This study was an investigation of the access problem to fresh and affordable fruits and vegetables and how limited access influenced the beliefs and opinions of residents of a food desert as designated by United States Department of Agriculture. Many researchers have documented that price, availability, and transportation are barriers to fruit and vegetable consumption, particularly among low-income individuals. Researchers in other studies have concluded that these barriers are further exacerbated by an individual's distance from a supermarket or grocery store. However, much less information is available regarding the beliefs and opinions about life in a food desert and how these factors affect food-shopping. Accordingly, this study used the socioecological model framework to explore the beliefs and opinions of the low-income residents who lived in a food desert. Qualitative data were collected from semistructured interviews with 14 low-income participants to learn their beliefs and opinions about access to fresh produce. The qualitative data were transcribed and analyzed, using ATLAS.ti software, to generate themes. Results showed that the participants felt fresh fruits and vegetables were available, but they were not always able to purchase them because of cost. Respondents had an awareness of how their budgets influenced food choices and shopping behaviors as well as how the mode of transportation and mileage from a grocery store impacted food shopping behaviors. The implications for positive social change include creating additional options for food access, such as farmers' markets, community gardens, mobile food trucks, and lowered prices (or subsidies).

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Across Australia and other developed nations, morbidity and mortality follows a socioeconomic gradient whereby the lowest socioeconomic groups experience the poorest health. The dietary practices of low socioeconomic groups, which are comparatively less consistent with dietary recommendations, have been thought to contribute to the excess morbidity and mortality observed among low socioeconomic groups, although this phenomenon is not well understood. Using a socioecological framework, this thesis examines whether the local food retail environment and confidence to cook contribute to socioeconomic differences in fruit and vegetable purchasing. To achieve this, four quantitative analyses of data from two main sources were conducted. The food retail environment was examined via secondary analysis of the Brisbane Food Study (BFS) and confidence to cook was examined in a cross-sectional study designed and carried out by the author. The first three manuscripts were based on findings from the BFS. Briefly, the BFS was a multilevel cross-sectional study, designed to examine determinants of inequalities, that was conducted in Brisbane in the year 2000. A stratified random sample was taken of 50 small areas (census collection districts, CCDs) and 1003 residents who usually shopped for their households were interviewed face-to-face using a schedule that included a measure of fruit and vegetable purchasing and three socioeconomic markers: education, occupation and gross household income. The purchasing measure was based on how often (never, rarely, sometimes nearly always or always) participants bought common fruits and vegetables for their households in fresh or frozen form, when in season. Food shops within a 2.5 km radius of the CCDs in which survey respondents lived were identified and audited to determine their location, type, their opening hours, and their price and availability of a list of food items. The first publication demonstrated there was minimal to no difference in the availability of supermarkets, greengrocers and convenience stores between areas that were most and least disadvantaged, in terms of the number of shops, distance to the nearest shop, or opening hours. Similarly, the second publication showed the most disadvantaged and least disadvantaged areas had no large or significant difference in the price and availability of fruits and vegetables within supermarkets, greengrocers and convenience stores, but small differences were consistently apparent, such that on average, low socioeconomic areas had lower prices but also lesser availability than more advantaged areas. The third submitted manuscript presents results of multilevel logistic regression analyses of the BFS data. While there were some associations between environmental characteristics and fruit and vegetable purchasing, environmental characteristics did not mediate socioeconomic differences in purchasing the fruit and vegetable items since there was no substantial socioeconomic patterning of the price or availability of fruits and vegetables. The fourth submitted manuscript was based on the cross-sectional study of cooking skills. A stratified random sample of six CCDs in Brisbane was taken and 990 household members ‘mostly responsible’ for preparing food were invited to participate. A final response rate of 43% was achieved. Data were collected via a self-completed questionnaire, which covered household demographics, vegetable purchasing (using the same measure employed in the BFS for continuity), confidence to prepare these same vegetables, and confidence to cook vegetables using ten cooking techniques. Respondents were asked to indicate how confident they felt (ranging from not at all- to very- confident) to prepare each vegetable, and to use each technique. This fourth study found respondents with low education and low household income had significantly lower confidence to cook than their higher socioeconomic counterparts, and lower confidence to cook was in turn associated with less household vegetable purchasing. Collectively, the four manuscripts comprising this thesis provide an understanding of the contribution of food accessibility, affordability and cooking skills to socioeconomic differences in fruit and vegetable purchasing, within a socioecological framework. The evidence provided by this thesis is consistent with a contributory role of confidence to cook in socioeconomic differences in fruit and vegetable purchasing, but is not definitive. Additional research is necessary before promoting cooking skills to improve population nutrition or reduce nutritional inequalities. An area potentially useful to examine would be how cooking skills integrate with psychosocial correlates of food and nutrition, and socioeconomic position. For example, whether improvement of cooking skills can generate interest and knowledge, and improve dietary behaviours, and whether a lack of interest in food and nutrition contributes to a lack of both fruit and vegetable consumption and cooking skills. This thesis has demonstrated that an inequitably distributed food retail environment probably does not contribute to socioeconomic variation in fruit and vegetable purchasing, at least in contemporary Brisbane, Australia. Findings are unlikely to apply to other time periods, rural and regional settings, and perhaps other Australian cities as residential and retail development, and the supply and pricing of produce vary substantially across these dimensions. Overall, the main implication for public health is that interventions targeting the food supply in terms of ensuring greater provision of shops, or altering the available food and prices in shops may not necessarily carry a great benefit, at least in major cities similar to Brisbane. Future studies of equitable food access may need to look beyond mapping the distribution of shops and prices, perhaps to more personal and subjective facets of accessibility and affordability that incorporate individuals’ perceptions and ability to access and pay for foods.

The aim of this study is to investigate how densification can be used to increase social and ecological sustainability in an urban area. This study focuses on the visions of the municipality of Sundsvall, a city located on the east coast of central Sweden, from a social and ecological sustainable development perspective and whether these visions are achievable for the densification of its urban centre. Additionally, this study considers how densification fulfils the social and ecological urban development of the city of Sundsvall. Given the possibility of both positive and negative impacts occurring through densification it is prudent to consider these impacts and to determine whether these impacts can be reduced by a socioecological urban developing perspective. To determine this, this study uses both quantitative and qualitative methods, such as GIS analysis, personal interviews and municipality resources to establish a sustainable, social and ecological outcome for the urban centre. Sundsvall aims to achieve a higher population density within its city centre. Increase accessibility to the waterfront and improve public transport options, therefore reducing the need for private vehicles and promoting environmentally sustainable alternatives. The aims of the municipality are certainly attainable, however due to certain factors specific to Sundsvall, these can only be achieved to a certain extent. Given the city’s location between two mountains, issues like sunlight, limited space for public service and the inability for smog to easily disperse creates a plethora of issues discussed in this study.

<p><b>Objectives</b> The study will assess patterns of known individual, interpersonal, and community-level circumstances leading to suicide to understand how these factors can co-occur. These patterns will help focus on prevention strategies.</p><p><b>Methods</b> Data was collected from the Iowa Violent Death Reporting System, Census data from the American Community Survey, and 2010 rural-urban commuting area codes from the Economic Research Service. The study consisted of three steps. The first step latent class analysis was conducted on data from suicide deaths from Iowa in 2016-2018 to create classes of patterns of circumstances leading to suicide. The second step maximum probability assignment was used to assign the sample of 1,276 to the created latent classes. Finally, in the third step bivariate regressions were ran to understand the relationship between the created latent classes and the rurality variable (nonmetropolitan vs metropolitan).</p><p><b>Results </b>Five latent classes of distinct patterns of suicide factors emerged. Class 1 is physical health problems living in areas that are average on all community-level variables. This class 1 is seen to happen with higher odds in nonmetropolitan areas. Class 2 is interpersonal problems in areas where living alone is high. This class 2 happened with higher odds in nonmetropolitan areas. Class 3 is mental health problems or depressed mood with no legal problems in areas that had lower educational attainment. This class 3 did not indicate greater odds based on rurality. Class 4 is history of mental health treatment in well-off areas. This class 4 was seen to happen with higher odds in metropolitan areas. Class 5 is substance abuse problems in poorer areas. This class 5 did not indicate greater odds based on rurality. All the classes shared a common theme of experiencing mental health issues or being in a depressed mood.</p><p><b>Conclusions </b>Suicide is a complex concern that could be classified into several classes that have distinct patterns of suicide factors. These classes and patterns help with identifying what services and interventions are needed in certain communities. Overall, providing support in regards to mental health as well as intervening in childhood to support positive development may provide substantial mitigation to the odds of committing suicide. In investigating these patterns, future prevention and intervention effort can take into consideration these patterns to tailor to the individual and the environments where they live.</p>

Resilience, as a trait, process or outcome, is the negation of an undesirable outcome or of an expected maladjustment in the context of an adversity. Young people represent a developmental stage in which there is a vulnerability to experience deleterious outcomes during adversity. The literature on risk and promotive factors for resilience in youth is compounded by narrative reviews which have not applied a rigorous search methodology and which have failed to operationalise resilience. To date, the majority of research in resilience for emotional distress has focussed on data collected in high income countries. The first paper presents a systematic review of the literature on risk and promotive factors for trait resilience in youth. The findings indicate that there are differences in the magnitude of association between trait resilience and various risk and promotive factors, which were conceptualised into biological, intrapersonal, interpersonal and environmental factors. The largest body of evidence reviewed pertained to intrapersonal risk and promotive factors for trait resilience. Factors predicting trait resilience were also identified. Implications for future research include addressing the methodological and sampling limitations of the reviewed studies. The second paper presents an empirical study investigating factors within a microsystem which differentiate adolescents with resilience for emotional distress and those vulnerable to emotion distress in India (<i>N</i> = 967) and in Peru (<i>N</i> = 606). Factors which predict low emotional distress in each country and factors which differentiate between low emotional distress Indian and Peruvian adolescents were additionally investigated. A cross-sectional exploratory investigation of secondary data was employed. The findings suggest that the profile of low vulnerability for emotional distress differs between different cultural contexts and contribute to an extraordinarily limited evidence-base in low and middle income contexts. Extensive additional research is required to delineate culturally-specific profiles of resilience for emotional distress in a bid to develop culturally-sensitive treatment targets.

Unravelling the psychological processes determining landowners\' support towards forest conservation is key, particularly, in developing countries, where most forest remnants are within private lands. As human-nature connections are known to shape pro-environmental behaviors, the intention of preserving forest remnants should be ultimately determined by the ecological context people live in. Here, we investigate the pathways through which the ecological context (forest cover), via experiences with nature (contact, uses and losses associated with forests), influences the psychological determinants of conservation behavior (beliefs, attitude and intention towards preserving forest remnants). We conceptualized a model based on the Reasoned Action Approach, using the ecological context and experiences with nature as background factors, and tested the model using Piecewise SEM. Data was collected through an interview-based protocol applied to 106 landowners across 13 landscapes varying in forest cover in a region in the Brazilian Atlantic Forest. Our results indicate that: (i) ecosystem services are more important than disservices for shaping intention of preserving forests, particularly those related to non-provisioning benefits; (ii) contact with forest has an indirect effect on intention, by positively influencing forest uses; (iii) people living in more forested ecological contexts have more experiences with nature, and ultimately stronger intention of preserving forests. Hence, our study suggests a dangerous positive feedback loop between deforestation and the extinction of human-nature connections. Local demands across the full range of ecosystem services, the balance between services and disservices, and the ecological context people live should be considered when developing conservation initiatives in rural areas / Desvendar os processos psicológicos que determinam o apoio dos proprietários de terras à conservação das florestas é fundamental, particularmente, nos países em desenvolvimento, onde a maioria dos remanescentes florestais se encontra em áreas privadas. Como as conexões humano-natureza são conhecidas por moldar comportamentos pró-ambientais, a intenção de preservar remanescentes florestais deve ser, em última instância, determinada pelo contexto ecológico no qual as pessoas vivem. Neste trabalho, investigamos os caminhos pelos quais o contexto ecológico (cobertura florestal), através das experiências com a natureza (contato, usos e perdas associados às florestas), influencia os determinantes psicológicos do comportamento de conservação (crenças, atitude e intenção de preservar remanescentes florestais). Formulamos um modelo baseado na Abordagem da Ação Racional, usando o contexto ecológico e as experiências com a natureza como fatores de base, e o testamos através da Piecewise SEM. Os dados foram coletados através de protocolo aplicado, por meio de entrevista, a 106 proprietários de terra em 13 paisagens que variam em cobertura florestal em uma região da Mata Atlântica. Nossos resultados indicam que: (i) serviços ecossistêmicos são mais importantes que desserviços para moldar a intenção de preservar florestas, particularmente outros serviços que não os de provisão; (ii) o contato com a floresta tem um efeito indireto sobre a intenção, influenciando positivamente os usos da floresta; (iii) as pessoas que vivem em contextos ecológicos mais florestados têm mais experiências com a natureza e, assim, uma intenção mais forte de preservar as florestas. Nosso estudo, portanto, sugere um perigoso ciclo de retroalimentação positiva entre o desmatamento e a extinção das conexões humano-natureza. As demandas locais considerando toda a gama de serviços ecossistêmicos, o balanço entre serviços e desserviços e o contexto ecológico no qual as pessoas vivem devem ser considerados ao se desenvolverem iniciativas de conservação em áreas rurais

Human-wildlife conflicts (HWC) emerge as complex conservation challenges impairing human livelihood and wildlife populations. Research on HWC, however, has traditionally approached these components apart and focused on single/ similar species, hampering a broader understanding of the connections between ecological drivers and human dimensions of conflicts. We here develop and test a model integrating ecological and human components of HWC, focusing on three species - opossum, crab-eating fox and puma. We investigated the pathways through which the ecological context (forest cover) affects experiences with wildlife (contact and damage), and how such experiences influence tolerance via beliefs, emotions and attitude. We interviewed 114 landowners across 13 landscapes varying in forest cover in a region of the Brazilian Atlantic forest and tested our model using Piecewise Structural Equation Modeling. We found that: i. forest cover negatively affected tolerance, but just towards the largest species; ii. relevance and effects of distinct experiences with wildlife on beliefs and emotions varied across species; iii. beliefs and emotions influenced tolerance, but negative emotions were relevant only for the largest species. Conflicts with larger species can then be understood as disservices provided by forests, indicating the relevance of framing HWC within a broader perspective that consider the trade-offs with ecosystems services. For some species, positive experiences with wildlife may counteract the negative effects of damages to livestock in shaping human behavior. Models such as ours - that structure relationships between ecological and human components - can help identifying deeper, more effective leverage points to improve interventions to mitigate HWC / Conflitos entre seres humanos e fauna silvestre emergem como desafios complexos, ameaçando o sustento de populações humanas e a conservação de populações de animais silvestres. Contudo, pesquisas sobre conflitos tradicionalmente abordam esses componentes separadamente e focam em espécies individuais ou similares, dificultando o entendimento mais amplo das conexões entre determinantes ecológicos e dimensões humanas dos conflitos. Neste estudo, desenvolvemos e testamos um modelo conceitual integrando componentes ecológicos e humanos dos conflitos, focando em três espécies - gambá, cachorro-do-mato e onça-parda. Investigamos os caminhos através dos quais o contexto ecológico (cobertura florestal) afeta experiências (contato e dano), e como tais experiências influenciam a tolerância à fauna por meio de crenças, emoções e atitude. Entrevistamos 114 proprietários rurais em 13 paisagens com diferentes proporções de cobertura florestal em uma região da Mata Atlântica e testamos nosso modelo usando equações estruturais do tipo Piecewise. Encontramos que: i. a cobertura florestal afetou negativamente a tolerância, mas apenas para a maior espécie; ii. a importância e os efeitos de diferentes experiências com a fauna sobre crenças e emoções variaram entre as espécies; iii. crenças e emoções influenciaram a tolerância, mas emoções negativas foram relevantes apenas para a maior espécie. Conflitos com espécies maiores podem então ser entendidos como desserviços providos por florestas, indicando a relevância de inserir os conflitos humano-fauna em perspectiva mais ampla, que considere as relações com serviços ecossistêmicos. Para algumas espécies, experiências positivas podem compensar os efeitos negativos dos danos a criações na formação do comportamento humano. Modelos como o nosso - que estruturem as relações entre os componentes ecológicos e humanos - podem ajudar a identificar pontos de alavancagem mais profundos e efetivos para melhorar intervenções visando a mitigação dos conflitos com a fauna

Human papillomavirus (HPV) is the most prevalent sexually transmitted infection in the U.S., where one HPV-related cancer is diagnosed every 20 minutes. The most common HPV-related cancer is cervical cancer, with an estimated incidence of 12,000 cases annually, a third of which lead to death. Cervical cancer disparately affects women of ethnic minority groups and geographically isolated regions, such as Appalachia. Tennessee ranks third highest in cervical cancer incidence in the country. Many cases of cervical cancer could be prevented through vaccination against HPV, however, vaccination rates for females in Tennessee are among the lowest in the country. This mixed-methods study included an in-depth exploration of the factors that influence HPV vaccine acceptance in Appalachian Tennessee. Healthcare providers, mothers of adolescent girls, and college-aged women were recruited to participate in the study. From October 2016 to January 2017, interviews were conducted with healthcare providers (n=12), focus groups were conducted with mothers (n=13), and a survey was administered to college women (n=479). Interview and focus group sessions were recorded, transcribed and analyzed using a thematic framework. Survey responses were analyzed using descriptive tests, comparison of means, and regression analyses. The predominant barriers to vaccine acceptance identified in the study were: cost and novelty of the vaccine, vaccine safety, lack of school-entry requirement, and the implication of vaccine acceptance on adolescents’ sexual activity. Most negative perceptions towards the vaccine appeared to be propagated by the sociocultural influence on sex and reproductive health communication within the community. Perceived benefits for cancer prevention and receipt of strong and personal provider recommendations facilitated vaccine acceptance. Additionally, college students who reported vaccine acceptance reported discussing sexual health topics with their mothers more often than those who had not been vaccinated. The findings from this study provide foundational insights about the facilitators and barriers of HPV vaccine acceptance in Appalachian Tennessee. Identifying and understanding these factors is crucial to improving HPV vaccination rates and essential to maximizing the primary benefit of the vaccine in addressing the existing cervical cancer disparity in the region.

There is growing concern that the accelerated pace and increasing complexity of environmental change may be challenging people's ability to test, refine, and adjust livelihood strategies. This would be particularly challenging for poor households in hazardous environments, generating greater vulnerability to disasters. The context for this concern was examined in four rural communities from two different cultural realms along the Caribbean coast of Honduras. An ethnographic approach was used to understand how women household managers, community leaders, and elderly residents from Garifuna and Mestizo communities perceive and respond to hazards and other challenges in their environment. The analysis revealed how economic pressures combine with political context to contribute to an intensification of local land and resource use in the four communities. The consequent matrix of environmental hazards generates troubling uncertainties for these small-scale socioecological systems, particularly as the local ecological resources once available for livelihood adjustments become scarce. To make matters worse, institutional efforts to resolve environmental and economic challenges generating vulnerabilities for some rural communities are perceived as authoritarian, superimposed, and even culturally inappropriate. Confused or frustrated by so many uncertainties, households from both cultural realms try to adjust by increasing their dependence on an evolving web of political and financial resources beyond their communities, indeed from outside Honduras. / text