This research explores gender inequality in education, with a focus to examine the implications of gender disparities in schools on girls’ health and education. The study sought to investigate whether school management practices is a possible factor impacting the health behaviours of female students in senior secondary schools in Lagos, Nigeria. The study employed mixed methods design and gathered primary data in two consecutive phases, in line with sequential explanatory design. Data in Phase one was gathered through the use of questionnaire while phase 2 gathered primary data using semi-structured interviews to complement survey data. The sample frame included 2 public secondary schools, 42 students, 9 teachers, 1 vice principal and 2 principals. Quantitative data were analyzed using Statistical Package for Social Sciences (SPSS), while qualitative data were analyzed with help of ATLAS.ti. The findings of the study revealed school related barriers that influence high absenteeism and dropout among girls. Further findings also show the schools lack appropriate school management policies that promote healthful behaviours and encourage positive learning environment for girls. The researcher recommends leadership and school management training for school principals and their deputies, improving quality of health instruction in the curriculum, developing strict policy against school-related gender-based violence and adopting health-promoting policies.

Yes / Automated tools to speed up the process of evidence synthesis are increasingly apparent within health behaviour research, however, frameworks to evaluate the development and implementation of such tools are not routinely used. This commentary explores the potential of the Non-adoption, Abandonment, Scale-up, Spread and Sustainability framework (NASSS; Greenhalgh et al., 2017) for supporting automated evidence synthesis in health behaviour change by applying it to the ongoing Human Behaviour-Change Project, which aims to revolutionise evidence synthesis within behaviour change intervention research. To increase the relevance of NASSS for health behaviour change, we recommend i) terminology changes (‘condition’ to ‘behaviour’ and ‘patient’ to ‘end user’) and ii) a that it is used prospectively so that complexities can be addressed iteratively. We draw three conclusions about i) the need to specify the organisations that will use the technology, ii) identifying what to do if interdependencies fail and iii) even though we have focused on automated evidence synthesis, NASSS would arguably be beneficial for technology developments in health behaviour change more generally, particularly for invention development (e.g. for a behaviour change app).

Mental health problems are increasing in Swedish adolescents and mortality rates are higher in this age group than among younger. 10-20% of all adolescents suffer from a chronic medical condition (CC). Few protective factors (PF) and clustering of health-risk behaviours (HRB) are frequent among adolescents with CCs. One of the most common CC in Swedish adolescents is type 1 diabetes mellitus (T1DM). Metabolic control often deteriorates during adolescence, especially in girls. Poor metabolic control is associated with increased risk for long-term complications, of which cognitive problems are common. However, the implication of cognitive/executive problems in patients with T1DM has not been sufficiently studied. Neither has the impact of neurodevelopmental problems (NDP), such as ADHD, on HRB in adolescents with CCs been analysed. Methods: In paper I and II the questionnaire ”Life and Health in Youth” was distributed to all students in year nine and year two of the upper secondary school in the county of Sörmland, 2008 (n=5771) and 2011 (n=5550). Adolescents with CCs were compared to healthy peers with regard to PFs and HRBs. In paper III, the ”Five to Fifteen” questionnaire was used in 175 paediatric patients with T1DM. Patients with indications of NDPs were compared with patients without such problems with regard to metabolic control. In paper IV, the BRIEF questionnaire and the ADHD Rating Scale as well as data from the Swedish Childhood Diabetes Registry was used in 241 adolescents with T1DM. Patients with indications of executive problems were compared with patients without such problems with regard to diabetes control. Results: CCs were associated with few PFs and clustered HRBs. The combination of CCs and low numbers of PFs was found to be associated with an increased risk of clustered HRBs. In the presence of coexisting ADHD the pattern of few PFs and clustering of HRBs was aggravated. ADHD was more common among adolescents with other CCs. Definite memory and learning problems as well as mild executive problems were associated with poor metabolic control, especially among adolescents. Executive problems were also associated with many outpatient visits and low physical activity. Girls with T1DM tended to self-report executive problems to a larger extent than boys, while parents more often reported these problems in boys. Conclusion: Knowledge about factors influencing treatment adherence and life in general is essential in the work with chronically ill adolescents. Focus must be put on enhancing PFs in order to avoid HRBs. Identification of coexisting NDPs, such as ADHD, is crucial, since such problems can adversely influence treatment adherence, HRBs and school achievements

Sleep-disordered breathing and insomnia are common sleep disorders and associated with an increased risk of morbidity. The aim of this thesis was to study the contribution of a behavioural sleep medicine perspective on sleep-disordered breathing and insomnia. More specific, factors considered important for changing eating behaviour and the impact of physical activity were studied. Methods: In study I, semi-structured interviews of participants with obstructive sleep apnoea and obesity (n = 15) were analysed using a qualitative content analysis. A population-based female cohort was followed prospectively over ten years in study II and III using a postal questionnaire on two occasions (n = 4,851 and n = 5062, respectively). In study IV, a series of five experimental single-case studies was conducted testing how an aerobic exercise intervention affected selected typical snores, following an A1B1A2B2A3 design over nine days and nights (n = 5). Results:  Facilitators and barriers towards eating behaviour change were identified. A low level of self-reported leisure-time physical activity was a risk factor among women for future habitual snoring complaints, independent of weight, weight gain alcohol dependence or smoking. Maintaining higher levels or increasing levels of leisure-time physical activity over the ten-year period partly protected from snoring complaints (study II). Further, a low level of self-reported leisure-time physical activity is a risk factor for future insomnia among women. Maintaining higher levels or increasing levels of leisure-time physical activity over the ten-year period partly protect against self-reported insomnia, independent of psychological distress, age, change in body mass index, smoking, alcohol dependence, snoring status or level of education (study III). Single bouts of aerobic exercise did not produce an acute effect on snoring the following nights in the studied individuals. A pronounced night-to-night variation in snoring was identified (study IV). Conclusion: Women with sleep disorders would benefit from a behavioural sleep medicine perspective targeting their physical activity in the prevention and management of snoring and insomnia. This is motivated by the protective effects of physical activity confirmed by this thesis. Knowledge was added about facilitators and barriers for future eating behaviour change interventions.

<p>Bakgrund: Varje individ rekommenderas att ägna sig åt någon form av fysisk aktivitet minst en halvtimme varje dag. Ett nytt arbetssätt är att skriva ut fysisk aktivitet på recept och en arbetsform för utskrivning kallas ordinerad fysisk aktivitet (OFA). Patientföljsamheten ökar genom personlig kommunikation mellan vårdgivare och patient, vårdpersonalens initiativ att kontakta patienten och patientens möjlighet till att aktivt deltaga i sin sjukdomsbehandling. Individens sjukdom eller skada, sociala intresse, personliga uppfattningar och omgivningens tillgänglighet för träning har betydelse för fysisk aktivitet enligt tidigare forskning.</p><p>Syfte: Studiens syfte var att studera vilka faktorer som möjliggjorde för personer som har fått OFA i Västmanland att följa sin ordination.</p><p>Metod: Studien var en kvalitativ intervjustudie med explorativ design. Kvalitativ innehållsanalys användes för bearbetning av intervjuerna.</p><p>Resultat och slutsats: Personalens betydelse för illtro till egen förmåga att träna framträder som ett centralt tema i informanternas berättelse enligt författarnas tolkning. Temat uttrycks i olika koder, underkategorier och kategorier. Fysiska faktorer som är betydelsefulla är kroppen och hälsan. Psykologiska faktorer är individens organisatoriska förmåga, tankar, känslor och erfarenheter samt personliga förhållningssätt. Närstående, personalen och deras insatser samt den fysiska miljön är betydelsefulla omgivningsfaktorer. Den sociala gemenskapen med familj och träningskamrater beskrivs också som betydelsefulla för att komma igång med OFA.</p> / <p>Background: Every individual are recommended to spend at least thirty minutes per day with some form of physical activity. Writing prescription of physical activity is a new approach and one form of prescription is called prescribed physical activity (OFA). Patient compliance increases through personal communication between health care professionals and patients, initiative from health care professionals and patients’ possibility to take active part in their own treatment. A person’s injury or illness, social interest, personal preferences and exercise possibilities in the environment has importance for physical activity according to previous research.</p><p>Purpose: The aim was to study what factors that made it possible for persons that have been prescribed physical activity (OFA) in Västmanland to follow their prescription.</p><p>Method: The study was a qualitative interview study with explorative design. Qualitative content analysis was used for analysing the interviews.</p><p>Results and Conclusion: Personnel’s importance for confidence in the ability to exercise appears as a central theme in the informants’ statement according to the authors’ interpretation. The theme is expressed in different codes, subcategories and categories. Important physical factors are body and health. Psychological factors are a person’s organizational ability, thoughts, feelings and experiences as well as personal adaptive attitude. Family, personnel and their contribution and the physical surroundings are important environmental factors. The social fellowship with family and exercise partners is also described as important in order to get started with OFA.</p>

Bakgrund: Varje individ rekommenderas att ägna sig åt någon form av fysisk aktivitet minst en halvtimme varje dag. Ett nytt arbetssätt är att skriva ut fysisk aktivitet på recept och en arbetsform för utskrivning kallas ordinerad fysisk aktivitet (OFA). Patientföljsamheten ökar genom personlig kommunikation mellan vårdgivare och patient, vårdpersonalens initiativ att kontakta patienten och patientens möjlighet till att aktivt deltaga i sin sjukdomsbehandling. Individens sjukdom eller skada, sociala intresse, personliga uppfattningar och omgivningens tillgänglighet för träning har betydelse för fysisk aktivitet enligt tidigare forskning. Syfte: Studiens syfte var att studera vilka faktorer som möjliggjorde för personer som har fått OFA i Västmanland att följa sin ordination. Metod: Studien var en kvalitativ intervjustudie med explorativ design. Kvalitativ innehållsanalys användes för bearbetning av intervjuerna. Resultat och slutsats: Personalens betydelse för illtro till egen förmåga att träna framträder som ett centralt tema i informanternas berättelse enligt författarnas tolkning. Temat uttrycks i olika koder, underkategorier och kategorier. Fysiska faktorer som är betydelsefulla är kroppen och hälsan. Psykologiska faktorer är individens organisatoriska förmåga, tankar, känslor och erfarenheter samt personliga förhållningssätt. Närstående, personalen och deras insatser samt den fysiska miljön är betydelsefulla omgivningsfaktorer. Den sociala gemenskapen med familj och träningskamrater beskrivs också som betydelsefulla för att komma igång med OFA. / Background: Every individual are recommended to spend at least thirty minutes per day with some form of physical activity. Writing prescription of physical activity is a new approach and one form of prescription is called prescribed physical activity (OFA). Patient compliance increases through personal communication between health care professionals and patients, initiative from health care professionals and patients’ possibility to take active part in their own treatment. A person’s injury or illness, social interest, personal preferences and exercise possibilities in the environment has importance for physical activity according to previous research. Purpose: The aim was to study what factors that made it possible for persons that have been prescribed physical activity (OFA) in Västmanland to follow their prescription. Method: The study was a qualitative interview study with explorative design. Qualitative content analysis was used for analysing the interviews. Results and Conclusion: Personnel’s importance for confidence in the ability to exercise appears as a central theme in the informants’ statement according to the authors’ interpretation. The theme is expressed in different codes, subcategories and categories. Important physical factors are body and health. Psychological factors are a person’s organizational ability, thoughts, feelings and experiences as well as personal adaptive attitude. Family, personnel and their contribution and the physical surroundings are important environmental factors. The social fellowship with family and exercise partners is also described as important in order to get started with OFA.

The Health Promoting School (HPS) is s a model that advances both the health and learning needs of students. Yet there is a lack of consensus on student indicators that reflect a HPS or a coherent understanding of what a HPS represents amongst various stakeholders. The goal of this research was to establish indicators of student health and wellbeing associated with policies and practices in schools, and to further our understanding of health promoting schools. The research proceeded in three phases. The first phase established a relationship between student health and academic achievement. The second phase examined the associations amongst student health and wellbeing and student and school-level factors. The third phase involved case studies of two schools in Ontario to examine the organisational and structural elements associated with achieving a HPS, and the mechanisms by which these elements support student health and wellbeing. The association between students’ self-rated health and their academic achievement found in the first phase provides a platform for advancing the health promoting school agenda in Canada at the research and policy levels. Subsequent findings established an association between the environment and disciplinary climate in schools, and the school’s academic and socioeconomic standing to student health and wellbeing outcomes. These findings also suggest overlapping effects of schools and neighbourhoods on students’ health and wellbeing, implying that school health promoting efforts will be more successful when partnered with efforts within neighbourhoods and communities. Finally, the case studies suggest that embracing a HPS philosophy that addresses students’ emotional and physical wellbeing may help support students’ overall learning. Findings, presented in an implementation model of a HPS, emphasise key action areas that need to be addressed when implementing HPS initiatives and enhancing the capability of the education system to improve the health and learning of students. / Thesis (Ph.D, Education) -- Queen's University, 2009-10-05 13:45:06.342

HIV and AIDS is one of the biggest challenges facing South African young people today (Govender, 2010). Young people are at risk, partly through their own behaviour and partly through the attitudes, expectations and limitations of the societies in which they grow up (Panos AIDS Briefing, 1996).The are many HIV prevention programmes developed globally and nationally, specifically for young people but the pandemic still escalates rapidly. The fourth decade now calls for multidimensional approaches when communicating HIV prevention for young people. This thesis explores how young people can contribute to this multidimensional approach through their active participation in the various phases of developing HIV projects. The study does this through a sample of eight youth-focused HIV organisations in KwaZulu-Natal and a sample of students from the University of KwaZulu-Natal, to gain more insight into participation of young people in the development of HIV programmes. Bodymapping, a visual and art-based method, was used to explore young people’s understanding of HIV, their perceptions of HIV programmes and the possibilities of their participation in the developing of further HIV projects. The study used a grounded approach and applied principles of participatory action research to collect data in four phases. The first phase used interviews and focus group discussions with eight sample organisations to give insight into the programmes offered to young people and how they engage and make sense of their participation within these programmes. The second phase draws on previous bodymapping workshops that have been conducted with students from UKZN and young people in various communities to explore the application and relevance of bodymapping. In the third phase, data is presented on two bodymapping workshops conducted, to engage with young people about their contribution to the development of HIV programmes. The final phase draws on two focus group discussions, conducted with bodymapping participants, to examine their experiences and interpretation of the bodymapping process. Some of the key findings indicate that a blanket approach to HIV programmes will not always work, as young people’s sexual behaviour needs to be explored within a wider socio-ecological framework that recognises the inter-relational and interconnected system in which they make their sexual choices. The data indicates that youth and organisations strongly support the importance of participation and the inclusion of participants when developing HIV projects. However, discussions about participation indicated that while young people could identify the importance of participation, they still lacked an understanding of how to participate and how they could learn more about their lived experiences through participation. This was evident in the data where there was a distinction in how participation was defined from those in the UKZN group and those from rural KZN. In understanding what constitutes participation, young people are better positioned to aid the process of developing effective HIV related projects that are participant specific. I argue that bodymapping can be used as a process to initiate and aid the participation of young people in the various phases of developing HIV projects. A three level model for applying bodymapping and planning processes has been developed to encourage participation with young people where the first step ensures that young people define what participation means to them. This becomes the foundation for how communication practitioners and academics make sense and theorise participation from a participant informed perspective. Bodymapping was pivotal in this process of engaging young people in self-reflection and introspection which encouraged a process of dialogue towards better understanding and defining participation from a participant perspective. Bodymapping in this way can be identified as a catalyst that encourages dialogue as part of communication for participatory development. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2013.

Bakgrunn: Frisklivssentralen, eller fysisk aktivitet på resept,er en kommunal forebyggende helsetjeneste i Norge med tilbud om hjelp til endring og mestring av levevaner.Forskning som dokumenterer langtidseffekten av deltagelse i tilbudeter begrenset. Formål: Denne studien undersøker om Frisklivssentralenoppnår målsettingen om varig endring av fysisk aktivitetsnivå og helserelatert livskvalitet,målt tre år etter deltagelse. Metode: Tre år etter deltagelse i Frisklivssentralen (04.2010-03.2011) ble en spørreundersøkelse besvart av 33 tidligere deltagere for å utforske deres nåværende fysisk aktivitetsnivå, opprettholdelse av aktivitetsnivå, faktorer som påvirker opprettholdelse av aktivitet, helserelatert livskvalitet og erfaringer fra oppfølgingen i Frisklivssentralen. Resultatene ble sammenlignet med data innsamlet ved baseline og tre måneders oppfølging. Deskriptive statistikker ble brukt for å beskrive utvalget og fordelingav svarene. Ikke-parametriske tester ble brukt for å se på endring over tid og for å sammenligne subgrupper. Resultater: Resultateneviserat denpositiv endringeni aktivitetsnivå fra baselinetil tre måneder vedvarte til tre år etter(P=0.001). Fra baseline til tre år hadde 39,4% av respondentene økt aktivitetsnivået. De som ikke økte aktivitetsnivået hadde et høyere aktivitetsnivå ved baseline. Etter tre år var medianen for hele utvalget etaktivitetsnivå på &gt; 4 timer per uke. Uavhengig av endring i aktivitetsnivå fra baseline til tre år,rapporterte deltagerne positiveendring i helserelatert livskvalitet(P≤0.001). Konklusjon: Frisklivssentralen øker fysisk aktivitetsnivå og helserelatert livskvalitet. Deltagere som i utgangspunktet var mindre aktive (f.eks. 1-2timer per uke)økte sitt aktivitetsnivå til &gt; 4 timer per uke og opprettholdt det i tre år. Respondentene oppnådde bedring i helserelatert livskvalitet uavhengig av endring i aktivitetsnivå. / Background:Frisklivssentralen, or physical activity on prescription, is an intervention used by Norwegian municipalities for preventive health services. This approach helps individuals change lifestyle habits and increase physical activity. Research documenting thelong-termeffects of participation in Frisklivssentralen is sparse. Objective:This study aimed to evaluate whether Frisklivssentralen achieves its goal of permanently changing individuals’ activity level and health-related quality of life, as measured three years after participation. Method: Three years after the Frisklivssentralen intervention (04.2010–03.2011) concluded, 33 former participants answered a questionnaire exploring their current level of physical activity, adherence to physical activity, factors affecting such adherence, health-related quality of life, and experiences from participation at Frisklivssentralen. We compared their answers to data collected at baseline and the 3-month follow up. We used descriptive statistics to assess the range and is tribution of participants and their answers. Non-parametric tests explored changes over time and compared subgroups. Results: Our results revealed that the positive change in activity level achieved from baseline to 3-month follow upp ersisted three years later(P=0.001). From baseline to three years, 39.4% of participants increased their activitylevel. Interestingly, participants in the current study who reported no increase in activity were more activeat baseline. After three years, the median activity level for the total sample was&gt; 4 hours per week. Regardless of changes in activitylevels from baseline to three years, participants reported positive changes in health-related quality of life (P≤0.001). Conclusion: Frisklivssentralen increases physical activity levels and health-related quality of life. Participants who initially were less active (i.e., 1–2 hours/week) increased their activity level to &gt; 4 hours per week and maintained it for 3 years. Respondents improved their health-related quality of liferegardless of changes in activitylevel / <p>ISBN 978-91-86739-85-0</p>

The general objective of this dissertation is to study breast cancer screening and specifically social inequalities by social class and country of origin and its relationship with decreasing mortality. Therefore, four different studies have been done: three with quantitative methodology and one with qualitative. According to the quasi-experimental study, breast cancer mortality decreased in Barcelona before the introduction of the population screening program, but this reduction is more marked after its introduction. According to data from the Spanish National Health Survey in 2006, there are inequalities in the rate of breast cancer screening according to country of origin and social class. According to two studies conducted in Barcelona, immigrant women from low-income countries are less aware, and hence do less, early detection practices, as they have other priorities and perceive more barriers and taboos. Chinese women are the immigrants who present more differences with native women, followed by Maghribian and Philippine women. Place of origin, social class and migration process are key factors in preventive practices. In conclusion, it is necessary to encourage access to preventive screening practices for all women and also to undertake specific actions directed at the most vulnerable groups, taking into account any socio-cultural factors that influence the use of preventive practices. / L’objectiu general d’aquesta tesi és estudiar el cribratge de càncer de mama i en concret les desigualtats socials per classe social i país d’origen, així com la seva relació amb la disminució de la mortalitat. En conseqüència, s’han realitzat quatre estudis diferents: tres de metodologia quantitativa i un de qualitativa. Segons l’estudi quasi-experimental, la mortalitat per càncer de mama a Barcelona disminueix des d’abans de la introducció del programa poblacional de cribatge, però aquesta reducció és més accentuada desprès de la seva introducció. En base a l’Enquesta Nacional de Salut de l’Estat Espanyol de l’any 2006, existeixen desigualtats en la realització de mamografies periòdiques segons país d’origen i classe social. Segons els dos estudis realitzats a Barcelona, les dones immigrades procedents de països de renda baixa coneixen i realitzen menys les pràctiques de detecció precoç, ja que tenen altres prioritats i perceben més barreres i tabús. Les dones xineses són les que presenten més diferències amb les dones autòctones, seguides de les magribines i les filipines. El lloc d’origen, la classe social i el procés migratori són factors claus en les practiques preventives. En conclusió, és necessari afavorir l’accés a les pràctiques preventives a totes les dones i també realitzar accions específiques dirigides als grups més vulnerables sense deixar de tenir en compte els factors socioculturals que influeixen en les pràctiques preventives de les dones.