Maternal alcohol consumption during pregnancy is a public health concern due to the possible lifelong physical and cognitive effects in offspring. Prevention of alcohol-exposed pregnancies (AEP) should begin preconceptionally, either by preventing unintended pregnancies or by discouraging alcohol consumption in women who are at-risk for pregnancy. The purpose of this dissertation is to utilize the Theory of Planned Behavior's construct of perceived behavioral control (PBC)--including perceived power and control beliefs--to guide the measurement and understanding of two behaviors related to AEP among non-pregnant women: birth control use and binge drinking. For the first specific aim--to estimate the prevalence of alcohol-exposed pregnancies--a secondary data analysis was conducted using surveillance data from North Dakota and South Dakota women who have had a child with FAS. The FAS prevalence estimates (per 1,000 live births) in both states (ND=0.8/1,000; SD=0.9/1,000) were found to be higher than that calculated from national averages (0.7/1,000) using a comparable surveillance methodology. The goal of Specific Aim 2 was to determine risk for AEP among a random group of women, while Specific Aim 3 determined the control beliefs and perceived power to using birth control and decreasing binge drinking levels, and Specific Aim 4 focused on relating PBC of these two behaviors to behavioral intentions. Data for aims 2-4 were derived from a mailed, cross-sectional survey of 190 non-pregnant women randomly chosen from an electronic health records system in the upper Midwest. Of the 190 women included in the analyses, eight (6.6%) were binge drinking while being at-risk for pregnancy (i.e., being sexually active but not always using an effective form of birth control) (Specific Aim 2). This is lower than national estimates. For Specific Aim 3, there were high direct PBC scores for both birth control and binge drinking, and there was a positive correlation between birth control direct and indirect scores (although a negative correlation between binge drinking direct and indirect scores). Finally, Specific Aim 4 uncovered high intentions to both use birth control and to not binge drink. Also, the direct birth control PBC measure was significantly associated with birth control intention when controlling for other variables, although neither PBC nor intention appeared to be associated with actual birth control behavior. For binge drinking, the intention score and the direct measure of PBC were significantly associated with one another; as well, the direct measure of PBC and intention were both significantly associated with actual binge drinking behavior. Therefore, the relationship between PBC and intention was validated for both behaviors, and the association between PBC, intention, and actual behavior was indicated for binge drinking. Overall, the study both supported and disagreed with previous research, indicating that additional research with this theory and topic matter is necessary.

Due to the growing recognition of the social and ecological consequences of the global decline in pollinator species, the need for more effective policies for the conservation of pollinator habitat is now more than ever. These trends call for research that provides a deeper understanding of farmers' decision-making processes. In this regard, this study tested a modified version of the Theory of Planned Behavior as a conceptual model for explaining farmers' perceptions and behavior regarding the adoption of pollinator conservation programs and practices. Specifically, the study tested how farmers' perceived behavioral control, attitudes, subjective norms, concern about herbicide resistance issues, and sociodemographic variables influence their intentions and actual adoption of pollinator conservation programs and practices. Quantitative survey data were gathered from 41 principal farm operators in the state of Illinois through the administration of a web-based survey. The resulting data were first explored using descriptive statistics and correlation analysis, following which multiple regression analysis was used to test four hypotheses on the predictors of farmers' intentions to adopt, as well as their adoption of pollinator conservation practices and programs. The results from the regression analysis showed that farmers' attitudes and their subjective norms had statistically significant positive effects on their adoption of pollinator conservation practices on their farms, as well as their intentions to adopt those practices in the near future. Perceived behavioral control also had a statistically significant positive effect on farmers' adoption of federal pollinator conservation programs, as well as their intentions to enroll in these programs in the future. Overall, these findings call for comprehensive pollinator conservation policies that facilitate the provision of information and incentives for farmers to voluntarily adopt pollinator conservation practices on their farms, as well as the provision of appropriate resources and opportunities for farmers to enroll in pollinator conservation programs over which they have minimal control.

Rural adolescents suffer from poor nutrition, increasing their risk for obesity and other chronic diseases. The Summer Food Service Program (SFSP), an off-shoot of the National School Lunch Program, provides meals to qualifying children, including low-income, rural adolescents, under the age of 18. The purpose of this study was to: 1) examine the impact of the SFSP on the nutrition–related knowledge, self-reported fruit and vegetable (SRFV) consumption, and the constructs of the Theory of Planned Behavior (attitudes, subjective norms, perceived behavioral control, and behavioral intentions) of rural, low-income adolescents; and 2) examine the relationship between nutrition behaviors (quality food selection and consumption) and participation in the SFSP using digital photography. The participants (N = 78) were recruited from those enrolled in the Upward Bound (UB) Summer Program at a mid-sized university that utilized the SFSP. The UB, a federally funded program, provided the opportunity to reach high school students from low-income, rural areas to study the aforementioned effects of the SFSP. The quasi-experimental pre- post-intervention design used a survey (n = 57) to determine predictors of positive nutrition behaviors and digital photography (n = 43) to determine actual food selection and consumption of those enrolled in the SFSP. A nutrition quality scale (0-6, with 6 indicating higher quality) was developed in order to categorize food items within food groups according to their nutritional value, and aided in determining quality of foods selected and consumed. Paired samples t-test showed a significant increase in knowledge (t(56) = -8.09, p = .000) and SRFV consumption (t(56) = -3.20, p = .002) from pre- to post-intervention. Regression analysis demonstrated that all constructs of the Theory of Planned Behavior (TPB) were significant (F(4, 52) = 14.56, p < .001 with an R2of .53) for predicting behavior intentions, with perceived behavioral control (PBC) being the most salient predictor of intentions to increase fruit and vegetable consumption. A one-way repeated measures MANOVA was not significant for the comparison of pre- and post- survey scores for knowledge, SRFV consumption, and the constructs of the TPB, F (4, 53) = .604, p = .660. Digital photography showed a significant increase in consumption from week 1 (baseline) to week 5 (program completion) for fruit (t(42) = -2.04, p = .048) and milk (t(42) = -3.13, p = .003) at lunch, for milk (t(42) = -3.01, p = .003) at supper, and for milk overall (all three meals combined), t(42) = -3.08, p = .004. Vegetable consumption decreased significantly from week 1 to week 5 t(42) = 2.47, p = .018 at supper and overall (all three meals combined) t(42) = 2.65, p = .011. Two proportion z tests showed a statistically significant decrease in the selection of food items at quality level 2 from week 1 (.34) to week 5, z = 3.11, p = .002, and statistically significant increases in the selection of quality level 3 (.20), z = -2.15, p = .031, and quality level 5 (.17), z = -3.33, p < .000, item. Two proportion z tests showed a statistically significant decrease in the consumption of food items at quality level 5 from week 1 (.62) to week 5, z = 2.94, p = .003. However, the analysis showed no consistent increase in the quality of foods selected or consumed from week 1 to week 5. Opportunities for shaping adolescent nutrient intake and eating behaviors during and outside of enrollment in the SFSP exist. Reinforcing positive attitudes, subjective norms and perceived behavioral control while participants are enrolled in the SFSP may help to increase nutrition behavioral intentions and therefore, nutrition behaviors. Opportunities also exist for offering healthier food options for those participating in the SFSP. SFSP participants are a captive, impressionable group, and providing a supportive social and physical environment, and high nutritional quality choices in the SFSP more often may provide the potential for behavior change that may lead to an increase in healthy nutritious habits for adolescents from rural areas.

This study examined teachers’ beliefs about mental health issues in students. A quantitative research method was utilized, and survey instrument was created modeled after the theory of planned behavior. Thirty-seven teachers were surveyed in five areas in relation to their beliefs about assessment and referral; including, previous assessment and referral; mental health training; attitudes toward assessment and referral; the perceived social normality of assessment and referral; and perceived self-efficacy or behavior control. These five areas became independent variable measures, with the dependent variable being their future intention of assessing and referring students with mental health issues. Multiple regression analysis revealed that the overall model was statistically significant in predicting teachers’ intention to assess and refer students; however, independent analysis of independent variable revealed teachers’ attitudes, past behavior, and accesses to mental health training were most the most significant predictors of future intention. Implications of this study highlight the need qualified mental health professionals to be present in schools and/or expanded training of teachers.

The majority of organic foods consumed by Americans are sourced internationally, which has global-reaching implications on health, economics, and sustainability. Current research findings show that environmental devastation and negative health outcomes have resulted from unsustainable, nonorganic agricultural practices; including herbicides, pesticides, and overcultivation. However, there is a lack of quantitative research on factors that motivate Americans to consume organic food. Based on the theory of planned behavior, this quantitative study employed an online survey to examine the role of attitudes, subjective norms, descriptive norms, and perceived behavioral control on the intention and behavior of American consumers to consume organic foods. Additional descriptors of willingness to pay and perceived product attributes were also measured. Theory of planned behavior and American Organic Consumption questionnaires were completed by 276 adult consumers in the United States. Multiple regression analyses were performed to identify relationships and create predictive models between constructs of a modified theory of planned behavior, sociodemographics, and organic consumption. Key findings revealed that a modified theory of planned behavior, which included descriptive norms, predicted intent to consume organics stronger than the nonmodified theory of planned behavior. Attitudes, perceived behavioral control, and descriptive norms were significant predictors of intention to consume organics. Health was perceived as the major product attribute for organic consumption and low willingness to pay was perceived as the major barrier. This study has implications for positive social change such that it contributes to understanding motivational factors behind American's food choices and consumption, which can be used to modify and target consumer behaviors and market campaigns.

Primary teachers in the United States accept responsibility for teaching children how to read, and the instruction they provide results in reading proficiency for approximately 37% of students. Although researchers have established a relationship between teacher-related factors and students' performance in reading, they have not yet been able to identify the combination of teacher characteristics that best predicts teachers' intention to provide evidence-based reading instruction. The purpose of this study was to examine the relationships among teacher knowledge, teacher beliefs, and intention to provide evidence-based reading instruction using a conceptual framework that integrated the theory of planned behavior with the implicit theory of intelligence. An online survey was used to gather data from a convenience sample of 37 primary teachers in the United States to examine characteristics effective reading teachers have in common. The results of multiple regression analysis indicated different patterns for different groups of readers. For beginning readers, teachers' behavioral beliefs was the only significant predictor of intention to provide evidence-based reading instruction. For struggling readers, teacher knowledge of reading disabilities was the only significant predictor of intention. This study provided additional evidence of deficits in teachers' knowledge of basic language concepts and reading disabilities. Identifying teacher characteristics that influence students' reading proficiency outcomes may inform efforts to improve professional development and teacher preparation programs to better support and prepare teachers to ensure successful reading outcomes for all children.

Obesity is a serious health problem that leads to several chronic diseases and premature deaths. TheIn this project,was used to evaluate the effectiveness of the the Weigh Forward (WF) program, a 10-week weight-loss program administered in retail clinics, was evaluated, and it is provided in retails stores. The project analysis was completed on a limited data set on The population consisted of 15 obese participantsmembers of the program, 18 years and above, at 13 dispersed clinics in Maryland and Virginia.in the WF program from 13 dispersed clinics in Maryland and VirgiObesity is a body mass index (BMI) > 30 kg/m2. Participants were 18 years and above The theory of planned behavior (TPB) was used as the framework from which to view the project. The project was usedpurpose was to determine the efficacy of the WF program for weight reduction by comparing the baseline body mass index (BMI) and the waist circumference (WC) to the BMI and WC at the end of the program. Descriptive The aanalysis was done using correlation coefficient on the 15 participants,, who completed the 10-week WF program. The result, showed the mean and mode for BMI reduction to be 2 kg/m2, and the mean and mode for the WC reduction was 3 inches. The percentage weight loss varied from 3-11%, with the completion rate for the enrolled participants at 29%. Thise study has implications for the social change because the findings support intensive behavioral modification as an effective approach to weight loss. The study can help healthcare providers appreciate the is the need to complete preventive care assessment on patients, identify patients with obesity, and provide these patients with the requisite information on the need to lose weight. Also, the clinicians provide the patients with information and available resources to enable help them lose weight. The mean and mode of 2 kg/m2 for BMI reduction, and 3 inches for the reduction in WC at the end of 10 weeks, showed that the WF program was effective for weight loss because the participants lost significant amount of weight. The findings from the project can guide the development of practice guidelines for administering the WF program in the retail clinic.

Workplace bullying caused business owners to lose about 80 million employees' workdays each year. Workplace bullying can cost an organization up to $300 billion for increased medical claims, lost productivity, and employee turnovers, and up to $23 billion in additional expenses, such as costs for employee absenteeism and legal costs. The purpose of this single case study was to explore successful strategies to address workplace bullying used by 7 human resource (HR) managers and executives in 1, small-to-medium-sized organization in Central Florida. The HR managers and executives had 5 or more years of HR experience. The risk management framework and theory of planned behavior were the conceptual frameworks that guided exploration of the phenomenon. Data were collected from semistructured interviews with HR managers and executives and from company artifacts, such as HR and risk management policies. Member checking and transcript review strengthened trustworthiness of data analysis and interpretations. Data were analyzed using thematic analysis. Five themes emerged from the data analysis: enhanced training, encourage reporting, develop HR business partner model, implement policies and guidelines, and enforce zero-tolerance policy. The findings of this study may contribute to positive social change by building awareness of workplace bullying for employees, organizations, and society, and by providing strategies to reduce the number of bullied victims and enrich social harmony within organizations and communities.

Many studies have observed the involvement of stakeholders in farm to school (FTS) programming to further understand their role, yet no study had previously assessed the role of Utah farmers in FTS programming. As a result, the purpose of this research was to describe Utah farmers' role in FTS programming and their interest in institutional marketing of local foods. The researcher sent an online descriptive survey to 5,470 farmers belonging to the Utah Farm Bureau. The survey used Dillman's Tailored Design Method. Of the 184 survey responses received, 143 surveys were usable. The theory of planned behavior was the theoretical framework for the study. Respondents reported a positive attitude toward FTS programming, although a majority (83.6%) had not participated. They indicated that building relationships with community members and increasing awareness of local food were top benefits associated with FTS programming. Top barriers to participating in FTS programming included a lack of information about schools seeking to purchase local products and restriction of growing seasons. Respondents indicated that they intended to host farm tours for students and food service personnel. Their training and resource needs related to FTS programming included small business assistance. Demographics characteristics revealed a majority of respondents were male and had more than 22 years of farming experience. The subjective norm and perceived behavioral control components of the theory of planned behavior statistically predicted the intention of respondents to participate in farm to school programming. Theory components, including attitude, accounted for 67.2% of the variance in intention to participate in FTS programming. These findings suggest other influences contributed to the intention of respondents to participate in FTS programming. One future research recommendation for FTS programming includes conducting similar studies with different groups of farmers. The researcher recommends continued use of the theory of planned behavior as a theoretical framework for studies assessing involvement in FTS programming. Variables not included in this study may discover further influences on farmers' intention to participate in FTS programming. One recommendation is to increase outreach and marketing to farmers who may be interested in FTS programming.

Cancer is the second leading cause of death in the United States. Prostate cancer is the leading cause of cancer deaths among African American men, and African American men have the highest incidence of prostate cancer in the world. Limited studies have been conducted that address this critical issue. Existing literature reveals that the primary cause of increased mortality rates of prostate cancer in African American men is lack of participation in prostate cancer screening activities. The purpose of this three-phase study was to develop a valid and reliable instrument to measure prostate cancer screening intention among African American men. Three gender-specific focus groups were conducted in the first phase of the study. Twenty men from two north Florida churches participated in the focus groups. Eight dominant themes emerged from the focus groups and were utilized to develop the items for the intention instrument: fear, healthy lifestyle, hopelessness/helplessness, machismo, mistrust of healthcare providers, social/familial support, job requirements and transportation barriers. The second and third phases of the study consisted of development of the instrument and assessment of the instrument for validity and reliability. The Cancer Screening Intention Scale-Prostate (CSIS-P) consists of 43 items and was developed utilizing the results of the focus groups. The reading level of the CSIS-P was 5.6 utilizing the Flesch-Kincaid index and 7.0 utilizing the SMOG Readability Formula. The CSIS-P was assessed for content validity by a panel of oncology experts. The content validity index for the scale was .90 and internal consistency was found to be .92. The CSIS-P was evaluated for construct validity utilizing factor analysis techniques. Test-retest procedures were also conducted to assess stability of the CSIS-P and the reliability coefficient was .93. Factor analysis techniques demonstrated a three-structure model. The factors that emerged were benefits to prostate cancer screening, barriers to prostate cancer screening, and health promotion. The internal consistency of the three factors were found to be .88, .81, and .86 respectively. Factor analysis procedures reduced the CSIS-P to a 17-item scale. The CSIS-P is a parsimonious, culturally sensitive instrument that is valid and reliable in assessing prostate cancer screening intention. Recommendations for future study of the instrument include replication of the study with a more heterogeneous sample and utilization of the scale with other cancers.