyserades sedan enligt Graneheim och Lundmans kvalitativa innehållsanalys. Resultat: Fem huvudkategorier framkom: Vårdnadshavarnas avgörande roll för beteendeförändring, Att använda ett systematisk men samtidigt individanpassat arbetssätt, Elevernas medverkan och möjligheten att få lyckas: nyckel till framgång, Socialt stöd och gruppens betydelse för både elev och fysioterapeut, Fysioterapeuten är beroende av och utgår ifrån skolans egna resurser i sitt arbete. Dessa kategorier delades därefter in i 16 underkategorier. Slutats: Skolfysioterapeuterna i Sverige arbetar huvudsakligen för att aktivera och identifiera elever med motorisk svårighet som skolan själva inte når. I arbetet med dessa elever identifieras skolmiljön och dess resurser som viktiga för skolfysioterapeutens förmåga och handlingsutrymme att arbeta med elevers rörelsebeteende. / Introduction: Physical activity has been proven to be beneficial for cognition, academic results, overall health, and motor development. Physiotherapists have a profound knowledge in how to promote physical activity and movement. This knowledge is made use of in other countries, where school-based physiotherapists are common. In Sweden, on the other hand, school-based physiotherapists are scarce.  Purpose: To explore how school-based physiotherapists in Sweden experience their ability and room for manoeuvre when it comes to affecting children's movement behaviours.  Method: A qualitative study based on three semi-structured interviews with school-based physiotherapists in Sweden. The interviews were recorded, transcribed, and later analysed according to Graneheim and Lundman’s qualitative content analysis. Result: The results revealed five main categories and 16 subcategories. The main categories that were identified were: Guardians crucial role for behaviour change, Using a systematic but at the same time individualised approach, Students participation and the opportunity to succeed: the key to success, Social support and the group's importance for both student and physiotherapist and Physical therapists are dependent on the school's own resources.  Conclusion: The school-based physiotherapists in Sweden mainly work to activate and identify students with motor difficulties that the school itself does not have the ability to help. School-based physiotherapists identified the school environment and its resources as important for their ability and room for manoeuvre to work with students' movement behaviours.

The current study is a user-centred enquiry into how wellness-related personal informatics (PI) systems can be more effectively designed to better promote lasting behaviour change and sustained wellbeing in the context of the changing health paradigm. Until recently, the Western biomedical model with its disease focus has been effective in delivering health care; however, this paradigm does not efficiently support a system in crises - the contemporary health care system which is confronted with complex challenges of modern lifestyle diseases and behavioural disorders. Enabled by the technological revolution, a Systems Medicine model - a preventative, personalised, predictive and participatory (P4) approach - is emerging and PI systems play a significant role in realising this pre-clinical, patient-centric, behaviour-focussed shift in health care. This viewpoint paper argues that design strategies applied in PI systems to promote behaviour change play a vital role in supporting health outcomes, specifically, persuasive and mindful user experience (UX) strategies. By applying a phenomenographic research methodology, a user-centred approach is taken to understand qualitatively different ways in which PI systems (and their inherent design strategies) are experienced by users, to inform more intuitive design of PI systems that balance behaviour change strategies to support more lasting shifts and sustainable states of wellbeing. Drawing together ideas from systems medicine, complexity theory, persuasive and mindful design approaches in conjunction with phenomenography, this study aims to understand experiential nuances to offer implications for the future design of health care through PI systems. The theory built through the research process is applied in a prototype design, which is presented as an example of a PI system design that balances persuasive and mindful strategies and aims to promote lasting behaviour change and enduring states of wellbeing more effectively.

I denna studie undersökte vi hypotesen att visuella subtila ledtrådar kan användas i augmented reality-glasögon för att påverka människors beslutsfattande. Det var baserat på den konceptuella visionen om att AR-glasögon en dag kan vara en del av vårt dagliga liv, och då kan påverka hur beslut fattas. För att undersöka detta genomfördes en litteraturstudie och ett valbaserat videoexperiment. 39 deltagare i olika åldrar deltog i experimentet. Deltagarna delades slumpmässigt upp i tre grupper med olika förutsättningar; en kontrollgrupp, en grupp som exponerades för subtila “priming”-villkor och en grupp som exponerades för subtila “point-of-decision”-villkor. Resultaten påvisade samband mellan subtil priming och beslutsfattande, men inga samband kunde styrkas       mellan subtila “point-of-decision”-villkor och beslutsfattande. / In this study we investigated the hypothesis that visual subtle cues can be used in Augmented Reality glasses to affect human decision making. This was based on the conceptual vision that AR-glasses might one day be a part of our daily life, and could then affect the way decisions are made. In order to investigate, a literature study and a video-based choice experiment was conducted. 39 participants of varied ages took part in       the experiment. Participants were randomly assigned to a control condition, subtle priming cues condition, or a subtle point-of-decision cues condition. The subtle priming cue was in the form of action words and smiley faces, and the subtle point-of-decision cues were in the form of flashing lights. The results showed evidence of a relation between subtle priming cues and the choices made by the participants, but no evidence of such relations were found between subtle point-of-decision cues and the choices made.

This single-case study examines the influence of social media practices on tennis players’ physical behaviours in the context of Swedish tennis club. Through semi-structured interviews with tennis club members, the research aims to understand how social media practices impact tennis players’ physical behaviours. The study draws on theoretical frameworks that highlight social media’s influence on both the production and consumption of content, which can shape tennis players’ physical behaviours. The findings reveal that social media practices affect tennis players’ physical behaviours. Firstly, these practices can lead to changes in coaching approaches as coaches adapt their strategies and techniques based on social media trends and feedback. Tennis players may develop new habits influenced by what they observe and engage with on social media platforms. Additionally, social media practices can impact tennis players’ societal position, influencing their interactions with others and potentially affecting their social dynamics within the sports community. In conclusion, this study emphasizes the importance of considering social media practices beyond online engagement and their impact on physical behaviours. The findings provide valuable insights for sports organizations aiming to develop strategies that promote positive social media practices among tennis players while mitigating negative influences. Moreover, the study contributes to the research field by exploring the influence of social media practices on tennis players’ physical behaviours in offline settings. Researchers interested in further investigating this topic can draw upon the methodology and findings of this study as a guide for their own investigations.

Commercial buildings are one of the main contributors to energy consumption while both energy management and occupants’ consumption behaviour play crucial roles in how energy is consumed. This study explored the energy awareness of occupants in a commercial building with the goal to investigate how increased awareness could support behaviour change. For this purpose, a cooperative gamified visualization of energy consumption data, “EnerSpace”, is designed, implemented and evaluated. 8 occupants participated in this study who experienced a one-week baseline period and a one-week “EnerSpace” game period. In EnerSpace, the participants were divided into two teams and powered a spaceship with their energy saving respectively on a resource exploitation trip to Mars. Each participant had an avatar in the spaceship who introduced the participant’s personal consumption data. The energy conservation of the participants affects the moving speed of the spaceship and the living condition of their avatars. Participants were rewarded by a postcard sent by the avatars when reaching a destination. The results showed that the participants 1) decreased their energy consumption, 2) reported a fun and engaging experience with EnerSpace, and 3) felt motivated for energy conservation by different motives. This study indicated a potential for energy saving in a commercial building using a cooperative game. / Kommersiella byggnader är en av de främsta bidragsgivarna till energiförbrukningen, medan både energihantering och passagerarnas konsumtionsbeteende spelar en viktig roll i hur energi förbrukas. Denna studie undersökte medvetenheten om passagerare i en kommersiell byggnad med målet att undersöka hur ökad medvetenhet kunde stödja beteendets förändring. I detta syfte utformas, implementeras och utvärderas en kooperativ gammal visualisering av energiförbrukningsdata, "EnerSpace". 8 personer deltog i den här studien som upplevde en veckors baslinjeperiod och en veckas "EnerSpace" spelperiod. I EnerSpace delades deltagarna i två lag och drev ett rymdskepp med respektive energibesparing på en resursutnyttjandesresa till Mars. Varje deltagare hade en avatar i rymdskeppet som introducerade deltagarens personliga konsumtionsdata. Deltagarnas energibesparande påverkar rymdskeppens rörelsehastighet och deras avatars levnadsförhållande. Deltagarna belönades med ett vykort skickat av avatarer när de kom till en destination. Resultaten visade att deltagarna 1) minskade sin energiförbrukning, 2) rapporterade en rolig och engagerande erfarenhet av EnerSpace, och 3) kände sig motiverade för energibesparing med olika motiv. Denna studie indikerade en potential för energibesparing i en kommersiell byggnad med hjälp av en kooperativ gammal visualisering.

Uppsatsen baseras på en åtta veckor lång fältstudie i Jinja, Uganda och behandlar socialt arbete med fokus på HIV-rådgivning. Syftet är att beskriva HIV- rådgivning och hur det utförs. Detta genom frågeställningar om interaktionens natur mellan klient och rådgivare utifrån en ugandisk kontext, vad respektive parter har för upplevelser av rådgivning samt vilka utmaningar som kan identifieras gällande såväl HIV- prevention som HIV- rådgivning. Studien är kvalitativ och den insamlade empirin består av semistrukturerade intervjuer med sammanlagt nio informanter, varav fyra är eller har varit aktiva rådgivare, fyra är HIV- positiva klienter som får rådgivning och en är aktiv både som rådgivare och som klient. Vi har valt att spegla vår empiri mot teorier om stigma, sexuella skript och pastoralmakt. Ur resultatdelen har det mellan klienter och rådgivare framträtt en bild som visar på en samstämmighet såväl som diskrepans gällande relationens natur och innehåll såväl som utmaningar kopplat till HIV- rådgivning och preventionsarbete. Relationen bygger på vänskap såväl som professionalism och det tycks finnas en förväntan på rådgivaren som räddare som understöds av såväl klienterna som rådgivarna själva. Det framkommer att stigma fortfarande framträder kopplat till HIV, men i mindre utsträckning än förut och i högre utsträckning bland män och barn än bland kvinnor. Sedan ARV, bromsmediciner, kommit HIV- smittade till del, talar de klienter vi intervjuat om hur HIV numera inte behöver ses som värre än vilken annan sjukdom som helst, vilket rådgivarna menar på också är en risk, då minskad respekt för sjukdomen också kan leda till ett ökat riskbeteende. I de rådgivande samtalen låg fokus på beteendeförändringar baserade på ett hälsofrämjande tänkande och handlande, så kallat positive living. Vidare framgår att religionens framträdande roll i det ugandiska samhället även tar sin plats genom ord eller handling i mötet mellan rådgivare och klient. / This study is based on a minor field study that took place during eight weeks in Jinja, Uganda. It discusses the aspect of social work in HIV counselling, with the object to describe HIV counselling and how it is conducted. The study attempts to answer questions about the nature of the interaction between the client and the counsellor from a Ugandan context, what experiences that lies between them, as well as what challenges can be identified when it comes to HIV prevention as well as HIV counselling. The study’s research strategy has a qualitative approach and the collected data is derived from semi-structural interviews with four HIV positive women who receive counselling, four counsellors and one woman who is both a client and a counsellor. We have chosen to understand our empirical findings through theories of stigma, sexual scripts and pastoral power. From our findings, we were able to conclude that there is consensus as well as discrepancies between the clients’ and the counsellors’ perceptions of their relationship, the counselling content as well as the challenges that is connected with HIV counselling. The relationship is the result of an intertwining of friendship and professionalism and there seem to be an expectation on the counsellor as a savior, which is supported by both clients and counsellors. It appears that stigma still appears in relation to HIV, but to a lesser extent than before and more so among men and children than among women. Since the introduction of ARV’s, many of our interviewed clients seem to view HIV as any other disease, which is regarded as something of a risk by many of our interviewed counsellors, as it may lead to increased risky behavior when it comes to HIV transmission. In the counselling session, the focus seems to be on behavioral change through the concept of positive living, which revolves around the idea of physical and mental well-being. Furthermore, religion has a great impact on the Ugandan society, which can be seen in the words and actions in the meeting between counsellor and client.

Sustaining behaviour change is fundamental for the effective uptake of policies and practices aimed at improving individual and collective health, yet it can be very difficult for individuals to adhere to new desired health-related behaviours. A prospective solution is to focus on instilling these behaviours as a habit. Once instilled as a habit, behaviours are performed automatically given specific cues, and they relieve the cognitive stress of having to make a volitional decision towards performing the behaviour - making it more resistant to relapse. Several information systems (IS) are being proposed to help individual users instil target behaviours as habits so that they can be performed even when intentions shift. However, these systems tend to be designed in an ad hoc manner and, as a result, their effectiveness can vary substantially. To better guide the design of information systems that can support users in forming health-related behaviours as a habit, we define a subclass of systems called Habit Formation Support Systems (HFSS) and adopt the design science research approach to develop two artifacts: (1) a design-relevant theory explaining and predicting how IS-supported habit formation can be achieved called the Theory for the Formation of IS-Supported Habits (T-FISSH); and (2) a suite of design principles to guide the design of systems that can effectively support users in forming a desired health-related behaviour as a habit. We contend that habit theory and IS continuance theory can be used to anchor the development of the two artifacts. The T-FISSH was refined and validated using exploratory and confirmatory focus groups with academics and health behaviour change practitioners respectively. The design principles were refined with systems design and development professionals and validated through a reusability check that involved a design activity and reusability questionnaire. The theoretical contribution of the thesis lies in moving the habit formation knowledge base into the design realm through the development of a design-relevant explanatory/predictive theory. From a practical perspective, this research presents a suite of theory-anchored design principles that are intended to guide the design and development of systems that can support users in forming desired health-related behaviours as a habit.

Background: Type 2 diabetes (T2D) is increasing in young people. Reporting on the processes used when developing prevention interventions is needed. We present the development of a family-based interactive lifestyle intervention for adolescents with risk factors for T2D in the future. Method: A multidisciplinary team in the UK site led the intervention development process with sites in Portugal, Greece, Germany and Spain. Potential programme topics and underpinning theory were gathered from literature and stakeholders. A theoretical framework based on self-efficacy theory and the COM-B (capability, opportunity, motivation, behaviour) model was developed. Sessions and supporting resources were developed and refined via two iterative cycles of session and resource piloting, feedback, reflection and refinement. Decision on delivery and content were made by stakeholders (young people, teachers, parents, paediatricians) and all sites. Materials were translated to local languages. Site-specific adaptations to the language, content and supporting resources were made. Results: The “PRE-STARt” programme is eight 90-min interactive sessions with supporting curriculum and resources. Iterative development work provided valuable feedback on programme content and delivery. Conclusion: Reporting on the intervention development process, which includes stakeholder input, could yield a flexible approach for use in this emerging ‘at risk’ groups and their families.

This thesis deals with the energy saving in smart building with focus on the impact of the user behaviour on the energy consumption. The problem of human behaviour modelling has been widely studied in the state of the art, but it is still an open problem in the field of smart building since the stochastic nature of the behaviour is difficult to be accurately represented by numerical tools. An interdisciplinary approach is proposed in order to identify the suitable user features from the psychological and social point of view and to integrate such a representation into a DSS for appliance scheduling and energy cost reduction. The proposed method has exploited location-based features of the users in order to represent their habits and needs and to compute the schedules that maximize the user acceptance toward an “energy-aware” behaviour. The obtained results point out a reduction of the peak-to-average ratio higher than 40% also considering the user constraints imposed by their presence into the building.