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<p>Ontario’s Regional Cancer Programs provide an organized system of adjuvant treatment and follow-up care in its 13 Regional Cancer Centres. For breast cancer patients in particular, these centres become a part of daily activities, as appointments over five years of cancer care result in patients repeatedly accessing these centres at varying frequencies over their treatment periods. The experience of seeking out and receiving care has grown to incorporate cancer care services that exist on a variety of spatial scales, in both formal and informal environments (e.g. support groups, workshops). This study focuses on the role of geography in health behaviors and care experiences of breast cancer patients. Individual interviews were conducted with patients (<em>n=</em>23) attending the Juravinski Cancer Centre in Hamilton, Ontario about their care experiences in their community, and the location and organization of the centre. Rosenstock’s (1966) health belief model and Bandura’s (1986) social cognitive theory informed the analysis of patient satisfaction and produced attitudes that impact the likelihood of health action. Results demonstrated that patients were generally satisfied with their interactions with health care providers and the design and location of the centre. Parking and perceived disconnect between the centre and community health care providers (e.g. family doctors) were identified as being sources of patient dissatisfaction. Patients made sense of their care experience through ‘routinization’ – fixed times and predictable intervals – of travel and appointment schedules. Satisfaction with accessibility to health care providers when at home (e.g. call-in services) appeared to impact at-home adherence to medication and suggested lifestyle changes. Uptake of community support services depended on patient perceptions of need, suitability and proximity, but went largely unused. Patients’ understanding of their care experiences highlight the need to give greater consideration to geography and the physical care environment in the future planning of breast cancer care services.</p> / Master of Arts (MA)

Drywall finishing operations have been associated with worker exposure to dust that contains known particulate respiratory health hazards, such as silica, talc, and mica. Despite the existence of engineering, work-practice, and personal-protective-equipment (PPE) control technologies for the mitigation of this hazard, worker exposures persist in the drywall finishing industry. This research employed a macroergonomic framework to evaluate this problem and identify barriers to dust control technology adoption in the key subsystems: personnel, technological, and organizational. In the first study, the organizational subsystem was evaluated through a telephone interview of 264 drywall finishing firm owners. This study found the most commonly used dust control technology was respiratory protection. Cost, usability, environmental factors, and productivity were barriers identified in preventing adoption of other technologies. In the second study, of the technological subsystem, 16 participants performed simulated drywall finishing tasks with each of four methods, in a laboratory setting. Dust particles were monitored and compared among the technologies used. Participants performed usability evaluations of the four tools. The ventilated sander produced less respirable-size class dust than did the other three tools. The block sander produced more dust than the other three tools. Usability evaluations revealed that the block sander was easiest to learn, easiest to use, and perceived to be the best overall, while the wet method and pole sander were considered to have poor usability in terms of ease of use and productivity. Usability problems associated with perceived comfort and ease of use were identified for the ventilated sander, but it was tied for "overall best" with the block sander. The third study, of drywall finishing worker perceptions, employed the Health Belief Model to assess barriers to technology adoption, risk, susceptibility, and benefits. Results showed that workers have a high perception of the risk associated with drywall dust, but a lower perception of individual susceptibility to disease as a result of occupational exposure. Barriers to the use of dust control technologies were identified as being associated with organizational and usability factors. Most participants indicated having access only to respiratory protection, among the available dust control methods. / Ph. D.

Despite the well-established effectiveness of couple therapy for reducing distress and improving relationship satisfaction (Cohen, 1988; Christensen and Heavey, 1999), less than a fourth of couples seek couple therapy prior to divorce (Albrecht, Bahr, and Goodman, 1983; Wolcott, 1986). Rather, the majority of couples wait over 5 years before seeking therapy (Johnson et al., 2002). Barriers to seeking individual therapy are well established and are associated with decreased rates of therapy attendance and the negative consequences of untreated distress and mental health problems (Corrigan, 2004; Killaspy, Banerjee, King, and Lloyd, 2000; Vogel, Wade and Hackler, 2007). It is unclear as to whether the same barriers exist for individuals who are seeking couple therapy. This study examined the applicability of the Health Belief Model (HBM; Rosenstock, 1966), with the addition of demographic characteristics (gender, income, education, and religion) and contextualizing individual factors (relational distress and perceived stigma), to predict an individual in a committed relationship's (N =158) motivation to seek couple therapy. When controlling for demographic variables and contextualizing factors, the Health Belief Model factors of lower barriers and lower benefits were predictive of higher motivation to seek couple therapy. Throughout all iterations of the model, lower income and lower relational distress were also associated with higher rates of motivation to seek couple therapy. This research indicates that barriers, including high levels of relational distress, impact an individual's motivation to seek couple therapy. Further investigation of the application of the HBM factors to mental health, including research into more systemic measurements of these factors, is needed. Future research should also identify other potentially contextualizing factors, as the overall model accounted for a relatively small amount of variation in the individual's motivation to seek couple therapy. / Ph. D. / Couple therapy has been shown to provide relief for relationship distress and individual mental health problems (Cohen, 1988; Christensen & Heavey, 1999). Despite this, the majority of couples choose to either live with relationship distress prior to seeking couple therapy or never seek treatment prior to getting divorced (Albrecht, Bahr, & Goodman, 1983; Gottman & Gottman, 2013; Johnson et al., 2002; Wolcott, 1986). Unfortunately, very little is known about the reasons couples avoid couple therapy; therefore, this research is based on the established barriers found in the literature on why individuals do not seek mental health treatment. Because of the inclusion of an established help-seeking theory, known as the Health Belief Model (HBM; Rosenstock, 1966), the results of this study can more broadly inform individuals, couples, therapists, and policy makers about the reasons individuals may not seek couple therapy. An online survey of 158 couples indicated that higher levels of relationship satisfaction, lower income levels, lower perceived benefits to couple therapy, and lower perceived barriers to accessing treatment were associated with higher motivation to seek couple therapy. Overall, research should continue to examine the application of the Health Belief Model constructs (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action) to mental health seeking behavior, especially couple and family therapy. Research should also identify other potential constructs, beyond those used in this study (gender, income, education, religion, self-stigma, and relational distress), that impact an individual’s motivation to seek couple therapy.

Virginia's temperate climate is suitable for several mosquito species capable of transmitting pathogens to humans. In southwest Virginia, La Crosse encephalitis and West Nile fever are most prominent. The objective of this research, which uses the Health Belief Model (HBM) as a theoretical framework, is to assess knowledge of mosquito-borne disease in southwest Virginia, as well as perceptions and practices of mosquito prevention. Given that several cases of La Crosse encephalitis have been reported in Wise and Tazewell counties, they were selected as study sites to conduct surveys. Five demographic and socioeconomic variables (gender, age, income, education level and length of time one has lived in the county) were used as predictor variables in logistic regression analyses. Gender, age, and length of residence time in the county were found to be statistically significant predictors of specific health-related behaviors. Within the framework of the HBM, barriers to removing standing water around the home and wearing insect repellent were highlighted. Knowledge of mosquito-borne diseases within the area was generally low, with only one individual correctly identifying La Crosse encephalitis as a threat in the region. Higher numbers (6%) were aware of West Nile virus, while 4% reported malaria in the region, demonstrating a disconnect between actual and perceived risk. These results can enhance existing public health programs by increasing knowledge, addressing public uncertainty about insect repellent safety, and addressing ways to make recommended practices more effective with the knowledge of how different aspects are perceived by varying groups within the community. / Master of Science

This study used the Health Belief Model to examine the effects of viewing valenced levels of consequences of sexual decision found in prime time television programs. When exposed to portrayals of negative consequences, participants had higher levels of perceived severity than those in the positive condition. After viewing positive portrayals, participants perceived an increased amount of benefits of behavior modification when compared to those who were exposed to the negative portrayals. In addition, multiple correlations were found between several individual-level variables that were tested for in the study and the HBM constructs. Theoretical implications and practical implications are discussed. / Master of Arts

<p>Syftet var att undersöka fyra hälsovägledares uppfattningar och strategier för att motivera individer till viktminskning. Avsikten var även att utreda vad de bygger sina uppfattningar och strategier på, samt att jämföra deras strategier med befintliga teorier om beteendeförändring såsom Motiverande samtal, Stages of change, Social learning theory och Health belief model. Teorierna valdes då de belyser hur en beteendeförändring kan gå till samt att de varit fram­gångsrika i tidigare forskning. Studien är kvalitativ och genomfördes med ostrukturerade intervjuer där respondenterna valdes genom ett bekvämlighetsurval. De fyra hälsovägledarna arbetade med att motivera individer till viktnedgång, alla hade utbildning inom hälso­främjande arbete som varierade mellan en vecka till flera år. Resultatet visade på att hälso­vägledarna använder sig av befintliga teorier samt av strategier som bygger på deras utbildning och egna erfarenheter. De förändrar sin arbetsmetod efterhand som de får ny kunskap samt då de reflekterar över sitt arbetssätt, vilket tyder på att de är reflekterande praktiker.</p>

Syftet var att undersöka fyra hälsovägledares uppfattningar och strategier för att motivera individer till viktminskning. Avsikten var även att utreda vad de bygger sina uppfattningar och strategier på, samt att jämföra deras strategier med befintliga teorier om beteendeförändring såsom Motiverande samtal, Stages of change, Social learning theory och Health belief model. Teorierna valdes då de belyser hur en beteendeförändring kan gå till samt att de varit fram­gångsrika i tidigare forskning. Studien är kvalitativ och genomfördes med ostrukturerade intervjuer där respondenterna valdes genom ett bekvämlighetsurval. De fyra hälsovägledarna arbetade med att motivera individer till viktnedgång, alla hade utbildning inom hälso­främjande arbete som varierade mellan en vecka till flera år. Resultatet visade på att hälso­vägledarna använder sig av befintliga teorier samt av strategier som bygger på deras utbildning och egna erfarenheter. De förändrar sin arbetsmetod efterhand som de får ny kunskap samt då de reflekterar över sitt arbetssätt, vilket tyder på att de är reflekterande praktiker.