Introduction and Rationale: Childhood obesity is a public health epidemic in the United States. Prevention of childhood obesity is an important health concern, but there is a lack of prevention efforts focused on infancy (Birch, Anzman-Frasca, & Paul, 2012). Many health behaviors are learned in the very early childhood years (Dattilo et al., 2012), so infancy is an opportune time to begin obesity prevention efforts (Grote, Theurich, & Koletko, 2012; Paul et al., 2011). There are very few resources available to educate mothers and caregivers of infants on protective infant feeding practices to reduce obesity risk. Purpose and Objective: The purpose of this DNP project is to develop educational material about infant feeding practices as a significant modifiable risk factor for the development of childhood obesity. The educational material is directed towards pregnant women and caregivers of infants less than 12 months of age. The objective is to educate parents and caregivers about infant feeding practices and the importance of preventing excessive weight gain during the first year of life for the prevention of childhood obesity. Methods: The Information-Motivation-Behavior (IMB) Model of Health Behavior serves as a framework for the content of the educational material. The Toolkit for Making Written Material Clear and Effective serves as a guide for the design of the educational material. Results: A systematic assessment of the educational material was conducted using the Patient Education Materials Assessment Tool (PEMAT), a validated evaluation tool. The educational material was revised based on the PEMAT score. The PEMAT score was calculated for the revised handout and the handout is presented as an educational tool for the prevention of childhood obesity. Conclusions: This DNP Project demonstrated childhood obesity as a current significant health problem and identified infant feeding practices as a significant modifiable risk factor for the development of childhood obesity. Due to a lack of obesity prevention efforts focused on infancy, educational material was created using the IMB model of health behavior and the Toolkit for Making Written Material Clear and Effective. The final PEMAT evaluation yielded educational material that will likely have a positive health influence on the pediatric population.

The main aim of this study was to apply the Information, Motivation and Behavioural Skills (IMB) model in a school-based programme for the reduction of HIV-risk behaviour among adolescents in South Africa. The study also aimed at evaluating the effectiveness of the model in improving levels of information, motivation to act upon the information, and imparting behavioural skills aimed at reducing HIV-risk behaviour in high school adolescent learners. Prior to the main study, a preliminary study was conducted to identify existing and prior intervention initiatives targeting HIV-risk behaviour within the schools in Alexandra township, Johannesburg. This was a qualitative study in which participating learners from two secondary schools reported on the HIV and AIDS education they were exposed to prior to the main study and intervention. The study sample consisted of 259 Grade 11 learners of which 123 were from School 1 (ES) and 136 from School 2 (CS). The findings from the preliminary study indicate that, while much HIV/AIDS education was done through the LoveLife campaigns, important gaps still existed in the levels of HIV/AIDS information, motivation and behavioural skills among the learners in the participating schools. The main study was quantitative in nature, and involved the same sample as the preliminary study. Data was collected with the use of a questionnaire adapted from the Teen Health Survey instrument. School 1 (ES) was the Experimental group, while School 2 (CS) was the Control group. A baseline assessment (Time 1) was conducted at both schools. This assessment was followed by a 3-week HIV/AIDS intervention programme at School 1 (ES) which focused on HIV/AIDS information, motivation and behavioural skills. A post-test (Time 2) was carried out at both schools. The intervention at School 1 (ES) was then repeated at School 2 (CS). This was followed by another post-test (Time 3) at both schools. A final test (Time 4) was done at both schools. This was followed by another post-test (Time 3) at both schools. A final test (Time 4) was done at both schools. Data was analyzed using repeated measures ANOVA including univariate ANOVA and paired t-tests. The results show significant increases in information across time for both schools. However, while there was clear change, it was not directly linked to the intervention. Overall estimates for all three variables, for instance, indicate that the mean scores at School 2 (CS) rose at Time 2, despite the absence of the intervention between Times 1 and 2 at that school. The fluctuating pattern of mean scores further attests to the deviation of the mean scores from the hypothesized pattern. In some of these fluctuations, the results showed the same trend for both groups, irrespective of the difference in the timing of the intervention. It is recommended, among other things, that when applied in the South African context, the IMB model should be used along with other HIV/AIDS prevention strategies to incorporate the social, cultural, economic and other structural challenges faced by learners.

The objective of this study was to assess levels of HAART adherence and factors affecting it. An observational, analytic, cross-sectional and quantitative study using IMB model was conducted on a randomly selected 349 HIV/AIDS patients on a HAART regimen. Data collection was done by interviewing respondents using a structured questionnaire. Both descriptive and inferential statistics used in the study. Only 80.2% of the total sample population reported a HAART adherence rate of more than or equal to 95% in this study. The findings highlight the need for on-going educational, informational and other interventions to address the knowledge, motivation and adherence behavioural skills of patients in order to improve the current levels of HAART adherence behaviour. The study also suggested the need for research into objective measures of adherence as well as longitudinal studies on adherence behaviour because strict adherence to treatment is a long-term process and not a one-time activity. / Health Studies / M.A. (Public health)

The objective of this study was to assess levels of HAART adherence and factors affecting it. An observational, analytic, cross-sectional and quantitative study using IMB model was conducted on a randomly selected 349 HIV/AIDS patients on a HAART regimen. Data collection was done by interviewing respondents using a structured questionnaire. Both descriptive and inferential statistics used in the study. Only 80.2% of the total sample population reported a HAART adherence rate of more than or equal to 95% in this study. The findings highlight the need for on-going educational, informational and other interventions to address the knowledge, motivation and adherence behavioural skills of patients in order to improve the current levels of HAART adherence behaviour. The study also suggested the need for research into objective measures of adherence as well as longitudinal studies on adherence behaviour because strict adherence to treatment is a long-term process and not a one-time activity. / Health Studies / M.A. (Public health)

Syftet med studien är att undersöka hur kunskap och/eller självuppfattning påverkar individers kreditkonsumtion. För att besvara syftet genomfördes en kvalitativ innehållsanalys där 29 fall av det svenska TV-programmet Lyxfällan studerades. Studiens teoretiska utgångspunkt grundar sig i IMB-modellen, där utgångspunkten är att självuppfattning och kunskap har en inverkan på individers kreditkonsumtion. Studiens huvudsakliga resultat visar på att kunskap och självuppfattning är något som i hög grad har en påverkan på individers kreditkonsumtion. Resultaten visar även att individer som skuldsatt sig på grund av onödig konsumtion hade en genomgående låg kunskapsnivå. Vidare kan vi se ett mönster där lyxkonsumtion i alla observerade fall motiverades av ett idealt- eller oönskat själv. Vi kan även se en förändring i beteendet hos de individer som slutade jaga en ideal självbild genom konsumtion. / This study aims to investigate how knowledge and / or self-perception affects credit consumption. Through a qualitative content analysis we have studied 29 cases of the Swedish TV show Lyxfällan. Our theoretical approach is based on the IMB model and that selfperception and knowledge have an impact on credit consumption. We came to the conclusion that knowledge and self-perception is something that to a large extent has an impact on credit consumption. Furthermore, we could see that individuals who lend money due to unnecessary consumption had a consistently low level of knowledge. Finally, we saw a pattern where luxury consumption in all observed cases was motivated by an ideal or dreaded self. We could also see a change in the behavior of the individuals who stopped chasing an ideal self-image through consumption. (This paper is written in Swedish).

Given the lack of effective vaccine or medicine, changing an individual's risk behaviours has been crucial in preventing the spread of HIV. Consistent and correct condom use has been considered as the most effective form of HIV prevention among female sex workers. Despite coordinated national level interventions over the last decade, a consistent decline in condom use among female sex workers has been evidenced in the Ethiopian context, particularly with non-paying partners. Thus far, no study has been produced that has illustrated major determinants of consistent condom use among female sex workers which would help in developing effective intervention strategies for the prevention of HIV spread in the country. In other countries, the Information, Motivation and Behaviour (IMB) model has been used to identify individual level determents of condom use. However, the researcher postulated that behaviour emanating from the personality structure of individuals could be the fundamental individual level determents of adherence to condom use and chose to investigate this using the Enneagram theory of personality, which was acknowledged for its heuristic value in explaining and enhancing self-development of at-risk individuals. This cross-sectional study was conducted in Addis Ababa. With the Without Finite Population Correction of the Sample Size Estimation Formula, the sample size of 350 was set and participants were recruited using Respondent-Driven Sampling (RDS). Using trained female sex workers, the Essential Enneagram Test (EET) and an Information-Motivation-Behaviour (IMB) questionnaire were administered to collect data. General Linear Modeling (GLM) Multivariate analysis was carried out to assess the correlation between personality style and consistent condom use among participants in the last seven days before the interview. The finding of this study revealed that personality type, measured by the Essential Enneagram Test (EET), is able to predict adherence to condom use among female sex workers and provided a new dimension for policy makers and practitioners in behavioural intervention programmes, such as Information-Education-Communication, peer-to-peer approaches, as well as health and rehabilitation services by using the Enneagram principles and universal growth process. / Psychology / D. Litt. et Phil. (Psychology)

Given the lack of effective vaccine or medicine, changing an individual's risk behaviours has been crucial in preventing the spread of HIV. Consistent and correct condom use has been considered as the most effective form of HIV prevention among female sex workers. Despite coordinated national level interventions over the last decade, a consistent decline in condom use among female sex workers has been evidenced in the Ethiopian context, particularly with non-paying partners. Thus far, no study has been produced that has illustrated major determinants of consistent condom use among female sex workers which would help in developing effective intervention strategies for the prevention of HIV spread in the country. In other countries, the Information, Motivation and Behaviour (IMB) model has been used to identify individual level determents of condom use. However, the researcher postulated that behaviour emanating from the personality structure of individuals could be the fundamental individual level determents of adherence to condom use and chose to investigate this using the Enneagram theory of personality, which was acknowledged for its heuristic value in explaining and enhancing self-development of at-risk individuals. This cross-sectional study was conducted in Addis Ababa. With the Without Finite Population Correction of the Sample Size Estimation Formula, the sample size of 350 was set and participants were recruited using Respondent-Driven Sampling (RDS). Using trained female sex workers, the Essential Enneagram Test (EET) and an Information-Motivation-Behaviour (IMB) questionnaire were administered to collect data. General Linear Modeling (GLM) Multivariate analysis was carried out to assess the correlation between personality style and consistent condom use among participants in the last seven days before the interview. The finding of this study revealed that personality type, measured by the Essential Enneagram Test (EET), is able to predict adherence to condom use among female sex workers and provided a new dimension for policy makers and practitioners in behavioural intervention programmes, such as Information-Education-Communication, peer-to-peer approaches, as well as health and rehabilitation services by using the Enneagram principles and universal growth process. / Psychology / D. Litt. et Phil. (Psychology)

N世代青年族群是開始以網路為主，資訊傳遞翻轉的新興世代，本研究藉由資訊-動機-行為技能模式（簡稱IMB模式）瞭解影響青年族群正確用藥行為的因子，探討青年族群醫藥素養、個人態度、用藥自我效能、行為障礙感知、醫藥傳播資訊暴露程度及正確用藥行為的發展現況，藉此發現喚起病人或家屬對病人安全及醫療風險認知的切入點，並增加警覺及主動積極性行為，與醫藥人員共同合作。為自己的健康狀態把關。 本研究所採用的方法是網路問卷調查，針對1977年到1997年出生的N世代青年族群蒐集資料，共獲得1,198份有效問卷。 本研究發現青年族群整體的用藥行為偏向經常做到，其中實踐程度由高至低依序為堅持正當藥品取得方式、主動告知身體狀況、看清楚用藥標示和主動諮詢專業。青年族群九成九以上有高醫藥素養，有六成以上的受訪者得到滿分。大部分青年族群偏向「同意」有正向的用藥態度；自我效能整體的認同度偏向於「同意」。受訪者對於用藥行為障礙感知程度整體偏向「不同意」有用藥行為障礙。 多數青年從媒體獲得醫藥資訊的頻率偏向「每月1~2次」為主。整體面向暴露由高至低為專業管道、傳統大眾媒體及新興網路。青年族群前三大醫藥資訊暴露管道依序為Facebook、電視、醫護人員，而BBS、大眾運輸工具看板、海報、傳單、宣傳手冊、產品包裝等是接著依序常用的管道。 醫藥素養只對堅持正當藥品取得方式有統計顯著正向預測力。個人態度和自我效能與用藥行為的四項依變項主動告知身體狀況、看清楚用藥標示、堅持正當藥品取得方式和主動諮詢專業，在相關分析及階層複迴歸分析都顯示有統計顯著正向相關。行為障礙感知與用藥行為的四項依變項主動告知身體狀況、看清楚用藥標示、堅持正當藥品取得方式和主動諮詢專業，在相關分析及階層複迴歸分析都顯示有統計顯著負向相關。 傳統大眾媒體與主動告知身體狀況、看清楚用藥標示和主動諮詢專業，在相關分析顯示有統計顯著正向相關，但階層複迴歸分析都未有統計顯著預測力；堅持正當藥品取得方式在相關分析及階層複迴歸分析都是顯著負向相關。新興網路與主動告知身體狀況和主動諮詢專業，在相關分析及階層複迴歸分析顯示都有統計顯著正向相關；新興網路與看清楚用藥標示，在相關分析顯示有統計顯著正向相關，但階層複迴歸分析未有統計顯著預測力；新興網路與堅持正當藥品取得方式在相關分析及階層複迴歸分析都是顯著負向相關。專業管道與主動告知身體狀況、看清楚用藥標示和主動諮詢專業，在相關分析及階層複迴歸分析顯示都有統計顯著正向相關；專業管道與堅持正當藥品取得方式在相關分析是顯著負向相關，但階層複迴歸分析中是無統計顯著預測力。 本研究的主要貢獻是證實藉由IMB模式的各項因子，都能有效預測部分或全部的正確用藥行為，尤其是個人態度、自我效能及行為障礙感知這三面向，並且呼應行為技能是影響行為的重要關鍵。因此往後如果有醫藥行為要推廣或宣傳時，就可以藉助IMB模式的因子為原型、大綱，相信會有更好的效果產生，也希望有人可以做後續相關研究，證實IMB模式的可行性。 / The Net Generation is the first generation to grow up in the digital world. The goal of this study is to understand the medical behavior of the Net Generation using the information-motivation-behavioral skills (IMB) model and the conditions of health literacy, personal attitudes, medical self-efficacy, the perception of behavioral barriers, the level of media exposure and medical behavior. To emphasize patient safety and medical risks, we tried to find the way to improve the awareness and active behavior to cooperate with medical professionals and to maintain self-health. The 1,198 effective samples were collected from people who were born between 1977 and 1999 through a web questionnaire. The study found that the Net Generation usually had correct medication-taking behavior. The frequency of the behavior from high to low was obtaining medicine through official channels, actively telling self-conditions, clearly reading medication labels, and actively consulting medical professionals. Over 99% of the participants had high health literacy and over 60% got full scores. Most of the participants tended to agree that they had positive personal attitudes and self-efficacy but disagreed they had the perception of behavioral barriers. Most of the participants obtained medical information through media once or twice a month. The exposure to media from high to low was professional channels, traditional mass media, and internet. The exposure to media channels in order were: Facebook, television, medical professionals, BBS, public transportation boards, and advertising brochures. Health literacy could only positively predict actively telling self-conditions. Personal attitudes and self-efficacy could positively predict four dependent variables of correct medication-taking behavior including obtaining medicine through official channels, actively telling self-conditions, clearly reading medication labels, and actively consulting medical professionals. And, the perception of behavioral barriers could negatively predict them. There were some statistically positive correlations between traditional mass media and correct medication-taking behavior including actively telling self-conditions, clearly reading medication labels, and actively consulting medical professionals. However, there was no prediction in hierarchical regression. There was a statistically negative correlation in Pearson’s correlation and hierarchical regression between traditional mass media and obtaining medicine through official channels. There were statistically positive correlations in Pearson’s correlation and hierarchical regression between internet and actively telling self-conditions or actively consulting medical professionals. However, there was a statistically negative correlation between internet and obtaining medicine through official channels. There was a statistically positive correlation between the internet and clearly reading medication labels but there was no prediction in hierarchical regression between them. There were statistically positive correlations in Pearson’s correlation and hierarchical regression between professional channels and actively telling self-conditions, clearly reading medication labels, or actively consulting medical professionals. There was a statistically negative correlation between professional channels and obtaining medicine through official channels but there was no correlation in hierarchical regression. The main contribution of this study was to support the argument that the IMB model could predict correct medication-taking behavior, especially when personal attitudes, self-efficacy and the perception of behavioral barriers are looked at. Therefore, behavioral skills were the key to correctly using medication. If someone wants to do medical behavior promotions, then the concept of the IMB model could be very effective.