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The relationships between health, the scientific approach in medicine and concepts of epidemiology underlie theoretical and cultural attitudes of the nature of behavior and health risks. Medical tests that diagnose risk factors are thought to be predictive of disease. Physicians employ these tests to more accurately assess the health of their patients and convince their charges to change their behaviors. Communication of newly described risk factors is challenging for both physicians and patients as each party negotiates modifications of behavior and perceptions of reality.

Magister Artium (Child and Family Studies) - MA(CFS) / Families remain a major social support system that plays a key role in the provision of primary healthcare (PHC) for children, and this role is especially important as PHC would normally take place before a child is taken to hospital for further treatment. The literature shows that although families have a direct influence on their children’s PHC, the former’s role is limited as a result of socio-economic factors such as poverty, unemployment and distance to healthcare centres. In South Africa, PHC is offered by the state but is of a lower standard than the more specialised, ‘hi-tech’ health services available in the private sector. Although the public health sector is over-stretched and under-resourced, the government has established PHC facilities in many locations throughout South Africa. This status quo requires families to play a role by knowing the locations of such facilities in order to maintain their children’s health. The provision of primary health in South Africa is a two-tiered system that requires the involvement of both families and healthcare providers. The results of the study indicated that there were various interpretations of PHC by both parents and health professionals, owing to different levels of knowledge about the concept. The lack of knowledge of the various forms of home remedies greatly affected the application of PHC in terms of a need to appreciate PHC practices in the family setting; and health professionals need to disseminate knowledge to parents on a routine basis as part of their work at hospitals. The findings furthermore suggested that parents and healthcare workers faced various challenges in the provision of PHC. The implications of the study pointed to the need for a more extensive study that engaged a high number of participants of both parents and healthcare professionals to place the results into perspective. Other implications required a concerted effort from government, parents, healthcare professionals and other stakeholders to arrive at a prudent and logical improvement of PHC in South Africa.

Background: Older Canadian women are not meeting recommended calcium intake levels and therefore require calcium supplementation to maintain bone mass. Objective: To examine factors associated with calcium supplementation among older community-dwelling women, using the Health Belief Model (HBM) as a conceptual framework. Methods: Data previously collected from Ontario community-dwelling women aged 65 to 90 years (n=798) were analyzed. Multivariable logistic regression was utilized to determine HBM factors associated with calcium supplement use. Results: About half (54%) of women reported taking calcium supplements. Positive correlates of calcium supplementation included: perceived osteoporosis susceptibility, perceived calcium benefits, natural health product use, residing in Toronto and general osteoporosis management factors (discussion with a physician or pharmacist, osteoporosis screening, falls history and preventive health check-ups); a negative correlate included: use of etidronate therapy. Conclusion: Only half of older women were taking calcium supplements. Discussions with healthcare practitioners may help to improve recommended calcium intake levels.

Background: Older Canadian women are not meeting recommended calcium intake levels and therefore require calcium supplementation to maintain bone mass. Objective: To examine factors associated with calcium supplementation among older community-dwelling women, using the Health Belief Model (HBM) as a conceptual framework. Methods: Data previously collected from Ontario community-dwelling women aged 65 to 90 years (n=798) were analyzed. Multivariable logistic regression was utilized to determine HBM factors associated with calcium supplement use. Results: About half (54%) of women reported taking calcium supplements. Positive correlates of calcium supplementation included: perceived osteoporosis susceptibility, perceived calcium benefits, natural health product use, residing in Toronto and general osteoporosis management factors (discussion with a physician or pharmacist, osteoporosis screening, falls history and preventive health check-ups); a negative correlate included: use of etidronate therapy. Conclusion: Only half of older women were taking calcium supplements. Discussions with healthcare practitioners may help to improve recommended calcium intake levels.

Objective¡G Influenza is an important public health problem, and may seriously damage the elderly population. Although influenza vaccination is a safe, and can significantly reduces morbidity and influenza -related complication mortality in elderly people, however, the influenza vaccination rate did not reach expected goals. Therefore, to explore the potential factors that affect the vaccination rate becomes a critical research question. The purpose of this study was to apply the Health Belief Model, which includes demographic, health state and healthy behaviour, knowledge about influenza and influenza vaccine, perceived susceptility, perceived seriousness, perceived benefit and barrier, and cues to action variables, to understand factors motivating the community elderly people to receive influenza vaccination. Design: The sampling designs were stratified and systematic sampling with total 700 sample. During June 2007 , a structured questionnaire was sent to the elderly people¡]¡Ù65 years¡^in Kaohsiung city¡C Result: The male and female sample distribution rates were equally in 50%, average age was 72.87 years old and 59.6% elderly people had chronic disease (such as hypertension, heart disease and diabetes). Chi-square tests showed that ¡§chronic disease¡¨, ¡§health examination¡¨, ¡§always seek care from specific physician¡¨, ¡§exercise ¡§, ¡§ recognize about influenza and influenza vaccination¡¨, ¡§ perceived seriousness¡¨, ¡§ perceived benefit and barrier¡¨, were significantly associated with having ever been vaccinated. Logistic regression results indicated that ¡§think the influenza vaccination can effectively prevent influenza¡¨, ¡§regular health examination¡¨, ¡§cues to action¡¨ and ¡§perceived barriers¡¨ were found to be the significant predictors of acceptance of influenza vaccination. Conclusions¡GThe study results indicated that health care worker¡¦s attitude about influenza and influenza vaccination will directly influence community elderly people's cognition. Therefore, by educating the health care worker about influenza seriousness and the vaccination effectiveness may successfully promote vaccination rate. Through health education activities in the community, it may increase correct cognition about influenza and the benefit of vaccination. In addition, the health department needs to strengthen the health policy marketing in order to increase influenza vaccinations rate, reduce morbidity and influenza -related complication mortality.

In Taiwan, colorectal cancer incidence rate and mortality rate had been increased remarkably. Colorectal cancer was the third leading cause of death in all cancers in Taiwan, which had cause serious threaten on the health condition of people. The CRC screening rate is relatively low in Taiwan, from the statistic information in Bureau of Health Promotion shows that less than 20 % of colorectal cancer cases were detected on stage 0 and stage £L in Taiwan. The early detection rate was relatively low as comparing with colorectal cancer in the United States. However, if colorectal cancer is vital for the optimal treatment to obtain a correct diagnosis promptly, the long-term survival rate can reach as high as 90% for the early staged CRC. As we know, regular screening examination for colorectal cancer was the first step to treat colorectal cancer. The key point for promoting the colorectal cancer screening rate was to realize the factors which affecting the willingness of receiving the screening examination among older adults. Due to that, this study is aimed to identify the attitude toward screening and health-belief recognition among older adults above 40 years old within the community screening program, in order to realize factors influence the older adults¡¦ willingness of the colorectal cancer screening and Colonoscopy. The study design was a cross-sectional co-relational community-based survey. The data collection period was from August 2007 to May 2008. Data were collected from older adults which above 40 years old in Taipei and Kaohsiung. There were 462 samples which included 279 samples were having an experience of CRC screening before, and 183 samples were never had such screening before. The data was analyzed with descriptive statistics and inferred statistics such as Chi-square, Independent T-Test, Logistic regression analysis, Path analysis. The Logistic regression analysis was used to determine the related factors which might affecting the willingness of CRC screening among the older adults in community, including the factors applying from Health Belief Model such as Perceived threat, Perceived benefits of taking actions, Perceived barriers of taking actions, Cues to actions, Self-Efficacy, Health Motivation. Also addressed the factors related to attitudes such as fear about cancer, worry about accurate or safety of screening method, optimistic. The results of the study were as following. (1)In health belief related sectors, Perceived threat, Barriers, Cues to actions were significant with both the willingness of receiving Colonoscopy and FOBT screening. Except for those three factors that mentioned above, Health motivation would influence the willingness of FOBT screening, instead of Colonoscopy. (2) In attitude related sectors, fear about cancer, worry about accurate or safety of screening method were significant with both the willingness of receiving Colonoscopy and FOBT screening. (3) In health status sectors,bowel symptoms were significant with the willingness of receiving FOBT screening. Health behavior would only significant with the willingness of receiving Colonoscopy. (4) Age, social activity, screening experience would affect the willingness of receiving FOBT screening. On the other hand, the willingness of receiving Colonoscopy was no significant with demographic characteristic. Besides, the results of the path analysis were shown as below. (1)Optimistic would affect Cues to actions factor, and health behavior may affect Health motivation factor, under such relation, optimistic and health behavior would indirect affect the willingness of receiving FOBT.(2)Bowel symptoms would affect Perceived threat which may indirect affect the willingness of receiving Colonoscopy. (3)The knowledge of CRC and CRC screening would also indirect affect the willingness of receiving FOBT and Colonoscopy. The major attribution of this study was to realize the factors influence the willingness of accepting CRC screening, which could provide for health promotion policy makers to develop suitable policy for CRC health protect planning. The study may be implicated in the following aspects¡G(1) Not only settle the goals of screening, and also suggest policy makers to promote the awareness and health belief toward colon cancer to target groups which the study result had shown. (2)With the union of the community and medical, physician counseling may enhance the CRC screening rate, especially Colonoscopy. (3)Fulfill the knowledge of detect colon cancer and CRC screening among older adults, make themselves know how to decrease the threat of the disease, in order to achieve the goal of improving their health and saving the expense of the injure.

Master of Science / School of Family Studies and Human Services / Jared R. Anderson / Couples often wait until the very end to seek help for their relationship, with divorce being one of the primary concerns cited in couple’s therapy (Doss, Simpson & Christensen, 2004). While couples appear to be reluctant to seek formal resources, we know that over 50% of individuals are confiding in friends and family about their relationship (Lind Seal, Doherty, & Harris, 2015). Currently, the literature is limited and unable to provide a comprehensive explanation for why individuals do or do not seek help for their relationship. Using an interdisciplinary approach, we adapted a medical model- the Health Belief Model (HBM)- to relationship help-seeking. Based on the success of this model at predicting help-seeking behaviors related to physical and mental health, we believe it could be applicable to relationship help-seeking. In addition to identify factors associated with relationship help-seeking behaviors, we hope to identify factors that mediate both formal and informal relationship help-seeking behaviors. To study this we collected data from 347 individuals in emotionally committed relationships. The results of the analysis showed that the perception of threats, such as greater relationship instability and greater negative social comparison, were linked to more online help-seeking; whereas expectations such as the greater endorsement of stigma of self and masculinity were linked to lower levels relationship help-seeking behaviors and worse attitudes toward help-seeking. Furthermore, greater stigma of self was found to be directly linked to having a worse attitude toward help-seeking, as well as indirectly linked to lower rates of formal and online relationship help-seeking behaviors via the prior effects of attitudes toward help-seeking. The results of this study suggest further areas for investigation in regard to relationship help-seeking, specifically around self-stigma.

Human Immune Virus (HI)V /Acquired Immune Deficiency Syndrome (AIDS) has emerged as the most devastating epidemic that the world has experienced. Voluntary counselling and testing (VCT) has proven to be an effective way of preventing and controlling HIV. South African universities provide free VCT services on their campuses; however, these facilities are underused. The study’s objectives were to use the components of the health belief model (HBM) to explore and describe the factors that influenced the decision made by university students who have gone for VCT. The sample consisted of five male students. Data was collected through one-on-one in depth interviews, which were recorded. Data was analysed using thematic analysis, and the components of the HBM were used as codes for the data. Themes were generated for each component. The results indicated that perceived severity, perceived benefits and cues to action played a role in influencing the participants’ decision to go for VCT. In addition, results show that perceived susceptibility had little influence on their decision to go for VCT. Even though participants acknowledged barriers to VCT, they reported that the perceived benefits for VCT outweighed the barriers, and the decision to go for VCT was made. Participants suggested that to increase uptake of VCT on their campus, the university could improve current VCT campaigns, introduce rewards for VCT and introduce couples VCT.

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