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This study employed an experimental design intended to be an analog to the workplace to examine a person by situation interactive effect on OCBs, which were evaluated as prosocial behaviors. This study also sought to provide initial empirical support for the two-stage social cognitive model of OCBs proposed by Hauenstein and Kalanick (2008). Participants were 194 undergraduates. The study was a 2 (Helpfulness) by 2 (Fairness) design. After completing distracter tasks 1 and 2, participants received either a helpfulness prime or a control prime (task 3). Participants then either experienced either a fair manipulation or an unfair manipulation. Results indicated a distinction between the decision to help and helping effort, which has not been thoroughly examined in literature on OCBs. Results revealed main effects for the helpfulness prime and fairness manipulation on the decision to engage in helping. The nature of these effects was that participants helped more when they were primed with helpfulness and when they experienced fairness. However, once helping commenced, there was an interactive effect between helpfulness and fairness such that the helpfulness prime had a stronger effect on participants treated unfairly. Implications for future research on OCBs are discussed. / Ph. D.

College students engage in poor dietary behaviors which put them at risk of weight gain and subsequent future health problems. This necessitates implementation of nutrition interventions which target dietary behaviors in college students so that healthy dietary patterns can be adopted and maintained through adulthood. Dairy intake is one of the many dietary behaviors which has declined substantially in young adults (18-30 years of age) - a period which includes the college age population. According to 2005 dietary guidelines for Americans three or more than three servings of low-fat/fat-free dairy foods is recommended for young adults, which is associated with overall nutrient quality of the diet and several health benefits. Still dairy consumption in this age group is below two serving per day. As emerging adults, college students may be more receptive to health advice than young adults older than traditional college years whose health habits are more established; nutrition intervention to improve dairy intake may be well received. Psycho-socio variables from Social Cognitive Theory (self regulation, social support, self-efficacy and outcome expectations) have been associated with adoption of healthy eating habits in college students and are associated with dairy consumption in adolescents. A series of studies were conducted to assess and improve dairy intake in college students by changing the mediating psycho social variables from Social Cognitive Theory (SCT) of behavior change including social support, self efficacy, outcome expectations and self regulation. A pilot web based nutrition education intervention was conducted to improve dairy intake in college students using SCT. The aim of this study was to evaluate the effect of the intervention on self efficacy, outcome expectations, self regulation, behavior and dairy product intake. Two hundred and ninety four students participated in the study and data on dairy intake and SCT variables were collected using 7 day food records and questionnaires. A 5 week electronic mail intervention was conducted. The intervention improved some social cognitive factors such as self regulation and self efficacy regarding increased dairy intake in college students, though dairy intake did not change. Next, to understand factors associated with dairy intake in college students, qualitative data were collected using focus group discussions (n=3), elicitation interviews (n=13) and online asynchronous discussion forums (n=3) using identical questions. Fifty students participated in the study and the aim was to identify relevant barriers, motivators and facilitators to dairy and low-fat dairy consumption. The results indicated that there was widespread lack of clarity regarding amount of dairy/calcium required and whether students felt they were getting enough. Major barriers to consuming dairy foods included short shelf life, storage issues, taste and accessibility to dairy foods on campus. Major facilitators included constant reminders, knowing immediate benefits, more accessibility and breakfast consumption. The aim of the final study was to improve social support, self efficacy, outcome expectations, self regulation and behavior related to dairy intake in college students using Social Cognitive Theory (SCT). One hundred and ninety one students participated in the study which included 8 week electronic mail intervention. Data collected included 7 day food records and for dairy intake and questionnaires for SCT variables. The intervention resulted in significant improvement in total dairy intake and use of self regulation strategies by college students. Taken together, these results suggest that theory-based nutrition education interventions can improve nutrition behavior in college students, a population prone to poor dietary habits. Developing mastery experiences to improve self efficacy may enhance self regulatory skills like goal setting, planning and monitoring to improve dairy intake in college students. Health care providers should aim at dietary behavior modification via theory based intervention. / Ph. D.

Type 2 Diabetes Mellitus (T2D) is a major public health issue. Diabetes prevalence is growing and is the 7th leading cause of death in the US. Virginia has a slightly higher prevalence than the national average. Community-based diabetes lifestyle management programs that include a physical activity component are effective at improving glycemic control and influencing lifestyle behavior changes among people with T2D. The Balanced Living with Diabetes (BLD) program uses an active learning approach to improve glycemic control and healthful lifestyles. The Lifelong Improvements through Fitness Together (LIFT) program uses behavioral strategies to improve functional fitness, participant engagement, and program adherence. Participant retention is a challenge for community-based program. Participants may start the program, but then fail to complete the program and/or adhere to program recommendations. Two pilot studies were conducted to evaluate strategies for increasing participant retention and improving outcomes. The first evaluated the implementation and impact of a retention plan implemented in BLD programs conducted from 2015-2017. There were more participants returned to the reunion class session prior the development of the retention plan. There were improvements in some health behavior and self-efficacy indicators in programs that used the retention materials, however, impacts on outcomes were mixed. Preliminary findings showed that the retention plan could be a tool for providing additional support to participants, however strategies for dissemination of the retention plan needs to be reevaluated. The second study evaluated the impact on participant engagement and program outcomes when the LIFT program is incorporated with the BLD program. There was an increase in participant retention, self-efficacy and one health behavior for physical activity and health behaviors related to diet in BLD+LIFT programs. Extension Agents are willing to implement the BLD+LIFT programs, however, clarity of program logistics is needed prior to implementation. Extension Agents indicated that implementation of these programs in locations with older adults that have greater disability may not be the best locations. Having larger studies on the effect of incorporation of LIFT with the BLD with older adult populations that have fewer co-morbidities are needed to determine the impact of addition of the LIFT program with the BLD program on program outcomes. / Doctor of Philosophy / Type 2 Diabetes is a chronic disease in which the body does not use insulin as it should or does not produce enough insulin. The Centers for Disease Control and Prevention (CDC) indicates that the prevalence of diabetes was 23.1 million among US adults in 2015. The prevalence of diabetes in Virginia is slightly higher than the national average. Community-based diabetes lifestyle management programs that include a physical activity component are effective in improving glycemic control and influencing lifestyle behavior changes among people with T2D. The Balanced Living with Diabetes (BLD) program uses an active learning approach to influence better glycemic control and healthful lifestyles. The Lifelong Improvements through Fitness Together (LIFT) program uses behavioral strategies to improve functional fitness, participant engagement, and program adherence. The challenge with implementing community-based programs is retention. Participants may initially agree to participate in a program, but then fail to complete the program and/or follow program recommendations. Two pilot studies were conducted to evaluate strategies for increasing participant retention and program outcomes. The first evaluated the implementation and impact of a retention plan implemented in BLD programs conducted from 2015-2017. There were more participants returned prior to the development of the retention plan. There were improvements in some health behavior and self-efficacy indicators in programs that used the retention materials, however, impacts on outcomes were mixed. Findings showed that the retention plan could be a useful tool for providing additional support to participants, however distribution of the retention plan needs to be reevaluated. The second study evaluated the impact of program outcomes when the LIFT program is combined with the BLD program. There was an increase in participants' self-confidence to perform physical activity and making changes in their diet in BLD+LIFT groups. Extension Agents were enthusiastic about conducting more BLD+LIFT programs, however, program procedures and the time commitment needs to be understood before doing so. Expanding the conduct of BLD programs that incorporate the LIFT program can be effective in improving glycemic control and increasing physical activity, however, working with organizations that service people that have diabetes with fewer health conditions that limit physical activity may be more effective.

Abstract  Background: Growing global concerns about sustainability highlight the importance of environmental sustainability, particularly environmentally conscious behaviors. There has been a growing focus on pro-environmental behavior (PEB) as a way for individuals to minimize their environmental impact. Global environmental challenges underscore the pressing need for proactive environmental action, particularly the growing emphasis on the importance of motivating individuals' daily actions and choices, as they directly contribute to environmental conservation and pro-environmental behavior. In the context of Sweden, the country is widely recognized for its commitment to environmental sustainability. Moreover, considering the increasing number of international university students in Sweden, it contributes to the academic environment and allows for the exploration of environmental behaviors within a diverse population. Given this, understanding, and promoting pro-environmental behaviors among this demographic in Sweden is essential, and it also helps contribute to the societal commitment to environmental conservation.  Purpose: This thesis aims to investigate the determinants that influence pro-environmental behavior among international university students in Sweden, employing social cognitive theory and the reciprocal determinism model. Focusing on personal (internal) factors like environmental knowledge and attitudes as well as environmental (external) factors like subjective norms and place attachment, this thesis also explored the interaction between pro-environmental behavior and its associated factors. By understanding these factors’ roles, this thesis aims to contribute to the development of effective strategies for promoting pro-environmental behavior among this population. Method: This thesis adopts a quantitative approach to examine the interplay of variables via an online survey. Data were collected from 203 individuals in Sweden, focusing on investigating the relationships between different factors and pro-environmental behavior based on eight formulated hypotheses. Respondents were selected using judgmental sampling, and data analysis was conducted using techniques such as Pearson’s correlation and multiple regression analysis in SPSS.  Conclusion: The results of this thesis reveal a significant association between different factors and pro-environmental behavior among international university students in Sweden. Specifically, environmental attitude and place attachment were found to positively influence pro-environmental behavior. Moreover, subjective norms were shown to have a positive impact on both environmental knowledge and attitude. However, neither the relationship between place attachment and environmental knowledge nor the relationship between environmental knowledge and subjective norms had any significant impact on pro-environmental behavior.

Doctor of Philosophy / Department of Family Studies and Human Services / Kristy L. Pederson-Archuleta / Viewership of reality television has been indicated to influence behaviors among individuals and groups, as existing literature has linked reality television viewership to an increase in the likelihood of demonstrating other non-financial behaviors. The literature notes increases in risky sexual and dating behavior, increases in tobacco, drug, and alcohol use, and increases in violent behavior. This dissertation examined the perceptions of the influence of reality television on financial behavior. Situational reality television programming was found to have the greatest influence on the financial behaviors of college students. Ten college students were interviewed using a phenomenological qualitative approach. There were four primary findings from this study. The first was that reality television has the ability to inform the financial behavior of college students. Second, an individual’s connection to his or her social system has an influence on financial behavior. Third, reality television does have the ability to influence financial behavior change and fourth, reality television influences the meaning of money as perceived by the respondents. The results of this study provide valuable information to promote further inquiry as to how reality television and other forms of media influence financial behavior.

The current study examined the impact that components of Social Cognitive Career Theory (SCCT) have on choice behavior and academic performance in African American or Black, undergraduate students. SCCT is a highly valued and researched theory, but few studies examine the impact that SCCT components have on choice behavior and academic performance in Black college students. This study focused on evaluating SCCT components’ relevance to variables that have been shown to predict later objective career success. This is important because African Americans tend to have significantly lower paying and less prestigious jobs, as well as attain lower levels of education than most other racial populations in the United States. However, there is a paucity of current career development and attainment literature specific to the African American undergraduate population. In an effort to promote understanding of within group differences in SCCT variables that can contribute to educational and career success, 247 African American undergraduates were recruited to participate in this study. The participants completed online questionnaires regarding demographic information, self-efficacy, contextual barriers, contextual supports, choice goals, and choice behavior. Participants also gave permission for researchers to access grades. Findings indicate that academic coping self-efficacy, contextual barriers, and contextual supports may be particularly important to academic choice behavior in African American college students. Further, choice behavior appears to be important to grade point average. Implications, limitations, and recommendations for future research associated with this study’s findings are discussed.

Bakgrund: Andelen äldre i vårt samhälle ökar och alltfler äldre är fysiskt inaktiva, vilket kan ses som ett folkhälsoproblem. Att utforska inaktiva äldres syn på fysisk aktivitet kan bidra till värdefull kunskap när det gäller att stödja dessa personer till en ökad fysiskt aktiv livsstil.  Syfte: Att ta reda på vad inaktiva äldre upplever har betydelse för att vara fysiskt aktiva, samt vad de anser kan få dem att förändra sitt beteende till en mer fysiskt aktiv livsstil. Metod: En kvalitativ studie med semistrukturerade intervjuer genomfördes med ett bekvämlighetsurval med sex kvinnor, 65–74 år. Data analyserades induktivt med kvalitativ innehållsanalys där koder och kategorier sorterades fram.  Resultat: Fysisk miljö och yttre stöd ansågs ha betydelse för att inaktiva äldre skulle vara mer fysiskt aktiva. Vardagliga aktiviteter prioriteras framför fysisk aktivitet. Yttre stöd, förändrade rutiner i samband med pension, kunskap och erfarenheter samt känslor och attityder kring fysisk aktivitet ansåg de äldre ha betydelse för den fysiska aktivitetsnivån. Slutsatser: De psykosociala faktorerna uppfattades ha stor betydelse vad gäller fysisk aktivitet, deltagarna betonade omgivningens betydelse, yttre stöd ansågs ha en stor betydelse för att en beteendeförändring skulle kunna ske. / Background: The number of elderly in our society is increasing and the quantity of physically inactive seniors is growing along with it, this observation can be viewed as a global health issue. By exploring inactive elderly people´s view of physical activity it can contribute to valuable knowledge for supporting this age group into a more physical active lifestyle. Aim: To find out what elderly experiences have importance for being physically active, and what they think can make them change their behavior into a more physically active lifestyle. Method: The study was qualitative, semistructured interviews were made, a convenient sample of six women, 65-74 years old, were included. Data were interpreted inductive with a qualitative content analysis and then sorted into codes and categories. Result: Physical environment and external support was considered to be important by elderly inactive people to be more physically active. Ordinary everyday activities are prioritized over physical exercise. External support, changed habits after retirement, knowledge, experience and attitudes regarding physical activity. This altogether results in an impact on the level of physical activity amongst elders.   Conclusion: The psychosocial factors  were perceived to have great importance in terms of physical activity. The participants expressed how the support from the surroundings has a great importance for a behavioural change.

Bakgrund:Som yrkesverksam fysioterapeut inom primärvården finns det flera olika behandlingsmetoder för långvarig ländryggssmärta att välja mellan, men inga tydliga riktlinjer att följa. Grundat i det kliniska resonemanget tar fysioterapeuter beslut som påverkas och förändras i mötet med patienten. Då det finns lite forskning som undersökt hur fysioterapeuter utbildade inom Mekanisk diagnostik och terapi (MDT) beskriver sitt kliniska resonemang till patienter med långvarig ländryggssmärta syftar denna studie till att åskådliggöra fysioterapeuters syn på ämnet.    Syfte:Att undersöka hur fysioterapeuter beskriver sitt kliniska resonemang gällande användning av MDT till patienter med långvarig ländryggssmärta.    Metod:Kvalitativ semistrukturerad intervjustudie med induktiv ansats och deskriptiv design. Datainsamling skedde genom sex intervjuer. En kvalitativ innehållsanalys användes vid analys av materialet.    Resultat:Analysen genererade 22 underkategorier fördelade i sju kategorier. Informanterna beskrev sitt kliniska resonemang vid användning av MDT i form av sin syn på metoden, patientdelaktighet i undersökning, struktur och tydlighet, fynd som påverkar behandling, hypotestestning, patientansvar i behandling och värdering av egna förmågor.   Slutsats:Studiens resultat visade att informanterna beskrev sitt kliniska resonemang vid användning av MDT vid långvarig ländryggssmärta inom primärvården främst påverkades av biomekaniska fynd hos patienten. Psykologiska fynd beskrevs som sekundära faktorer att ta hänsyn till, och sociala faktorer beskrevs lite eller inte alls trots att de är viktiga att ta hänsyn till för att åstadkomma en beteendeförändring. Därmed har ett utvecklingsområde för MDT inom fysioterapi tydliggjorts då det finns evidens för att ett biopsykosocialt arbetssätt vid långvarig ländryggssmärta är att föredra. / Background: As a physiotherapist in primary care, there are several different treatment methods for persistent low back pain to choose from, but no clear guidelines to follow. Based on the clinical reasoning, physiotherapists take decisions that are affected and changed in the patient encounter. Since there is a lack of research that have investigated how physiotherapists educated in Mechanical Diagnosis and Therapy (MDT) describe their clinical reasoning to patients with persistent low back pain, this study aims to illustrate the physiotherapists' view of the topic.   Aim: To explore how physiotherapists describe their clinical reasoning regarding the use of MDT for patients with persistent low back pain.   Method: A qualitative semi-structured interview study with an inductive approach and a descriptive design was conducted. The data collection included six interviews. A qualitative content analysis was used to analyze the data.   Result: The analysis generated 22 subcategories divided into seven categories. The informants described their clinical reasoning when using MDT as their view of the method, patient participation in examination, structure and clarity, findings that affect treatment, hypothesis testing, patient responsibility in the treatment and evaluation of own abilities.   Conclusion: The study's results showed that the informants described their clinical reasoning when using MDT with persistent low back pain in primary care were mainly influenced by biomechanical findings with the patient. Psychological findings were described as secondary source to take into consideration, and social factors were described very little or not at all even though they are important to take into consideration in order to achieve a behavioral change. Thus, a development area for MDT in physiotherapy has been clarified as there is evidence that a biopsychosocial approach to persistent low back pain is preferable.

Bakgrund: Digitala patientmöten ökar med visionen om ökad e-hälsa, det kan användas för att nå fler patienter och verka kompletterande till traditionell fysioterapi. Det finns lite information om digitala patientmöten med fokus på att kunna stödja beteendeförändring. Syfte: Syftet med studien var att undersöka hur fysioterapeuter beskriver sina möjligheter och begränsningar att kunna stödja beteendeförändringar hos patienter i digitala patientmöten.Metod: Studien utfördes som en kvalitativ intervjustudie med en induktiv ansats. Sex fysioterapeuter deltog i studien och data från intervjuerna analyserades med en kvalitativ innehållsanalys. Resultat: Intervjuerna resulterade i fem kategorier med tolv underkategorier. Dessa kategorier var: behov att överbrygga det fysiska avståndet, digital fysioterapi passar kortare, enklare kontakter, krävs mer tydlighet i digitala möten för att få med patienten, avsaknaden av fysisk kontakt vid digital fysioterapi hindrar samt rutin för uppföljning. Slutsatser: Deltagarna beskrev det digitala patientmötet som positivt för enkla och snabba patientkontakter. Dock menade de att det inte kan ersätta traditionell fysioterapi då avsaknaden av den fysiska kontakten och den bristande uppföljningen begränsar deras möjligheter att stödja beteendeförändringar. Studien ger grund för fortsatt forskning om organisatorisk implementering av stödjande arbetssätt för beteendeförändringar i digital / Background: Meeting patients in a digital format increases with the vision of increased e-health. It can be useful to reach more patients and work complementary to traditional physiotherapy. There is little information on digital patient meetings with a focus on being able to support behavioral changes. Aim: The aim of this study was to investigate how physiotherapists describe their possibilities and limitations to support behavioral changes in digital patient meetings.Method: The study was conducted as a qualitative interview study with an inductive approach. Six physiotherapists participated in this study and data from the interviews were analyzed with a qualitative content analysis. Result: The interviews resulted in five categories with twelve subcategories. These categories were: the need to bridge the physical distance, digital physiotherapy fits for shorter, simpler contacts, more clarity is required in digital meetings to engage the patient, the lack of physical contact during digital physiotherapy prevents and routines for follow-up. Conclusions: The participants described the digital patient meetings as positive for simple and quick patient contacts. However, they meant that it could not replace the traditional physiotherapy since the lack of physical contact and the lack of follow-up limits their ability to support behavioral changes. This study provides support for continued research on the organizational implementation of supporting working methods for behavioral change in a digital environment.