Too many elderly women suffer rapid aging decline, frailty and hypokinetic disease simply because of inadequate levels of physical activity. While the biopsychosocial benefits of regular exercise are now well-known, explanations are lacking for the reluctance of aging Canadian females to take up, or keep up, healthful forms of leisure-time physical activity. The purpose of this study was to examine and explain the variability of participation in health-promoting form sof exercise in elderly women. Several health behavior theories and personal attributes have shown promise in explaining exercise behavior, and thus, a second purpose of the study was to test the utility of a composite theoretical model. The composite model included ten personal and situational attributes as well as five cognitive beliefs about physical activity adapted from Social Cognitive Theory and a belief about personal control over one's health from Health Locus of Control Theory. A city-wide sample of 327 Vancouver women aged 70 and 98 years filled out survey questionnaires providing information on the 16 model variables in addition to kilocalorie estimates of exercise in the past week. Multiple regression analysis was used to explain late life exercise in three stages: 1) regression on the ten personal and situational attributes; 2) regression on the six cognitive beliefs; and 3) combined regression on all the significant predictors. From the life situational variables, health, childhood movement confidence, school location, and age were significant factors explaining 18% of the variability seen in current exercise level. From the cognitive variables, current self-efficacy to exercise and current social support to engage in physical activity were the only significant predictors (R2 = 22%). A full regression model was tested by including the four statistically important situational variables and the two cognitive variables from the previous analyses. The utility of the Composite Model was supported in that both situational variables and self-referent beliefs played significant and independent roles in explaining late life exercise (R2 = 26%). The main reasons that older women were physically active were: 1) they perceived high levels of social support to exercise (b = .239, p< .01); 2) they felt efficacious for fitness-types of activities (b = .185, p< .01), 3) they had satisfactory health (b = .174, p < .01), and 4) they were educated in foreign countries (b = -.125, p < .01). Health locus of control offered some explanation but was not able to demonstrate significance alongside other cognitive beliefs (b = -.106, p < .06). Education, socioeconomic status, work role, family size, and marital status were not able to explain late life exercise. This study found that health difficulties do indeed interfere with women’s activity patterns. However, women are also influenced by perceptions of declining social support, lower levels of movement confidence, and chronological age, to reduce their physical activity. Thus, regardless of their health situation, the explanation of exercise involvement in older women rests to a large degree on the amount of social encouragement they perceive from family, friends and physicians, their self-efficacy for fitness activity, as well as perceptions of age-appropriate behavior. Older women who were educated as children outside of Canada, Britain and the U.S. appear to be culturally advantaged for late life physical activity participation. Moreover, childhood movement confidence stands as a significant predictor among the situational variables. These findings suggest that participation in physical activity, and positive beliefs about exercise in late oo, are rooted in competencies and experiences acquired in childhood. Perceptions of inadequate encouragement appear to be limiting females, from childhood on, to develop and sustain confidence in their physical abilities that would promote a more active lifestyle into their oldest life stage. / Education, Faculty of / Educational Studies (EDST), Department of / Graduate

Understanding how women learn during pregnancy is the foundation for planning prenatal education programs. To date, adult educators have not investigated, in any depth, the learning process during pregnancy. The purpose of this study was to examine learning during pregnancy and relate this learning to learning outcomes. The principal research questions were: "What are the learning patterns of pregnant women?" and "What is the relationship between learning and health behavior of pregnant women?" It is unknown whether learning during pregnancy is directly associated with behavior or mediated through health beliefs. The objectives of this research were to identify pregnant women's health behaviors, learning patterns, and health beliefs. The three health behaviors examined in this study were eating, drinking, and smoking. These behaviors were operationalized in terms of their outcomes: weight gain, alcohol consumption, and tobacco use. These factors are amenable to an education intervention and are behavioral risk factors associated with low birth weight. The process of investigating learning patterns consisted of identifying: what was learned during the pregnancy, which resources were utilized, what advice was given, what amount of time was spent in learning, who initiated the learning episodes, and what learning transaction types emerged. Determining learning transaction types was based upon an adaptation of Tough's (1979) concept of planners and Knowles's concept of self-directed learners. The process of investigating health beliefs consisted of identifying pregnant women's concerns, perceived risk, perceived use of the information, and perceived barriers, defined according to an adaptation of the Health Belief Model. The principal hypotheses of the study were: (1) self-initiated learning will be positively correlated with knowledge scores, (2) self-initiated learning will be positively correlated with ideal health behaviors, and (3) health beliefs will be positively correlated with ideal health behaviors: ideal weight gain during pregnancy, reduced alcohol consumption, and reduced cigarette smoking. The research, an ex post facto design, involved a one hour structured interview with women within the week following delivery of their infants in hospital. A proportional sample of 120 primigravidas was selected from seven hospitals with average number of monthly births greater than 100. Reporting of results was based upon 120 interviews conducted as part of the main sample and eight interviews conducted during the pilot study. Pilot responses were included because these responses were similar to responses provided by the main sample, with the exception of health belief data. One case was excluded from the sample, making for N = 127. Data analyses were based upon the entire sample N = 127, with the exception of health belief measures. Since alcohol and smoking health belief questions were administered to drinkers and smokers and since health belief measures related to weight gain, alcohol, and smoking were missing data, health belief analyses were based upon N=123 for weight gain, N = 88 for alcohol, and N = 43 for smoking. Women had spent an average of forty-one hours learning about weight gain, alcohol consumption, and tobacco use during pregnancy. The principal resources used were: reading materials, physicians, family members, and prenatal classes. The majority of pregnant women had engaged in other-initiated learning episodes in the one to one setting, that is with a health professional, family member, or friend. Self-initiated learning about weight gain was associated with higher knowledge scores and ideal prenatal weight gain (p≤0.05); and, weight gain health beliefs were negatively correlated with ideal prenatal weight gain (p≤0.05). Finding a negative correlation, in contrast to the predicted positive correlation, may have been due to the fact that in a retrospective study the behavior precipitated reporting of health beliefs. Other-initiated learning about alcohol was associated with higher knowledge scores and reduced alcohol intake (p≤0.05); however, alcohol health beliefs were not associated with reduced alcohol intake. For smoking, neither self-initiated nor other-initiated learning was associated with knowledge scores or reduced cigarette smoking; however, a low degree of perceived risk was predictive of reduced cigarette smoking (p≤0.05). Knowledge about tobacco use was positively correlated with health beliefs, suggesting that learning may be indirectly related to smoking behaviors. This study contributes to the knowledge about learning during pregnancy by providing a descriptive profile of learning patterns during pregnancy, and by examining the relationship between learning, health beliefs, and behavior. Fostering a learning environment which stimulates self-initiated learning may assist women reach ideal weight gain during pregnancy. For alcohol, encouraging health professionals, family members, and friends to initiate learning about the hazards of consuming alcohol during pregnancy seems warranted. Self-initiated learning may not be superior to other-initiated learning but may be topic specific, due to the nature of the health behaviors examined. Identification of women's smoking health beliefs seems warranted during prenatal education. Further research is required to better understand the role of learning with respect to changing smoking behaviors during pregnancy. / Education, Faculty of / Educational Studies (EDST), Department of / Graduate

In the past twenty-five years there has been a marked increase in the number of women in the paid labour force, especially among women with young children. Time studies have shown that when a woman has a young family plus a position in the paid labour force, she works a very long day and has little time for recreational or leisure pursuits. This thesis therefore poses the following questions: 1. Do women who participate in the paid labour force report poorer health status than their counterparts who are homemakers? 2. Do women who participate in the paid labour force exhibit lifestyle patterns significantly different from their homemaker counterparts? 3. Do women in the paid labour force exhibit health care utilization patterns significantly different from their homemaker counterparts? and 4. Do women's lifestyles, reported health status and health care utilization patterns differ from those of their male counterparts in the paid labour force? Data from the 1978-79 Canada Health Survey (C.H.S.), which had asked a wide cross-section of Canadians about their lifestyle, health status and use of the health care system, were used to explore these questions. A model was then developed for this study which linked health risk behaviours, health status and health care related behaviours, and which used the variables available in the C.H.S. data base. Multiple Classification Analyses were carried out to determine the best predictors of women's health risk behaviours, health status and health care related behaviours. The three study groups were then standardized using the top two predictors and the rates of the various states and behaviours were compared. First, in the prediction of women's health risk behaviours, the demographic variables included in the model were not effective as only 3-4% of the variance in the scores could be explained. Secondly, in the prediction of health status scores, the composite health risk scores developed for each subject plus the demographic variables were able to explain 4 - 11% of the variation. Thirdly, in the prediction of women's health care related behaviours the composite health risk scores, the health status scores and the demographic variables were together able to explain 14 - 27% of the variance. When the standardized rates for high health risk behaviours were compared, there were significant differences between the three groups but no group was consistently better or worse than any other. The men's group however, consistently reported better health and less use of the health care system. The women's groups reported similar health states but women in the paid labour force reported a higher use of medications and fewer days in hospital. The C.H.S. was designed to address issues which affect the whole population. The questions therefore, were not always sufficiently specific to describe the special circumstances of women, especially for example in their childbearing and nurturing years. The rapidly changing social and economic circumstances of women and their families, as women enter the paid labour force, plus the need for more information on their health risk behaviours - what these behaviours are, and what predisposes women to engage in them - point to the need for more research focused specifically on this section of the population. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

This descriptive correlational study was designed to increase the knowledge needed to understand the relationship among health-related variables that facilitate or sustain health-promoting behaviours of midlife women. Specifically, this study investigated the relationship among self-esteem, health locus of control, and health-promoting behaviours of women in this age group. Pender's (1982) original Health Promotion Model provided the theoretical framework to structure this study. The sample included 84 midlife women volunteers who were current or prospective members of a Vancouver-based social networking group for mature women. Data were collected using the Rosenberg (1965) Self-Esteem Scale, the Multidimensional Health Locus of Control Scale -Form A, and the Health-Promoting Lifestyle Profile. Data were analyzed using descriptive statistics, Pearson's product-moment correlations, and stepwise multiple regression. Three significant predictors, self-esteem, chance health locus of control, and powerful others health locus of control, explained 24.5% of the variance for engaging in health-promoting behaviours. The study findings supported Pender's Model which postulated that individual perceptions of self-esteem and health locus of control, among other personal factors, influence one's likelihood of engaging in health-promoting behaviours. The findings also supported Pender's contention that selected demographic variables, as modifying variables, have an impact on health-promoting behaviours. / Applied Science, Faculty of / Nursing, School of / Graduate

Current social services provided in Canada for low-income women are primarily 'crisis management' in nature as they almost exclusively provide safe housing, adequate nutrition or employment training, and many are under severe financial pressure due to a shifting public policy. As a result, services offered for single mothers living below the poverty line rarely deal with health promotion in terms of physical activity, even though it has been demonstrated that socioeconomic status is a key determinant of health (Frankish, Milligan & Reid, 1996). Although there are many positive mental and physical health benefits associated with regular physical activity (King 1991), its organizational context remains problematic for those who live in poverty and are unable or unwilling to conform to dominant expectations inherent with the consumption of modern forms of physical activity. A moral reasoning tone pervades prescriptions for maintaining and improving health, and those unable to achieve and maintain good health are considered individually responsible, thus obscuring organizational and structural factors that limit involvement. The purpose of this case study of the YWCA was to examine the provision and consumption of health and wellness services for low-income single mothers. Research questions were posed in four areas: i) what meanings do low-income single mothers and YWCA service providers associate with the provision of health and wellness services; ii) how are health and wellness services located within the political, social and economic context of the YWCA; iii) are there points of disjuncture between the provision and consumption of health and wellness services for low-income single mothers; and iv) if points of disjuncture are uncovered, what are the possibilities for emancipatory change in service provision? Several bodies of literature were reviewed to inform the study: social construction of poverty, ideologies of health and physical activity, feminist organization theory, and feminist action research (FAR). FAR is a research process that merges participatory action research with critical feminist theory. Key principles of feminist action research include: 1) gender as a central piece to emerging explanatory frameworks (Maguire, 1987); 2) collaboration and negotiation at all stages of the research process between the researcher, the service providers and the research participants (Green et al., 1995); 3) empowerment through giving control of the research process and decision making to the research participant, while deconstructing the power structures associated with social class (Fals-Borda, 1991; Fawcett, 1991); and 4) social/organizational action and emancipatory change enabled through the democratic production of knowledge (Green et al., 1995). The research methodology involved an examination of: 1) The meanings and experiences of eleven low-income single mothers participating in the FOCUS Pre-employment Training Program which has a wellness component. The data collection strategies included focus groups; a validation meeting the original participants; observations during group meetings and program sessions; and informal discussions. 2) The meanings and experiences of five service providers who were either facilitators of FOCUS or occupied managment positions in the YWCA. The data collection strategies included one-on-one semi-focused interviews; observations of program meetings, group and informal discussions; and a final meeting to discuss potential change. 3) Relevant documents, including brochures, pamphlets, reports and promotional flyers to obtain background and contextual information about the YWCA. The data was analyzed using inductive analysis and the qualitative software program, Q.S.R. NUD.IST. The overall finding was that neither the service providers nor the single mothers viewed wellness as a priority. At the organizational level, the explanation for this finding was that physical activity opportunities were not valued by the funders, whereas employment training was their primary concern. The YWCA's upscale health and wellness services, which offered another opportunity for single mothers to participate, catered on a fee-for-service basis to middle and upper income women and men and pursued a market-driven ideology towards service provision, thus making low-income single mothers' involvement less likely. The social, economic and political context in which FOCUS was situated had a profound influence on the nature of service delivery, and funding constraints were a source of stress for the service providers and infringed on the nature and scope of the services offered for the single mothers. Themes related to points of disjuncture included the service providers' attitudes towards the provision of health and wellness services. Some providers believed that within the confines of the organizational structure and the FOCUS program guidelines, the physical activity opportunities offered to the women were sufficient. Conversely, other providers believed that the organization could take a more active and critical role in determining routes for change and establishing stronger connections between health and wellness activities and the other components of the FOCUS program. All of the service providers alluded to the importance of the women's input and the "organic growth" of the program, however the program's strict curriculum and scarce evaluations resulted in a non-collaborative approach to service delivery. From the single mothers' persepctives, stereotypes of the lazy and unmotivated "welfare single mother" inhited their involvement in community life, including organized forms of physical activity (Fraser & Gordon, 1994; Lord, 1994; Belle, 1990). The women reported experiences with discrimination, a cycle of poverty, complications with social assistance, social stigmas, and childcare responsibilities as their major constraints. Three main reasons for the women's lack of participation were their low sense of entitlement towards physical activity, their ambivalence towards their bodies, and little access to wellness facilities. However, involvement in health and wellness activities was a low-priority for the FOCUS participants, though some of the single mothers mentioned the desirability of incorporating more regular activity sessions into the FOCUS curriculum. Other tensions arose between the realities and ideals of feminist organizing. Distinctions based on class, ethnicity and age separated the upper managerial service providers, the on-site facilitators, and the women accessing the program, perpetuating an elitist, non-collaborative and hierarchical organizationial structure. Based on the single mothers and the service providers' suggestions, four major recommendations for change were provided. First, the participants should be central to and fully collaborative in the organizational processes of the YWCA. Second, if the women involved in the program value physical activity, they should determine ways in which it can become a part of their daily reality. Third, for those involved with the planning and implementation of the FOCUS program, the role of the funders vis a vis the needs of the participants should be determined, and a consistent and 'women-centered' approach to service delivery established. Finally, the YWCA's approach to wellness service delivery should be evaluated and re-conceptualized so that it fulfills and is congruent with the YWCA mission statement. What remained unexplored by the service providers was the potential for the women to redefine hegemonic notions of physical activity (Birrell & Richter, 1987) and to be involved in a meaningful and self-expressive form of activity (Hargreaves, 1990). By listening to the various perspectives and situating experiences within the organizational, political, economic and social contexts, this study provided the beginnings of a critial understanding of the tensions involved in women organizing for women to promote physical activity. / Education, Faculty of / Kinesiology, School of / Graduate

The full text of this thesis/dissertation is not available online. Please <a href="mailto:upetd@up.ac.za">contact us</a> if you need access. Read the abstract in the section 00front of this document. / Thesis (DPhil (Human Movement Scinece))--University of Pretoria, 2000. / Arts, Languages and Human Movement Studies Education / unrestricted

A culturally-based theoretical model about how cultural beliefs about cancer and breast cancer screening techniques influence the screening behaviors of women of Mexican descent was developed using grounded theory. Across levels of acculturation and socioeconomic status, 34 women (49 to 81 years old) were interviewed through focus groups. Women who hold more traditional health beliefs about causes, nature, and responsibility with regard to breast cancer are more likely to "feel healthy" and not engage in breast cancer screening. Women who hold more traditional beliefs about propriety of female and health care provider behavior are more likely to "feel indecent" and also not engage in screening. The cultural health belief model is integrated within a sociocultural and a socioeconomic context.

Intrauterine infection with the oral commensal anaerobe Fusobacterium nucleatum has been associated with adverse pregnancy outcomes. We have previously established a mouse model to study the mechanism of hematogenous F. nucleatum leading to fetal and neonatal death. Here, we report that Toll-like Receptor 4 (TLR4) from the maternal rather than paternal, and endothelial rather than hematopoietic cells mediate placental inflammation, especially the production of the proinflammatory cytokine interleukin-1 beta. Downstream of TLR4, a spatiotemporal pattern of the transcription factor NF-kB activation was observed spreading from the decidual endothelium to the surrounding spongiotrophoblasts within the first six hours of infection. Maternal TRIF, an adaptor protein downstream of TLR4 pathway, but not NLRP3, a cytosolic signaling receptor that constitutes inflammasome complex, mediated the fetal and neonatal death. In an effort to find a prophylactic preventive method against the detrimental birth outcome induced by F. nucleatum placental infection, omega-3 fatty acids were tested for their anti-inflammatory properties. Omega-3 oil supplementation in pregnant mice inhibited the transcription and release of inflammatory cytokines, prevented fetal and neonatal death, and also suppressed the proliferation of F. nucleatum in the placenta. Moreover, omega-3 supplementation was shown to enhance neutrophil recruitment to the site of infection. However, omega-3 supplementation did not protect the pregnancy from Listeria monocytogenes infection in vivo, despite the in vitro results where inflammation induced by both Gram-negative and Gram-positive bacteria were suppressed by omega-3 fatty acids. This study presents the first direct evidence of maternal, rather than fetal, signal leading to adverse pregnancy outcome, and suggests an exciting therapeutic potential of dietary omega-3 fatty acids.

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