People with psoriasis are known to engage in high levels of unhealthy lifestyle behaviours which may lead to poorer psoriasis outcomes and increase the risk of cardiovascular disease (CVD). Thus, helping individuals with psoriasis understand the link between behaviours and health risks, that is health risk communication, and direct support for lifestyle behaviour change (LBC) are important aspects in optimal management of psoriasis, a long-term inflammatory skin condition. There are two aspects of the literature that remain unclear. First, whether adequate support is given to patients to enable them to understand the links between lifestyle behaviours and health outcomes is part of psoriasis patient management strategies. Second, whether there is agreement around effective health risk communication techniques. This programme of research aimed to examine these gaps in the literature using four related studies. The first study used content analysis to examine general and dermatology-specific healthcare professionals’ core training competencies for evidence of skills relating to LBC. An important finding was the lack of explicit skills relating to LBC and changing understanding of health risks. There was little or no reference to recognised LBC techniques that could be used to support and facilitate LBC with patients. The second study used observational techniques to examine messages about the links between behaviour and health outcomes and LBC signposting (such as leaflets or posters about healthy living) for patients with psoriasis in primary and secondary care patient waiting areas. There was little evidence of psoriasis-specific information about healthy living. Generic information (not specifically about psoriasis) was often of poor quality and was poorly displayed, and did not conform to evidence-based recommendations for effective LBC signposting. The third study combined observational and qualitative techniques to examine how healthcare professionals communicate information about CVD risk to patients and the role of LBC in reducing risk in the context of primary care risk assessments with people with psoriasis. A key finding was that interpretation of risk information was not always linked to specific advice about how to modify each risk factor. Discussion was mostly instructional rather than a shared collaborative discussion about behaviour change and risk reductionThe fourth study used experimental methods to examine the effects of message framing theory as a health risk communication strategy on reported behavioural intentions (BIs) in people with psoriasis. An important finding was that for messages about psoriasis symptom reduction, gain-framed (positively-framed) messages were more effective in increasing BIs for alcohol reduction. Conversely, for messages about CVD risk reduction, loss-framed (negatively-framed) messages were more effective for increasing BIs to reduce alcohol consumption. The body of work presented in this thesis demonstrated that much needs to be done to increase the skill sets of healthcare professionals in order to help people with psoriasis recognise the specific links between their own health behaviours and health outcomes. In addition specific recommendations have been suggested as a way of improving risk communication strategies, such as using theory-based personally-relevant health information for people with psoriasis.

Thesis (Ph. D.)--University of Washington, 2006. / Vita. Includes bibliographical references (leaves 156-170).

Submitted by Jorge Silva (jorgelmsilva@ufrrj.br) on 2017-05-19T17:56:48Z No. of bitstreams: 1 2016 - Ana Paula da Concei??o Fernandes de Amorim.pdf: 3124663 bytes, checksum: 3efcd80a29fa4dcabb2739fbe1a6d204 (MD5) / Made available in DSpace on 2017-05-19T17:56:48Z (GMT). No. of bitstreams: 1 2016 - Ana Paula da Concei??o Fernandes de Amorim.pdf: 3124663 bytes, checksum: 3efcd80a29fa4dcabb2739fbe1a6d204 (MD5) Previous issue date: 2016-07-07 / The results of this study were obtained from interview socioeconomic and biological analyzes of urine and hair of 94 people living in the city and environmental analyzes of soil, water and air to evaluate the presence of mercury in these environmental compartments. These results were the basis for the identification of risk and vulnerability of the population exposure to mercury in the environment, and provided subsidies for the development of risk communication strategies. In addition to the primary data, there was also a secondary data research and literature review. This study was conducted under the Project "Development of Clinical Protocols and Therapeutic Guidelines for Health Surveillance of Populations Exposed to Mercury". This study demonstrated, along with research, the population of the city of Descoberto, Minas Gerais, It is environmentally exposed to mercury. The results of environmental samples were: Hg in the air with an average level of 39,4 ? 37,5 ng m-3, Hg soil with an average of 0,37 ? 0,71 mg kg-1 and Hg in water with values ranging from 1,1 a 2,8 ng L-1, and the results of biological samples were: Hg average level in the urine of 0,15 ? 0,30 ?g L-1 with the median 0,23 ?g L-1 and mercury levels in the hair of de ? 0,096 ?g g-1 a 1,92 ?g g-1 with a mean of 0,25 ? 0,28 ?g g-1and a median of 0,15 ?g g-1.Therefore in view of the characteristics of the population, as evidenced in the results of socio-economic research, the results of environmental and biological analyzes , prepared to risk communication strategies as one of the management measures of risk exposure and consequent health surveillance. Risk Communication in this folder and DVD model in order to achieve the objective information and reach the largest number of the population. / Este estudo tem como objetivo geral a elabora??o de estrat?gias de comunica??o de risco para popula??es expostas ao merc?rio no Munic?pio de Descoberto, Zona da Mata do Estado de Minas Gerais, Brasil. Os resultados desse estudo, foram obtidos a partir de entrevista socioecon?mica e an?lises biol?gicas de amostras de urina e cabelo de 94 pessoas, residentes no munic?pio e an?lises ambientais de solo, ?gua e ar para avalia??o da presen?a de merc?rio nesses compartimentos ambientais. Esses resultados serviram de base para a identifica??o do risco e vulnerabilidade da popula??o ? exposi??o ao merc?rio no meio ambiente e, forneceram subs?dios para a elabora??o das estrat?gias de comunica??o de risco. Al?m dos dados prim?rios, houve tamb?m uma pesquisa de dados secund?rios e revis?o bibliogr?fica. Este estudo foi realizado no ?mbito do Projeto ?Elabora??o de Protocolos Cl?nicos e Diretrizes Terap?uticas para a Vigil?ncia em Sa?de das Popula??es Expostas ao Merc?rio?. Este estudo evidenciou, junto com a pesquisa, que a popula??o do munic?pio de Descoberto, Minas Gerais, est? exposta ambientalmente ao merc?rio. Os resultados de amostras ambientais encontrados foram: Hg no ar com n?vel m?dio de 39,4 ? 37,5 ng m-3, Hg no solo com m?dia de 0,37 ? 0,71 mg kg-1 e Hg na ?gua com valores variando entre 1,1 a 2,8 ng L-1, e, os resultados de amostras biol?gicas foram: n?vel m?dio de Hg na urina de 0,15 ? 0,30 ?g L-1, com a mediana em 0,23 ?g L-1 e n?veis de merc?rio no cabelo de ? 0,096 ?g g-1 a 1,92 ?g g-1 com m?dia de 0,25 ? 0,28 ?g g-1 e mediana de 0,15 ?g g-1. Portanto tendo em vista as caracter?sticas da popula??o estudada, evidenciada nos resultados da pesquisa socioecon?mica, os resultados das an?lises ambientais e biol?gicas, elaborou-se estrat?gias de comunica??o de risco como uma das medidas de gerenciamento do risco de exposi??o e consequente vigil?ncia em sa?de. Comunica??o de Risco essa no modelo de folder e DVD, a fim de alcan?ar o objetivo informativo e atingir o maior contingente da popula??o.