Smoking remains a leading cause of premature, preventable death in South Africa killing 44 000 South Africans each year. Through the introduction of comprehensive tobacco control policies, the South African government has tried to reduce the death toll and a significant reduction in tobacco use has been recorded since its peak in the 1990’s. Smoking among women, however have remained unchanged, which calls for actions. Pregnant mothers are specifically vulnerable as their smoking detrimentally affects their own health as well as the health of their babies. This thesis gives an account of the role the antenatal care system could play in reducing the burden caused by cigarette smoking.   The overall aim was to contribute to an understanding of how a person-centred approach to smoking cessation among disadvantaged pregnant women with high smoking rates may influence smoking behaviour. The specific objectives were to confirm the high smoking rates of the target population, assess their readiness to quit, explore existing barriers and promoting factors towards smoking cessation efforts within the public antenatal health care system, and to qualitatively assess the attitudes and perceptions of disadvantaged pregnant women regarding a personcentred smoking cessation intervention.   The high smoking rates of the target population was confirmed based on a cross-sectional study at antenatal clinics in four main cities of South Africa. It focused on the prevalence of smoking during pregnancy and used the stages of change theory to identify their readiness to quit. Additional questions concerned pregnancy related disease experiences, socio-economic determinants of continued smoking as well as attitudes towards the existing clinic services and its possible role in smoking cessation. A qualitative interview study analyzed more in-depth barriers for two-way communication between pregnant mothers and midwives. Both these studies informed the design and development of a person-centred smoking cessation intervention delivered at four public sector antenatal clinics in Cape Town. The intervention was subjected to a comprehensive evaluation based on a combination of quantitative and qualitative measures. This thesis utilizes data from the qualitative process assessment part, comprising individual interviews and focus group discussions with pregnant women during the implementation period of the intervention.   The survey results pointed out a high prevalence of smoking of 46% amongst disadvantaged pregnant women, with varying readiness for behaviour change. Most women were in the contemplation stage of behaviour change and thus ready to quit. Many of the women felt positive about the role of the midwife as an antenatal care provider, but they did not have confidence in midwives concerning encouraging or supporting women to change addictive behaviour be it smoking, alcohol or other illegal substances. The qualitative research highlighted the need for revised curricula for health education and counselling. The analysis illustrated how the current situation created tension between clinic staff and pregnant women making women feel unworthy and thus leaving little room for changing behaviour. The in-depth interviews and the focus group discussions provided an analytical account of how the person-centred approach in this population was perceived by the women themselves. It illustrated that a multifaceted intervention programme, using peer counselors and educational material designed specifically for a given target population, can successfully bring about behaviour change. The intervention succeeded in shifting women’s perceptions of hopelessness into feelings of being empowered to face their addictions and competent to make a change. Though the intervention meant greater rapport with the midwives, involving peer counsellors was rated highly by the participating women. The women reported having used the educational material and attached a great value to the appropriateness of the material to their life situations, and the effectiveness of having it combined with counselling from a peer counsellor. This qualitative evaluation showed the importance of a multifaceted intervention approach, in helping women identify with their behaviour change.   The thesis highlights the importance of designing smoking cessation interventions that are specific to the needs of target populations. When smoking cessation efforts are included into routine antenatal services it is important that the target group inform the nature and specific components of the intervention.

Local Food Systems (LFS) is a relatively new concept in geographical and planning research. Academic, professional, and public interest in LFS is in part a reaction against the social, environmental, and economic effects of a dominant Production Agriculture paradigm (Lyson, 2004), and growing concern with the potential impacts of climate change on the food supply (Ostry, Miewald, and Beveridge, 2011). While there is a growing public and policy interest in making transformative change in LFS, there is a lack of theoretical work that addresses how change processes in food systems occur. In this study, a classic Glaserian grounded theory research project investigated the subject area of local food system planning. The primary research goal was the development of a theory grounded in the experience of practitioners, elected officials, and members of the public. The emergent theory, called Transformative Incrementalism (TI) describes the social process underlying planning initiatives focused on achieving significant (transformative) change in local food systems. The data for this research project are drawn from interviews with 29 elected officials, public stakeholders, and planning staff in five communities with local food system initiatives. In addition, 10 member checking interviews were also conducted. The core category identified in the emergent TI theory was Power, with Values, Praxis, and Outcomes being other main themes. From this research, Power could be defined as the ability, through authoritative and non-authoritative influence, to have an effect on a person, process, action, or outcome. Values act as sources of power to the extent that they motivate and drive the actions of individuals and groups. Praxis includes activities designed to create, use, and maintain power, such as building relationships with other people that will give ongoing support for food planning initiatives. Outcomes include broader system and social changes resulting from local food system planning processes and activities. The main findings from this dissertation underscore the fact that the role of power has been largely ignored in the planning literature (Friedman, 2011; Flyvbjerg, 2012; Assche, Duineveld, and Buenen, 2014). Power is the main driver of change; therefore, a lack of understanding about what power is and how it operates would seem to compromise the ability of planning efforts to be effective. This research identifies and illustrates the interrelationship between the political, public, and bureaucratic spheres of actors, and examines how values, praxis, and outcomes are pivotal to transformative change in food planning initiatives. Transformative change is achieved through a long process of incremental efforts (programs, policies, and actions) by actors within the public, political, and bureaucratic groups whose values and beliefs converge and align over time. The incremental efforts are intended to support a transformative change goal. / Graduate

Crime prevention and community safety are issues that the Swedish government constantly have to struggle with. With different working conditions, priorities and budgets for each region and municipality, such tasks could turn into colossal challenges if the right solutions aren’t taken. In the last couple of years the government has together with the police and crime-preventing council (Brottsförebyggande rådet) issued a number of publications encouraging the municipal councils to cooperate with police, governmental bodies and local civil actors. The motive being that crime-preventive reforms and measures only work if all actors act like a coherent body, from planning to implementation of policies. These publications have also advocated the use of several crime-preventive methods when planning such reforms. The goal with this essay is to examine the incorporated crime-prevention methods such as the control theory and structural change theory. Questions to be answered are also about the measures taken and levels of cooperation in the two municipalities of Örebro and Karlstad. This has been done through the lens of the qualitative method because we were interested in studying the subject on different levels. To do so we have performed four interviews with one municipal commissioner from each municipality, one security coordinator in Karlstad and a local area police in Örebro. We have also studied several documents related to the empirical material. The conclusion has been that there are similarities regarding the usage of crime-prevention methods but that the implementation of measures differs regarding community safety and long-term effects to provide a safe environment for the citizens

The purpose of this qualitative study was to examine teacher perception of changes in the instructional delivery and learning opportunities via technology during and throughout the COVID-19 pandemic from March 2020 until May 2021. The COVID-19 pandemic has greatly affected educational organizations. School closures in March 2020 forced teachers to change their instructional delivery from an in-person platform to a virtual platform. This disruption to the delivery of instruction with the use of technology changed the way teachers plan for learning, delivery content, present learning activities, and assessment. The urgency required teachers to develop new strategies and experiment with adaptations to their traditional instructional delivery. The purpose of this phenomenological study was to describe the experiences of teachers as they adapted their instruction to a new platform. The theoretical framework used was change theory. The research was accomplished by interviewing 11 core-content classroom teachers from different school systems. Participants described their experiences and approach to the challenges faced while teaching during the uncertainty of the pandemic. The participants in the study described factors that influenced changes in their use of technology and how the different platforms changed the way they used technology for instructional delivery. The researcher used the Change Theory Framework to code responses and identify the internal and external factors that influenced the changes.

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Students of all ages host a wide variety of scientifically inaccurate ideas and conceptions about everyday astronomical phenomena, such as the seasons, the moon phases, and gravity. The field of Astronomy Education Research has over the last decade experienced an accelerating growth, although the majority of studies have been conducted in the USA. In this work, the 9th grade students of a typical Swedish school were surveyed by means of a questionnaire in order to probe their conceptual understanding of several key concepts in astronomy. In the end, the number of respondents amassed to a total of 90. The results were analyzed with a constructivist approach in light of conceptual change theory and phenomenological primitives. In conjunction to this a postmodern view of the problem in question is presented. The compiled numbers were compared to the results of American high school students found in the large database of A Private Universe Project. The two samples were found to display only minor differences. Most notably, only around one in ten Swedish students could correctly account for the origin of the seasons, and only a very small percentage could point out the true distance-relation between the Earth and the Moon. In addition, approximately half of the students did not know the reason for why the Moon changes phase, and one in every four or five students believes there are stars between the planets in the Solar system. An analysis of the student sample was also made after separating out students who will obtain further education in astronomy in upper secondary school. With only one exception, no differences between the groups were found, suggesting that the misconceptions treated in this survey are present among all groups of students up to a certain educational level. However, in the group not intending to study more astronomy an astonishing 72 % had incorrect beliefs regarding the day/night cycle, indicating a possible fundamental lack of conceptual understanding about one of the most everyday astronomy-related concepts.

Radical change theory (RCT) was conceived in a North American context in the mid-1990s, in order to explain changes in contemporary literature for youth related to the digitization of society. This study uses directed qualitative content analysis (DQlCA) to look at a select sample of contemporary award-winning Arabic picturebooks through the lens of radical change theory. The aim of the study is to ascertain whether and to what extent these acclaimed and promoted books display radical change characteristics (Dresang 1999). Children’s books that embody many such characteristics may be seen as products of an underlying ideology of childhood that is arguably gaining traction in contemporary societies–one in which children are seen as capable and seeking connection rather than innocent and in need of protection or depraved and needing to be controlled. All books in the present study were found to contain radical change. This can be viewed as revealing of larger trends affecting and perhaps changing the societies in which these books were published, distributed and promoted. In addition, radical change books are thought to be especially attractive to digital age children (by creating more interest and an elevated understanding), which is of special interest in the context of Arabic children’s literature because of the hurdles to accessibility that the use of literary Arabic creates.

There is a significant body of literature showing improved student outcomes in higher education STEM courses when evidence-based instructional practices (EBIPs) are used. Despite this, traditional, lecture-style instruction remains the primary means of instruction in these courses. However, given the situation of the sudden shift to online teaching as a result of the COVID-19 pandemic, faculty were participating in training programs with greater frequency, and thus learning more about the use of EBIPs than ever before. Through the lens of Kurt Lewin’s theory of organizational change in the three stages of unfreezing, change, and refreezing, this explanatory mixed methods study sought to explore through a survey and interviews whether this shift to online teaching and the resulting increase in training participation did, in fact, result in changes in instructional practices, implementation, and perceptions of EBIPs, and whether any changes were sustained upon the return to in-person instruction.The survey tool used in this study was a subset of the Teaching Practices Inventory, developed by the Carl Wieman Science Education Initiative from the University of British Columbia. This generated a modified “extent of use of research-based teaching practices” (METP) score, as well as METP sub-scores in five subcategories of the survey. These results, as well as data obtained from demographic questions and questions about teaching responsibilities and training participation, informed the selection of twelve participants for semi-structured interviews. Through one-way ANOVA testing, the quantitative analysis showed a statistically significant increase in METP (p < .001) from Pre-Covid to Post-Covid scores. Statistical significance was also found in the subcategories of In Class Features (p = .003) and Collaboration (p = .005). Two-way ANOVA testing was also done to explore statistical significance for demographic subcategories, which was found to exist for gender, tenure status, and various categories relating to participation in training and professional development. Interview data supported the quantitative data analysis, and offered further insight and context for the changes that have been made and sustained, including changes regarding the use of educational technology tools, introduction of authentic learning experiences, streamlining of content, and intentional alignment of activities and assessments with course goals. Additional analysis showed faculty relied on virtual collaboration to develop community with other instructors, and realized the importance of student feedback to inform their instruction and of fostering a classroom community. Most significantly, the ability to see first-hand the effect of the pandemic on students and to have a window into their personal lives caused faculty to make sweeping changes with respect to their beliefs in the affective domains of learning, emphasizing the need for empathy, flexibility, and equity-mindedness in their classrooms. This study showed that faculty became convinced of the need for change, consistent with Lewin’s unfreezing stage, not solely through training and professional development, but largely through the realizations about the individuality of students that faculty experienced during the pandemic. This occurred simultaneously with an increase in virtual collaboration as well as the influence of changes peers had made and suggested upon the return to in-person instruction. The recognition of the need to center students in learning combined with these outside influences resulted in the increased use of EBIPs upon the return to in-person instruction, therefore creating the desired change. Lastly, these practices have been maintained as of two years after the return to in-person, thus indicating refreezing, and further data showed that faculty continue to adapt their practices to create more inclusive and student-centered learning environments. / Policy, Organizational and Leadership Studies

Implementation is a phase included in nearly all instructional development models, yet literature on instructional design and technology reveals little about implementation's nature and the special conditions that must be considered as users go beyond adoption (Ely, 1999). Ely (1990b; 1999) contends these conditions include dissatisfaction with the status quo, leadership, commitment, participation, resources, time, incentives and rewards, and knowledge and skills. When employing Ely's conditions as a framework for investigation, attention is shifted away from the innovation to the environment where the innovation has actually been adopted and utilized as a facilitating factor in implementation. The move to online and software-based environments in recent years is accompanied by a need for additional research to further validate Ely's conditions within this new context. This exploratory study identified and analyzed user pre and post-implementation perceptions regarding the relative importance of Ely's conditions for the successful implementation of an actual innovation, a product management system. An online survey, the Implementation Profile Instrument created by the founders of iphase.org, was adapted and utilized to capture user perceptions. Descriptive statistics and factor analyses revealed important differences with past innovations and contexts, and between pre and post implementer groups and pre and post-implementation stages. / Ph. D.

Accurate temperature assessment is essential in neonatal patients and allows for prompt recognition of illness. Temperature can be measured by rectum, which is subject to injury, axillary, which is time-consuming, and temporal artery, which is safe and fast. The purpose of this evidence-based practice quality improvement project was to create an educational toolkit for nurses teaching temporal artery thermometers for routine temperature measurement on neonates, to establish the content validity of the toolkit, and to make recommendations for implementation of the toolkit. The format applied was the Kellogg Logic Model that proceeded from the assumption, to planned work, and results. The theoretical framework was Roger's Diffusion of Innovations, which identifies champions as the initial change agents, helps engage the staff, and facilitates the change. The project consisted of a two-phase process. Phase 1 was the development of the toolkit contents by integrating the evidence and applying the framework in the context of working nurses. Phase 2 was the validation of the toolkit by expert nurses and educators with Item-CVI ranging from 0.80 to 1.00 and the scale-CVI at 0.98. The Toolkit for Implementation of Temporal Artery Thermometers for Neonates with three short video presentations was validated. The toolkit is shared on multiple webpages and is available to the public. Adopting the temporal artery thermometer for routine temperature measurement could be a new standard for temperature monitoring that is accurate and fast. Improved family satisfaction would result from a quicker temperature process and a less invasive method resulting in a more comfortable experience for their infant.