This study has presented findings on the correlations of the attitudes of the health promotion program provider and the program decision-maker in measuring the success of their worksite health promotion programs. The purpose of this study was to answer the following three questions: 1) Do company decision-makers and primary program providers agree upon which evaluation methods are currently being used in their worksite health promotion program? 2) Do the company decision-makers and primary program providers rank the top five evaluation criteria in the same order of importance? and 3) In rank order, what are the top five preferred evaluation criteria of the program provider? Results indicate a strong correlation of agreement for questions 1 and 2 (0.937 and 0.951 respectively). The data suggests that primary health promotion program providers and company decision-makers share strong agreement on which evaluation criteria should measure program success. Justification of worksite health promotion requires that the program provider be accountable for the criteria on which the decision-maker bases the programs' success. / Fisher Institute for Wellness

The purpose of this study was to determine the effectiveness of group nutrition and physical activity education classes in lowering cholesterol levels of worksite employees at 6-and 12-month intervals. A total of 32 participants were followed through the study. The group of participants included 24 female and 8 males, all over the age of 40. The data were analyzed using one-way ANOV A with repeated n1easures, post¬hoc analysis, Pearson's correlation coefficient, and ANCOV A to test six null hypotheses. Statistically significant differences in HDL cholesterol levels were found between baseline and 12 months (p=O.OOO) and between 6 months and 12 months (p=O.OOO). Statistically significant differences were also found in TCIHDL cholesterol ratios between baseline and 12 months (p=0.02) and between 6 months and 12 months (p=0.021). / Department of Family and Consumer Sciences

During a period from May, 1993 to July of 1993, 309 employees of a large telecommunication's company selfselected to participate in an eight-week health promotion program designed to assist them in changing health behaviors. The program participants were then surveyed at the end of one-year to determine if they had maintained the health behavior changes practiced during the eight-week program and the impact of family, friends and coworkers on the level the participant was practicing the health behavior changes at the end of one-year.A growing body of evidence suggests ongoing research in the area of health behavior change because health related medical claims, absenteeism and decreased productivity continue to have serious financial consequences for American business. In Corporate America, health education programs have been organized to give employees the opportunity to change negative health habits and replace them with positive health habits. The assumption being, that healthier employees': (1) use less medical benefits (2) report fewer absent sick days and (3) are more productive employees.In addition, prior research indicates that being part of a social network or having access to social group support can help individuals decrease the level they practice negative health habits and increase the level they practice positive health habits. Thus, an understanding of social group support on the behavior change process is important to education professionals evaluating the effectiveness of health education programs within the corporate setting.This research study was designed to examine a health promotion program offered to employees of a large telecommunication company and the impact social groups andcontent had on the level participants changed their health related behaviors. The research assumed that examining encouragement and discouragement provided by: (1) family, (2) friends, and (3) coworkers would lead to a greater understanding of the impact social groups had on the level a participant practiced health behavior changes at the end of one year.This research indicated that social group participation played a significant role in the level a program participant was practicing health behavior changes at the end of one year. The analysis further indicated that support from family and friends were significant factors in the behavioral change process.In addition, organizational support prior to and during the "Health Habits Challenge" program had no significant impact on the level participants were practicing health behavior changes at the end of one year. However, participants receiving organizational support prior to and during the "Health Habits Challenge" program perceived their health as having improved during the one-year maintenance phase, while participants who did not receive organizational support reported their health status had declined.Relationships reported by this research study are sufficiently strong enough to warrant further research both qualitative and quantitative, to provide health educators with a better understanding of how social groups and organizational content influence health behavior changes. The factors are potentially important, not only for theoretical and research purposes but also for making practice and policy decisions appropriate to health promotion and health education. / Department of Educational Leadership

There is no abstract available for this dissertation. / Department of Educational Leadership

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.

Physical activity (PA) is likely to constitute an important aspect of health-related behaviour in growing children. However, the knowledge on levels and patterns of PA in children is limited, due to the difficulty of precisely measuring this complex behaviour in normal daily living. Information on variables that significantly contributes to the variability in PA patterns is warranted as it may inform strategies for promoting physically active lifestyles in school-age youth. The overall purpose of the present studies was to increase the knowledge about the use of accelerometry when assessing PA in children, and examine sources of variability in objectively assessed PA behaviour in children. The study samples included 1954 nine- and 15-year-old children from four geographical locations in Europe (Norway, Denmark, Estonia and Portugal), and additionally 16 Swedish seven-year-old boys and girls. PA was assessed by the MTI accelerometer during free-living conditions, including both weekdays and weekend days. A part of the PA assessment was conducted using different time sampling intervals (epochs). Predictions of estimates of daily energy expenditure from accelerometer output were calculated using previously published equations. Potential correlates of PA behaviour were assessed by self-report. The main findings were; a) the epoch setting had a significant effect when interpreting time spent at higher intensities of PA in young children, b) predicted energy expenditure differed substantially between equations, c) between- and within-day differences in overall levels of PA, time spent at moderate-to-vigorous intensity physical activity and time spent sedentary differed between age, gender and geographical location, d) outdoor play and sports participation were differentially associated with objectively measured PA in 9- and 15-year-old children. It is concluded that the sporadic nature of children’s physical activity require very short epoch settings for detecting high intensity PA, and that different published equations for estimations of daily energy expenditure cannot be used interchangeably. The interpretations of average energy expenditure from available equations should be made with caution. Based on a large sample of children of different ages, weekend days and leisure time during weekdays seem appropriate targets when promoting PA in order to increase the proportion of children achieving current recommendations on health enhancing PA. Further, significant correlates of PA behaviour dependent on age group are presented, which should be considered when planning interventions for promoting PA in school-age youth.

The state and individual must both understand that the increase in fat rates is a social phenomenon that requires reconciliation between collective and individual participation. A social movement needs to be generated that seeks solutions to this health phenomenon through preventative health measures; because the state’s current reactionary response does not address the factors that contribute to increased fat. These factors transcend the direct relationship between an individual, food and exercise, and also involve power. The current policy definition of fat is incorrect because it does not address the multiple variables that have generated an increase in common indicators of obesity; rather, it relies on inaccurate measurement systems, differing conceptions of the healthy individual, and narrow understandings of what causes obesity. The result is the current paralysis of policy reform. This thesis provides solutions that reconcile the current political definition with my own in order to advocate health promotion strategies that activate both the citizen and the state. / Graduate

Following the philosophical oeuvre of Michel Foucault, I locate and discuss how the discursive formulation of adolescent health promotion defines the conceptual possibilities and determines the boundaries of nurses’ thinking and practices as they are written about in nursing texts. From my archaeological work, I locate and name two confident nursing practices within the context of young people and their health: “reducing risk” and “promoting well becoming” and go on to locate those practices within two broader theoretical discourses within human science: the biological view and the social constructionist view. From my genealogical work, I consider how the management of the adolescent body has become a matter that situates biological life (puberty) as a political event and situates the nurse within governing practices of pastoral power. I question the ways in which adolescent health may be shaped through political interests of economy and social order and question: When is an adolescent ever deemed responsible in matters pertaining to their health? I offer an alternative view of responsibility and argue for a shift in established binary thinking that allows for the consideration of co-responsibility. / Graduate / 0569 / 0758 / 0680 / mmryan@uvic.ca

Background: Type I diabetes is a chronic disease that places great demands on the child and family. Parental involvement has been found to be essential for disease outcome. However, fathers’ involvement has been less studied, even though high paternal involvement has been correlated with less disease impact on the family and higher quality of life among adolescents. Aim: The overall aim of the study was to explore and analyze constructions of fathers’ involvement in their child’s everyday life with type 1 diabetes from an ecological and health promotion perspective. Four specific aims were applied: 1) explore and describe discourses in health care guidelines for children with type 1 diabetes in Nordic countries, focusing on parents' positioning (I), 2) analyze how Swedish pediatric diabetes teams perceived and discussed fathers’ involvement in the care of their child with type 1 diabetes, and to discuss how the teams’ attitudes toward the fathers’ involvement developed during a focus group process (II), 3) explore and discuss how fathers involved in caring for their child with type 1 diabetes experience support from their pediatric diabetes team in everyday life with their child (III), and 4) analyze how involved fathers to children with type 1 diabetes understand their involvement in their child’s daily life and to discuss their perceptions from a health promotion perspective (IV). Material and methods: A qualitative and inductive approach was applied. Data were collected and analyzed during 2010-2012. The sample consisted of three pediatric guidelines originating from Norway, Denmark and Sweden (I), three Swedish pediatric diabetes teams (PDTs) (II), and 11 (III) and 16 (IV) fathers of children with type 1 diabetes who scored high involvement on the Parental Responsibility Questionnaire. Data were collected through repeated focus group discussions with the PDTs (II), online focus group discussions (III) and individual interviews (III, IV) with the fathers. Three analysis methods were applied: analysis of discourses (I), Constructivist Grounded Theory (II, III) and content analysis (IV). Findings: The findings illuminated the complex interaction between the pediatric guidelines, the PDTs and the fathers. Fathers highly involved in their child’s daily life experienced different levels of tension between the general recommendations and their personal experiences of living with a child with type 1 diabetes (III). The fathers regarded their involvement in their child’s diabetes care as additional to their general parenting, and a fine balance was identified between a health promotion perspective and a controlling involvement. The common denominator between the highly involved fathers was their use of parental leave (IV). The PDTs initially perceived fathers’ involvement as gendered and balanced on the mother’s agement, but as focus was set on fathers’ engagement the PDTs increased their awareness of this and started to identify and encourage their engagement II). At the macro-level, parents’ voices were diminished in Nordic pediatric diabetes guidelines in favor of an expert discourse (I). Conclusions: Fathers’ involvement concerning a child with type 1diabetes is constructed in a complex way, based on an interaction between the fathers’ perceptions of their additional involvement and the support provided by the PDTs; the PDTs’ perceptions of the fathers’ involvement; and how parents/fathers are constructed in pediatric diabetes guidelines. In order to promote the health and well-being of children with type 1 diabetes, fathers’ involvement needs to be taken into account in the pediatric guidelines as well as in clinical practice.

Society and the workplace are two factors that are important for the individual's health status. It is important that the individuals has the right skills to take care of their health. For organizations, it is important to strive for the welfare of their employees. This has proven to have a positive impact on work performance, reduced absenteeism and reduced costs for rehabilitation. In 2007, the local authorities in Umeå implemented a wellness offering for all employees working in the municipality administration. They later saw a need to assist employees who needed help getting started with new exercise habits. This study aims to examine how the participants in the "Get Started Programme", succeeded in creating lasting exercise habits , 3-4 years after completing the program. Research questions are: How have the participants increased their knowledge practically and theoretically after the programme has finished? How have the participants succeeded in creating the content of the programme in their daily lives? How do the participants assess their health compared to before they participated in the programme? Are there any beneficial factors highlighted by the participants as during the program? The study was conducted on the basis of semi-structured interviews with eight voluntary participants who previously participated in the Get Started Programme. The results show that six of the eight participants succeeded to get started with the goals for behavioral change, and still maintain a sufficient physical activity level today. Participants who do not consider themselves to have succeeded in reaching the goals they set up in the beginning of the program, point out that they have the tools needed to go on and continue the behavioral change they strive for.