This dissertation contains two secondary quantitative data analyses studies. In the first, implementation of the WannaBee Healthy? Be Smart! Be Active! Be a Leader! health science curriculum was examined to expand understanding about teacher usage of an integrated health curriculum. Specifically, researchers assessed the amount of activities within each curriculum domain (i.e., books, creative expressions, language/literacy, math, science) and the number of activities within each theme of the lessons (i.e., nutrition, physical activity, sleep) utilized by participating teachers. Prior to implementation, teachers (N = 68; M age = 35.5 years old) attended a one-hour training where use of the curriculum and supplemental material toolkit were exhibited. Participants were instructed to implement the curriculum over the course of a month and directed to record lessons implemented on a teacher usage checklist, indicating a “Y+” if they taught the lesson and would likely teach it again, a “Y-” if they taught the lesson, but would not likely teach it again, and an “N” if the lesson was not implemented. An overall total number of activities and a total number of activities within each curriculum domain (e.g., language/literacy) and within each theme (e.g., nutrition) was calculated using a frequency analysis. Results show that more than 20% of reporting teachers (n = 10; 21.8%) implemented all or almost all (i.e., 49 or 50 lessons) of the curriculum’s 50 activities. Children had more exposure to the book domain and the theme of nutrition, with less engagement in the domain of math and sleep-themed lessons. Based on the results of the first study, the second study examined the association between the dosage of the WannaBee Healthy? curriculum implementation within each classroom (i.e., frequency use of curriculum domains; frequency use of lesson themes) and child health knowledge outcomes (e.g., USDA MyPlate accuracy). Explicitly, is the dosage and type of content implementation directly associated with student’s gain in knowledge and the ability to successfully identify the following: (1) food from each of the five food groups, (2) healthy plate that includes all recommended food groups, (3) food origins, (4) four activities that increase heart rate, and (5) sleep, healthy plate, and physical activity as behaviors needed to keep our body healthy. Researchers utilized the information from the teacher usage checklist to determine dosage and content implementation of lessons. Pre- and post-assessments were randomly conducted on 252 pre-kindergarten (17.9%) and kindergarten (82.1%) students (M age = 5.02) whose parents had provided consent. Pearson correlations identified strong, positive correlations regarding implementation across the curriculum and within the domains and themes. A series of One-way ANOVAs were conducted, identifying a significance in outcomes of at least one child assessment and in both health themes (i.e., nutrition, physical activity). However, overall findings indicate that curriculum dosage alone was not related to changes in child health knowledge. Further testing did not show a significant difference in association between changes in child knowledge when controlling for time between pre- and post-assessments. Results suggest the effectiveness of the WannaBee Healthy? curriculum is not based on curriculum alone.

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Made available in DSpace on 2016-12-06T17:07:14Z (GMT). No. of bitstreams: 1 Leandro A Romansini.pdf: 912075 bytes, checksum: 736f7fa9636f40a34923d636f8e715cd (MD5) Previous issue date: 2007-08-22 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This is a descriptive research that had as objective to investigate the habits of health, the body composition, the physical aptitude related to the health and to the motor acting of scholar of both sexes, in the age group from 12 to 14 years old, participants of the 24th edition of the School Games of Santa Catarina (JESC). The participants of the study were 431 school-athletes selected in the database of PROESP/SC. The health habits (physical activity, alimentary habits and consumption of alcohol and tobacco) were collected with adapted instrument of the Global School-Based Student Health Survey GSHS questionnaire, the antropometric measures of body composition were weight, stature and skin folds (triciptal and sub scapular), and the variables of physical aptitude related to the health and to the motor acting followed the protocol proposed by PROESP/SC. To analyze the data the descriptive statistic was used, the test "t" of Student for independent samples, with significance level of p<0,05, and analysis of multivaried variance (MANOVA) with post hoc of Scheffe. The results presented that 36,8% of the sample were considered physically active. The most preoccupying sedentary behavior was the spent time watching TV, in a typical day, where 60,5% of the sample told more than two hours watching TV each day, however in a general way most of them was not exposed to sedentary behaviors. The scholars' proportion that didn't reach the minimum frequency of fruit and vegetable consumption was high, 73,1% and 85,3% respectively. A small proportion told an inadequate consumption of candies and salted except for the soda (50%). In relation to the use of cigarettes and alcohol, the proportion didn't reach 5% of the scholars. The girls presented larger averages in the percentile of fat, adds of the skin folds and fat body mass, while the boys presented a larger thin body mass. In relation to the physical aptitude related to the health (ApFRS), the boys presented larger averages in the cardio respiratory aptitude and in the abdominal resistance while the girls were better in the flexibility. Most of them were classified inside or above the criteria for health. In the physical aptitude related to the motor acting (ApDM) the boys were superior in all the variables (force of inferior members, force of superior members, agility and speed) and most of the scholars were classified with a good motor acting. Then, it s possible to note that the scholars have good health habits, an appropriate body composition for the health and great levels of ApFRS and ApDM, suggesting that the cultural factors and the practice of sports extra-class can influence positively in the behaviors related to the health and for a good physical aptitude. / Esta é uma pesquisa descritiva que teve como objetivo investigar os hábitos de saúde, a composição corporal, a aptidão física relacionada à saúde e ao desempenho motor de escolares de ambos os sexos, na faixa etária dos 12 aos 14 anos, participantes da 24ª edição dos Jogos Escolares de Santa Catarina (JESC). Os participantes do estudo foram 431 escolares-atletas selecionados junto ao banco de dados do PROESP/SC. Os hábitos de saúde (atividade física, hábitos alimentares e consumo de álcool e tabaco) foram coletados com instrumento adaptado do questionário Global School-Based Student Health Survey GSHS, as medidas antropométricas de composição corporal foram o peso, estatura e dobras cutâneas (tricipital e subescapular), e as variáveis de aptidão física relacionada à saúde e ao desempenho motor seguiram o protocolo proposto pelo PROESP/SC. Para análise dos dados foi utilizada a estatística descritiva, o teste t de Student para amostras independentes, com nível de significância de p<0,05, e análise de variância multivariada (MANOVA) com post hoc de Scheffe. Os resultados apresentaram que 36,8% da amostra foram considerados ativos fisicamente. O comportamento sedentário mais preocupante foi o tempo gasto assistindo TV, em um dia típico, onde 60,5% da amostra relataram mais de duas horas de assistência a TV por dia, porém de maneira geral a maioria não estava exposta aos comportamentos sedentários. A proporção de escolares que não atingiram a freqüência mínima de consumo de fruta e vegetais foi elevada, 73,1% e 85,3% respectivamente. Uma pequena proporção relatou um consumo inadequado de doces e salgados com exceção do refrigerante (50%). Quanto ao uso de cigarros e álcool, a proporção não chegou a 5% dos escolares. Com relação aos indicadores de composição corporal, as meninas apresentaram maiores médias no percentual de gordura, soma das dobras cutâneas e massa corporal gorda enquanto os meninos uma maior massa corporal magra. Quanto a aptidão física relacionada à saúde (ApFRS) os meninos apresentaram maiores médias na aptidão cardiorespiratória e na resistência abdominal enquanto as meninas foram melhores na flexibilidade. A maioria foi classificada como dentro ou acima dos critérios para saúde. Na aptidão física relacionada ao desempenho motor (ApDM) os meninos foram superiores em todas as variáveis (força de membros inferiores, força de membros superiores, agilidade e velocidade) e a maioria dos escolares foram classificados com um bom desempenho motor. Conclui-se que os escolares possuem bons hábitos de saúde, uma composição corporal adequada para a saúde e ótimos níveis de ApFRS e ApDM, sugerindo que os fatores culturais e a prática esportiva extra-classe possa influenciar positivamente nos comportamentos relacionados à saúde e para uma boa aptidão física.

Sammanfattning Syftet med denna kvalitativa interventionsstudie var att undersöka hur anställda med stillasittande kontorsarbete upplever hälsocoaching med fokus på fysisk aktivitet och stillasittande. Arbetet har utgått från följande tre frågeställningar: ·      Vilka fördelar upplever de anställda med hälsocoachinterventionen på arbetsplatsen? ·      Vilka faktorer i hälsocoachinterventionen upplever de anställda som stöttande för att upprätthålla hälsosamma vanor på arbetsplatsen?  ·      Vilken roll upplever de anställda att en hälsocoach på arbetsplatsen kan ha för deras hälsovanor?   Semistrukturerade intervjuer genomfördes med samtliga sju deltagare/anställda med stillasittande kontorsarbete, för att undersöka hur de upplevt hälsocoachinterventionen på arbetsplatsen.   Kvalitativ innehållsanalys användes för att analysera datainsamlingen. Resultatet besvarar studiens forskningsfrågor enligt följande teman: Fördelar: En arena för hälsofrågor, Hälsocoachens breda kunskap, Individuellt samtal på de anställdas arbetsplats.  Stöttande faktorer: Hälsocoachingens individanpassning, Styrkan med målsättning. Hälsocoachens roll: Förebyggande roll, Holistisk roll, Pushande och stöttande roll.    Slutsatsen som dras i denna interventionsstudie är att anställda med stillasittande kontorsarbete upplever både fördelar och stöttande faktorer i hälsocoachinterventionen för att upprätthålla hälsosamma vanor på arbetsplatsen. De har därmed en positiv upplevelse av hälsocoachinterventionen på arbetsplatsen. De uttrycker att det finns ett stort behov av fortsatt hälsocoaching som kan integreras på fler arbetsplatser. De anställda upplever att hälsocoachen kan ha både en förebyggande-, holistisk, stöttande och pushande roll, för deras hälsovanor på arbetsplatsen. / Abstract The purpose of this qualitative intervention study was to investigate how employees with sedentary office work experience health coaching with a focus on physical activity and sedentary behavior. The work has been based on the following three questions: • What benefits do the employees experience with the health coach intervention in the workplace? • Which factors in the health coach intervention do the employees perceive as supportive in maintaining healthy habits in the workplace? • What role do employees feel that a workplace health coach can have for their health habits?   Semi-structured interviews were conducted with all seven participants/employees with sedentary office work, to investigate how they experienced the health coach intervention at the workplace.   Qualitative content analysis was used to analyze the data collection. The results answer the study's research questions according to the following themes: Advantages: An arena for health issues, The health coach's broad knowledge, Individual conversation at the employees' workplace. Supporting factors: Individual adaptation of health coaching, Strength with goal setting. The health coach's role: Preventive role, Holistic role, Pushing and supporting role.   The conclusion drawn in this intervention study is that employees with sedentary office work experience both benefits and supportive factors in the health coach intervention to maintain healthy habits in the workplace. They thus have a positive experience of the health coach intervention in the workplace. They express that there is a great need for continued health coaching that can be integrated in more workplaces. The employees feel that the health coach can have both a preventive, holistic, supportive and pushing role for their health habits in the workplace.

Abstract The aim of this study was to evaluate the association between dental fear and dental attendance, oral health habits and dental condition. A further aim was to study the association between subjective oral impacts and dental fear. The nationwide two-stage stratified cluster sample (n=8028) represented Finnish adults aged 30 years and older. The data were collected in interviews, with questionnaires and at clinical dental examinations. Dental fear was measured with the question: “How afraid are you of visiting a dentist?” and subjective oral impacts with the OHIP-14 questionnaire. Multiple logistic regression analyses were used to determine the association between dental fear and dental attendance, oral health habits, dental condition and subjective oral impacts, taking into consideration the possible confounding and/or modifying factors (e.g. age, gender and education). Of Finnish adults aged 30 years and older, 10% were very afraid and 30% somewhat afraid of visiting a dentist. Those with high dental fear were more likely to report subjective oral impacts than were those with lower fear. Age modified the effect of the association between dental fear and dental attendance, oral health habits and dental condition. Among all age groups, except the 30- to 34-year-olds, irregular attenders were more likely to be very afraid of visiting a dentist than regular attenders were. Dental condition was also poorer among those with high dental fear than among those with lower fear. The association between dental fear and number of decayed teeth was positive in all age groups. Among the age group 65+ years, the numbers of missing and sound teeth were positively, and among the age group 30-34 years negatively, associated with dental fear. Among the age group 65+years, those who brushed their teeth less than twice a day were more likely to have high dental fear than were those who brushed at least twice a day. Regular smokers were more likely to have high dental fear than were those who smoked occasionally or not at all. Dental fear is very common among adults in Finland. Because those with dental fear use dental services irregularly, they are likely to need emergency care. However, those for whom oral health services have been provided regularly since childhood seem to continue to use these services regularly in spite of high dental fear. Dental teams should be aware of the increased oral health risks that smoking, irregular attendance and poor tooth-cleaning habits cause among those with dental fear. Treating dental fear could have positive effects on subjective oral impacts by reducing psychological and social stress as well as improving regular dental attendance and oral health. Birth cohort or age should be taken into account when associations between dental fear and dental attendance, oral health habits and dental condition are studied. / Tiivistelmä Tutkimuksen tarkoituksena oli selvittää hammashoitopelon ja hammashoitopalveluiden käytön, suunterveyteen liittyvien tapojen sekä hammasterveyden välisiä yhteyksiä. Tavoitteena oli myös tutkia suunterveyteen liittyvien ongelmien yhteyttä hammashoitopelkoon. Kaksivaiheinen ryvästetty otos (n=8028) edusti suomalaista 30 vuotta täyttänyttä väestöä. Tutkimuksessa käytetty tieto koottiin haastattelujen, kyselyjen ja suun kliinisen tutkimuksen avulla. Hammashoitopelkoa selvitettiin kysymyksellä ”Onko hammaslääkärissä käynti mielestänne: ei lainkaan pelottavaa, jonkin verran pelottavaa, erittäin pelottavaa?” ja suun terveyteen liittyviä ongelmia OHIP-14-kyselyllä. Logististen regressioanalyysien avulla tutkittiin hammashoitopelon ja palveluiden käytön, suunterveyteen liittyvien tapojen ja ongelmien sekä hampaiden terveyden välistä yhteyttä huomioiden mahdollisia sekoittavia ja/tai vaikutusta muovaavia tekijöitä (mm. ikä, sukupuoli, koulutus). Suomalaisista aikuisista 10 % pelkäsi hammashoitoa kovasti ja 30 % jonkin verran. Kovasti hammashoitoa pelkäävät raportoivat suunterveyteen liittyviä ongelmia useammin kuin vähän tai ei lainkaan pelkäävät. Ikä vaikutti siihen, millainen yhteys oli hammashoitopelon ja hammashoitopalvelujen käytön, suun terveyteen liittyvien tapojen ja hammasterveyden välillä. Kaikissa muissa ikäryhmissä paitsi ikäryhmässä 30–34 epäsäännöllisesti hoidossa käyvät pelkäsivät hammashoitoa todennäköisemmin kuin säännöllisesti hoidossa käyvät. Kovasti pelkäävillä oli myös huonompi hammasterveys kuin vähemmän pelkäävillä. Kaikissa ikäryhmissä kovasti hammashoitoa pelkäävillä oli useampia reikiintyneitä hampaita kuin jonkin verran tai ei lainkaan pelkäävillä. Poistettujen hampaiden lukumäärän lisääntyessä kovan hammashoitopelon todennäköisyys pieneni ikäryhmässä 30–34 ja kasvoi ikäryhmässä 65+. Näissä ikäryhmissä sama ilmiö oli havaittavissa myös terveiden hampaiden lukumäärän muuttuessa. Ikäryhmässä 65+ hampaansa harvemmin kuin kahdesti päivässä harjanneet pelkäsivät hoitoa todennäköisemmin kuin vähintään kahdesti päivässä harjanneet. Säännöllisesti tupakoivat pelkäsivät hammashoitoa todennäköisemmin kuin epäsäännöllisesti tai ei lainkaan tupakoivat. Hammashoitopelko on yleistä Suomessa. Koska pelkäävät käyvät hoidossa epäsäännöllisesti, hammaslääkärit kohtaavat pelkääviä potilaita usein akuuttivastaanotolla. Ne, jotka ovat tottuneet hammashoitopalveluiden säännölliseen käyttöön lapsuudesta alkaen, näyttävät jatkavan palveluiden säännöllistä käyttöä pelosta huolimatta. Hammashoitotiimien tulee huomioida hammashoitoa pelkäävien epäsäännöllisen hoidossa käymisen, puutteellisten kotihoitotottumusten ja tupakoinnin suunterveydelle aiheuttama kohonnut riski. Hammashoitopelon hoitamisella olisi positiivisia vaikutuksia suunterveyteen liittyvään elämänlaatuun, koska pelon hoito vähentää psykologista ja sosiaalista stressiä, lisää säännöllistä hoidossa käyntiä ja parantaa suun terveyttä. Syntymäkohortti tai ikä pitää huomioida tutkittaessa hammashoitopelon yhteyttä hammashoitopalveluiden käyttöön, suunterveyteen liittyviin tapoihin ja hammasterveyteen.

Un peu plus de 2 % de la population québécoise est membre des Premières Nations. Malgré les efforts investis dans la promotion de la santé et la prévention de la maladie, une majorité d’entre eux souffrent de multiples maladies chroniques. Par ailleurs, le récent rapport de la Commission d’enquête sur les relations entre les Autochtones et certains services publics (CERP, 2019) a mis en lumière les barrières culturelles et les problèmes d’accès aux services de santé. La présence simultanée de ces enjeux, reliée notamment à certaines habitudes de vie et à l’accès aux soins, justifie la pertinence de mieux comprendre l’état de la situation. L'objectif général de ce projet doctoral est d’examiner les habitudes de vie et les services de santé offerts aux Premières Nations de la région de la Mauricie et Centre-du-Québec. Réalisé à l’aide d’un devis de recherche mixte (questionnaires et entretiens semi-dirigés), ce projet doctoral comporte trois sous-objectifs : (1) dresser un portrait des comportements alimentaires et d’activités physiques des Autochtones à l’aide d’un examen de la portée (étude 1); (2) explorer les comportements alimentaires et d’activités physiques des personnes issues des Premières Nations et les significations qui y sont associées (études 2a et 2b); et (3) examiner l’autoperception de la compétence culturelle des infirmières travaillant auprès de la clientèle autochtone (étude 3). Considérant l’aspect holistique de la santé, le cadre conceptuel qui oriente ce projet est celui du ministère de la Santé et des Services Sociaux (MSSS) portant sur la santé et ses déterminants, avec ces cinq catégories : le contexte global, les systèmes, les milieux de vie, les caractéristiques individuelles et l'état de santé de la population. Les résultats de l’étude 1 de cette thèse soulignent la transition alimentaire des Autochtones du Canada par une diminution de la consommation d’aliments traditionnels, qui renvoie à une baisse de la qualité nutritionnelle. Il y a également une pratique régulière d’activités physiques, malgré la présence de nombreuses barrières associées à l’environnement physique, économique et politique En ce qui concerne l’étude pilote 2a et son déploiement 2b, l’alimentation traditionnelle est apparu comme une constituante importante du menu, mais parfois difficilement disponible. Un écart est observé entre les recommandations du Guide alimentaire canadien (version Premières Nations, Inuit et Métis) et la réalité des participants, notamment quant à la consommation de fruits et légumes. Pour sa part, la pratique d’activités physiques des Premières Nations à l’étude est comparable à l’ensemble de la population québécoise. Aussi, les significations associées à ces deux habitudes de vie sont imprégnées d’une vision holistique, soit l’équilibre entre les aspects physiques, émotionnels, psychologiques et spirituels. Enfin, en ce qui concerne les résultats de l’étude 3, les infirmières du département de l’urgence, en centre hospitalier, qui agissent souvent en première ligne, se sentent moins confiantes dans leurs habiletés d’aborder certains aspects de la santé avec la clientèle autochtone et pour cause, la formation initiale sur ce sujet semble peu développée. Ce projet doctoral offre donc une meilleure compréhension des habitudes de vie et des services de santé offerts aux Premières Nations de la Mauricie et Centre-du-Québec. L’originalité du projet repose sur sa méthodologie mixte, l’implication de collaborateurs autochtones et la diversité des participants, résidant à la fois dans des communautés territoriales et des milieux urbains. Enfin, sa pertinence s’appuie sur les inégalités de santé vécues par les Autochtones, l'importance des compétences culturelles à développer et maintenir chez les professionnels de la santé, de même que l’importance sociale de ce sujet, qui est directement en lien avec les priorités actuelles de recherche et même politiques. / First Nations people comprise just over 2% of the Quebec population. Despite the effort invested in health promotion and disease prevention, a majority of them suffer from multiple chronic diseases. Moreover, the recent Public Inquiry Commission (2019) report on relations between Indigenous peoples (First Nations, Métis and Inuit) and certain public services in Quebec highlights the cultural barriers and problems Indigenous people encounter when accessing health services. The simultaneous presence of these concerns, which are related to particular lifestyle habits and access to care, justify the relevance of seeking a better understanding of the situation. The general objective of this doctoral project is to examine lifestyle habits and health services offered to the First Nations people of the Mauricie and Centre-du-Québec region. Conducted using a mixed research design (questionnaires and semi-structured interviews), this doctoral project has three sub-objectives: (1) to draw a portrait of Indigenous people’s eating behaviours and physical activities (study 1), (2) to explore the eating and physical activity behaviours of First Nations people and the meanings associated with them (studies 2a and 2b), and (3) to examine the self-perceptions of cultural competence among nurses working with Indigenous clientele (study 3). Considering the holistic aspect of health, the conceptual framework guiding this project is that of the Ministry of Health and Social Services of Quebec (MHSSQ) on health and its determinants using five categories: the global context, systems, living environments, individual characteristics and the health status of the population. Two-eyed seeing and cultural safety are also concepts that guides the entire research process. In this thesis, the results of study 1 emphasize the dietary transition of Indigenous people in Canada through a decrease in the consumption of traditional foods, which is related to a decrease in nutritional quality. Also, there is regular physical activity, despite the presence of many barriers associated with the physical, economic and political environment. In the pilot study 2a and its deployment 2b, traditional food appeared to be an important component of the menu, but sometimes difficult to obtain. A gap was observed between the recommendations of Canada's Food Guide (First Nations, Inuit and Métis version) and the reality of the participants, particularly with regard to the consumption of fruits and vegetables. While the physical activity level of the First Nations in the study is comparable to that of the general Quebec population. Also, the meanings associated with these two lifestyle are imbued with a holistic vision, namely, the balance of physical, emotional, psychological and spiritual elements. Then, with respect to the results of study 3, nurses in hospital emergency departments, who are often an individual’s first contact with health services, lack confidence in their ability to address particular aspects of health with Indigenous clientele. This is understandable, as initial training for nurses on this issue does not seem to be well developed. This doctoral project provides a better understanding of the lifestyle habits of First Nations people in the Mauricie and Centre-du-Québec region and the health services offered to them, and it may increase awareness of this clientele’s the region’s health issues among staff in the area’s health networks. Its originality is derived from its mixed methodology, the involvement of First Nations patients as partners and the diversity of the First Nations participants who reside in both territorial communities and urban settings. Finally, its relevance is based on the health inequalities experienced by Indigenous people, the importance of developing and maintaining cultural competencies among health care professionals and the high social relevance of its topic, which is directly related to current research and even political priorities.