In a Department of Veterans Affairs hospital on the East Coast of the United States, behavioral outbursts result in 2 out of 10 veterans dismissed from a posttraumatic stress disorder (PTSD) unit prior to completing the 6-week program. The purpose of this evidence-based quality improvement project was to create a clinical practice guideline (CPG) based on social cognitive theory (SCT) to provide new strategies for managing veterans with PTSD and to improve the confidence of the nurses in managing outbursts. The Star Model guided the project development with the Delphi method to achieve participant consensus, the AGREE II to assess the CPG quality, and the Generalized Self-Efficacy (GSE) scale to measure the change in participant knowledge and confidence. The literature was searched, compiled, assessed, and shared with 10 participants, registered nurses on the PTSD unit. Through the Delphi process, the participants achieved consensus (8/10) for the CPG, with two neutral participants. The GSE was administered pre- and post-test and analyzed using a paired t test to measure the mean differences of the GSE scores. The data was normally distributed to different scores to gauge the impact of the CPG development process on improving nursing knowledge and confidence was normally distributed [t(9) = -4.188, p < 0.05, &, t(9) = -2.714, p =0.003]. The data indicated a significant increase in participant knowledge about role of SCT, and confidence toward implementing the CPG into clinical practice. This project contributes to positive social change as nurses identified a clinical practice problem, transferred evidence about strategies from the literature into their clinical practice through a CPG, and implemented the CPG with the knowledge and confidence to impact patient care.

Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) is a national priority for several reasons including its endemic/pandemic status and economic demand. Adolescents 15 to 24 years old who are sexually active acquire nearly half of all new Sexually Transmitted Infections (STIs). Recent findings from the Centers of Disease Control (CDC) have documented increased teen birth rates, escalating births to unwed mothers, and STIs ascribed to one in four adolescent females, are reasons to enhance effective prevention efforts. The specific aim of the study, based on Bandura's social cognitive theory, was to test associations among communication system methods and HIV/AIDS self-efficacy, perceived risk, knowledge, and sexual decision-making among older adolescent females. Communication systems consist of interpersonal relationships, mass and print media. Research questions are: (1) What are the associations among demographic variables (age, race/ethnicity, education, socioeconomic status) in young women and the types of communication systems preferred (media and interpersonal)? (2) What are the associations among the types of communication systems preferred by young women and person factors (HIV/AIDS self-efficacy, perceived risk, and knowledge)? (3) What are the associations among the types of communication systems preferred by young women (media, print, interpersonal) and behavior (sexual-decision making)? (4) What are the associations among young women's person factors (HIV/AIDS self-efficacy, perceived risk, knowledge) and behaviors (sexual decision-making)? The study used a non-experimental cross sectional design. The sample included 866 females, 18 to 21 years old, attending the the second largest public university or a historically black university in Florida. Data was collected using validated instruments transcribed into an electronic survey program. Data analysis consisted of frequency distributions, descriptive statistics, and Multiple Regression Analysis. Results indicated that there were associations beween all proposed constructs that constitute the theoretically derived conceptional model. Interpersonal relationships explained the most variance (parents--22%; partners-12%) when associated with other communication systems. Overall, students reported that parents had more influence on their decisions with regards to basic beliefs, value systems, sexuality, dating, and alcohol use. The communication systems associated with older adolescents' sexual decision-making may assist public health advocates in developing related preventive interventions for young adult females.

Self-focused information processing has become a central aspect of cognitive explanations of social anxiety disorder. Indeed, Clark and Wells (1995) theorized that the key feature of the disorder is the processing of the self as a social object. It is proposed that when socially anxious individuals enter feared situations, they shift their attention to a detailed monitoring of themselves. Such self-focused attention triggers recollections of negative experiences from the past and directs attention towards signs of threat. This interferes with the processing of the situation and leads to misinterpretation of others' behaviours. Although there is now considerable support for the Clark and Wells' model from research on imagery, post-event and anticipatory processing, there is surprisingly little evidence for memory disturbance. Unlike mood disorders, to date, deficits in accessing autobiographical memories have not been found for social anxiety. In this thesis it is argued that a possible reason for the lack of evidence of memory deficits in social anxiety is that researchers have not attempted to manipulate participants' levels of self-focus in conducting research on autobiographical memory. The focus of this thesis was on the accessibility and quality of the autobiographical memories of socially anxious and non-socially anxious individuals obtained under conditions of self-focus in comparison to responses obtained when not self-focused. The present research utilized a two-phase quasi-experimental design with a sample of 144 adults taken from an initial pool of 203 volunteers. The final sample comprised 30 men and 114 women, ranging in age from 17 to 67 years (M = 26, SD = 11.91, median age = 20 years). The sample consisted of 292 undergraduates and community participants recruited via advertisements. Group membership was based on selection criteria from a measure of social anxiety, the Social Phobia and Anxiety Inventory (SPAI; Turner, Beidel, Dancu & Stanley, 1989b), depression and general anxiety from the Depression, Anxiety and Stress Scale (DASS; Lovibond & Lovibond, 1995), and the anxiety disorder interview schedule (ADIS-IV-L; Di Nardo, Brown & Barlow, 1994). Initial respondents were allocated to socially anxious (SA), socially anxious depressed (SAD), and non-socially anxious (NSA) groups, with the SAD group forming a further control group of respondents with high scores in SPAI social anxiety and DASS depression. Approximately half of each group was primed to Self-focus, by making an impromptu speech which was videotaped and replayed to each participant individually, following an adaptation of a priming methodology by Perowne and Mansell (2002). The other half of the participants was not self-focused. Rather, they viewed video tape of a confederate giving a speech so as to Other-focus. The priming was prior to participants' provision of written responses to positive and negative (social anxiety) cue words using Williams' (2002) Autobiographical Memory Test. The quality of the memories was measured according to overgenerality for positive and negative cues. Reaction time was recorded for memories to the same valenced cues. The incidence of anxiety and depression content in the memories was determined using coding schemes devised by Gottschalk and Gleser (1969). As hypothesised, the results confirmed that greater levels of generality and longer reaction time to positive cues (not for negative cues) were evident when comparing self-focused SA with self-focused non-socially anxious (NSA) individuals, reflecting findings for other emotional disorders such as depression. Self-focused socially anxious (SA) individuals responded with greater levels of generality and longer reaction times for memories for valenced cues, particularly positive ones, than other-focused SA individuals. Further analysis for generality found that self-focused SA respondents were more general than other-focused socially anxious with comorbid depression (SAD) individuals for memories for positive cues. However, both groups were similar for negative memory cues. As confirmation for memory deficits as a function of the priming manipulation, greater generality and longer reaction times for memories for positive cues occurred when comparing self-focused SA individuals, to all control groups (NSA groups and other-focused SAD individuals). Without priming, SA individuals did not demonstrate autobiographical memory deficits in quality or accessibility compared to NSA controls. Exploration of the autobiographical memory content indicated that SA (compared to SAD and NSA) individuals, irrespective of focus, reported more depression than anxiety content in their memories. Additionally, self-focused SA in contrast to other-focused SA individuals, experienced heightened depression content in their memories, although none of the individual categories of depression was prominent. Predictions of SPAI social anxiety and DASS depression scores from the significant predictors associated with the memories, were undertaken separately for self- and other-focused individuals. Reaction time to positive cues was found to be the only stable predictor of both social anxiety and depression for the self-focused respondents. For the other-focused condition, only total anxiety content theme was found to predict social anxiety, albeit poorly. Overall, the present thesis established that the self-focusing manipulation unearthed a memory processing deficit in socially anxious individuals, similar to that found in most emotional disorders in terms of quality, accessibility, and content, of the memories. This result was particularly apparent in relation to responses to positive cues. The findings are consistent with the Clark and Wells' (1995) model of the disorder emphasising the role of the views of the self as the core element of the disorder. The results also show that the processing deficits of social anxious individuals are confined to the self-focus condition. It is suggested that more attention should be placed on the self-role in social anxiety and that mindfulness-based cognitive therapy, efficacious in mood disorders by reducing the overgenerality effects, is also relevant to social anxiety disorder. Future longitudinal research should be conducted with clinical groups of socially anxious patients, using a self-focus manipulation, to ascertain if the results of the present can be replicated and extended. Pre- and post-treatment measurements of the autobiographical memories of socially anxious patients should be measured and compared, to ascertain whether the deficits can be repaired through the use of mindfulness-based cognitive therapy (MBCT; Williams, Teasdale, Segal & Soulsby, 2000). Self-focus priming could also be used with other anxiety disordered individuals such as generalised anxiety disorder and panic individuals, as they too, appear to be likely candidates for the ruminative self-focus which has contributed to the memory processing deficits established in the autobiographical memories in social anxiety disorder.

This thesis develops the Effects of Power Model to explain why some power users come to behave in anti-social ways and what can be done about it. The model shares an analytical focus on the effect of the exercise of power on the power user with the Metamorphic Model of Power (Kipnis, 1976), but overcomes limitations in the Metamorphic Model by using the integrating framework of Social Cognitive Theory (Bandura, 1986). This theory guided the identification of the Effects of Power Model's main variables and their relationships, and provides a powerful framework for designing normative applications based on those variables and relationships. The Effects of Power Model describes a self-regulatory process which begins with a consideration by the power user of whether and what type of power or influence tactic he or she should use. To make the decision, the power user considers both internal standards and experiences (either vicariously gained or directly). Having acted, the power user then evaluates his or her action against both feedback and internal standards. If evaluation indicates that the action was contrary to either internal standards and/or to expected outcomes, there are two possible reactions. One is to feel bad and to plan to choose another course of action in future. The other is to rationalise the action through the use of disengagement mechanisms. The latter enables the power user to excuse his or her action and maintain a commitment to the action in the future. Over time, repeated use of disengagement mechanisms to excuse behaviour leads to a change in internal standards and to a rising commitment to the behaviour. The model's descriptive power is tested using a two-stage laboratory experiment with between subject manipulations and random allocation of subjects. A range of analytical frameworks are used to test the data including correlation, regression and Chi square analyses. Results strongly support the model. The model's prescriptive power is also considered by developing a program to enhance pro-social behaviour among power users, particularly professionals. Examples are identified that support key propositions of the model, relating to how the circumstances of professionals may influence their anti-social behaviour and how changes in circumstances could promote pro-social behaviour.

<p>The subject of this essay is a comparison of essays written by the same learners at two different points in time - i.e. while they were in the first and in the third grades of the Swedish secondary school. The essay includes a presentation of the raw data that have been used. The theoretical background is a general survey of some of the abundant literature relating to Second Language Acquisition and Error Analysis, and a large part of it deals with interlanguage theories. The analytical part of the work presents the results of the study, including a grammatical classification of the totality of the errors encountered as well as a presentation of the results for the whole of each class and for each individual learner. Finally, some of the theories are related to the results of the analysis and some conclusions are drawn. A part of the work consisted in the gathering of essays written by learners (exclusively with Swedish as their mother tongue) of the same class in a real school context, first to make a quantitative study of their errors, and second to make a comparison between their essays written at two different points in time. The aim was to find out if there had been an evolution, and to what extent the evolution had taken place. The hypothesis formulated at the beginning of this essay is that learners, in general, should make fewer errors after two years have passed. The results are that errors concerning Verbs (especially Concord), as well as miscellaneous spelling errors, were the most frequent ones, and this is true for both grades. As the total number of errors is lower for the third grade than for the first, and since the learners' production is larger in the third grade than in the first, the hypothesis can be considered to be true, though a larger study should be conducted to see if a general pattern can be found.</p>

Introduction: Several national trials have demonstrated the efficacy of lifestyle interventions on decreasing the incidence of type 2 diabetes in adults with prediabetes. Behavior change pertaining to physical activity (PA) and diet were central to these lifestyle interventions; however it is likely a majority of adults with prediabetes are not currently meeting public health guidelines for PA and dietary intake. Little information is available on different influences of behavior central to prediabetes treatment. Given these findings, further investigation into potential influences on the efficacy of prediabetes service provision is warranted. Purpose: This dissertation aimed to explore prediabetes service provision to identify potential influences on PA and dietary intake in adults with prediabetes. Methods: The first study used Grounded Theory methodology to obtain opinions on necessary components of an optimal diabetes prevention program from health professionals (n=20) and adults with, or at high risk of, prediabetes (n=12). The second, third, and fourth studies involved individuals with prediabetes (N=232) in Northern Alberta, Canada. Participants completed a mailed survey assessing various demographic, health and behavior influences in August-September, 2008. Results: Data from Study 1 identified four influences on behavior change in adults with prediabetes: service provision, knowledge or confusion, motivational influences, and goal-setting. Potential strategies to increase effectiveness of prediabetes programs were also identified. In Study 2, individuals with prediabetes achieving PA guidelines (38%) reported higher physical and mental health-related quality of life compared to those not meeting PA guidelines. In Study 3, a number of preferences for PA and PA programming were identified. Activity status, health, and demographic variables all demonstrated significant influence on different PA preference variables. In Study 4, behavior-specific social cognitive theory constructs including self-efficacy, outcome expectations, and goal formation demonstrated significant associations with each other and PA, fat, and fibre intake. Conclusions: Evidence suggests it is possible to prevent or delay the progression of prediabetes to diabetes with small changes in body weight, physical activity and dietary intake. The results reported in this dissertation identified a number of factors that may influence potential success of a prediabetes program to promote behavior change and increase the public health impact of prediabetes prevention programs.

Research regarding use of complementary and alternative medicine (CAM) among all populations in America is needed to understand what seems to be an increasing trend. Education has been shown to be a significant determinant of CAM use, therefore, college students are likely to be CAM users. Little research has addressed the prevalence and predictors of CAM use among this population, so the purpose of this study was to: (1) measure the prevalence and type of CAM use among a sample of college undergraduates; and (2) test the significance of select social-cognitive constructs and demographics as predictors of CAM use. A random sample of undergraduate students within the Texas A&M University System was solicited via email to complete a web-based survey. Findings show high rates of CAM use. Gender, attitude toward CAM, outcome expectancies regarding the health care encounter, and social network use of CAM were shown to be significant predictors of CAM use. Results can inform health care and health education professionals interested in improving health care processes and addressing positive and negative issues related to CAM use.

Light skin color sits within a space of privilege. While this has global significance and relevance, it is particularly true in Jamaica, a former British colony. The majority of the population is of African descent, yet there is an elevation of Eurocentric values and a denigration of Afrocentric values in many facets of life, specifically in the promotion of light skin as an indicator of beauty and social status. The purpose of this study was to examine the psychological and socio-cultural factors that influence the practice of skin bleaching in the postcolonial society of Jamaica. Additionally, the study outlined the nation's efforts to combat the skin-bleaching phenomenon. The naturalistic paradigm of inquiry was used to frame the study and to collect and analyze data. The sample consisted of fifteen participants—twelve participants (six males and six females) with a history of skin bleaching; a retailer of skin lightening products; a local dermatologist who has written and published in local newspapers on the practice; and a representative from the Ministry of Health who was integrally involved in the national educational efforts to ban the practice. Data came from three sources: in-depth interviews with respondents; observation of participant's skin-bleaching practices; and a review of local cultural artifacts from popular culture and the media. Data from the audio recorded and transcribed interviews were analyzed using a thematic analysis. Some of the findings reveal that there are multiple and inconsistent definitions of bleaching; skin bleaching enjoys mixed reviews—much attributed to economic and social class distinctions; bleachers demonstrate and boast of their expertise in managing the bleaching process suggesting, that because of this expertise, they are immune to any negative side-effects of the practice; the bleaching practice was found to be intermittent, time consuming and laborious, costly and addictive; there are several motivations for the skin-bleaching practice, and these are primarily connected to issues of fashion, beauty, popularity, self-image and acceptability; there is a certain level of defiance towards the government‘s efforts to ban bleaching yet an expressed sense of responsibility among bleachers. The overall findings show that there is a bias in Jamaica for light skin over dark skin and these values are taught in non-formal and informal ways from very early in life. The practice of skin bleaching is of social and public health concern, and this study has implications for national policy, practice and theory.

Syfte: Syftet med studien var att undersöka det förväntade resultatet (outcome expectations) vad gäller fysiska, själv-värderande och sociala förväntningar av regelbunden träning hos äldre fysiskt aktiva respektive fysiskt inaktiva och även jämföra de båda grupperna och se om skillnad förelåg. Metod: 32 stycken deltagare inkluderades i studien genom bekvämlighetsurval för att representera populationen äldre (&gt;65 år) friska individer. Deltagarna fick fylla i en enkät gällande motionsvanor senaste 12 månaderna och delades sedan in i grupperna regelbundet fysiskt aktiva respektive inaktiva beroende på vad de svarat i enkäten. Deltagarnas förväntningar på resultatet av regelbunden fysisk aktivitet mättes sedan med en enkät kallad Multidimensional Outcome Expectations for Exercise Scale (MOEES) som undersöker fysiska, själv-värderande och sociala förväntningar. Resultat: De regelbundet fysiskt aktiva hade högre resultatförväntningar på regelbunden fysisk aktivitet gällande fysiska förväntningar. Ingen signifikant skillnad mellan grupperna kunde ses gällande själv-värderande och sociala förväntningar. Konklusion: Äldre som regelbundet är fysiskt aktiva har högre fysiska förväntningar på fysisk aktivitet än äldre inaktiva. Fler studier som undersöker och jämför det förväntade resultatet gällande fysiska, själv-värderande och sociala förväntningar av fysiskt aktivitet mellan äldre aktiva och inaktiva behövs för att styrka sambanden mellan att vara fysiskt aktiv och vad äldre förväntar sig att få ut av det. / Purpose: The purpose of this study was to examine outcome expectations in terms of physical, self-evaluative and social expectations of regular physical activity/exercise in physically active or physically inactive older adults, and compare the two groups and see if any difference existed.Method: The participants were 32 conveniently selected individuals, representing the population elderly (&gt; 65 years) and healthy individuals who are regularly physically active or inactive. The participants answered a questionnarie regarding their level of physical activity during the last 12 months which divided them into two groups, physically active or physically inactive. The Multidimensional Outcome Expectations for Exercise Scale (MOEES) questionnaire was then used to measure the participant´s level of outcome expectations of regular physical activity/exercise. Results: The regularly physically active participants had higher scores on MOEES, in terms of physical expectations than participants who were physically inactive. No significant difference where seen between the two when comparing the total score of MOEES and the subgroups self-evaluative, and social expectations for regular physical activity/exercise. Conclusion: This study showed that there in older adults, is a relation between being physically active and having higher physical outcome expectations of physical activity/exercise. Further studies which examines outcome expectations in terms of physical, self-evaluative and social expectations of regular physical activity/exercise, in physically active or physically inactive older adults is warranted.

The current study examined the influence of social cognitive variables on physical activity and proposed an intervention for an 8-week physical activity promotion program. Four specific components were examined: implementation intentions, goal commitment, barrier self-efficacy, and value. Participants included faculty and staff enrolled in a university Employee Wellness Program. Participants in the treatment group received goal-setting prompts focused on developing implementation intentions, identifying the value of outcome expectancies, and overcoming self-efficacy barriers. Participants in the control group did not receive goal-setting prompts. The use of goal-setting prompts did not result in significantly more minutes spent exercising. Overall, participants who received goal-setting prompts maintained their engagement in physical activity throughout the program, while participants in the control group steadily declined after week 5. For the treatment group, physical activity was dropping after the first week, but after receiving implementation-intentions prompts, physical activity increased. The use of implementation intentions should be further investigated. Additionally, the use of administering prompts throughout the complete program should be examined.