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Yes / In order to determine the efficacy of behavior change techniques (BCT) applied in dietary and physical activity intervention studies, it is first necessary to record and describe techniques which have been used during such interventions. Published frameworks used in dietary and smoking cessation interventions undergo continuous development and most are not adapted for online delivery. The Food4Me study (N=1607) provided the opportunity to use existing frameworks to describe standardized online techniques employed in a large-scale internet-based intervention to change dietary behaviour and physical activity.

The Expanded Food and Nutrition Education Program (EFNEP) and its youth component, 4-H EFNEP, were established nationwide by the Cooperative Extension Service in 1969. 4-H EFNEP provides nutrition education to low-income youth, aged 5 to 19 years; however, there has been no standard instrument to evaluate behavior change among participants in Virginia or nationwide. A 24-item Youth Food Behavior Checklist (YFBC) was developed based on 13 topics and food-related behaviors taught in 4-H EFNEP. Data were collected on 47 youth enrolled in 4-H EFNEP in the summer of 1998. The YFBC was tested for test-retest reliability and ability of each item and the total instrument to detect change from pre- to post-intervention. The YFBC demonstrated good test-retest reliability with a Pearson Correlation of 0.81. Overall, the YFBC demonstrated sensitivity to detect change in nutrition behaviors, by showing positive change for some items and negative change for other items in all but nine of the participants. The YFBC also appeared to successfully measure behaviors taught in 4-H EFNEP lessons, as questions regarding only two topics did not demonstrate change from pre- to post-intervention. Since not all checklist items showed significant positive change from pre- to post-intervention, the YFBC should be tested again with a larger sample and in situations where the intervention and the administration of the instrument are better controlled. This would increase the power of the study and the credibility of the YFBC as an assessment instrument for wider use in 4-H EFNEP. / Master of Science

Successful recruitment and engagement of participants is essential for large-scale dissemination and implementation efforts, yet it is especially challenging in socioeconomically disadvantaged communities. This mixed-methods study is a secondary analysis of a behavioral intervention targeting Appalachian adults, and examines the effect of enrolling with others versus enrolling alone in regards to reach, engagement, retention, and behavior change, as well as perceived barriers to program participation. Further, this study explores how engagement, retention, and behavior change are influenced by social networks. Contrary to our hypothesis, using an 'enrolling with others' recruitment strategy did not improve reach, engagement, retention, or behavior change; rather, enrolling alone was associated with greater significant differences in engagement in classes (p=.042), missed class calls (p=.005), total activities (p=.001), and retention (p<.001). Qualitative responses reveal barriers to engagement by both groups of participants. Network density scores had a significant impact on participant engagement in classes (p=.001), total activities (p=.024), and retention (p<.001), and qualitative responses identified the participant's relationship to other participants had a positive impact on their enrollment and behavior change in SIPsmartER. However, these findings are limited by the small sample size and high enrollment of a worksite with a high network density and high engagement. The findings and limitations paired with the enrolling with others and social network literature suggest the need for exploration with a larger study population to better understand the impact on reach, engagement, retention, and behavior change in behavioral interventions targeting individuals from socioeconomically disadvantaged communities. / Master of Science

Many designers today are creating communication materials that encourage individuals to change their behavior related to environmental issues. The problem is that people are often unaware of existing research on effective methods for these communications. For example, environmental psychologists have studied best practices for creating persuasive communications for several decades. During this yearlong master’s thesis project, I conducted my own research studies, exploring how the emotional tone and medium of a communication piece affect a person’s decision to change his or her behavior. My second goal was to connect designers to existing research in the fields of psychology, decision sciences, and persuasive technology. In the end, I created a roadmap to behavior change: a compilation of research from my own studies and existing literature. The roadmap includes observations and practical tips people can use when designing for environmental issues, as well as a set of ethical principles that should be followed when designing for behavior change. I believe that my work will help designers use communication to empower individuals with knowledge, encouraging them to begin and sustain a journey toward positive behavior change.

Cardiovascular diseases and diabetes are increasing worldwide due to unhealthy lifestyle habits. Behavior change support systems (BCSS) are a new means of promoting a sustainable lifestyle change. These systems are more effective when behavior change theories are applied. The aim of this thesis to integrate well-known behavior change theories into a conceptual model of behavior change progress to form the basis for the BCSS. The research question of this thesis is: what parameters of behavior change should be included in a conceptual model of behavior change progress? The model was created by integrating concepts and their relationships from existing behavior change theories. Next, the model was the validated by experts in behavior change. The outcome is a conceptual framework that can be function as a tool for understanding causal relationship between behavior change concepts, for presenting feedback, and building automated assessments. Furthermore, the model extends already existing knowledge networks.

Heart failure is a chronic illness requiring self-management to prolong individual lifespan while improving quality of life. The intent of this doctoral project was to conduct a quality improvement (QI) program focused on systematically educating patients about a two gram sodium diet, by using an educational pamphlet, provider-based patient-centered teaching, and follow up during the transition period between hospital discharge and first outpatient visit. This QI project provided systematic education for newly diagnosed heart failure patients to increase knowledge about a two gram sodium diet and facilitate translation of knowledge into self-management. The QI project used the plan, do, study, act model and was implemented by the Heart Failure Educator at Banner University Medical Center-Tucson. Patients were given the Sodium Restriction Questionnaire, to determine baseline knowledge and behavior, then educated on a two gram sodium diet and given a pamphlet with the same information for home reference. At home, patients were expected to document daily sodium intake and weight and received a phone call twice a week to obtain these values. Twice a week, patients received visual feedback to illustrate their self-management from a graph that represented personal sodium and weight values. After two weeks the same questionnaire was given to determine possible improvement. The average pre assessment questionnaire score was 19 and the average post assessment score was 21.2, showing an average improvement score of 2.2. All five patients, 100%, consumed less sodium and ingested less than two grams during the second week of monitoring sodium intake and daily weight compared to week one. Three patients, 60%, had lower average daily weight during week two by three to five pounds compared to week one. On average the patients consumed 307.18 milligrams less sodium and weighed 2.56 pounds less during week two. Results suggest that educating patients on a two gram sodium diet and providing transitional support from hospital to home, using individualized graphs and patient recording of daily sodium intake and weight, improved self-management behavior and knowledge as evidenced by improved average weight and sodium consumption and an average two point increase on the post assessment questionnaire.

Ohälsosamma levnadsvanor så som dålig kost och brist på fysisk aktivitet leder till övervikt och fetma hos barn och ungdomar idag. För att inte de ohälsosamma levnadsvanorna ska ge framtida komplikationer är det viktigt att se till att barn och ungdomar får den hjälp de behöver för att motiveras till en beteendeförändring så tidigt som möjligt. Motiverande samtal (MI) är en samtalsmetod för att få individer motiverade till en förändring. Denna studie kommer att fokusera på just hälsosamma levnadsvanor. Olika hälso- och sjukvårds professioners använder motiverande samtal som metod för att stödja en beteendeförändring hos överviktiga ungdomar. Därutifrån har syftet till denna studie skapats vilket är att undersöka professionernas upplevelser av hur metoden fungerar på barn och ungdomar med övervikt. Studien har en kvalitativ insats som inkluderade intervjuer med sex stycken professioner. Intervjuerna spelades in och analyserades. Resultatet av studien visade att professionerna upplevde MI som en mycket positiv och användbar samtalsmetod och att kontinuitet behövdes för att upprätthålla kunskapen. Möjligheterna med att använda MI menar de professionella är att de ofta kan se en positiv förändring hos patientens beteende samt att de ser positivt på användningen av MI i framtiden. Författaren anser att det är viktigt att fortsätta utbilda personal som jobbar med människor inom MI då samhället troligtvis kan “spara” både pengar och tid hos personalen genom att använda MI i exempelvis primärvården. / The unhealthy lifestyles such as poor diets and lack of physical activity can lead to overweight and obesity for children and adolescents today. To not have the unhealthy lifestyles lead to future complications it’s important to give them the help and support they need to get motivated to change theirs behavior. Motivational interviewing (MI) is a method to help people change their behavior, this study will focus on a healthy lifestyle changes. A profession in healthcare uses the MI as a method to support the lifestyle change for children and adolescents with obesity. The purpose of this study is to examine what the professions experiences is concerning how the method works with children and adolescents with overweight. This study has used a qualitative method with six interviews. The interviews were recorded and analyzed. The result of this study showed that professions experiences MI as a very positive and useful method, also that the professions needed to use the method continuity to maintain the knowledge. The potential of MI as a method was that the professions often could see a positive change in the patient and the respondent had a positive view in using MI in the future. The author of this study believes that it’s incredibly important to keep working with MI as it probably can "save" money both for society and the work hours for professions in healthcare.

This thesis provides a comparative study of managerial practices in Europe. Patterns of behaviour and preferred modes of organisation are identified in four countries, based on an in-depth case study of a chosen/specific European company. While the corporate culture and industry remain constant, national context manifests itself as the essential variable between the different operations. The thesis proposes/argues that this factor — national context — is a powerful variable which frames the activity of management. Europe is a continent of diversity; each nation has unique traditions, particular historical and cultural roots as well as its own institutional framework. This diversity means that managers learn to operate in a manner that suits their particular context. The thesis documents such national divergence in terms of managerial practices and behaviour. The processes of integration of European Union member States and of globalisation also contribute towards the shaping of management. The case study company, as a leading provider of Information Technology services, is among the avant-garde pioneers of a technological, borderless world. Common pressures affecting managers across the board — and thus regardless of national context — are also identified: these include the pressure to achieve profit and efficiency. In addition, a degree of convergence between human resource management policies and practices also makes itself visible. The thesis demonstrates, above all, the influence of national culture and national environment vis-à-vis management; an argument which may be reaffirmed given the context of globalisation. In brief, a European company is a cultural kaleidoscope