Background: This thesis stemmed from my experience as a hospice social worker. In this role I was aware that children were often excluded from conversation, education and support about death, dying and bereavement and was keen to explore how the Hospice team could address this issue. My practice experience paralleled UK policy making on end-of-life care, which argued for discourse on death, dying and bereavement to be promoted in the community to help prevent negative end-oflife and bereavement experiences (Scottish Government 2008; Department of Health 2008; Department of Health 2010). In Scotland, engaging with schools to equip children with skills and knowledge to cope with death and bereavement has been emphasised (Scottish Government 2010). These policy movements recognise the significance of public health approaches to end-of-life care, which focus on the multi-dimensional (physical, psychological and social) nature of problems and required solutions. Recently, such approaches have been gaining recognition concerning their contribution to end-of-life care. It has been suggested that hospices are well situated to promote such activities due to their expertise in end-of-life care (Salau et al. 2007). Aim and objectives: This thesis aimed to explore, implement and evaluate models of best practice in which hospices and schools can work in partnership to promote education and support around death, dying and bereavement from a health promotion perspective. It specifically sought to increase understanding about current practice in primary schools related to death, dying and bereavement and develop practice knowledge about the role of the Hospice in working with school communities to enhance such work. Methods: The research was facilitated in two primary schools in Scotland, using collaborative inquiry within an action research methodology. It was conducted over three phases. Phase one (preparation and scoping) involved a literature review, visits to other hospices and focus groups with hospice staff. Phase two (exploration) included a series of interviews and focus groups with children aged 9 – 12 years, parents and schools staff to develop collaborative inquiry and engage in a process of change. Phase three (planning and developing) comprised of deciding and advancing models of practice. Findings: Practice innovations were identified at each school that were of relevance to the school curriculum, the relationship between hospices and school communities, and the relationship between hospices and the wider society more generally. These innovations can be understood as health promoting palliative care activities, as defined by Kellehear (2005), due to the process in which they were designed and their focus on developing capacity to respond to death, dying and bereavement. Conclusion: The action research process identified the significance of sharing and transferring knowledge across and between hospice and school communities. It demonstrated that hospices have unique capacity to develop conversation, education and support around death, dying and bereavement in school communities. In order to fulfil this potential role, this will require a reorientation of service delivery that focuses on wider training, support, awareness raising and advocacy. The study has also demonstrated that action research is well situated to develop health promoting palliative care activities according to the shared goals of participation, ownership and empowerment.

Magister Scientiae (Physiotherapy) - MSc(Physio) / Assessing and understanding the health needs and abilities of university and college students is vital in creating healthy campus communities. Student learning is a central part of the higher education academic mission, and health promotion serves this mission by supporting students and creating healthy learning environments. Findings from various studies suggest that students entering the university setting put themselves at risk through unhealthy behaviours. Health science students are the future health professionals who will teach health promotion and disease prevention. The aim of this study was to determine and analyse health risk behaviours and health promoting behaviours among health science students at the University of the Western Cape. The study further aimed to identify the factors influencing these students' engagement in these risk behaviours. / South Africa

Class of 2006 Abstract / Objectives: To further define the health promotion and disease prevention domain of the Outcomes Expected (OE) document at the University of Arizona, College of Pharmacy to make it consistent with the other domains. Also, it was aimed to make Domain 3 meet standards consistent with other health sciences curricula. Methods: This was a systematic review of all publications pertaining to health promotion or disease prevention curricula using Medline and IPA between the years 1995 and 2005. The data extraction form was developed based on a compilation of articles published in the December, 2004 issue of American Journal of Preventive Medicine which presented a framework of competencies. These consisted of four competencies: Evidence Base of Practice, Clinical Preventive Services-Health Promotion, Health Systems and Health Policy, and Community Aspects of Practice. Results: The initial search yielded a total of 197 results. Of those results, 63 articles fit within the framework of the data extraction form. Key concepts were identified after reviewing the articles and provided the basis for creating components within the competencies. Conclusion: After reviewing the literature, it is evident that the OE document needs to be changed to further define health promotion and disease prevention. The updated Domain 3 is proposed in Appendix 1 and provides components that were substantially addressed in the articles reviewed.

As HIV/AIDS continues to disproportionately impact men who have sex with men (MSM) (CDC, 2010a), effective and timely prevention strategies for this population must be developed. Specifically, evidence-based interventions that can be easily adapted and have proven effectiveness are needed. Hence, the purpose of the current study was to assess the impact of the Mpowerment Project (Hayes, Rebchook, & Kegeles, 2003), a community level HIV prevention program originally designed for young urban gay men, when adapted for rural gay men. The Mpowerment Project is recognized as evidence- based intervention by the CDC (CDC, 2009b). The current study is an extension of this research, assessing Mpowerment model fidelity and the behavioral and attitudinal changes that occurred among participants. Data were collected from participants in a rural area of southeast Idaho from 2002-2004. Data were collected prior to M-Group participation and at a three months follow-up. The 66 individuals completing the M-Group pre and posttest assessment also attended a minimum of three study events and a maximum of 226 events. Results revealed no significant changes in attitudinal variables and all but one behavioral variable among Rural Mpowerment (R-MP) participants. The one significant behavior change was an increase in reported safer sex discussion among friends, indicating a possible change in the social norm regarding safer sex. Results also indicate that program fidelity was maintained and the Mpowerment Project is adaptable to rural areas. However, there was no indication of attitudinal changes in participants of this study. There were no changes in behavioral variables aside from discussion about safer sex with friends increasing. The lack of evidence-based interventions for rural gay men highlights the need for further research on the community impact of the Mpowerment Project on rural participants.

Southern Africa has the highest prevalence of Human Immunodeficiency Virus (HIV) infection in the world. With a high prevalence of HIV, as well as a rising incidence of chronic diseases of lifestyle (CDLs), South Africa is faced with the dual burden of infectious diseases and CDLs. Health promoting behaviours (HPBs), including physical activity (PA), maintaining good nutrition and taking responsibility for personal health, play an important role in managing the symptoms of HIV infection and the side effects of antiretroviral (ARV) use. Additionally HPBs improve health-related quality of life (HRQOL) in people living with HIV (PLWHIV). Furthermore, research indicates that HPBs should be encouraged among university students as they will become the future decision and policy makers in their places of employment. This study sought to determine the PA levels, HPBs and HRQOL of university students living with HIV, in order to better promote PA participation and HPBs in this population. Additionally, participants‘ perceptions of and attitudes towards exercise participation were investigated, as were barriers that mitigated against PA participation and HPBs. This study was exploratory-descriptive in nature and utilised a mixed methods design. The University Campus Health Clinic (CHC) staff recruited 29 HIV positive students (HIVPS) between the ages of 18 and 25 through purposive sampling. In the quantitative portion of the study the HIVPS completed a demographic questionnaire as well as three self-administered questionnaires, namely: the International Physical Activity Questionnaire (IPAQ), the Health-promoting Lifestyle Profile (version 2, HPLP-II) and the World Health Organisation Quality of Life Brief Questionnaire (WHOQOL-HIV-BREF) to determine PA levels, health-promoting lifestyle behaviours and HRQOL, respectively. Height and weight, as well as the most recent CD4 count were also recorded.

Research applications in the field of positive organisational behaviour are developing as part of the paradigm of fortology. Both psychofortology and positive psychology support the development of the strengths (fortology) of human behaviour. Health and wellness research in working contexts build theory in the field of Industrial Psychology. The objective of the present research is to develop and test a holistic work-wellness model for employees of a life insurance organisation in South Africa. Holistic work-wellness research requires that wellness, organisational factors and individual dispositions be treated as part of an integrated and dynamic system. The relationship between these constructs provides some understanding of total work wellness. A cross-sectional survey designed was used with a sample of 673 participants. The 5 Factor Wellness Survey, the Maslach Burnout Inventory – General Survey, Utrecht Work Engagement Scale and the Job Diagnostics Survey were administered. The empirical research results have shown that a positive relationship exists between motivational job characteristics, sense of coherence, engagement and wellness. A somewhat negative relationship exists between burnout and wellness in the holistic work-wellness model. The structural equation modelling statistics provided reasonable goodness of fit indices with some room for modification. According tot the Root Mean Square Error of Approximation criterion, the results support the acceptance of the holistic work-wellness model. A path diagram, in which cause and effect arrows flow from the exclusive latent variable back to the primary factors, was developed. The development of this holistic work-wellness model addresses the research problem and builds theory with which to holistically understand work wellness. It can be concluded that the development of this particular model can be used in the insurance organisation to implement employee health and wellness care. The Indivisible Self: An Evidence-Based Model of Wellness that consists out of 17 wellness and 4 contextual factors were successfully applied as a clinical wellness model in an organisational context (Myers and Sweeney, 2005). A principle factor analysis confirmed the factor structure of previous wellness research for the first time in a South African study. Structural equation modelling statistics on the wellness model confirmed the 19-factor model with adequate goodness of fit indices. The empirical research data confirms The Indivisible Self: An Evidence-Based Model of Wellness for the insurance organisation. This wellness model can therefore be used as an independent wellness model to explain wellness from the theory and from the present empirical study. From the literature it is clear that research on wellness in relation to motivational job characteristics are developing as a research topic. The empirical research in the present study confirmed that a positive relationship exist between these two phenomena. Goodness of fit indices confirm that the six-factor motivational job characteristics model cannot be used as an independent model in the insurance organisation. Subsequently this did not validate the practically significant positive relationships in the independent job model. However these findings were still useful in an explorative study that focused on the development of a holistic work-wellness model. A strong sense of coherence can therefore be hypothesised to help employees to face stressful situations and to handle complex tasks because demands from the environment are understood and believed to be under their personal or significant others’ control. They are likely to regard the tasks as challenging enough to spend energy on. It can be described as the characteristic inherent to individuals, which assists them in their interaction with their work-environment and situations that might arise as a consequence thereof. Empirical statistical results indicated that the three factors meaning, comprehension and manageability are confirmed for the sense of coherence construct. A principle factor analysis confirmed reliable Cronbach alphas for meaning and comprehension in the present research. Structural equation modelling proves that the sense of coherence model cannot be used independently due to poor goodness of fit statistics. However, sense of coherence is still useful in the development of a holistic work-wellness model. The research results also showed that engagement could be considered a positive indicator of employee wellness. Findings validated and confirmed the factorial validity of vigour and dedication. Goodness of fit statistics produced goodness of fit indices of intermediate quality. Empirical statistics verified and validated burnout as a four-factor model. Researched statistics showed internally consistent results for the four-burnout subscales (exhaustion, cynicism, professional efficacy and cognitive weariness). It can be concluded that these factors are reliable and valid factors. Results from the structural equation modelling proposed good fit (RMSEA) for the four-factor burnout model, with some modification required to improve the other indicators. Conclusions and recommendations in terms of the implementation of managed health and wellness care for employees in the insurance organisation are based on the development of the holistic work-wellness model. Health and wellness programmes should be researched to develop the empirical application of the holistic work-wellness model. / Prof. R.P. De la Rey

Master of Science

Master of Science in Education

Drawing on developments in the public health field, this exploratory study applies the ideas of Health Promotion (HP) to the University of Cape Town (UCT). It defines UCT as a setting within which HP can and should take place. Following the World Health Organisation (WHO), health is seen as encompassing physical, mental, social, and other environmental factors (WHO, 1978). Sociological perspectives that acknowledge the relationship between social action/behaviour and the social context, hence the relationship between students' wellbeing and the UCT environment are employed. Data and information for this study were collected through focus group discussions, in-depth interviews, participant observation, and a sample of information gathered by first year sociology students. The fear of failure, housing problems, limited social integration, and availability of cigarettes and junk food on campus were found to be some of the factors that influence and constrain students' weIIbeing. It was also found wellbeing is not an explicit consideration in the university plans and policies, even though implicitly these are meant to enhance wellbeing. Strategies to promote health in UCT need to be guided by a commitment to wellbeing in the university's policies. This thesis recommends that the university be required to pass a 'wellbeing test'.

A thesis submitted to the Faculty of Humanities University of Zululand in partial fulfillment of the requirements for the degree of Doctor of Philosophy: Community Psychology in the Department of Psychology, 2006. / This investigation was contextualised within the community psychological model of mental health promotion and Zimmerman's empowerment theory (1995) and psychological intervention being conceptualized as a positive component with a view to enhancing psychological well-being. This study investigated psychological intervention as a strategy for the promotion of well-being among caregivers in a children's home. The primary focus was the caregivers in children's homes in the greater Durban area and the secondary consideration was the positive cascade effect it had on the children under then-care. The research design comprised an experimental and control group. A psychological intervention was implemented and the Maslach burnout inventory (1986) was used to measure the well-being outcomes. This was complemented with qualitative techniques that included a needs assessment questionnaire, intervention, consultation, focus group, appreciative enquiry, children's behaviour profile and the principal's pre and post intervention evaluation. The improvement in caregivers' well-being was also evaluated in the positive behaviour changes of selected children assessed by the Conners rating scale (1979). The SPSS findings indicated negligible change in the pre and post test MBI scores for caregivers. There was no significant differences in the pre and post test scores on the Conners rating scale. However, the descriptive qualitative measures indicated significant levels of improved psychological well-being by caregivers which generated a positive cascading effect on selected children under their charge. These descriptive improvement trends are attributed to the comprehensive treatment or intervention. / National Research Foundation (NRF)