In New Zealand, cardiovascular disease is higher among Maori and Pacific peoples than other ethnic group. Researchers in Cardiology documented that CVD begins early in a person’s life and that a person's risk of cardiovascular disease is determined by risk factors that contribute to a form of CVD over time. This thesis, “The Cardiovascular Risk Factors in Adolescents of Christchurch: A Cross-Sectional Survey (CRFAC)”, is the first of its kind in the South Island, and was designed to estimate the prevalence of risk factors for cardiovascular disease for adolescent high school students in New Zealand. The aims of the study were to determine cardiovascular risk factor levels between, Pacific, Asian, Maori, and European students, with the Pacific communities including (Samoan, Cook Islands, Tongan, and Niuean). The CRFAC was a school-based cross-sectional survey of 1051 adolescent students, across nine Christchurch High Schools. The study specifically aimed to determine ethnic-specific differences in lifestyle and intermediate variables that have been established as cardiovascular risks. Variables included: smoking, alcohol consumption, leisure-time physical activity (LTPA), television exposure, and sun exposure, and body mass index (BMI). Demographic variables analyzed included: form (level of education), gender, ethnic group, and socioeconomic status. In regards to smoking and alcohol consumption, Maori had the highest rates overall 77% and 88%, respectfully. As for LTPA, the type of activity that was participated in varied between sex and ethnicity. For instance, netball was played predominately more for females than males, and rugby was played more so by European/Pakehas than compared to Asians. Maori and Pacific also had a higher proportion 43.4% and 33.7%, respectively, who watched TV four or more hours per week day on average compared to the other ethnicities. Sun exposure varied strongly with ethnicity, with Asian students having a smaller proportion 20.1% in the high daily sun exposure category compared with Maori 40.8 % daily (p< 0.001). The CRFAC study results showed that demographic variables were associated with the intermediate variables: lifestyle and BMI. The findings showed that there were substantive ethnic variations between the four main ethnic groups (Pacific, Maori, Asian and European) in risk factors for cardiovascular disease. The CRFAC study was able to identify contributing factors, for which gave the investigator clarity to possible reasons for ethnic differences in BMI. The CRFAC study results showed that Pacific participants had the highest BMI levels of all the ethnic groups, followed by Maori.

<p>The purpose of this dissertation was to use an integrative theoretical framework to examine the individual and environmental factors associated with leisure-time physical activity (LTPA) for persons living with spinal cord injury (SCI). Using a systematic approach, three studies were conducted to: (1) survey the accessibility and availability of physical activity facilities for Canadians living with mobility disabilities, (2) test an integrative, theoretical framework for understanding LTPA among people with SCI, and (3) implement a theory-based intervention that focuses on helping beginner exercisers living with SCI cope with salient individual and environmental LTPA barriers. </p> <p>Study 1 involved two sub-studies. Study lA used a modified version of the AIMFREE instrument (Rimmer et al., 2004) and provided evidence of the limited accessibility of fitness and recreational facilities (n=44) for persons with mobility disabilities. Study lB applied a geographical technique, Geographical Information Systems (GIS), to develop an objective proximity measure specific to persons with SCI. Results indicated a small, negative association between the objective presence of physical activity facilities and L TPA in a sample of persons with SCI (n=50), suggesting that living in close proximity to a facility which provides adaptive programming and equipment does not necessarily translate into greater LTPA for persons with SCI.</p> <p>As an extension of Study 1, Study 2 used structural equation modeling to conduct a cross-sectional examination of whether an environmental factor --neighbourhood perceptions--could enhance the Theory of Planned ehaviour's (TPB; Ajzen, 1985) ability to explain LTPA intentions and behaviour in persons with SCI (n=246). Results indicated a small, negative association between perceived wheeling infrastructure and LTPA intentions. However, perceptions of neighbourhood aesthetics and wheeling infrastructure did not explain significant variance in either L TPA intentions or behaviour, beyond that accounted for by the TPB constructs, suggesting that these eighbourhood factors do not enhance the TPB's ability to explain LTPA behaviour.</p> <p>Lastly, Study 3 used a randomized, controlled design to examine the effects of a 10-week action and coping planning intervention on enhancing LTPA and coping self efficacy in exercise intenders living with SCI (n=47). Results indicated greater LTPA for participants who formed action plans and coping plans (A+C condition) than for the participants who only formed action plans (A condition). Furthermore, the A+C condition had greater confidence to schedule their L TPA and overcome L TPA-related barriers than the A condition. These findings provide evidence of the benefits of supplementing action plans with coping plans for enhancing L TP A and coping self-efficacy beliefs among exercise intenders living with SCI. </p> <p>Together, these three studies provide a broader understanding of L TPA correlates and determinants in people with SCI, and provide evidence of the efficacy of multiple planning strategics for promoting L TPA in persons with SCI. The results provide an impetus for extending the scope of the research on the physical environment and LTPA towards persons with mobility disabilities. Moreover, the findings demonstrate the value of theory-based research for identifying the multidimensional correlates and determinants of LTPA, and for designing effective LTPA-enhancing interventions in persons with SCI. </p> / Thesis / Doctor of Philosophy (PhD)