Yes / UK South Asian women are less likely to engage with cancer screening than the general population and present later with more advanced disease. Tailored interventions are needed to address barriers to these women accessing screening services. 'Wise up to cancer' is a community-based health intervention designed to increase cancer screening uptake. It has been implemented within the general population and a study was undertaken to implement it within a South Asian female community. This paper explores one workstream of the wider 'Wise up to Cancer' study which involved working out how best to adapt the baseline questionnaire (the first part of the intervention) for South Asian women in an inner-city location in Northern England. The aim of this workstream was to evaluate what worked well when implementing the adapted 'Wise up to Cancer' with South Asian women. In 2018, we conducted qualitative semi-structured interviews and focus group with 14 key stakeholders; women who had received the intervention, health champions and community workers to explore their perspectives on how the adapted intervention worked within a South Asian female community. The interviews were audio recorded or (notes taken), data were transcribed verbatim and the dataset was thematically analysed. We found that training peers as community health champions to deliver the intervention to address language and cultural barriers increased participant engagement, was beneficial for the peers and supported participants who revealed difficult social issues they may not have otherwise discussed. Accessing women in established community groups, following planned activities such as English language classes worked but flexibility was needed to meet individual women's needs. Further research is needed to explore the impact of adapting 'Wise up to Cancer' for this community in terms of engaging with cancer screening. / Tampon Tax, The Department for Digital, Culture, Media and Sport, Gov UK (Grant number A1967)

Background: Cigarette smoking is a leading preventable factor associated with complications in pregnancy including preterm birth and low birthweight. Past interventions have raised cessation rates by approximately 6% overall (Lumley et al. 2009). Methods: A three-part literature review, two qualitative studies with a total of 36 participants, and the development of an intervention to promote smoking cessation during pregnancy were completed. Central to the design of the research was the creation of the theoretical basis which was developed in line with recommendations from the MRC Framework for Complex Interventions (Craig et al. 2008, Campbell et al. 2000). For part one of the literature review, 24 qualitative and 44 quantitative studies were re-analysed to complete a mixed-methods secondary analysis of the active ingredients in interventions to promote smoking cessation during pregnancy. Part two consisted of an exploration of psychological models and constructs which are likely to predict or influence smoking behaviour during pregnancy. The final part was a discussion regarding the modes of delivery by which an intervention could feasibly be delivered. Qualitative interviews were carried out with participants from stakeholder groups to fill in gaps in literature and determine the acceptability and feasibility of the proposed intervention. The intervention was created using the theoretical basis developed from the findings. Further qualitative interviews, a focus group, and heuristic evaluation were used to determine the acceptability and usability of the intervention for the target group of pregnant smokers. Results and Conclusions: Findings from this work are potentially relevant for a wide range of behaviours and behavioural interventions. An intervention which has a strong grounding in theory and evidence, and is acceptable and feasible for the target group and in clinical practice was developed using evidence gathered in this thesis.

African American women have the highest rates of HIV infection among women of all racial/ethnic groups in the United States, and over 50% of HIV infected young adults are unaware of their infection. HIV testing is a cost-effective mechanism for reducing HIV transmission. Despite this, limited research has been devoted to developing interventions specifically promoting HIV testing. This two-part study proposed to address this gap through developing a culturally tailored HIV testing message aimed at increasing HIV test intentions among young African American women. Study 1 was a quantitative study that examined predictors of HIV testing history and future HIV test intentions among 109 African American women aged 18-24. Measures on sexual behavior, HIV knowledge, HIV conspiracy beliefs, gender role beliefs, gender ratio imbalance beliefs were included in the survey. Next, a culturally tailored HIV testing message was developed based on findings from Study 1 which identified significant predictors of HIV testing and HIV test intentions. Findings revealed that number of sexual partners, perceived barriers, and perceived benefits were significant predictors of past HIV testing. Number of sexual partners, perceived importance of HIV testing, and perceived seriousness were significant predictors of HIV test intentions in the next 3 months. Study 2 compared the exposure effect of the tailored health message to a generic HIV testing message on self-reported future HIV test intentions. Findings revealed no significant differences between the health message groups on future HIV test intentions. There were also no significant differences between groups on the message acceptability outcomes.

To date, few high school based interventions have been shown to have lasting effects on adolescents' health behaviors. The need for health interventions targeting adolescents is underscored by data showing that several health behaviors with significant short and long term adverse effects begin in early adolescence and become progressively more prevalent toward late adolescence. This project tested the efficacy of a novel anatomy based health education curriculum at increasing health knowledge. The course was taught by first year Yale medical students. The curriculum placed emphasis on nutrition, physical activity and infectious disease. Forty Juniors from Career High School visited Yale's anatomy lab once every two weeks for ten hour-long sessions. In addition to visits to the anatomy lab, students completed two class projects, one covered nutrition and the other focused on exercise. Four additional sessions at Career High School were dedicated to the class projects. Pre and post test analysis showed an improvement in health knowledge with a thirteen percentage point improvement on a standardized health knowledge survey. The students' performance was compared to a control cohort of thirty-one students who were not exposed to the curriculum. Students exposed to the curriculum had a nineteen percentage point advantage compared to control students who had not been exposed. Curriculum efficacy as demonstrated by this small cohort validate further testing with larger cohorts and more vigorous controls as well as separate testing to measure changes in health behavior attributable to curriculum exposure.

The purpose of this study is to examine how the health care system in Babati meets the increasing need for control, treatment and prevention of diabetes and hypertension. By defining what kind of specific problems and obstacles that exists in this area, the result of the research can contribute to creation and adoption of improved policies and interventions. Field studies were conducted in Babati, Tanzania for three weeks in February and March 2014. This is a qualitative study with data collected through semi-structured interviews with informants from different levels of the health system, based on the pyramidal structure of Tanzania's health care system. The theoretical framework for the study is based on aspects that corresponding to critical functions of health systems. The type of problem being treated affects the adoption and diffusion of new health interventions and the extent to which they are integrated into critical health systems functions. The study shows that diabetes and hypertension is an increasing problem in Babati. In relation to the burden, resources are lacking at all investigated levels. Therefore it is difficult to meet the increasing needs for diabetes and hypertension. To meet the future challenges, a number of cost effective strategies with focus to improve the prevention, control and reduce modifiable risk factors is suggested. / Syftet med studien är att undersöka hur hälso-och sjukvården i Babati möter det ökande behovet för kontroll, behandling och förebyggande åtgärder för diabetes och högt blodtryck. Genom att definiera vilka typer av specifika problem och hinder som finns, kan resultat från studien bidra till att skapandet och antagandet av förbättrade strategier och åtgärder. Fältstudier genomföres i Babati, Tanzania under tre veckor i februari och mars 2014. Detta är en kvalitativ studie med data insamlat genom semistrukturerade intervjuer med informanter från olika nivåer inom sjukvårdsystemet baserat på den pyramidala struktur Tanzanias sjukvårdssystem bygger på. Det teoretiska ramverket för studien baseras på aspekter som motsvarar kritiska funktioner för sjukvårdssystem. Antagandet och spridning av nya hälsointerventioner och i vilken mån de är integrerade i kritiska hälso- systemfunktioner påverkas av den typ av problem som behandlas. Studien visar att diabetes och högt blodtryck är ett ökande problem i Babati. I relation till hur sjukdomsbördan ser ut, saknas det resurser på samtliga undersökta nivåer. Därför är det svårt att möta de ökande behov som finns för att hantera diabetes och högt blodtryck. För att möta de framtida utmaningarna i Babati har ett antal kostnadseffektiva strategier med fokus att förbättra förebyggande, kontroll och minska påverkbara riskfaktorer föreslagits.

Dans le champ de la protection de l’enfance, le débat sur l’évaluation pour déterminer les besoins et les objectifs d'une intervention socioéducative anime les acteurs de ce champ. Cette recherche s’intéresse à une équipe soignante qui, au sein d’une unité de soins intensifs du soir, accueille après l’école des enfants «agités». Cette équipe peut être amenée à prendre contact avec les services de protection de l'enfance et alors être actrice d'une démarche qui vise à déterminer les objectifs et les besoins d’une intervention des services de protection de l’enfance. Notre démarche compréhensive à partir d’une observation participante appréhende la pratique de ces soignants pour aborder la question de leur relation avec les services de protection de l’enfance. Nous nous sommes appuyée sur l'écologie de la prise de décision pour mettre en relief les différents facteurs qui interagissent dans la décision des soignants de prendre contact avec ces service. Nous définissons les cadres théoriques qui structurent la pratique des soignants et identifions les contraintes et les stratégies des acteurs dans la relation qu'ils construisent pour déterminer les besoins et les objectifs d'une intervention. Nous montrons que les soignants ne s’appuient pas pour s’engager dans un processus de séparation sur des caractéristiques de danger d'une situation mais plutôt sur la capacité des parents à se saisir de l'accompagnement des soignants pour agir sur leurs difficultés. Ces résultats nous conduisent à comprendre à une échelle plus large le passage, dans le travail social, d’une attente de conformisation de l'individu aux attentes sociales à une aptitude de ce dernier à élaborer les difficultés rencontrées pour les anticiper et les surmonter dans une exigence d’autoréalisation. / In the last few decade, in the field of child welfare, the debate on assessment to determine both needs and aims of a social intervention has been developing. This research focuses on a mental health care intervention designed for children with behavioral disorders. The children come to the intervention site once school is finished. The intervention team offers care services, but in some situations the question of a possible intervention of child protection services may emerge. The team of mental health clinicians becomes then actor of the assessment process. A comprehensive methodology based on a participant observation enables us to get a better understanding of the clinicians’ practice and address the question of their relationship with child protection services. To underline the different factors which interact with the decision process of the clinicians we use the decision making ecology. We first define theoretical frameworks which structure the team practice. Then we identify constraints such as the French rules of child protection services and strategies used by clinicians such as their expertise position and by child protection workers such as their intermediate position to understand how their relationship is built. We also highlight that the clinician team rather than stressing out the risk of danger for the child may decide to contact child protection services when parents are not able to elaborate on their difficulties. These results lead to a new understanding of social workers’ intervention. Aims are not anymore to conform individuals to the social rules but to help them to elaborate on their difficulties to anticipate and deal with them with a demand of self-realization in mind.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-10-05T18:03:38Z No. of bitstreams: 1 annaclaudiarodriguesalves.pdf: 563145 bytes, checksum: c6d2ccd48c1c861d1dea2fbdf8fe4b54 (MD5) / Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2016-10-06T12:30:42Z (GMT) No. of bitstreams: 1 annaclaudiarodriguesalves.pdf: 563145 bytes, checksum: c6d2ccd48c1c861d1dea2fbdf8fe4b54 (MD5) / Made available in DSpace on 2016-10-06T12:30:42Z (GMT). No. of bitstreams: 1 annaclaudiarodriguesalves.pdf: 563145 bytes, checksum: c6d2ccd48c1c861d1dea2fbdf8fe4b54 (MD5) Previous issue date: 2009-02-16 / O presente estudo tem por objeto a análise do modo tecnológico de gestão da assistência à saúde no hospital de ensino: HU/CAS/UJFJ, a partir da inter-relação da macro e micropolítica. Por macropolítica entende-se a relação entre o HU/CAS e a rede SUS e micropolítica, a relação institucional entre profissionais e gestores. A pesquisa foi iniciada com a revisão de literatura sobre os fundamentos da gestão do SUS e do conceito de assistência, com base no cuidado em saúde. O instrumento utilizado foi a pesquisa qualitativa com aporte na abordagem dialética, com o sentido de avaliar a concepção dos gestores e profissionais acerca dos processos de gestão e de assistência, considerando as atuais diretrizes organizacionais e políticas do HU/CAS/UFJF. Ao final, a análise dos dados contribuiu para a apresentação de um ensaio sobre o conceito de gestão da assistência, por acreditar no seu potencial de reorientar a operacionalidade das diretrizes do SUS no interior do espaço do hospital de ensino, tendo em vista uma administração qualificada e centrada nas necessidades e demandas da população-usuária. / The aim of this study was to analyze the technological way of health care’ management in the university hospital: HU/CAS/UFJF, from the inter-relationship of macro and micro-policies. It’s defined by macro-policies the relation between the HU/CAS and the SUS, and by micro-policies, the institutional relation between the professionals and the managers. The research started with a review of the literature, based in the health care, about the fundamentals of management of SUS and about the concepts of the health care. The qualitative research, with input in the dialectic approach, was used with the aim of evaluate the conception of managers and the professionals about the management and health care’s process, taking account the current organizational guidelines and policies of the HU/CAS/UFJF. At the end, the analysis of the results contributed for the presentation of a test about the health care’ management concept, that has a great potential at redirect the operationality of the SUS’ organizational guidelines in the university hospital, in a view of an administration qualified and focused on the necessities and demands of the population.

Cardiovascular diseases and diabetes are increasing worldwide due to unhealthy lifestyle habits. Behavior change support systems (BCSS) are a new means of promoting a sustainable lifestyle change. These systems are more effective when behavior change theories are applied. The aim of this thesis to integrate well-known behavior change theories into a conceptual model of behavior change progress to form the basis for the BCSS. The research question of this thesis is: what parameters of behavior change should be included in a conceptual model of behavior change progress? The model was created by integrating concepts and their relationships from existing behavior change theories. Next, the model was the validated by experts in behavior change. The outcome is a conceptual framework that can be function as a tool for understanding causal relationship between behavior change concepts, for presenting feedback, and building automated assessments. Furthermore, the model extends already existing knowledge networks.

Submitted by SBI Biblioteca Digital (sbi.bibliotecadigital@puc-campinas.edu.br) on 2018-03-15T13:45:12Z No. of bitstreams: 1 MARIANA PEREIRA DA SILVA.pdf: 1495567 bytes, checksum: cfe3269f86ef6ee276b2a7ebc6ca324d (MD5) / Made available in DSpace on 2018-03-15T13:45:12Z (GMT). No. of bitstreams: 1 MARIANA PEREIRA DA SILVA.pdf: 1495567 bytes, checksum: cfe3269f86ef6ee276b2a7ebc6ca324d (MD5) Previous issue date: 2018-01-30 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / This dissertation presents the results of an ?intervention-research?, which is so named due to the relevance of the intervention in the whole process. In this way, the objectives were to promote an intervention in a reflection group about work and health with workers from an automobile industry and to analyze the health-disease process experienced by them. It was attended by 14 workers from the same company whose form of organization of work and the productive processes is characteristic of Toyotism, a model of organization that stimulates individualism, competitiveness, outsourcing, flexibility and thus may favor the processes of work-related mental disorders. These workers shared their daily experiences related to work and reflected on them in a group, performed at CEREST in Campinas ? SP, over 11 meetings, during the period of six months. The group had an open character and was built together to the participants. The information shared by them showed that, initially, they wanted a lot to join the company, and while being admitted, they felt they have achieved a dream. During time, however, that dream has become a nightmare, as they experienced a context of psychological violence and demands for a high rate of production, which ended up favoring the development of physical injuries. As a result, the work-related mental suffering was intensified, as the injured workers were excluded, humiliated and reinserted to work in incompatible functions. In this sense, in the reflection group, subjects such as work under capitalism, flexible speech, the workers? guilt for illness, their life stories, new life projects, the union and solidarity among them, among other examples were discussed through conversation wheels and use of mediating materiality. It is possible to say that this kind of group assisted in the promotion of elements for the development of more critical reflections by the workers, who closed the meetings feeling less blame, stronger, united, in solidarity to each other, more active and responsible for social transformation. / Esta disserta??o apresenta os resultados de uma ?interven??o-pesquisa?, que est? sendo assim denominada devido ? relev?ncia da interven??o em todo o processo. Desse modo, os objetivos foram promover uma interven??o em um grupo de reflex?o sobre trabalho e sa?de com trabalhadores de uma ind?stria automobil?stica e analisar o processo de sa?de-adoecimento vivenciado por eles. Participaram 14 trabalhadores de uma mesma empresa, cuja forma de organiza??o do trabalho e dos processos produtivos ? caracter?stica do Toyotismo, um modelo de organiza??o que estimula o individualismo, a competitividade, a terceiriza??o, a flexibiliza??o e, assim, pode favorecer os processos de adoecimento mental relacionados ao trabalho. Tais trabalhadores compartilharam suas viv?ncias cotidianas relacionadas ao trabalho e refletiram sobre elas em um grupo, realizado no CEREST de Campinas - SP, ao longo de 11 encontros, durante o per?odo de seis meses. O grupo tinha um car?ter aberto e foi constru?do juntamente aos participantes. As informa??es compartilhadas por eles mostraram que, inicialmente, desejavam muito ingressar na empresa e, ao serem admitidos, sentiam ter realizado um sonho. Com o passar do tempo, no entanto, esse sonho se tornou pesadelo, na medida em que vivenciavam um contexto de viol?ncia psicol?gica e exig?ncias por alto ritmo de produ??o, o que acabava favorecendo o desenvolvimento de les?es f?sicas. Com isso, o sofrimento mental relacionado ao trabalho foi se intensificando, pois os trabalhadores lesionados eram exclu?dos, humilhados e reinseridos ao trabalho em fun??es incompat?veis. Nesse sentido, no grupo de reflex?o, se discutiu, por meio de rodas de conversa e utiliza??o de materialidades mediadoras, temas como o trabalho no capitalismo, o discurso flex?vel, a culpabiliza??o dos trabalhadores pelo adoecimento, suas hist?rias de vida, novos projetos de vida, a uni?o e a solidariedade entre eles, entre outros exemplos. Pode-se dizer que essa modalidade de grupo auxiliou na promo??o de elementos para o desenvolvimento de reflex?es mais cr?ticas pelos trabalhadores, que encerraram os encontros sentindo-se menos culpados, mais fortalecidos, unidos, solid?rios uns aos outros, mais ativos e respons?veis pela transforma??o social.

Cardiovascular diseases and diabetes are increasing worldwide due to unhealthy lifestyle habits. Behavior change support systems (BCSS) are a new means of promoting a sustainable lifestyle change. These systems are more effective when behavior change theories are applied. The aim of this thesis to integrate well-known behavior change theories into a conceptual model of behavior change progress to form the basis for the BCSS. The research question of this thesis is: what parameters of behavior change should be included in a conceptual model of behavior change progress? The model was created by integrating concepts and their relationships from existing behavior change theories. Next, the model was the validated by experts in behavior change. The outcome is a conceptual framework that can be function as a tool for understanding causal relationship between behavior change concepts, for presenting feedback, and building automated assessments. Furthermore, the model extends already existing knowledge networks. / På grund av allmänhetens ohälsosamma vanor ökar Diabetes och kardiovaskulära sjukdomar i hela världen. Olika stödsystem för beteendeförändringar (BCSS) är ett nytt sätt att främja en hållbar livsstilsförändring. Dessa system är mer effektiva då beteendeförändringsteorier tillämpas. Syftet med denna avhandling är att integrera välkända teorier om beteendeförändring i en konceptuell modell av beteendeförändringsframsteg som kan ligga till grund för BCSS. Forskningsfrågan i denna avhandling är: Vilka parametrar för beteendeförändring ska ingå i en konceptuell modell för beteendeförändringsframsteg? Modellen skapades genom att integrera koncept och deras relationer från befintliga teorier om beteendeförändring. Resultatet är ett konceptuellt ramverk som kan fungera som ett verktyg för att förstå orsakssambandet mellan beteendeförändringsbegrepp, för att presentera feedback och för att bygga automatiserade bedömningar. Dessutom utökar modellen redan befintliga kunskapsnätverk.