Syftet med studien har varit att kartlägga Norrvattens kommunikation kring hållbar vattenanvändning med sina medlemskommuner och medlemskommunernas kommunikation med kommuninvånarna. Ytterligare ett syfte med studien har varit att kartlägga hur andra VA-organisationer har kommunicerat kring hållbar vattenanvändning. Kartläggningarna har gjorts utifrån perspektiven hur kommunikationen genomförts, vad som kommunicerats och med vilket syfte. För att synliggöra kommunikationen har en didaktisk analys gjorts utifrån de didaktiska frågorna vem, vad, varför, när och hur. Slutligen har studien syftat till att utveckla ett underlag för en kommunikationsstrategi för Norrvattens kommunikation med medlemskommuner och kommuninvånare. Grunden i resultatet av kartläggningen av kommunikationen och enligt tidigare forskning ska kommunikationen syfta till att stärka möjligheter att hantera dricksvattenefterfrågan för hållbar vattenanvändning. I studien framkom att kommunikationen kring hållbar användning av vatten syftar till att förändra individers beteenden, för att minska den onödiga användningen av vatten. Respondenterna lyfter också fram att kommunikationen bör syfta till att öka vattnets värde samt öka kunskapen kring produktionen och produktionskapaciteten. Innehållsmässigt visar resultaten att kommunikationen ska beröra konkreta och praktiska handlingar, teknisk fakta och vattnets kretslopp i det större perspektivet. Olika kommunikationskanaler passar för olika typer av kommunikation, där resultatet visar att navet för kommunikationen med kommuninvånare är webben och sociala medier. Tonalitet, timing och sociala aspekter av kommunikationen framställdes i resultatet också som viktiga delar. Dessa har på olika sätt inkluderats i kommunikationsstrategin. Kommunikationsstrategin har utvecklats baserat på en modell framställd utifrån den teoretiska grund som använts i studien. Modellen har framställts som ett fundament medan resultatet från kartläggningarna av Norrvatten, medlemskommunerna och VA-organisationernas kommunikation tillsammans med tidigare forskning har utgjort innehållet. / The aim of this study was to map Norrvatten’s communication regarding sustainable water usage with Norrvatten’s municipalities and the municipalities’ communication with the municipal residents. Furthermore, the aim has also been to map how other water and sewerage organizations have communicated about sustainable water use. Focus of the systematic mapping of the communication was on how the communication was carried out, what was communicated and for what purpose. To understand the communication, a didactic analysis was carried out based on the didactic questions of who, what, why, when, and how. The last purpose of the study aimed to develop basis for a communication strategy for Norrvatten's communication with member municipalities and municipal residents. This was done based on the results of the communication mapping and previous research. The communication intends to strengthen opportunities to handle potable water demand relative to sustainable use of water. The result showed that communication about sustainable use of water aim to change individuals' behaviors, to reduce the unnecessary use of water. The respondents also emphasize that communication should aim to increase the value of water and increase knowledge of the production and production capacity. In terms of content, the results show that the communication touches on concrete and practical actions, technical facts, and the water cycle in the larger perspective. Communication channels are suitable for different types of communication, where the results show that the hub of communication with municipal residents is the website and social media. Tonality, timing, and social aspects of the communication were also presented in the result as important parts. These have been included in the communication strategy. The communication strategy was developed on a model produced on the theoretical basis used in the study. The model has been presented as a foundation, while the results from the communication mapping of Norrvatten, the member municipalities and the VA organizations' communication together with previous research have constituted the content.

Digitalization crosses all areas of life (Hess et al. 2014). Recent progress in artificial intelligence (AI) opens new potentials for further developments and improvements, with virtual coaching being a prime example. Virtual coaches (VCs) aim to optimize the user’s life by transforming cognition, affection, and behavior towards a stated goal. Since they emerged from the health and sports domain, a typical example are VCs in the form of digital avatars, which instruct physical exercises, shape health-related knowledge and provide motivational support to achieve the user’s goals (e.g., weight loss) (Ding et al. 2010; Tropea et al. 2019). Nonetheless, the application areas of VCs are versatile and exploring the potential areas (e.g., healthcare, work, finance, leisure, and environment) constitutes an essential topic of future research and development. According to Gartner’s hype cycle for human capital management technology, VCs are still in their infancy but are considered innovation triggers for the following years (Gartner, Inc. 2021). Specifically, VCs can be a replacement or complement for traditional human-to-human coaching scenarios and promise broad access to personalized coaching services independent of place and time (Graßmann and Schermuly 2021). As a result, VCs may contribute to solving challenges posed by an aging society and skilled labor shortage (European Commission 2016; Edwards and Cheok 2018). Last but not least, the recent COVID-19 pandemic additionally showcased the need for VCs as an alternative to traditional face-to-face interventions. Against this background and driven by the potential and promises of VCs, research has recently engaged in developing and understanding VC applications (Tropea et al. 2019; Lete et al. 2020; Graßmann and Schermuly 2021). To introduce the concept in information systems (IS) research and provide a basis for researchers and practitioners alike, this catchword aims at providing a holistic view on VCs. The structure of this paper is as follows. Section 2 elaborates a definition, delimits VCs from related system classes, and proposes a research framework. Section 3 aggregates existing research into the framework and concludes with an outlook on future IS research perspectives.

Introduktion: Fysisk aktivitet är viktigt för både psykiskt och fysiskt välbefinnande. Idag är vi allt mer fysisk inaktiva och stillasittande ökar. Fysisk aktivitet minskar risken för bland annat hjärt- och kärlsjukdomar och typ 2-diabetes. För de som har typ 2- diabetes eller graviditetsdiabetes funkar fysisk aktivitet även behandlande. I takt med digitaliseringens framfart ökar hälsoappar. Dessa har potential att främja hälsosamma beteendeförändringar. Syfte: Syftet med studien var att utvärdera vad för faktorer i hälsoappar som gör att vissa hälsoappar är effektiva för att öka fysisk aktivitet hos vuxna individer med risk för typ 2-diabetes, diagnostiserad typ 2- diabetes eller graviditetsdiabetes. Metod: Studien genomfördes som en systematisk litteraturstudie med 12 vetenskapliga artiklar. Studien analyserades genom en tematisk analys. Resultat: Effektiva appar är multifaktoriella, fler faktorer påverkar. Analysen genererades i tre teman; användarupplevelse och engagemang, beteendeteorier och funktioner i hälsoappar. Dessa tre teman är viktiga för att lyckas med beteendeförändring i en hälsoapp. Användarupplevelse och engagemang kan främjas genom regelbunden feedback. Även individanpassade mål kan ge bra effekt på engagemanget för hälsobeteenden. Appdesign som integrerar beteende teorier kan stödja motivation och hjälpa användare att övervinna hinder för fysisk aktivitet. Slutsats: Effektiva hälsoappar är multifaktoriella och kräver integration av funktioner som förbättrar användarupplevelsen, inkorporerar beteendeteorier och anpassas efter målgruppen för att stödja beteendeförändring. Framtida forskning bör fokusera på att utvärdera del ångsiktiga effekterna av digitala hälsointerventioner för att främja hållbara beteendeförändringar över tid. / Introduction: Physical activity is crucial for both physical and mental well-being. Unfortunately, society is becoming increasingly physically inactive, leading to more sedentary lifestyles. Engaging in physical activity reduces the risk of diseases such as cardiovascular conditions and type 2 diabetes. For individuals with type 2 diabetes or gestational diabetes, physical activity can be an important part of treatment. The rise of digitalization has brought about a proliferation of health apps, which have the potential to promote healthy behavior changes. Purpose: The purpose of the study was to evaluate the factors in health apps that make some of them effective in increasing physical activity among adults at risk for type 2 diabetes, diagnosed with type 2 diabetes, or gestational diabetes. Method: The study was conducted as a systematic literature review with 12 scientific articles. The analysis was performed using thematic analysis. Results: Effective health apps are multifactorial, influenced by multiple factors. The analysis generated three themes: user experience and engagement, behavioral theories, and app functionalities. These three themes are crucial for achieving behavior change in a health app. User experience and engagement can be enhanced through regular feedback. Additionally, personalized goals can positively impact engagement in health behaviors. App design that integrates behavioral theories can support motivation and help users overcome barriers to physical activity. Conclusion: Effective health apps are multifactorial and require the integration of features that enhance user experience, incorporate behavior theories, and are tailored to the target audience to support behavior change. Future research should focus on evaluating the long-term effects of digital health interventions to promote sustainable behavior changes over time.

Cette thèse a pour objectif d'évaluer un programme de formation visant à doter les professionnels de la santé d'outils de courtage de connaissances afin d'assurer l'intégration des meilleures pratiques dans les établissements de santé et de services sociaux. Elle vise à évaluer la fidélité de sa mise en œuvre et les effets du programme de formation sur les participants et leur cadre professionnel. Le programme est composé de huit ateliers de 2 heures, dispensés sur une période de trois semaines. Il a été construit et offert par le Consortium InterS4, dont l'objectif est de développer et d'intégrer les meilleures connaissances et pratiques dans les établissements de santé et de services sociaux de cinq régions administratives du Québec, par le biais d'activités de courtage de connaissances. Le programme de formation a été évalué auprès de quatre de ces régions en utilisant le modèle de Kirkpatrick. La collecte de données de ce projet d'évaluation comprend deux parties menées en parallèle, employant des méthodes mixtes pour recueillir des informations complètes. Les données ont été collectées au moyen d'une combinaison de questionnaires quantitatifs et d'entretiens qualitatifs, en tirant parti du modèle d'efficacité de la formation de Kirkpatrick, du Theoretical Domains Framework (TDF) et du Behavior Change Wheel (BCW) pour évaluer à la fois l'impact du programme de formation et les facteurs plus larges influençant le transfert de connaissances et le changement de comportement. Tout au long du processus d'évaluation de 24 mois, trois animateurs et 46 participants répartis en 7 cohortes ont pris part au projet de recherche. La mise en œuvre du programme a été évaluée à travers le contenu utilisé pour chaque cohorte ainsi qu'à travers les discussions avec les animateurs suite au dernier atelier de formation de chaque cohorte. Concernant les effets du programme, les réactions des participants, les apprentissages, les comportements et les résultats ont été mesurés à quatre moments différents ; avant le programme,3 après le dernier atelier, trois mois et six mois après le dernier atelier. Les facteurs contribuant au changement de comportement, à savoir la motivation, l’opportunité et la capacité, ont été évalués à ces multiples moments afin de déterminer leur influence sur la mise en œuvre des activités de courtage de connaissances. Les résultats mettent en évidence la satisfaction des participants concernant l’utilisation du courtage de connaissances dans leur travail. Tous les participants recommandent le programme à leurs pairs et parfois à d'autres professionnels de leur domaine. L'analyse thématique des verbatims suggère l’importance de conditions spécifiques pour la mise en place efficace de pratiques de courtage de connaissances au sein de ces établissements. Concernant les facteurs liés au changement de comportement, les données recueillies lors de l'évaluation font état d'une perception de gains de capacité par les participants à l'issue de la formation. Les participants avaient des convictions positives concernant le courtage de connaissances et ses effets. Cependant, beaucoup d’entre eux n’ont pas eu l’occasion de mettre en pratique les apprentissages en raison de priorités différentes dans leur rôle professionnel et de leur environnement de travail. Les recommandations consistent notamment à garantir que la direction connaît et exploite les capacités en courtage de connaissances, que les objectifs sont bien définis et que les parties prenantes sont alignées dans l'exécution des mandats. / This thesis has for objective to evaluate a training program aimed at equipping health professionals with KB tools to ensure that best practices can be integrated into health and social services institutions. It aims to assess the fidelity of its implementation and the effects of the training program on the participants and their professional setting. The program is made up of eight 2-hour workshops, administered over a period of three weeks. The training program was built and offered by the InterS4 Consortium, whose objective is to develop and integrate best knowledge and practices in the health and social services institutions of five Québec administrative regions, of which four were evaluated in this study, through KB activities. The research design of this evaluation project includes a two-part investigation conducted in parallel, employing mixed methods to gather comprehensive insights. Data was collected through a combination of quantitative questionnaires and qualitative interviews, leveraging the Kirkpatrick Training Effectiveness Model, the Theoretical Domains Framework (TDF), and the Behavior Change Wheel (BCW) to evaluate both the training program's impact and the broader factors influencing knowledge transfer and behavior change. Throughout the 24-month evaluation process, three animators and 46 participants spread into 7 cohorts took part in the research project. The implementation of the program was evaluated through the content used for each cohort as well as through discussions with the animators following the last workshop for each cohort training. Regarding the effects of the program, the reaction, learnings, behaviors and results were measured at four different times; before the program, following the last workshop, three months and six months after the last workshop. Factors contributing to behavior change—namely motivation, opportunity, and capability—were assessed at these multiple time points to capture their influence on the implementation of KB activities. The results highlight the satisfaction of the participants concerning the use of KB in their work. All participants recommend the program to their peers and sometimes to other professionals in their field. The thematic analysis of the verbatims suggests the importance of specific conditions for the effective implementation of knowledge brokering practices within these establishments. Concerning the factors related to the behavior change, the data collected during the evaluation reports a perception of gains in capability by the participants at the end of the training. Participants held positive beliefs regarding KB and its effects. However, many of them did not have the opportunity to put the learnings into application due to differing priorities in their professional role and due to their work environment. Recommendations include ensuring the management is aware of and leveraging the KB capabilities, goals are well-defined and stakeholders are aligned in the execution of the mandates.

Hypertension is a chronic non-communicable disease and a major risk factor for cardiovascular diseases, renal malfunction, disability, and premature death. One of the public health recommendations for the management of hypertension is the reduction of sodium/salt intake. There is need to develop and implement new evidence-based theoretical interventions to initiate and sustain behavior change in health education and promotion. Therefore, the quantitative cross-sectional method and design was used to investigate the adequacy of multi-theory model (MTM) constructs for the initiation and the sustenance of low sodium/salt intake behavior in hypertensive Nigerian adults. In addition, the impact of the MTM (initiation) constructs on actual salt/sodium intake was evaluated to validate self-reported behavior. A convenience sample of 149 consenting Nigerian adults with hypertension and of ages 20 to 60 years, self -administered the valid and reliable 39-item MTM instrument. The findings of confirmatory factor analysis showed construct validity of subscales for the initiation and sustenance model. All items loading for the two models were significant, p < 0.001. Multivariate regression analysis revealed 40.6% of the variance in initiating the consumption of low salt diets explained by advantages outweighing disadvantages, behavioral confidence, and changes in physical environment. About 41.8 % of the variance to sustain the intake of low salt diet was explained by emotional transformation, practice for change, and changes in social environment. The results justified the predictive role of MTM and adequacy of its utility to build evidence-based health education programs and interventions to address the health need of people with hypertension and contribute to social change in the country.

Objective: Dog owners have been shown to walk more per week compared to non-dog owners; however, 60% of dog owners are still not walking their dogs at intensities sufficient to reap optimal health benefits. The aim of this study was to evaluate the feasibility, acceptability, and efficacy of a 9-week feasibility randomized controlled trial involving a program of six weekly scheduled instructor-led group dog walks supplemented with theory-based strategies to encourage increased dog walking among dog owners in Greater Victoria, BC. Methods: This study was based on the multi-process action control (M-PAC) framework and utilized an open parallel randomized controlled trial design involving experimental and waitlist-control group participants. Quantitative data was collected using pedometers and self-report measures. A program evaluation survey was administered upon the completion of the study. Primary outcomes examined the feasibility and acceptability of the program; secondary outcomes analyzed pedometry and self-report moderate-to-vigorous physical activity (MVPA) data; and tertiary outcomes observed changes in participants’ perceptions of M-PAC constructs. Percentage calculations were used to obtain primary outcomes, and analysis of covariance (ANCOVA; controlling for baseline) was performed to examine secondary and tertiary outcomes to explore the direction of effects and obtain a first estimate of expected effect sizes. Eligibility: Male and female adults aged 18+ living in Greater Victoria, BC, who owned at least one healthy and friendly dog aged six months and above, who were not meeting recommended guidelines of 150 minutes of MVPA per week, and who were medically cleared to participate. Results: Feasibility outcomes included 74 interested responses, 23% recruitment rate (n = 17), 94% retention rate (n = 16), and 94% adherence rate (n = 15). Program participants were overall (very) satisfied with the program – worksheets (62.5%), program instructor (100%), various program/group dog walks logistics (75% to 100%). Total weekly step counts and average daily step counts, MVPA dog walking, and MVPA with dog increased at the end of the program and at follow-up, resulting in large effect sizes when compared to the waitlist-control group. MVPA dog walking and total MVPA (with and without dog) exceeded recommended guidelines at follow-up. Positive changes across time were observed for dog responsibility and M-PAC constructs of affective judgments, opportunity, planning, identity, and habit, resulting in medium and large effect sizes when compared to the waitlist-control group. Conclusions: This six-week group dog walking program is overall feasible, acceptable, and efficacious in encouraging increased dog walking and MVPA among dog owners. Attendance at weekly scheduled instructor-led group dog walks and exposure to the M-PAC construct worksheets resulted in program participants’ adoption and maintenance of positive behavioral changes at the end of the program and at follow- up. Program participants reported enjoying the program and being (very) satisfied with it. It is recommended for future studies to refine/modify initial recruitment strategies and eligibility criteria, reimburse medical/veterinarian clearance costs to reduce cost-related barriers to participation, offer a variety of options for program delivery (e.g., different locations/schedules/seasons, online programs, multi-site study) to accommodate more participants, and apply the M-PAC framework to a larger sample. / Graduate

Introduction : Quoique plus de 90 minutes/semaine d’activité physique (AP) soient recommandées, peu d'individus présentant un premier épisode psychotique (PEP) en pratiquent, malgré la présence de complications métaboliques fréquentes. La littérature suggère qu'une intervention d'AP incluant leurs préférences d’AP et des conseils motivationnels faciliterait leur adhésion. Objectifs: Vérifier la faisabilité, l’acceptabilité et l’impact d’une intervention d’AP sur la motivation à l’AP, le niveau d’AP, de sédentarité et la participation sociale. Méthodes: Essai clinique ouvert (étude pilote) conduit auprès de PEP. L’intervention de 24 séances d’AP supervisées est basée sur les « préférences-patient » et inclut des conseils motivationnels utilisant le modèle transthéorique. La faisabilité et l’acceptabilité étaient mesurées grâce au taux d’abandon, de présence et à la satisfaction. La motivation à l’AP, la participation sociale, le niveau d’AP et de sédentarité ont été mesurés. Résultats: Des 40 PEP (25,63±4,22 ans, 52,5% de femmes) recrutés, 40% ont abandonné; le taux de présence était 67,5%. Les PEP (94%) étaient beaucoup (4/5) à énormément (5/5) satisfaits. Le niveau d’AP est passé de 52,71 à 91,79 minutes/semaine (recommandations atteints) et la sédentarité de 90,85 à 33,75 ± 49,16 minutes. Aucun impact observé sur la motivation d’AP et la participation sociale. Conclusion: Les résultats préliminaires suggèrent qu'une intervention basée sur les préférences-patients est faisable et acceptable chez les PEP. De futures études contrôlées randomisées permettraient de déterminer si la diminution de la sédentarité et l’augmentation d’AP sont réellement attribuables à cette intervention et si elle peut contribuer à réduire les complications métaboliques chez les PEP. / Introduction: Although 90 minutes or more/week of physical activity (PA) is recommended, few individuals with early psychosis (IEP) practice it despite the frequent presence of metabolic complications. The literature suggests that a PA intervention including their preferred PA and motivational counseling would facilitate their adherence. Objectives: To determine the feasibility, acceptability and impact of a PA intervention on PA motivation, PA level, sedentary time and social participation. Methods: Open clinical trial (pilot study) conducted with IEP. The PA intervention of 24 supervised PA sessions is based on “patients-preferences” and includes motivational counseling using the transtheoretical model. Feasibility and acceptability were measured by drop-out rates and attendance and satisfaction level. PA motivation, PA level, level of physical inactivity and social participation were measured pre and post intervention. Results: Of the 40 IEP (age: 25.63 ± 4.22 years, 52.5% of women) recruited, 40% dropped out and the attendance rate was 67.5%. The satisfaction was rated (94%) “very satisfied” to “very much”. The PA level increased from 52,71 to 91.79 minutes/week (reaching recommendations) and physical inactivity decreased from 90,85 to 33.75 ± 49.16 minutes. The intervention had no impact on PA motivation and social participation. Conclusion: Our preliminary results suggest that an intervention based on patient preferences is feasible and acceptable in IEP. Future randomised controlled trials would allow to determine if the decreased physical inactivity and increased PA levels are due to this intervention and if it may contribute to reduce the frequent metabolic complications in IEP.

Dans les pays industrialisés tels que le Canada, les maladies chroniques non transmissibles comme le diabète et les maladies cardiovasculaires sont responsables de la majorité de la mortalité prématurée. Les comportements liés à la santé, comme le tabagisme, ont un impact majeur sur le développement de ces maladies. Les infirmières et les infirmiers , par le biais d’une approche motivationnelle nommée counseling bref en changement de comportement (CBCC), peuvent soutenir les patients dans le changement de comportement lié la santé. Toutefois, les études soulignent des barrières inhérentes à la mise en œuvre du CBCC par les infirmières en milieu hospitalier, comme le manque d’habiletés et des normes sociales défavorables. Cette thèse par articles présente les résultats d’une étude visant à (1) développer un programme de formation numérique adaptatif basé sur la théorie portant sur le CBCC pour la promotion de la cessation tabagique, l’adoption de saines habitudes alimentaires et l’adhésion aux traitements médicamenteux (E_MOTIVA) et (2) évaluer son effet auprès d’infirmières et d’étudiantes en sciences infirmières par un essai clinique à répartition aléatoire (ECR) en comparaison avec un programme de formation numérique standardisé partiellement basé sur la théorie (E_MOTIVB). Le programme E_MOTIVA a été développé selon une démarche systématique en fonction d’appuis empiriques et théoriques, incluant la Théorie du Comportement Planifié, la Théorie de la Charge Cognitive et le concept d’engagement. Le contenu du programme E_MOTIVA a été développé de manière à cibler les barrières et les déterminants théoriques associés à la mise en œuvre du CBCC chez des infirmières et des étudiantes en sciences infirmières (p. ex., attitude, normes subjectives, connaissances, intention). L’adaptation du programme E_MOTIVA a été opérationnalisée à différents moments lors du parcours d’apprentissage afin d’optimiser la charge cognitive et l’engagement des infirmières et étudiantes. Le programme E_MOTIVA incluait trois sessions de formation durant respectivement un maximum de 50, 60 et 20 minutes. Il pouvait être complété en ligne depuis un téléphone intelligent, une tablette ou un ordinateur. Nous avons mené un ECR à deux groupes parallèles en simple aveugle auprès de 102 infirmières et étudiantes inscrites dans un programme de baccalauréat en sciences infirmières au Canada afin d’évaluer le programme E_MOTIVA (groupe expérimental ; n = 51) en comparaison avec le programme E_MOTIVB (groupe contrôle ; n = 51). L’effet des programmes a été évalué sur 1) le changement dans l’intention de mettre en œuvre du CBCC pour la promotion de la cessation tabagique, l’adoption de saines habitudes alimentaires et l’adhésion aux traitements médicamenteux (H1) ; 2) les changements dans les variables de la Théorie du Comportement Planifié (H2 à H7) ; 3) la charge cognitive (H8 à H10) ; et 4) l’engagement (H11, H12). Les analyses de covariance n’ont indiqué aucune différence significative dans les scores de changement dans l’intention de mettre en œuvre du CBCC entre deux groupes de l’étude. Cependant, le score de changement dans l’intention était plus élevé dans le groupe expérimental (10,22 ± 3,34) que dans le groupe contrôle (9,04 ± 2,80) (p = 0,787). Il n’y avait pas de différence significative entre les groupes quant aux changements sur le plan des autres variables de la Théorie du Comportement Planifié. Dans les deux groupes, les scores d’intention (H1), d’attitude (H2), de normes subjectives (H3), de contrôle comportemental perçu (H4), de croyances comportementales (H5) et de croyances de contrôle (H7) se sont tous améliorés de manière significative entre les mesures de base et finales. Aucune différence significative n’a été observée entre les groupes concernant la charge cognitive et l’engagement. Cette étude a permis de développer un programme de formation numérique adaptatif basé sur la théorie (E_MOTIVA) portant sur le CBCC destiné aux infirmières et aux étudiantes en sciences infirmières. Les résultats suggèrent que les programmes E_MOTIVA et E_MOTIVB ont eu des effets positifs similaires sur le plan de l’intention de mettre en œuvre du CBCC chez les infirmières et les étudiantes. Des recommandations sont formulées à l’effet d’orienter la recherche vers la distinction entre l’approche basée sur la théorie et le processus d’adaptation et d’explorer des avenues de recherche visant la transformation de l’intention de mettre en œuvre du CBCC en sa mise en œuvre effective en pratique. / In industrialized countries such as Canada, chronic noncommunicable diseases such as diabetes and cardiovascular disease are the cause of most premature mortality. Unhealthy behaviors, such as smoking, have a major impact on the development of these diseases. Nurses can support patients in initiating and sustaining health behavior change through a motivational and collaborative approach called brief behavior change counseling (BBCC). However, studies highlight several barriers to nurses’ implementation of BBCC in hospitals, including lack of skills and unfavorable social norms. This thesis by articles presents the result of a study aiming to (1) develop a theory-based adaptive e-learning program on BBCC for the promotion of smoking cessation, the adoption of healthy eating habits and medication adherence (E_MOTIVA), and then (2) to evaluate its effect with nurses and nursing students in a randomized controlled trial (RCT) compared with a standardized e-learning program partially based on theory (E_MOTIVB). The E_MOTIVA program was developed following a systematic approach and informed by empirical data and theory, including the Theory of Planned Behavior, Cognitive Load Theory and the concept of engagement. The content of the E_MOTIVA program has been developed in such a way as to target the barriers and theoretical determinants of BBCC implementation in nurses and nursing students (e.g., attitude, subjective norms, knowledge, intention). The adaptation of the E_MOTIVA program was operationalized at different times during learning to optimize cognitive load and engagement in nurses and students. The E_MOTIVA program included three training sessions lasting respectively a maximum of 50, 60 and 20 minutes. It could be completed over the Internet from a smartphone, tablet or computer. We then conducted a two group, single blind, RCT with 102 nurses and students enrolled in a baccalaureate nursing program in Canada to evaluate the E_MOTIVA program (experimental group; n = 51) compared to the E_MOTIVB standardized e-learning program partially based on theory (control group; n = 51). The effect of the programs was assessed on: 1) change in intention to implement BBCC for promoting smoking cessation, adoption of healthy eating habits, and medication adherence (H1); 2) changes in the theoretical variables of the Theory of Planned Behavior (H2 to H7); 3) cognitive load (H8 to H10); and 4) experiential and behavioral engagement (H11, H12). Analyzes of covariance indicated no significant difference in the scores of change in intention to provide BBCC between the two study groups. However, the change in intention score was higher in the experimental group (10.22 ± 3.34) than in the control group (9.04 ± 2.80) (p = 0.787). There was also no significant difference between the two groups in the changes in the other variables of the Theory of Planned Behavior. In both groups, scores for intention (H1), attitude (H2), subjective norms (H3), perceived behavioral control (H4), behavioral beliefs (H5) and control beliefs (H7) all improved significantly between baseline and final measures. No significant difference was observed between groups in cognitive load and engagement. This study led to the development of a theory-based adaptive e-learning program (E_MOTIVA) on BBCC for nurses and nursing students. The results suggest that the E_MOTIVA and E_MOTIVB programs had similar positive effects in terms of intention to implement BBCC in nurses and students. Recommendations are made to guide future research towards the distinction between the theory-based approach and the adaptation process and to explore research avenues related to the transformation of the intention to provide BBCC into its actual provision in clinical practice.

No description available.

This study shows that stress is one of the important issues which may have a negative impactboth in physical and mental effects on a nurse's working life. Poor ergonomics of the hospitaland a poor behavior approach of nurses can cause stress. To reduce these stress factors, thisstudy suggests solutions based on gamification that imply activities to create a good workingenvironment and to reduce the stress to ensure the good health and well-being of the nurseswho work different shifts especially in night shifts. To achieve the purpose, qualitative researchis used as a method. For this study, nurses who work in hospitals were interviewed in differentshifts especially in night shifts with some open-ended questions related to stress andgamification. Based on their answers, trying to evaluate and analyze the problem and findings.Based on the findings, a gamification concept was developed to provide recommendations tohandle the stress and to be motivated and engaged to develop the well-being of life. / Denna studie visar att stress är en av de viktigaste frågorna som kan ha en negativ inverkanbåde på fysiska och mentala effekter på sjuksköterskans arbetsliv. Dålig ergonomi på sjukhusetoch sjuksköterskors dåliga beteende kan orsaka stress. För att minska dessa stressfaktorerföreslår denna studie lösningar baserade på gamification som innebär aktiviteter för att skapaen bra arbetsmiljö och för att minska stressen för att säkerställa god hälsa och välbefinnandehos sjuksköterskor som arbetar olika skift, särskilt på nattskift. För att uppnå syftet användskvalitativ forskning som metod. För denna studie intervjuades sjuksköterskor som arbetar påsjukhus i olika skift, särskilt på nattskift med några öppna frågor relaterade till stress ochgamification. Baserat på deras svar, försöker utvärdera och analysera problemet och resultaten.Baserat på resultaten utvecklades ett spelkoncept för att ge rekommendationer för att hanterastress och för att vara motiverad och engagerad för att utveckla livets välbefinnande.