The aim of this thesis was to study a worksite exercise intervention for sedentary workers in China. This involved a 10-minute Qigong exercise session twice a day. Four inter-related studies examined the development, implementation, and evaluation of this intervention. First, a feasibility study demonstrated that short exercise breaks could be integrated into the workday routine for employees with sedentary job roles. Second, a pilot study was conducted to test the intervention under research processes. Third, a waitlist controlled trial study showed increases in employees’ physical activity between baseline and post-intervention for intervention (n=193) and waitlist control (n=83) participants, but no changes in work performance or sickness absence. And finally, a process evaluation using RE-AIM framework, i.e. Reach, Effectiveness, Adoption, Implementation, and Maintenance, was conducted using data from focus groups, document analysis, and exercise log reviews. In terms of reach, the exercise intervention was successfully marketed to all employees. In terms of adoption, it was considered that organisational support to implement the intervention was good. The intervention had been implemented broadly as planned. There was high exercise acceptance, but a gradual decrease in exercise adherence through the intervention period. With regard to maintenance, there was no clear management plan to sustain the programme beyond the period of study. To the author’s knowledge, this research is the first to test the effectiveness of worksite exercise in China. It is recommended in future that such interventions focus further on the study of implementation and include outcomes more proximal to the intervention such as job satisfaction and work engagement.

This thesis provides an investigation into aggressive driving behaviour, from a Forensic Psychological perspective. The methods used include a systematic review, two quantitative research studies, and a psychometric critique. A systematic review and meta-analysis of the relationship between a measure of driving anger, the Driving Anger Scale (DAS; Deffenbacher, Oetting & Lynch, 1994), and various aggressive driving outcomes showed a strong positive correlation. However, the validity of this finding is hampered by the extensive use of self-report questionnaires, as opposed to real-world driving behaviours, to measure aggression on the roads. The first empirical research study investigated the relationship between personality characteristics (including driving anger) and aggressive driving outcomes. The results showed that three variables accounted for more than half of the variance in self-reported aggressive driving behaviour. These were a tendency toward physical aggression, the progress impeded aspect of driving anger, and psychopathic tendencies. The findings provide ideas for future research, and intervention to reduce aggressive driving behaviours. The second research study expanded on this, and considered the impact of inattentive responding on outcomes for online surveys, and how these may relate to the driving aggression literature. This was enabled by the discovery that around a third of respondents to a survey failed instructional manipulation checks; inclusion of these participants in analysis obscured the results found in the first study. The findings are discussed in terms of practical implications for researchers. A psychometric critique of the Propensity for Angry Driving Scale (PADS; DePasquale, Geller, Clarke & Littleton, 2001) is also presented. This raised questions about the reliability and validity of the PADS, which will be of interest to researchers considering driving anger and aggression in the future. The findings from each methodology are finally considered together, with a discussion of the implications for the field of aggressive driving research.

The overall aim of the research described in this thesis is to explore the role of socioeconomic status (SES) (defined in terms of education, salary, and job grade) and demographic and personal factors (including age, weight, number of dependants, and gender) in relation to the eating behaviours of employees, and to explore barriers and facilitators to healthy eating in the workplace. The purpose of examining these issues in the workplace is to better enable practitioners to develop interventions designed to assist workers in the adoption of healthy eating behaviours. The thesis opens, in Chapter 1, with an introduction to these concepts and consideration of their role in providing a focus for targeted workplace interventions to promote healthy food-related behavioural choices. Chapter 2 shows that the vast majority of academic research on relations between SES and eating behaviours is based on community samples. Little is known about such relations in occupational samples. This is an important knowledge gap because with many people spending more than half of their daily waking hours at work, the workplace represents an ideal location for the promotion of healthy eating choices. In response to the knowledge gap identified above, the overall aim of this investigation is to examine relations between three indices of SES (education, salary band, and grade), plus demographic and personal factors (age, gender, number of dependants, and Body Mass Index (BMI)) and eating behaviours in a large public sector employee sample. Five specific eating behaviours are considered: Consumption of a healthy, well-balanced diet, fruit consumption, vegetable consumption, eating past the point of being full, and cost of food influencing purchasing behaviour. Analyses were carried out on data from the Stormont Study, an organisation-wide health-focused employee survey conducted in 2012 (Time 1) and 2014 (Time 2) in the Northern Ireland Civil Service (NICS). The Stormont Study methodology is presented in Chapter 3. A descriptive epidemiology based on cross-sectional analyses of data collected at T1 and T2 is presented in Chapter 4. These analyses identified the importance of demographic factors, in addition to the measures of SES in relation to eating behaviours. To explore relations between SES and eating behaviours, cross-sectional, prospective, and longitudinal analysis was carried out in Chapter 5. Relations between SES and eating behaviours were observed in all three analyses – however only grade and education reached significance in the longitudinal analysis. The demographic variables significantly contributed to the statistical model in all three analyses; age and BMI produced consistently significant relationships with nearly all eating behaviours across all three sets of analysis. Chapter 6 explores the extent to which eating behaviours differed between age groups and BMI categories, to understand if interventions may benefit from demographic tailoring for high risk groups. In light of findings from the quantitative studies, and to better inform interventions to improve eating behaviours in the workplace, a qualitative study, in Chapter 7, was conducted in 2017, within a higher SES management group, in a large organisation that had recently been privatised after many decades in public ownership. The findings of the quantitative studies were explored with participants, in addition to asking them to consider the barriers and facilitators to eating a healthy, well-balanced diet, and their perceptions of the role of the employer in promoting healthy eating. Thematic saturation was reached upon completion of 15 interviews. Five main themes were identified, each containing multiple sub-themes: (1) knowledge, (2) behaviour, (3) access, (4) workplace culture and (5) responsibility (government and organisational responsibilities). Workplace culture was seen as a barrier to healthy eating, and therefore initiatives designed to modify work culture may prove effective as a means by which to promote healthy eating in the organisational setting. Chapter 8 considers the research as a whole and the application of findings to workplace health promotion practice. Strengths and limitations of the investigation are discussed and recommendations made for future study.

Objective: This thesis examined the prevalence of burnout, alcohol consumption, and psychological distress and their association with stress-related working conditions – defined either in terms of the Effort-Reward Imbalance (ERI) model, or the ERI model combined with the Job Demand-Control-Support (job strain) model (DCS) – in two large-scale international samples of humanitarian aid workers. The studies herein were the first in the extant literature to examine organisational stressors using job stress models in this occupational group. Furthermore, given the paucity of previous research on the subjective stress-related experiences of humanitarian aid workers, this thesis also contains an interview-based study that explored how humanitarian aid workers perceived the transactional stress process. One key characteristic of this thesis was that both quantitative and qualitative approaches were utilised to provide a deep and ecologically valid understanding of the stressor-strain relationship. Identifying the links between stressful aspects of work and both psychological and behavioural health outcomes may help inform the design of sector-specific health interventions. Methods: A mixed-methods approach was adopted to allow for a thorough examination of the prevalence of health and health-related behavioural outcomes, their relationship to stress-related working conditions (psychosocial stressors), and the concept of work-related stress in the population under study. Survey designs were used for Study 1 and 2 and involved the administration of a structured questionnaire. For the first study (Parts 1-2, Organisation A), logistic regression analyses were run based on a cross-sectional survey (N = 1,980) conducted separately for men and women to investigate the relations between ERI and both burnout (Part 1) and heavy alcohol consumption (Part 2) while controlling for demographic and occupational characteristics. In Study 2 (Organisation B), logistic regression analyses were based on a cross-sectional survey (N = 283) conducted separately for men and women to investigate the independent and combined relations between the ERI and DCS models and psychological distress while controlling for demographic and occupational characteristics. The final study was interview-based (Study 3, Organisation B) and it explored how humanitarian aid workers (N = 58) employed by a United Nations-aligned organisation perceived the transactional stress process. Results: The prevalence rates for the burnout components were as follows: high emotional exhaustion—36% for women and 27% for men; high depersonalisation—9% and 10%; and low personal achievement—47% and 31% for women and men, respectively. Intermediate and high ERI scores were associated with a significantly increased risk of high emotional exhaustion, with mixed findings for depersonalisation and personal achievement. The prevalence of heavy alcohol consumption among women (18%) was higher than the corresponding rate for men (10%), lending support for the effort-reward perspective only among women. Intermediate and high ERI scores in women was associated with a three-fold risk of heavy alcohol consumption. The results broadly suggest that occupational stressors from the ERI and DCS models, both individually and in combination, are significantly associated with psychological distress. A thematic analysis undertaken within the qualitative study revealed several main themes. An emergency culture was found where most employees felt compelled to offer an immediate response to humanitarian needs. The rewards of humanitarian work were perceived as motivating and meaningful, and employees experienced a strong identification with humanitarian goals and reported high engagement. Constant change and urgent demands were reported by the participants to result in work overload. Finally, managing work-life boundaries, and receiving positive support from colleagues and managers, helped buffer perceived stress, work overload, and negative health outcomes. Conclusions: The results of the present thesis convincingly demonstrate the usefulness of the ERI model as a framework for investigating burnout and heavy alcohol consumption among humanitarian aid workers. Furthermore, the findings demonstrate the independent and combined predictive effects of components of two alternative job stress models (ERI and DCS) on psychological distress. Taken together, the findings underscore the deleterious associations between work-related psychosocial hazards and mental and behavioural health outcomes. Specifically, unique insights were obtained about the work-related stress process in relation to humanitarian aid workers – for example, the emergency culture shaping organisational norms. The results suggest that interventions based on these two influential theories, and supplemented by knowledge on role-specific stressors evident in the sector, hold promise for reducing health outcomes. The practical implications of the results are discussed and suggestions are made in the light of the present research and stress theory.

Health promotion is an emerging discipline that seeks to enhance positive health and prevent ill health. This thesis is designed to inform practice in health promotion. It is based on an action research project that draws together interdisciplinary concepts of the measurement of health and community participation. In so doing it identifies the use of a survey, the Community Health Promotion Survey (CHPS). The thesis argues that when used creatively in this way a survey may simultaneously serve two purposes: first, measure health-related behaviour and, secondly, promote participation in health within a community. Thus, in this study, the survey process and its impact on the lay community were considered to be as important as the measurements of health-related behaviour obtained. Surveys to measure the health-related behaviour of whole populations have been well tested and standard methods were adopted. In this project two of the three local GP Practices gave permission for their FPC patients' lists to be used as a sampling frame which covered 75% of all Staveley's 13,420 adult patients. Lists were stratified by age and sex. A 20% systematic, random sample of 2,003 patients was drawn. The sample was shown to be representative by age and sex of the whole population. A postal survey of these patients, using two reminders, obtained a response of 59% after exclusions for non-delivery of 8%. Males and the elderly are under-represented in response. Teachers in all 3 local secondary schools agreed to administer the survey to their first and fourth year groups. Response from pupils attending school on the day on which the survey took place was 100%. Self-reported measurements of health-related behaviour were obtained, using reliable questions. For example, 23% of adult respondents were ex-smokers and 26% were daily cigarette smokers. 22% of respondents reported that they never drank alcohol and 18% of males had drunk more than 21 units of alcohol in the previous week. Analyses by chisquare and Mantel-Haenszel showed, generally, that the strongest influences on health-related behaviour were age and social class. For example, parental status was less strongly associated with levels of alcohol consumption than age. Re-administration of the adult survey to a matched sample identified changes in health-related behaviour, for example, there was a reduction in the frequency of egg consumption and younger people were more likely to have increased their frequency of drinking skimmed milk than older groups. The role of a survey in facilitating community participation is less well understood. Two crucial elements were therefore introduced and tested in the survey. These may be seen as early stages of community participation and contained key elements of "radical" survey methodology. First, the feasibility of surveying a range of non-representative "hard to reach" community groups was assessed. Of the 52 groups contacted 50 (96%) agreed to participate, with response being achieved from 47 (94%). Response rates from groups collectively was low (16%) but varied greatly between groups, reaching 86% in one instance. Groups producing the highest responses were social in nature, with a membership of 10 - 100. The study showed that many types of community groups will readily assist in the distribution and collection of questionnaires to group members. Secondly, extensive feedback from and about the survey to lay and professional individuals and groups was tested. Results showed that there was considerable lay interest in feedback. 62% of respondents selected, on average, three of the ten items offered. The summary of survey findings (38%) and healthy eating (36%) were of most interest, making up 40% of all feedback. Those often thought to be least interested in health, such as the unemployed, were just as likely to ask for information as others, although women requested 63% of all feedback. Information requested appeared to relate to the individual's circumstances with, for example, males in the "at risk" age group for heart disease asking for that leaflet. The impact of the CHPS on individual respondents and the lay community was measured. The study showed that awareness of the survey was raised amongst 40% of the community. Women (51%) were more likely to have heard about it than men (33%). The survey's ability to stimulate social networks was assessed. Friendships were shown to be the most important channels of information about the CHPS (37%). The family was of equal importance to posters (16%) in disseminating information about the survey. There was some evidence that, in a few groups, awareness of health issues had been raised and some activity had been generated. This appeared to be greater where contacts with a health promotion officer had been established. A surprising, and tentative, finding is that, in itself, the CHPS may have stimulated some change in a small number of individual respondents. Follow-through by professionals that builds on the surveying process and feedback may lead to more intensive levels of community participation. Practical opportunities for follow-through were identified, for example, systematic feedback about their own patients and school pupils to General Practitioners and teachers and feedback of a group's data to a participating community group. Response from health promotion professionals to follow-through opportunities were examined and found to be generally disappointing. The use of the method by policy makers, planners and practitioners was explored. Their dissemination of findings to other professionals and setting targets for changes in the population's health-related behaviour was similar to that observed elsewhere. However, practitioners' response to the implications of research for practice was negligible. It is recommended that health-related behaviour should continue to be seen as one limited but appropriate intermediate indicator for health promotion. The limitations of postal survey data need be recognised, for example, measurements often under-represent the health-related behaviour of some population groups, such as males and the elderly. Resulting bias in data are important considerations when using data in policy and planning, for example, setting targets for health promotion and monitoring population changes in health-related behaviour. Methods for increasing postal response from those known to be poorer responders are suggested, such as personalisation of postal contacts, telephone reminders and complementary data collection methods, including interviewing the elderly in their usual meeting places. It is recommended that, at a national level, reliable, standardised questions should be developed for use in postal surveys to facilitate comparison of data between populations. In terms of community participation in health it is proposed that, based on the CHPS experience, surveys in small areas to further examine their potential to promote participation in health should be carried out. Such studies should focus on examining ways in which surveys may activate social networks and innovative routes for feedback. Emphasis should be given to the use of data by practitioners and to identifying, carrying out and assessing the impact on the lay community of follow-through activities. It is recommended that training for health promotion staff in both research methods and community participation is required to underpin professional practice in community participation in health. The study demonstrated that a survey to measure health and, at the same time, promote participation in health was a feasible, coherent activity that was acceptable to the community. It may therefore be considered as one strategy by health promotion staff seeking economic and innovative methods for practice.

Microcomputer support for health care delivery is a relatively new concept in developing countries, despite serious shortages of human expertise. In this light, the concept of microcomputer-based decision support for patient management at the rural health centre level in The Gambia is discussed and developed. Possible methodologies are devised and evaluated, taking into account constraints imposed both by feasibility of hardware for the rural African setting and by appropriate software techniques. Clinical data were collected for a pilot system, which was implemented using a Bayesian methodology, and assessed, with encouraging results. Further sources of data were then considered in order to generalise the pilot system into a prototype, which was implemented on a portable solar-powered microcomputer. The evaluation of this prototype system, and the difficulties involved in undertaking rigorous evaluations of this type of decision aid, are described and discussed. Whilst it is not proven that major health benefits would arise from the widespread introduction of such systems, the results of this preliminary study suggest that this type of approach merits further consideration and development.

Thesis (Ph. D.)--University of Adelaide, Dept. of English, 1994. / Includes bibliographical references (leaves 270-301).

Thesis (Ph.D.)--Murdoch University, 2007. / Thesis submitted to the Division of Arts. Includes bibliographical references (p. 331-345).

Texte remanié de: Th.--Austin--University of Texas, 1982.

Thesis (M.A.)--Oregon State University, 2005. / Printout. Includes bibliographical references (leaves 84-87). Also available online.