Thesis (Ph. D.)--University of Rhode Island, 2004. / Typescript. Includes bibliographical references (leaves 220-231).

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This thesis is an investigation of the self-reported health behaviour changes made by adults in the Canadian Community Health Survey 2007, categorized by BMI category. Descriptive analyses and forward stepwise regression were performed to determine variables associated with HBC. The final sample n = 111,449. Overall, 58% of individuals had made a HBC in the past year. Increased exercise was the most common HBC (29%), followed by improved eating habits (10%) and losing weight (7%). Only 51% experienced barriers to HBC; lack of will power was most commonly cited. Overweight and obese individuals were more likely to undertake HBC. In the regression model, opinion of own weight was the strongest predictor of HBC, followed by fruit and vegetable consumption, number of consultations with doctor, smoking status, and perceived health.

In medical settings, a teachable moment (TM) has been described as an event which may lead to psychological changes prompting individuals to engage in health promoting behaviors. A cancer screening (CS) has been suggested as a potential TM because several types of positive health behavior change (HBC), ranging from dietary changes to smoking cessation, have been linked to CS. However, most research has examined the TM in CS settings using cross-sectional and prospective methodologies and has lacked a theory-driven model. Moreover, few intervention studies have attempted to capitalize on the potential TM in CS settings. In light of this, the primary purpose of this study was to examine the potential for routine ovarian CS to serve as a TM to enhance the potential for HBC using a theory-driven conceptual model of a TM. A prospective, longitudinal design was used to track changes in positive affect, self-efficacy (SE), HBC intentions and HBC following participation in routine ovarian CS. The impact of a brief, written intervention intended to enhance SE to engage in HBC was also examined. There were three total study assessments: the baseline (T1), 24-hour follow-up (T2), and one month follow-up (T3) assessment. Results indicated positive affect and positive consequences of screening increased over time (p’s<.01) and increases in positive affect were positively associated with greater healthy diet HBC. Additionally, greater positive consequences of screening at T2 predicted greater exercise HBC. No significant changes were observed in exercise or healthy diet intentions over time; there were no differential effects based upon the intervention for positive affect, SE, HBC, or HBC intentions (p’s>.05). Healthy diet SE and exercise SE remained stable (p>.05) but were found to be a robust predictor for both exercise and healthy diet HBC intentions. While several of our hypotheses were supported, the brief health information intervention did not appear to impact SE, HBC intentions, or actual HBC. To better equip health providers in CS settings, studies should continue examining both the potential for CS settings to serve as a TM to enhance HBC and how receipt of a normal test result impacts this potential.

Like other adults in the U.S., college students, have high rates of obesity and overweight, and they have a pattern of poor diet and physical inactivity. Emerging adulthood is a key developmental period for building life-long habits and behaviors, and health theory suggests that one’s social environment and amount of social support affects health behaviors, particularly among women. With the technological advances of Web 2.0, or social media, the opportunity for providing social support for health behaviors through the online social environment now exists; social media is a game changer for both research and practice related to understanding the social environment. The purpose of this descriptive qualitative study was to describe the ways in which social networking sites (SNS) provide college females with social support for their diet and/or physical activity goals. The social cognitive theory and previous research on the construct of social support, provided a conceptual framework for this study. With a purposive sample of 12 college females, data from three sources were collected over the course of four weeks. Journal responses and daily observations of each participant’s social networking site activity via Facebook, Instagram, Twitter and Pinterest were collected the first three weeks, and interviews were conducted the fourth week. Qualitative analysis was conducted at both the participant and group level, and results inform how the women engage with the topics of diet and physical activity during their daily SNS usage the ways in which their SNS experience provides them with support for diet and/or physical activity goals. Of the five functional measures of social support, participants most often indicated receiving emotional support, informational support and validation support from SNS usage. The findings of this study highlight current social media practices in college females, which can better inform the planning and implementation of health behavior programs that include an online, social component. Furthermore, the results serve to highlight examples of social support naturally occurring in the online environment, thereby adding to the body of literature about ways in which social support influence health outcomes.

OBJECTIVE: The Theory of Planned Behavior (TPB) and implementation intentions have been used effectively to explain and influence diet in middle-class, but not exclusively low SES populations. Furthermore, dietary research among low SES populations requires intake measures that are feasible and acceptable. Using three lines of research we evaluated 1) the utility of the TPB to explain fruit and vegetable (FV) intake, 2) efficacy, feasibility and acceptability of an implementation intention intervention to improve FV intake, and 3) agreement, feasibility, and acceptability of 2 dietary intake measures of FV intake in low SES women. DESIGN: Participants were adult female residents of Boston Public Housing. Study 1: Using a cross-sectional survey (n=144), we evaluated the utility of the TPB to explain FV intake. Study 2: We conducted a pilot randomized controlled implementation intention intervention to promote FV intake (n=20), and semi-structured interviews to evaluate feasibility and acceptability of the intervention (n=8). Study 3: We administered 2 24-hour recalls, a food frequency questionnaire (FFQ), and structured interviews (n=36) to determine agreement, feasibility and acceptability dietary intake measures. RESULTS: Study 1: The TPB construct perceived behavioral control significantly predicted intention to consume FV (OR=2.55,95%CI:1.23,5.27) and with BMI, FV intake (βPBC=0.37,t(1)=2.29,p=0.0235; βBMI= -0.02,t(1)= -2.41,p=0.0174; R2=.08,F[2,130]=5.72,p=0.0042). Study 2: Feasibility goals were met for retention and days to follow up, but not recruitment. Participants characterized the intervention as enjoyable. Limited hypothesis testing showed no significant increase in mean FV intake within (control (n=11):+0.50, 95% CI:-0.56,1.58 servings; intervention (n=9):+0.17, 95% CI:-0.85,1.20 servings) or between groups (control group +0.33, 95% CI:-1.06,1.73 servings). Study 3: Feasibility targets were met for contacts and retention, but not for enrollment. There was no significant association between 24-hr recall and FFQ measures for fruit (r=0.32, p=0.09) or vegetable (r=0.16, p=0.40) intake and no marked preference for method (35% FFQ; 31% 24-hour recall). CONCLUSION: The TPB may be useful to explain FV intake. Although acceptable, an implementation intention intervention may not be feasible or effective to influence FV intake. We demonstrated limited feasibility and association but generally equal preference between dietary measures of FV intake in low SES women.

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