Abstract Dental diseases such as dental caries and periodontal disease could well be seen as being behaviour-related. The high prevalence of periodontal disease in the Finnish adult population mirrors the need for improving oral health behaviours in a comprehensive manner. Thus far, scant attention has been drawn to the underlying psycho-social factors that could, in part, explain oral health and oral health behaviours. Deficiencies in oral health behaviour may also be indicative of an individual's poor health behaviour in general. The aim of this study was to introduce the salutogenic approach, called sense of coherence, into the domain of oral health and health behaviour. The present study uses data from the nationally representative Health 2000 survey carried out in 2000–2001 by the National Public Health Institute of Finland. The subjects of this study numbered 4175 in article I, 4131 in article II, 4039 in article III, and 4096 in article IV, and were 30- to 64-year-old dentate men and women. The cross-sectional data was collected via home interviews, self-administered questionnaires, or clinical examinations. Sense of coherence was positively associated with oral health behaviours, such as dental attendance and tooth-brushing frequency. In addition to tooth-brushing frequency, sense of coherence was also positively associated with the level of oral hygiene. The association between sense of coherence and level of oral hygiene weakened only marginally after controlling for tooth-brushing frequency. A strong sense of coherence was strongly associated with a positive oral health-related quality of life (OHIP). Sense of coherence was also associated with all of the OHIP sub-scales, and the association was most evident in the psychological discomfort, psychological disability and handicap sub-scales. Among males, health behaviours seemed multidimensional, whereas they tended to be unidimensional among females. A strong sense of coherence was a common determinant of healthy behaviours in general, as well as of a good subjective health status. The present study recognizes the sense of coherence as a common health-promoting determinant of oral and general health behaviours, good oral health, and a good oral health-related quality of life. The results thus suggest that the role of psycho-social factors should not be underestimated in health promotion.

OBJECTIVES: The Government of Canada legalized the recreational use of cannabis on October 17th, 2018. Our objectives were to determine the prevalence of Canadians (aged 15 years or older) intending to try or increase their cannabis use following legalization and explore characteristics associated with the intent to try or increase use. METHODS & DATA ANALYSIS: A secondary data analysis was conducted of cross-sectional data from Waves 1–3 of the National Cannabis Survey collected from February to September 2018. All respondents’ data were weighted and bootstrapped multivariable logistic and multinomial regression models were developed. Relative measures of association were reported as adjusted odds ratios (aORs) and relative risk ratios (RRRs), and absolute measures of association as adjusted risk differences (ARDs). RESULTS: Response rates were 51.2% (Wave 1), 51.3% (Wave 2), and 51.6% (Wave 3). An estimated 18.5% (95%CI: 17.6–19.5) of the study population indicated that they intended to try (12.3%) or increase (6.2%) cannabis use following legalization. Our weighted analysis represented 27,808,081 Canadians 15 years of age or older (unweighted n = 17,089). In our adjusted logistic model, being more likely to try or increase cannabis use was associated with younger age (15–24 years versus ≥65; aOR 3.8, 95%CI: 2.6–5.6; ARD 20.1%, 95%CI: 13.9–26.2), cannabis use in the past three months versus not (aOR 3.3, 95%CI: 2.8–3.9; ARD 20.4%, 95%CI: 17.1–23.6),higher income (≥$80,000 versus <$40,000; aOR 1.5, 95%CI: 1.3–1.9; ARD 6.1%, 95%CI: 3.2–9.0), and poor or fair mental health compared to good or excellent mental health (aOR 2.0, 95%CI: 1.6–2.6; ARD 11.5%, 95%CI: 6.7–16.2). CONCLUSIONS: Nearly 1 in 5 respondents reported their intention to try or increase cannabis use post–legalization. Intentions may not lead to actual changes in behaviour and further surveillance of cannabis use can help determine impact of policy change. / Thesis / Master of Public Health (MPH)

Yes / To assess physical activity outcomes of a pedometer-based physically active learning (PAL) intervention in primary school children. Methods: Six paired schools were randomly allocated to either a 6-week teacher-led pedometer-based physically active learning intervention or a control (n = 154, female = 60%, age = 9.9 [0.3] y). Accelerometers assessed total daily sedentary time, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). Preintervention mean daily MVPA minutes grouped participants as Low Active (<45 min/d) and High Active (≥45 min/d). Results: From the final sample size, the intervention (n = 52) significantly improved LPA versus control (n = 31, P = .04), by reducing sedentary time. More intervention (+10%) than control (+3%) pupils met the 60 minutes per day guidelines. In both intervention subgroups, pupils spent less time in LPA (P < .05) versus control. The greatest nonsignificant increase was found in the Low Active pupils MVPA levels. Conclusions: Improvements in LPA were statistically significant in the intervention versus control group. In subgroup analysis, Low Active pupils in the intervention showed the greatest beneficial effects and the Most Active pupils may have replaced MVPA and sedentary time with LPA. The intervention group housed clusters of pupils showing variable responsiveness, justifying routine examination of subgroup variability in future studies.

Cognitive behavioural theory suggests that excessive use of the Internet for health purposes can contribute to health anxiety but previous research examining the relationship between health anxiety and health-related Internet use is limited. This thesis aimed to explore if and how health-related Internet utilization and health anxiety are related, and whether such Internet use can exacerbate the health anxiety of health anxious individuals. Study 1 aimed to examine the possible relationship between health anxiety and the extent of, reasons for, and effects of health-related Internet use in university students, using a bespoke, theory-based questionnaire. Results suggested that health anxiety was significantly related to heightened and potentially problematic health-related Internet use, including: more frequent use, a greater proportion of health (vs. non-health) information sought, more time spent online for health purposes, more searches for illness information, and heightened tension post-search. We also found correlations between health anxiety and six-items concerning possible Internet addiction for health purposes. Study 2 sought to obtain information about health anxious individuals’ perspectives on health-related Internet use, using qualitative methodology. Themes uncovered during analysis were consistent with the results of study 1, and highlighted several other aspects of health-related Internet use that were relevant to health anxious users, including: metacognitions, Internet disadvantages, and health anxiety for others etc. Study 3 used the results of studies 1 and 2 to develop and psychometrically evaluate a new Internet use questionnaire in a large, non-clinical sample. Results suggested that the measure was both valid and reliable. Spearman correlations and simultaneous regressions substantiated previous findings from our earlier studies. Three aspects of health- related Internet use were uniquely predictive of health anxiety (illness-related Internet use: self; problematic use of the Internet for health purposes; anxiety post-search/perceived adverse consequences of searching). Study 4 aimed to determine the effects of presenting online health information in a manner designed to facilitate disconfirmatory information processing on subsequent anxiety, worry and illness beliefs. Results suggested that facilitating disconfirmatory information in this way was ineffective in reducing negative emotional outcomes post-search. Study 5 compared the frequency of ‘query escalations’ (searches for common, benign symptoms escalating to the consideration of serious causes/diseases) during online health searches between high and low health anxious students. We also examined the participants’ rationale for escalating queries and the effects of escalating on anxiety. Results found instances of query escalation in both high and low health anxious groups; though high health anxious participants were more likely to escalate their queries. Both groups reported increased anxiety post-escalation. In the final chapter I briefly summarise our studies, discuss major findings and the implications of our research, critically appraise our methodology, choices, and studies, and make recommendations for future research in this area.

Vidinė darna įvairių autorių yra laikoma vienu iš fizinės ir psichinės sveikatos išteklių, žmogaus atsparumo ir sėkmingos adaptacijos pagrindu. Nustatyta, kad pedagogų darbas yra vienas stresiškiausių, o tyrimų nagrinėjančių pedagogų vidinę darną atlikta per mažai, todėl šio darbo tikslas buvo įvertinti Vilniaus universiteto dėstytojų vidinės darnos lygį, gyvenseną ir jų sąsajas. Medžiaga ir metodai. Tyrime dalyvavo 289 VU dėstytojai, nuo 25 iki 72 m. amžiaus. Duomenų rinkimui buvo naudotas anoniminės anketinės apklausos metodas. Respondentams pateikta anketa, kurioje buvo demografinius duomenis, gyvenseną bei vidinę darną vertinantys klausimai (3 ir 13 klausimų klausimynai). Vidinė darna ir jos komponentai buvo vertinami pagal „Gyvenimo orientacijos anketą“ (A. Antonovsky, 1987), kurią sudarė 13 klausimų. Naudotas paplitimo epidemiologinis tyrimo tipas. Duomenų analizė atlikta statistine programa SPSS for Windows 13 versija. Naudotas statistinio reikšmingumo lygmuo p < 0,05. Rezultatai ir išvados. Rezultatai parodė, kad VU dėstytojai savo gyvenimo kokybę ir sveikatos būklę dažniausiai vertina kaip gerą. Gyvenimo kokybę geriau įvertino moterys, vieniši ir kelias darbovietes turintys dėstytojai. Lėtinėmis ligomis sirgo 43 proc. dėstytojų, iš jų dažniausiai našliai/ės. Tyrimo metu nustatyti, statistiškai reikšmingi skirtumai tarp gyvensenos veiksnių ir dėstytojų lyties, amžiaus bei šeimyninės padėties. Šiuo metu rūkantys prisipažino 38 proc. dėstytojų. Didesnis rūkymo... [toliau žr. visą tekstą] / Different authors consider sense of coherence to be one of the physical and mental health resources, stress resistance and successful adaptation basis. It is done not enough researches dealing with educationalists and sense of coherence, although it was found that pedagogical work is one of the most stressful. The aim of this work was to analyse the health behaviour, Sense of Coherence (SOC) and interfaces between them in the population of the lecturers in Vilnius University. Materials and methods. 289 Vilnius university lecturers of 25-72 years old age (mean age 43,82) participated in this survey. An anonymous questionnaire for getting data about social-demographic factors, health behaviour, subjective health assessment created by author was used in the survey. In the questionnaire Sense of coherence was measured with “The orientation to life questionnaire” consisting of 13 questions. It was composed by A. Antonovsky (1987). Data analysis was performed using Statistical program SPSS for Windows 13 version. Level of statistic significance was p< 0.05 Results and conclusions. The results showed that the quality of life and subjective health assessment mostly was reported as good. Single respondents ant those who had more than one workplace reported to have better quality of life. 43 % of lecturers reported to have chronic diseases, most of them were widows(-ers). Examination revealed that it was statistically significant differences between lifestyle and respondents gender... [to full text]

Regular physical activity (PA) participation and fruit and vegetable (FV) consumption confers numerous positive health outcomes for cancer survivors, including prevention of cancer recurrence, second primary cancers, and other non-communicable chronic diseases. Rural-living young adult cancer survivors (YAs) possess unique barriers and concerns that influence their ability to participate in traditional face-to-face behaviour change interventions. Few researchers have explored alternative means for delivering behaviour change interventions grounded in theory utilizing a mixed-methods approach to assess processes of change and behavioural outcomes. To fill this gap and provide recommendations for future interventions and services focused on positive health behaviours in this population, the objective of the research presented in this thesis was to explore the feasibility and acceptability of a 12-week theory-based telehealth behaviour change intervention aiming to improve PA and FV consumption using a single-arm, mixed methods pilot trial. Over a 7-month period, 14 YAs self-referred. Of these 14, 5 were eligible and consented to participate with 3 completing the study. Retention to the study was 73% and adherence to the health coaching program ranged from 66.67-100% with a 40% attrition rate. Inquiry into the acceptability of the intervention offered insight into participants experiences, which was summarized within five themes: (1) the more time the better, (2) the human factor, (3) supporting access, (4) influencing the basic psychological needs, and (5) finding motivation. Collectively, the findings suggest the methods used require minor modifications before being deemed feasible despite the general acceptability of the intervention. Importantly, they highlight the necessity of more expansive recruitment strategies and a need to explore participants’ underlying intentions for participating in behaviour change interventions. Further, recommendations are made based on the findings to improve this style of intervention, including testing stepped down models of support because it may help some YAs maintain behaviour change post-intervention.

<div>Growing automobile dependency and usage continue to exacerbate traffic congestion, air pollution, and physical inactivity in metropolitan areas. Extensive efforts have been made to leverage advanced technology and related policies to influence short- (within-day and day-to-day) and long-term (mobility and lifestyle) travel decisions to address these issues from the system operator and individual traveler perspectives. However, most studies have yet to address system operator and individual traveler needs together; provide sufficient understanding of the impacts of such technologies on safety and health; and consider the impacts of distinctive regional and political characteristics on responses to different policies among population subgroups.</div><div>This dissertation seeks to facilitate the leveraging of information technologies and related policies to influence short- and long-term travel decisions by: (1) developing a framework for apps that integrate augmented reality, gamification, and social component to influence travel decisions that address multiple user- and system-level goals, (2) understanding the safety and health impacts of these apps, (3) developing strategies to influence residential location decision-making to foster sustainable post-relocation travel behavior, (4) investigating the impacts of economic and legal policies on travel decisions by considering distinctive regional and political characteristics.</div><div>This dissertation can provide insights to system operators for designing a new generation of apps to dynamically manage traffic in real-time, promote long-term mode shifts from single-occupancy driving to carpooling, public transit use, walking and cycling, and address individual traveler needs. The dissertation also presents app mechanisms for providing feedback to legislators and app developers for designing policies and apps geared towards safe usage and promoting the physical and mental health of its users. </div><div>In addition, by considering the impacts of distinctive regional and political characteristics on population subgroups in terms of their responses to information technologies and economic and legal policies, additional measures can be deployed to support and facilitate the implementation of such technologies and policies.</div><div><br></div>

Bakgrund: Graviditetsdiabetes är den vanligaste metabola sjukdomen hos gravida. Sjukdomen ökar drastiskt relaterat till ökat stillasittande. Åtgärder inkluderar kostråd, råd om fysisk aktivitet, stöd att förbättra levnadsvanor samt vid behov insulinbehandling. Trots att forskning visar att fysisk aktivitet har flera positiva effekter på graviditetsdiabetes är mindre än hälften av populationen så fysiskt aktiva som de rekommenderas vara. För att bättre kunna stötta dessa kvinnor i sitt fysiska aktivitetsbeteende behövs mer information om deras kunskap och utfallsförväntningar avseende fysisk aktivitet. Syfte: Att undersöka hur fysiskt aktiva gravida med graviditetsdiabetes är, vilken kunskap och vilka utfallsförväntningar de har avseende fysisk aktivitet vid graviditetsdiabetes samt undersöka eventuella samband mellan kunskap, utfallsförväntningar och fysisk aktivitetsnivå. Metod: Observationsstudie av icke experimentell design genomfördes med webbenkät skapad i Google Forms. Bekvämlighetsurval från specialistmödravården samt sluten Facebook-grupp. Resultat: Majoriteten ägnade mindre än 30 minuter åt fysisk träning en vanlig vecka, uppfyllde inte rekommendationerna för vardagsmotion samt var stillasittande hela dagen. Majoriteten av deltagarna hade mer än häften rätt på kunskapsfrågorna och var säkra på att fysisk aktivitet är hälsosamt. Korrelationsberäkningarna var inte statistiskt signifikanta. Slutsats: Deltagarna hade kunskaper och höga utfallsförväntningar avseende fysisk aktivitet men låg fysisk aktivitetsnivå. Ytterligare forskning krävs för att undersöka eventuell korrelation. / Background: Gestational diabetes mellitus (GDM) is the most common metabolic disease in pregnant women. GDM increases drastically related to sedentary behaviour. Treatment includes dietary advice, advice on physical activity and if necessary, insulin therapy. Objective: The purpose was to examine how physically active women with GDM are, their knowledge and outcome expectations on physical activity during GDM and whether there is any correlation between knowledge, outcome expectations and level of physical activity. Method: Observation study of non-experimental design was performed with a web-based questionnaire created in Google Forms. Study participants from Specialistmödravården at Akademiska sjukhuset Uppsala and a closed Facebook group. Results: The majority devoted less than 30 minutes to physical exercise a regular week, did not meet the recommendations for everyday exercise and were sedentary throughout the day. Most of the participants answered more than half of the questions correctly and were confident that physical activity is healthy. No significant correlations were found. Conclusion: The study participants had knowledge and high outcome expectations regarding physical activity, but their physical activity level was low. Further research on correlations is required.

Concerns relating to the management of externalising and internalising behaviour are prevalent within UK educational policy and practice and represent a key domain for Educational Psychologist (EP) support. EP practice has been subject to change over time, following shifts in legislative approaches to managing behaviour in schools and changes to the contexts and systems within which EPs work, such as increased service trading. A systematic literature review (SLR) sought to represent EP behaviour practices within the existing literature. 12 papers, published between 2000-2017 were identified using a PRISMA framework and evaluated for methodological quality, appropriateness and relevance of focus. An empirical investigation, utilising the Research and Development in Organisations (RADIO) model within a single-case design, was also conducted within a north-west local authority educational psychology service. A focus group with 5 EPs and the Principal EP (PEP), and an interview with the PEP, were carried out and thematically analysed. The SLR identified a range of behavioural practices at individual, group and organisational levels, exemplifying the core functions of the EP role. Single and integrated psychological paradigms were applied, within relational and social constructionist approaches. The empirical investigation identified a range of behavioural practices, and underlying psychological paradigms, alongside ideas for future developments in behaviour service delivery and the possible facilitators and barriers to achieving this were considered. Reflections on the utility and experience of EP involvement in action research were also facilitated, with content analysis findings presented. Links to theory and practice, and implications for future research are considered, including empirical investigation of EP practice within local contexts. The application of psychology within local contexts and service development processes, are also considered. Finally, following an exploration of the concepts of evidence-based practice and practice-based evidence, and their implications for practitioner psychologists, a dissemination strategy for sharing findings with participants and the wider EP community is proposed.

This formative research examines the effects of health promotion on girls' and young women's health behaviours. Health promotion campaigns targeting women have previously had variable success. Some have been criticised for containing unhelpful values and messages, for example, those that were seen to cause harm to women outside the target population or use of stereotypical symbolism to support the message. Within this study these are called 'unintended consequences'. The Young Women and Health Promotion (YW&HP) study examines the potential for unintended consequences (both negative and positive) of health promotion in general. The focus is then narrowed to examine in more detail whether the use of specific methodologies (such as social marketing), contribute to unintended consequences when promoting physical activity, nutrition and non- smoking messages to girls' and young women. These health behaviours were specifically targeted as they are known to be the major modifiable risk factors for women in the prevention of many chronic illnesses. / This formative research involved the collection and analysis of qualitative and quantitative data from 132 girls and young women across three age categories. These were Year 7 girls (Children - 11-12 years), Year 10 girls (Adolescents - 14-15 years) and young adults (18-25 years). Eighteen focus groups and 15 in-depth interviews were conducted to elicit responses to examine the effects of health promotion on girls' and young women's health behaviours, with particular focus on unintended effects. Current and past health promotion materials, plus a selection of commercial campaigns were utilized to prompt discussion within the groups. The discussion allowed the exploration of girls' and young women's motivators (enabling and reinforcing factors) for personal health behaviours, attitudes and responses to health promotion materials, and the longer-term impacts of health promotion campaigns. A self-administered questionnaire was distributed at the commencement of each focus group, which provided additional information and was later triangulated with the qualitative data. Limitations due to the cross-sectional nature and sampling process of the study mean the results cannot be generalized beyond the study population. However the findings demonstrated that young women are motivated by a complex set of factors. The most common factors influencing the study groups were body image, self-esteem, media and role models. / In addition young women of all age groups had a high awareness of the available messages in the areas studied. All groups discussed the increasing volume of health information available that is targeted at women. Participants noted much of the information originated from commercial sources. This in addition to public health initiatives resulted in increased 'health noise' to which they 'switched off. Furthermore the YW&HP study revealed the importance of written media for women. The young women in this study appreciated the need for mass media advertising, however, preferred to have take-home advice to process at their own time. Discussion of how women process information revealed these young women to be a critical and analytical audience that are often skeptical of health information. Prior to making a decision, therefore, most of the women underwent a process of internal and external validation which included cross referencing information with peers, friends, family and health professionals to establish its accuracy, credibility and validity. Hence the findings of this study would support the need for further exploration of media such as women's magazines to promote health to young women which may in turn prompt discussion with peers and therefore expedite the validation process. / Due to study limitations, results from this formative research need to be interpreted with caution. The results, however, would indicate the area of health promotion and how it communicates health information to young women would benefit from further investigation. The findings suggest many types of media currently being used to communicate health information to young women were useful and appropriate, specifically the use of social marketing media, which, was seen as a worthwhile and necessary strategy for this target group. Methods routinely used by commercial companies were also viewed as effective especially the use of women's magazines. As part of a comprehensive health promotion approach, this is a strategy, which may be an equally useful vehicle for public health messages. In conclusion, discussion with participants revealed a number of negative and positive unintended consequences. This would, therefore, support the need for further research in this area. Furthermore, the research has highlighted the importance of a comprehensive approach to the delivery of health information to young women. Best practice suggests this approach should adhere to ethical communication principles, which would enhance the intended outcomes of the communications whilst also assisting to maximize positive unintended consequences and minimize negative unintended consequences.