The purpose of this study was to examine parents’ motivational beliefs for involvement in a Comprehensive School Health approach (locally called Healthy Active Schools, or HAS) at their child’s school. Literature suggests that parents’ role construction and parents’ self-efficacy are the most salient influences on parents’ decision to become involved at their child’s school. Twelve parents involved at two urban public elementary schools were interviewed. Questions were based on Hoover-Dempsey and Sandler’s model of parental involvement (1995, 1997, 2005c). Qualitative multiple case study analysis additionally utilized Penner’s (2002) model of sustained volunteerism and Bandura’s collective efficacy theory (1997, 2000; Goddard, Hoy, & Woolfolk-Hoy, 2004) to clarify findings. Results suggest most parents’ strong active role construction and negative valence grounded their parent-focused role orientation. School case study analysis revealed that the principal’s leadership, the structure of the HAS committee and the school’s climate uniquely influenced parents’ beliefs. Individual parent case analysis revealed four distinct patterns of parents’ motivational beliefs for HAS involvement. Future research is warranted to further examine the decisive impact of parents’ health and prosocial values on their decision to become involved specific to a CSH approach type of involvement. Additional case studies in local schools, school districts and provinces are recommended to illuminate unique contextual influences and the potential for the emergence of collective efficacy; including consideration for parents’ belief construct general invitations from the school would contribute to gaining a deeper understanding within this domain. Finally, the link between parents’ motivational beliefs of empowerment and their sustained motivation for involvement needs to be explored further.

With rapidly rising health care expenditures, health care cost containment has become a major issue facing this nation. A phenomenal growth in worksite health promotion has occurred with the recognition that these programs have the potential to reduce these costs. However, to be effective as a cost containment strategy, health promotion programs must successfully attract participants, particularly those whose health is most at-risk. Due to limited research on issues of participation, there is a need to investigate the characteristics of individuals attracted to worksite health promotion programs and the factors that influence their participation. The purpose of this study was to explore the characterization of participants and nonparticipants and to examine the factors that influence participation in health promotion programs. A self-selected participant group (n=173) was compared to a nonparticipant group (n =146) with respect to sociodemographic characteristics, health care costs, health status, and health risk behaviors. Qualitative and quantitative data were collected from the employer's records and from a questionnaire designed to address specific components of the program. Results indicated that management/administrative staff were more likely to participate in the health promotion program than were classified or faculty staff. For the period of the survey, participants were also more likely to be nonsmokers and were less likely to be injured on-the-job during one of the survey years. The workers' compensation claims costs for nonparticipants were significantly higher in one survey year and over the two-year average period considered. However, the nonparticipant claims were strongly influenced by one costly claim in 1988. The two groups did not differ when the absenteeism data from the employer's records were analyzed. In addition, it was found that subjects with the highest levels of participation also had the fewest number of children living in the household. Time constraints as a result of job schedule, work/activity load, and meeting times of the activities were the most important factors limiting participation in the program. Further research is needed to assess program effectiveness and program impact upon employee health and health care costs. The analysis should be conducted over a longer period of time and comparisons should be made within as well as between groups. / Graduation date: 1992

Collective kitchens are defined in a general way as groups of persons who meet to plan, shop for and cook meals, in large quantities. The purpose of this study was to explore the health promotion and food security experiences of collective kitchen members, during and away from collective kitchen meetings. The study used qualitative methods, including semi-participant observation and in-depth interviews to study collective kitchen groups. Between September 2000 and June 2002, a total of 21 collective kitchen groups in Saskatoon, Toronto and Montréal were sampled for maximum variation in terms of: type of participant; structure of the group belonged to; and support at the community and organizational level. Data was collected during prolonged observation throughout group planning and cooking sessions, and by conducting in-depth interviews with participants and group leaders. Additionally, data on the community, and the quality and quantity of organizational support provided to collective kitchen groups in each of the three cities, located in three different provinces, was collected through key informant interviews. Observations were recorded using field notes. Interviews were tape-recorded and transcribed verbatim. Observation and interview data from each of the three cities were analyzed separately for dominant themes and then integrated together to establish patterns of collective impacts on the lives of participants. Results indicate the benefits of collective cooking are numerous. First and foremost they are social support and reducing isolation are central themes to collective kitchen participation. Second they are educational elements include healthy eating and other food-related skills and learning, as well as some political and social education. Third, for some groups, particularly those experiencing less severe food insecurity, collective kitchen participation might increase food security. Additional impacts of participation include some aspects of community development and personal empowerment. While this research discusses many positive impacts of collective kitchens, poverty and community disintegration will not be solved by community programming alone.

Recently, the Saskatoon in motion physical activity health promotion initiative has worked with educators and high school administrators in the city of Saskatoon to develop a targeted physical activity strategy for high school students. The in motion high school strategy was implemented in each school by an in motion high school champion. In each school in motion could incorporate such things as announcements, bulletin boards, posters, physical activity clubs and physical activity challenges. The strategy was piloted in a Saskatoon high school previously and had positive impact on students activity levels. Purpose: To investigate the effectiveness of the in motion strategy at impacting the physical activity behaviour of a large sample of Saskatoon high school students, and to uncover how in motion could be better supported in the school environment. Method: in motion was implemented in eight Saskatoon high schools from October to June of the 2005/06 school year. Study participants were male and female students, from grades 9-12, attending the eight schools. The Godin Leisure Time Exercise Questionnaire was administered in October 2005 (n = 4395), and May 2006 (n = 3299) to assess self reported physical activity, and analysed using independent t-tests and ANOVA with Tukey post hoc tests.<p>In June of 2006, questionnaires were administered to the in motion champions (n = 8). Questionnaires inquired into the specific activities and events that comprised the in motion intervention in each school and champion experiences with in motion. Information obtained led to the classification of dose of intervention implemented at each school. Schools were separated into high, moderate, and low dose categories, and a dose-response relationship between dose of intervention and change in physical activity level was investigated. Qualitative data was analysed using typological analysis, and represented as summary of responses. Results: An overall increase in self-reported physical activity was found after the implementation of the in motion physical activity intervention (t (3920.355) = -21.15, p < 0.0001). Increases were observed in all genders, grades, and schools. Two schools were deemed high dose, four moderate dose, and two low dose. No dose-response relationship was found between dose of in motion and change in physical activity or students opinion of how in motion impacted personal activity levels. Dose-response relationship was found between dose of intervention and recognition of in motion. Additionally, through champion questionnaires, multiple supports and barriers for the in motion intervention, and suggestions for how in motion could be improved, was given by in motion champions. Conclusions: Student opinion of in motions impact on their personal activity level indicates that in motion is a promising tool for increasing physical activity in students. Lack of dose-response relationship between intervention and physical activity change, and student opinion of how in motion has affected activity level suggests that the definition of dose is too narrow. To further support in motion in schools, more staff involvement and appropriate activities for different demographic groups are needed.

Physical activity and healthy eating are key components of healthy living, and they reduce the risk of developing chronic diseases. Current research indicates that Canadian early years children are not active enough for healthy growth and development. Additionally their diets are high in processed foods and lack fresh and locally grown foods. Parents play a key role in establishing healthy behaviours; however caregivers also have a strong influence, as many early years children spend a large portion on their day in care centres. To date, very little is known about the factors influencing rural caregivers in the provision of healthy opportunities for early years children in their care. Purpose: The purpose of this study was to use an ecological framework to identify facilitators and barriers that rural caregivers face when providing physical activity and healthy eating opportunities in care centres. Methods: Caregivers (N = 8) in rural settings participated in one on one semi-structured interviews. Perceived facilitators and barriers reported by caregivers were categorized using the ecological model as (intrapersonal, interpersonal, institutional, community, and policy). Results: Caregivers identified facilitators and barriers. (i.e., personal health and wellness, caregiver perceptions of lack of parental knowledge, parental support and access to facilities and local foods in the community), that influenced their ability to provide physical activity and healthy eating opportunities for children in their care. Similar barriers and facilitators were clustered together to create themes within each ecological category. A total of 12 key themes emerged from the data. Conclusion: Rural caregivers identified a number of factors that facilitated and inhibited their ability to provide opportunities for engaging in health promoting behaviours. Interestingly caregivers did not identify any intrapersonal barriers. Factors in the interpersonal category were the most commonly reported. Thus behaviours of others were the often indicated as a key factor influencing caregivers in the provision of healthy opportunities. In the institutional and community categories caregivers identified a number of facilitators that supported them in the provision of healthy opportunities. Additionally, some caregivers discussed practices they used to overcome barriers and this in turn, facilitated the promotion of physical activity and healthy eating within the care centres. Research in rural areas is limited and the majority of studies focus the barriers to living in rural areas. This study contributes to the literature because it identified, not only challenges, but also benefits to living in rural areas. Furthermore, the use of an ecological framework allowed barriers and facilitators to be classified into distinct categories. This is important, as classification of specific factors can aid in designing initiatives that target facilitators and alleviate barriers. Such initiatives can then support early years caregivers in the provision of healthy opportunities for children. In turn, this will aid Canadian early years children in establishing lifelong physical activity eating and healthy eating patterns.

Physical activity and healthy eating are key components of healthy living, and they reduce the risk of developing chronic diseases. Current research indicates that Canadian early years children are not active enough for healthy growth and development. Additionally their diets are high in processed foods and lack fresh and locally grown foods. Parents play a key role in establishing healthy behaviours; however caregivers also have a strong influence, as many early years children spend a large portion on their day in care centres. To date, very little is known about the factors influencing rural caregivers in the provision of healthy opportunities for early years children in their care. Purpose: The purpose of this study was to use an ecological framework to identify facilitators and barriers that rural caregivers face when providing physical activity and healthy eating opportunities in care centres. Methods: Caregivers (N = 8) in rural settings participated in one on one semi-structured interviews. Perceived facilitators and barriers reported by caregivers were categorized using the ecological model as (intrapersonal, interpersonal, institutional, community, and policy). Results: Caregivers identified facilitators and barriers. (i.e., personal health and wellness, caregiver perceptions of lack of parental knowledge, parental support and access to facilities and local foods in the community), that influenced their ability to provide physical activity and healthy eating opportunities for children in their care. Similar barriers and facilitators were clustered together to create themes within each ecological category. A total of 12 key themes emerged from the data. Conclusion: Rural caregivers identified a number of factors that facilitated and inhibited their ability to provide opportunities for engaging in health promoting behaviours. Interestingly caregivers did not identify any intrapersonal barriers. Factors in the interpersonal category were the most commonly reported. Thus behaviours of others were the often indicated as a key factor influencing caregivers in the provision of healthy opportunities. In the institutional and community categories caregivers identified a number of facilitators that supported them in the provision of healthy opportunities. Additionally, some caregivers discussed practices they used to overcome barriers and this in turn, facilitated the promotion of physical activity and healthy eating within the care centres. Research in rural areas is limited and the majority of studies focus the barriers to living in rural areas. This study contributes to the literature because it identified, not only challenges, but also benefits to living in rural areas. Furthermore, the use of an ecological framework allowed barriers and facilitators to be classified into distinct categories. This is important, as classification of specific factors can aid in designing initiatives that target facilitators and alleviate barriers. Such initiatives can then support early years caregivers in the provision of healthy opportunities for children. In turn, this will aid Canadian early years children in establishing lifelong physical activity eating and healthy eating patterns.

The purpose of this study was to examine parents’ motivational beliefs for involvement in a Comprehensive School Health approach (locally called Healthy Active Schools, or HAS) at their child’s school. Literature suggests that parents’ role construction and parents’ self-efficacy are the most salient influences on parents’ decision to become involved at their child’s school. Twelve parents involved at two urban public elementary schools were interviewed. Questions were based on Hoover-Dempsey and Sandler’s model of parental involvement (1995, 1997, 2005c). Qualitative multiple case study analysis additionally utilized Penner’s (2002) model of sustained volunteerism and Bandura’s collective efficacy theory (1997, 2000; Goddard, Hoy, & Woolfolk-Hoy, 2004) to clarify findings. Results suggest most parents’ strong active role construction and negative valence grounded their parent-focused role orientation. School case study analysis revealed that the principal’s leadership, the structure of the HAS committee and the school’s climate uniquely influenced parents’ beliefs. Individual parent case analysis revealed four distinct patterns of parents’ motivational beliefs for HAS involvement. Future research is warranted to further examine the decisive impact of parents’ health and prosocial values on their decision to become involved specific to a CSH approach type of involvement. Additional case studies in local schools, school districts and provinces are recommended to illuminate unique contextual influences and the potential for the emergence of collective efficacy; including consideration for parents’ belief construct general invitations from the school would contribute to gaining a deeper understanding within this domain. Finally, the link between parents’ motivational beliefs of empowerment and their sustained motivation for involvement needs to be explored further.

The focus of the research study was to investigate the relationship of perceived benefits and perceived barriers to the health behaviors of exercise, nutritional eating practices, and elimination of smoking. Perceived barriers and benefits were measured by a tool developed by Sechrist , Walker, & Pender (1987).A randomized sample of 300 adults living in Indiana were surveyed. The adults were employed by Hooks-Super X, Inc. and were randomly selected from a population of 3200 adults employee.Variables of exercise, nutritional eating practices, and smoking behavior were examined to determine if a relationship existed between the variables and perceived barriers and benefits. Individual items measured the frequency of the variables.Three-way analysis of variance demonstrated that there was a relationship between exercise and perceived barriers and benefits. Chi Square Goodness of Fit demonstrated that age evidenced a significance relationship with exercise.The findings of the study revealed a relationship between the Health Promotion Model and exercise and perceived barriers and perceived benefits. / School of Nursing

Problem and significance: Adherence to health-promoting behaviors in a diabetes self-care regimen is essential for individuals with diabetes and can assist providers and individuals with diabetes management. The purpose of this research was to explore the relationship between personal factors (age, length of diabetes diagnosis, perceived health status, weight), perceived barriers to action (number of barrier days), interpersonal influences (social support), situational influences (depressive symptoms), and patient adherence to health-promoting behaviors (blood glucose monitoring, diet, and exercise) and health outcomes ( A1c and body mass index) in a diabetes self-care regimen. Methods: A descriptive correlational analysis was performed using baseline data from the National Health and Nutrition Examination Survey (NHANES) [2007-2008]. Constructs from the Health Promotion Model were used to predict health-promoting behaviors and health outcomes in diabetes self-management. The 713 participants with diabetes were primarily Black or Hispanic (57.5%), older ( M 62.2 years, SD 12.9), and married or living with a partner (56.2%). Approximately half of the participants were female (50.8%); 59% were obese. Results: The longer the time since diagnosis and the more barrier days experienced per month, the more frequently blood glucose monitoring was performed (R2 = .076, R2adj = .060, F (6, 363) = 4.875, p < .001). The greater the body weight, the more likely participants were to implement diet management behaviors (R2 = .097, R2adj = .081, F (7, 413) = 6.209, p < .001). The younger the age and the higher perceived health status, the more minutes per week were spent in exercise (R2 = .054, R2adj = .038, F (7, 412) = 3.307, p < .01). The older the age and the shorter time since diagnosis, the lower the A1c levels (R2 = .054, R2adj = .044, F (6, 568) = 5.391, p < .001). The younger the age, the more barrier days per month and the more diet management behaviors reported, the higher the BMI (R2 = .149, R2adj = .140, F (6, 581) = 16.764, p < .001). Findings indicate that treatment measures, not preventative, are being practiced, and that predictors of behaviors and outcomes are multifaceted and require further investigation.

Aim: To examine director’s experiences of the process to implement smoke-free working hours and also their need of support to make it feasible in the municipality of Östhammar. Method: A qualitative interview study with a descriptive design was used. Semi-structured interviews were made with six directors who were selected from different levels, localities and administrations in the municipality of Östhammar. A qualitative content analysis was used to analyze the data. Results: Many positive aspects were pointed out regarding the implementation of smoke-free working hours. The aspects of time and the support which had been offered to the smokers stood out among these. The majority of the directors considered that the support at the time of the implementation had been adequate.  The difficulties that were experienced were mostly related to practical issues. Only a few proposals of support concerning the difficulties that had been experienced were presented. Two of the study’s participants had not experienced difficulties. Two positive effects of the policy were reduction in smoking or quitting smoking. Particularly one director stated that the policy did not function at all up to that point. The requested types of support in the future were continuing existing support, activities connected to the policy and a follow-up of the policy. Conclusion: The experiences of the informants were that the implementation process has functioned well with the exception of a few particular difficulties. Few proposals of support emerged in addition to already existing ones. Some form of activity connected to the policy or a follow-up of the policy is important to once again make it a pressing issue.