Prevention and slowing the progression, of chronic diseases ( such as cancer, heart disease, arthritis, diabetes, asthma, osteoporosis, dementia and incontinence ), and influencing risk factors and health behaviours of a population, relies on the best available data - driven evidence. The quality of measurement techniques to collect representative population health survey and surveillance data is, as a consequence, brought under scrutiny. The presentation of this thesis is the culmination of 17 years work that has been focused on contributing to improving public health in South Australia. It is premised on the understanding that continual epidemiological assessment using representative population health surveys can deliver evidence - based information needed by health policy makers, health planners and health promoters to make appropriate, timely and efficient evidence - based decisions. The objective of the portfolio of published papers was to demonstrate the contribution to producing quality data - driven evidence using population surveys through rigour in collecting self - reported data, diversifying surveillance data collection methods and facilitating collaboration. This portfolio presents papers that have addressed a range of methodological and chronic disease and risk factor epidemiological issues. In terms of demonstrating rigour the publications have addressed the bias associated with non - response, the methodological rigour inherent in face - to - face surveys, the differences in estimates that can occur based on mode of administration, the science of telephone surveying and the importance of good questionnaire design to produce valid and meaningful data. The literature presented has also demonstrated the first South Australian population - wide prevalence survey dealing with the consequences of domestic violence and associated issues ( for males and females ) in the community, and in doing so, demonstrated the use of the telephone to collect large - scale data in Australia on domestic violence and associated factors in the population. In addition, the first time the importance of undertaking an array of methodological precautions during the data collection phase associated with collecting data on sensitive health issues on the telephone was demonstrated in Australia as was the assessment of the bias obtained in health estimates dependent upon which telephone - based sample was used. In demonstrating the need for diversity in data collection the research submitted within this thesis has demonstrated the range of telephone surveying development issues and challenges in Australia and the benefits and the value of both face - to - face and telephone as survey data collection tools in Australia. The publications also made a significant contribution to the literature in the survey methodology area, in particular, within the systematic error in questionnaire design, the measurement error in BMI self - reported measurements, validity of self - reported height and weight, and the overall CATI methodology area. Epidemiological collaborative research in particular in the areas of social capital, HRT, mental health, suicide ideation, osteoporosis, interpersonal violence, chronic disease epidemiology and risk factor epidemiology was demonstrated. As a consequence of my research, surveying populations about their health is now entrenched into public health and health service sectors in SA. Rigour in collecting self - reported data, diversifying survey and surveillance data collection methods and facilitating collaboration, has produced quality date - driven evidence for South Australia. / Thesis (Ph.D.)--University of Adelaide, School of Medicine, Discipline of Medicine, 2006.

A severe burn is a trauma fraught with stress and pain and may change the entire course of life. This thesis focuses on care utilisation, care experiences and patient satisfaction after a severe burn. The patients studied were treated at the Burn Unit at Uppsala University Hospital between 1980 and 2006. Burn-related health was examined using the Burn Specific Health Scale-Brief (BSHS-B), personality traits with the Swedish universities Scales of Personality (SSP), psychological symptoms using the Hospital Anxiety and Depression scale (HADS), symptoms of posttraumatic stress with the Impact of Event Scale-Revised (IES-R) and satisfaction with care using the Patient Satisfaction-Results and Quality (PS-RESKVA) questionnaire. Those utilising care years after injury reported poorer functioning on three of the BSHS-B subscales. Personality traits had a greater impact on care utilisation than injury severity. Social desirability was lower among care utilisers and was associated with burn-related health aspects. The participants reported a low level of negative care experiences, the most common of which was Powerlessness. Most patients were satisfied with care, more with quality of contact with the nursing staff, and less with treatment information. Multiple regressions showed that the BSHS-B Interpersonal relationships subscale was an independent variable related to all measured aspects of patient satisfaction. The highest adjusted R2 was 0.25. In a prospective assessment with multiple regression analyses, Age and Education, the personality traits of Stress susceptibility, Trait irritability, Detachment and Social desirability, in addition to the post-traumatic stress symptoms Intrusion and Hyperarousal, were predictors of satisfaction with care. The highest adjusted R2 was 0.19. The thesis has pointed out that interpersonal factors are related to care utilisation as well as satisfaction with care. However, satisfaction with care was only moderately associated with health and individual characteristics, which may imply that the care itself is of major importance.

Increasing evidence suggests that the environment is related to many public health challenges. Unequal distributions of services and resources needed for healthy lifestyles may contribute to increasing levels of health disparity. However, empirical studies are not sufficient to understand the relationship between health disparity and the built environment. This dissertation examines how health disparity are associated with the built environment and if the environmental conditions that support physical activity and healthy diet are associated with lower health disparity. This research uses a multidisciplinary approach, drawing from urban planning, regional economics and public health. The data came from the Behavioral Risk Factor Surveillance System, and the GIS derived environmental data and the 608-respondent survey data from a larger study conducted in urbanized King County, Washington. Health disparity was measured with the Gini-coefficient, and health status and obesity were used as indicators of health. Hot spot analysis was used to identify the spatial aggregations of high health disparity, and multiple regression models identified the environmental correlates of health disparity. The overall trend showed that disparity has increased in most states in the US over the past decade and the southern states showed the highest disparity levels. Strong spatial autocorrelations were found for disparities, indicating that disparity levels are not equally distributed across different geographic areas. From the multivariate analyses estimating disparity levels, spatial regression models significantly improved the overall model fit compared to the ordinary least-square models. Areas with more supportive built environments for physical activity had lower health disparities, including proximity to downtown (+) and access to parks (+), day care centers (+), offices (+), schools (+), theaters (+), big box shopping centers (-), and libraries (-). Overall results showed that the built environment, compared to the personal factors, was more strongly correlated with health disparities. This study brings attention to the problem of health disparity in the US, and provides evidence supporting the existence of spatial disparity in the environmental support for a healthy lifestyle. Further research is needed to better understand environmental and socioeconomic conditions associated with health disparity among more diverse population groups and in different environmental settings.

From the viewpoint of the public, academic work is relatively autonomous, stable, and stress-free as opposed to other professions. However, as the societal environment evolves, high satisfaction is no more an absolute consequence of academic work. Even in comparison to other professionals, the academics experienced longer working hours and heavier occupational stress; hence the events of ¡§Karoshi¡¨ among university academics happened from time to time. Actually, the reason resulting in ¡§Karoshi¡¨ has been proved related to health behavior, and the health behavior also has been proved associated with health belief. Following this concept, a study based upon ¡§health belief model¡¨ was carried out to investigate the health belief, health behavior, and health status of university academics, respectively, and the possible relationships among the aforementioned health related concepts. In total, 4,000 subjects were selected from among the 43,050 or so university academics nationwide based on stratified sampling approach. Data were collected through survey questionnaires which include personal demographics, health belief, health behavior, and health status information. From June through August 2004, 1,778 questionnaires returned with a response rate of 44.45%. SPSS was used for descriptive analysis and basic hypothesis test, and then the software package AMOS was used for structural equation modeling examination. Compared to the general population with the same age, the health status of university academics was worse in both physical and psychological function. Further, it was found that the factor work significantly contributed to each component of health belief (i.e. perceived susceptibility, perceived seriousness, perceived barriers, and perceived benefits). In terms of health behavior, although the academics had no unhealthy habits (i.e. smoking or excessive drinking), the average working hour after 10 pm was more than one hour and one in three teachers didn¡¦t take exercise regularly, which altogether are definitely harmful to health. The structural equation modeling showed that an academic¡¦s health belief would influence his/her health behavior and then influence the health status indirectly. In other words, positive health belief will lead to healthy status in the long run, and negative health belief will conduce to unhealthy status. To sum up, the issue on improving the health status of academics is on edge and the responsibility for taking this issue would be shouldered by teamwork¡X individuals, educational authorities, and public health agencies. An academic should try his/her best to improve the health; the educational authorities should assess the job loading on academic population from time to time and draw up a better educational system; and finally, the public health agency should play the role of information disseminator and catalyst for strengthening the health belief and then improving the health behavior and health status among the academics.

According to a recent report that in Taiwan, more than 50% health problems were due to unhealthy and harmful life styles. Most people, especially at workplace, either live under pressure, work sedentarily, exercise their body little or have a unhealthy diet. The subsequent problems of the overweight, sleeplessness and a declined condition of physical fitness all lead to health problems. A Quasi-experimental design of purposive samples was conducted using 51 participants from employees or faculty members from one school and one hospital. The purpose of this study is to investigate the effects of health self-management program with nutritional and exercise intervention to improve the participants¡¦ physical and psychological health status. Research measuring tools include a structural questionnaire, SF-36 scale, laboratory examination (blood test), physical fitness test administrated to the participants, and a 12-week follow-up test. After the intervention of health self-management, there were significant differences in sleep pattern and diet behavior. On health belief congnition, perceived susceptibility, perceived seriousness, and percieived barriers were increased. On the SF-36 scale, higher scores were attained on mental health dimension. Furthermore, Cholesterol, SGOT, SGPT, B.U.N, Crattinine, Uric acid and blood sugar were significantly decreased. As for body composition, fat mass and waist-hip-ratio were significantly reduced, while for physical fitness, muscular strength endurance and cardiorespiratory endurance were much improved among participants. The results suggest well-designed health self-management activities can reduce unhealthy habit and improve mental and physical health status. Furthermore, it can serve as one important component of health promotion stratigies.

Thesis (Ph. D.)--University of Chicago, School of Social Service Administration, 2001. / Includes bibliographical references. Also available on the Internet.

Thesis (Ph. D.)--University of Washington, 2003. / Vita. Includes bibliographical references (leaves 203-217).

Thesis (Ph. D.)--University of Washington, 2002. / Vita. Includes bibliographical references (leaves 133-141).

Lesotho, like any other country of the world, is faced with the task of improving the / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2007.

Spatial epidemiological studies which assume perfect health status information can be biased if imperfect diagnostic tests have been used to obtain the health status of individuals in a population. This study investigates the effect of diagnostic misclassification on the spatial statistical methods commonly used to analyze regional health status data in spatial epidemiology. The methods considered here are: Moran's I to assess clustering in the data, a Gaussian random field model to estimate prevalence and the range and sill parameters of the semivariogram, and Kulldorff's spatial scan test to identify clusters. Various scenarios of diagnostic misclassification were simulated from a West Nile virus dead-bird surveillance program, and the results were evaluated. It was found that non-differential misclassification added random noise to the spatial pattern in observed data which created bias in the statistical results. However, when regional sample sizes were doubled, the effect from misclassification bias on the spatial statistics decreased.