Increasing physical activity levels of older adults is a public health priority given the associated risks with sedentary lifestyles. Exercise such as walking may positively affect older adults as they age decreasing the risk of heart disease, stroke, or death. The purpose of this study was to examine physical activities of older adults in senior housing and to determine if age correlates with the amount of physical activity. Physical activity studies on older adults are limited due to time and resources. The health belief model and transtheoretical model frames this study theorizing that older adults will take positive steps towards achieving recommended physical activities based on their perceived threats and benefits. A correlational research design provided systematic information about physical activities of older adults in senior housing and aided in determining if age relates to the amount of physical activity. The study used a convenience sampling of 62 older adults in senior housing and data collected from the Community Health Activities Model Program for Seniors questionnaire. The make-up of the sample included 36 females and 26 males aged 65 to 84 years old. The age of older adults in a senior housing community is not related to the amount of physical activity completed per week. The results of the descriptive analyses show that 53% of older adults in senior housing are not meeting physical activity guidelines of at least 150 minutes of physical activity per week. However, this is not statistically significant since all p-values for physical activity are greater than .05% level of significance at .776. Additional services such as providing leisure activity support to older adults through peer monitoring or adequate recreational facilities in the community can aid in helping older adults achieve physical activity recommendations.

Obesity is a pandemic that directly affects chronic health problems and mortality. Researchers have shown that more than 54% of nurses are obese. The increasing rate of obesity among nurses and the long hours they work make healthy lifestyles, including daily physical activity, difficult. Tracking daily activity using a pedometer or fitness application has shown improved awareness and sustainability of daily physical activity. This project was an investigation of the daily steps of bedside nurses working a 12-hour shift, and their subsequent awareness of their daily physical activity. Pender's Health Promotion Model was used to consider motivating factors for improving daily physical activity. Thirty-seven nurses were recruited to use a pedometer application for 24 hours on a (12-hour) workday to track their steps for 3 consecutive days, as well as complete a final survey. A repeated measures ANOVA, with a Greenhouse-Geisser correction, determined that there was no statistical difference in the number of steps over the 3 time periods. Seventy-eight percent of the participants indicated that the project increased their awareness of physical activity. Extended research is needed to add a stronger support for the affect of wearing a pedometer and the benefits of increased awareness on health promotion. Pender's health promotion model suggests adding motivating factors such as competition. Fitness trackers now have this function and could play a large role in improving physical activity awareness and the battle of obesity for nurses and the general population. The results of this study may promote positive social change by making nurses more aware of the importance of their health and physical activity, given their long work days.

The purpose of this study was to understand the role of Sport for Development (SFD) in addressing health disparities in low-SES communities. This was done using a multiple case study design, in which administrators, staff, and youth participants from five SFD programs were interviewed. A theoretical model, consisting of the theory of fundamental causes (Link & Phelan, 1995), the classification of SFD programs (Coalter, 2007), and the ecological model of health promotion (McLeroy, 1988), was developed to guide this study. Interviews were transcribed and then analyzed using a deductive coding process (Gilgun, 2005). The findings revealed that the SFD programs in this study were driven by goals such as providing access and opportunity to sport, helping youth develop life skills, and promoting health. The programs worked to achieve those goals by providing education, through their use of sport, and by providing resources and services. Finally, the programs in this study promote health at the intrapersonal, interpersonal, organization, environment, and policy levels. These findings hold various practical, scholarly, and policy implications and could shed light on how SFD programs may operate in order to reduce health disparities among low-SES populations.

Employers adopt worksite health promotions to reduce the incidence of preventable diseases, reduce healthcare costs, reduce absenteeism and presenteeism, and improve productivity. The purpose of this qualitative phenomenological study was to explore the motivational factors affecting employee participation in employer-sponsored health awareness programs. The theory of planned behavior grounded the study and formed the conceptual framework. Data collection occurred through semistructured interviews with 24 participants in the northeastern United States with lived experiences in worksite health promotion. Participants answered open-ended interview questions regarding the motivations for engaging in health promotions. Data were transcribed and coded for trends and themes. During data analyses, 4 themes emerged, which included program recruitment and notification, employer commitment, employee motivations, and incentives and rewards. The implications for positive social change include the potential for employers incorporating the results to instigate enhanced employee participation in employer-sponsored health awareness programs. Higher employee rates of participation may aid employers in achieving the established benefits of worksite health promotion and may contribute to improving the health of employees.

Local public health units in the province of Ontario, Canada, are often the primary source of health promotion and health education resources, but many do not provide programming specific to the Indigenous population. As of January 2018, modernization of the Ontario Public Health Standards requires public health units to work with the Indigenous population in providing culturally appropriate programs and services. The practice question guiding the capstone project was to determine what chronic disease and injury prevention programs exist that are culturally appropriate for the Indigenous population. The purpose of this project was to do an environmental scan and compile an inventory of existing health promotion programming that is culturally appropriate to the Indigenous population. In total, 72 Indigenous-specific programs were identified from the 26 organizations that were included in the environmental scan. Of the 26 organizations, 3 were public health units, 7 were Aboriginal health access centers, 7 were Indigenous friendship centers, 5 were Indigenous health organizations, and 4 were non-Indigenous organizations with an Indigenous component. Results from the capstone project will inform public health units of available, culturally appropriate programs that can be adapted to their local context, thereby addressing a significant gap in the current public health system. This doctoral project aligns with the design of a new model of care in the Ontario public health system and has the potential to address a gap in practice at both the local and provincial level by providing culturally appropriate guidance in the effective delivery of CDIP programming specific to the Indigenous population. This positive social change would impact the health status of this underserved population.

Le travail de recherche présenté ici prend place dans le département de l’Allier, en Auvergne. Au travers de deux dispositifs – le premier vise à réduire les inégalités sociales de santé d’un territoire, le second à impliquer les membres des établissements scolaires dans une réflexion sur la promotion de la santé – nous cherchons à déterminer les relations qu’il peut y avoir entre les conceptions et les pratiques déclarées de collégiens avec les conceptions et les pratiques déclarées de professionnels d’un territoire sur les questions de santé et de bien-être des adolescents. Pour explorer ce sujet, nous nous appuyons sur deux recueils de données. Le premier est constitué de 49 entretiens semi-directifs et concerne les conceptions et pratiques déclarées de professionnels par rapport aux questions de santé et de bien-être des adolescents. Le second, basé sur 1170 questionnaires renseignés par des collégiens, porte sur les conceptions que les adolescents ont de leur santé et de leur bien-être ainsi que sur leurs pratiques relatives à ces questions. L’étude des systèmes de conceptions de divers professionnels en lien avec les conceptions et pratiques d’adolescents nous permettent de penser que la formation des professionnels sur les questions de santé, d’éducation à la santé et de promotion de la santé devraient permettre aux différents acteurs de mieux appréhender la complexité de leur public concernant les questions de santé et de bien-être, de mieux prendre en compte les différentes dimensions de la santé en favorisant le développement des compétences psychosociales et l’empowerment de leur public ainsi que la qualité des interactions entre pairs. De même, les questions concernant la prise en compte par les professionnels de l’environnement, notamment familial, des adolescents devraient être approfondies. / This research work takes place in the Department of Allier in Auvergne in Central France. Through two projects - the first aims to reduce social inequalities in health of a territory, the second aims to involve schools in a reflection on the health promotion - we are trying to determine the relationships there may be between the conceptions and declared practices of middle school students with the conceptions and the practices of professionals of a territory on issues of health and well-being of adolescents. To explore this topic, we rely on two collections of data. The first consists of 49 semi-structured interviews with respect to conceptions and practices of professionals with regard to questions of health and well-being of adolescents. The second, based on 1170 questionnaires filled in by school boys and girls, deals with conceptions and declared practices that adolescents have on their health and their well-being. The review of systems of conceptions of various professionals in relation to the concepts and practices of adolescents allow us to think that the training of professionals on the issues of health, health education and health promotion should enable stakeholders to better understand the complexity of their public about health and well-being issues; better take account of the different dimensions of health by promoting the development of life-skills and the empowerment of the adolescents and the quality of peer relationships. Then, issues concerning how does stakeholders take into account environment of adolescents, including family, should be improved.

Evidence supporting the benefits of worksite health promotion (WHP) programs is extensive. Research shows these programs can improve the health of participants, lower health care costs, and improve the bottom line of employers. Although the evidence of these benefits is vast, reported participation in WHP is not optimal. Little published data exists on employees' perceived incentives and barriers for participation in WHP. The purpose of this study was to determine perceived barriers and incentives for participation in an existing WHP program at a large land-grant university. Opinions of eligible WHP participants were collected using a web-based questionnaire (n = 321). The questionnaire was adapted from questions used in the 2004 HealthStyles survey. Overall percentages and odds ratios of responses were calculated and stratified by demographics. Respondents were 68.5% female, 76.6% were college graduates, 47% were active, and 32.7% had a BMI ≥ 30. The most common reported barrier to using employee wellness services was no time during work day (60.2%). Women were more likely than men to report lack of energy (OR, 4.5; 95% CI, 1.7-11.9) and no time during work day (OR, 2.6; 95% CI, 1.4-4.8) as barriers to participation. Respondents who were underweight and overweight were less likely to report lack of energy than respondents who were obese (OR, 0.2; 95% CI, 0.1-0.6; OR, 0.4; 95% CI, 0.2-0.9). The most common reported incentive was having programs at a convenient time (66.6%). Younger respondents were much more likely to report paid time off work to attend as incentive to participate than respondents 60 or more years (18-29 years OR, 10.8; 95% CI, 2.9-40.1; 30-34 years OR, 4.2; 95% CI, 1.5-11.7; 35-44 years OR, 3.1; 95% CI, 1.3-7.4). Most preferred wellness service or policies were available fitness center (75.9%), health screening tests (75.6%), and paid time to exercise at work (69.6%). The results of this study, combined with an employer's own employee needs assessment, may help universities, and other employers with similar characteristics, design more attractive employee wellness programs. Making employee wellness programs attractive to their potential participants may improve program participation.

Using advanced technologies can help increase the availability of educational offerings; however, the steps taken in this direction must be appropriate for the target population and the specific content taught. As such, understanding factors that lead to health educators' intentions and behavior related to computer-mediated instruction for continuing education is an important step in developing and marketing appropriate computer-mediated instruction programs (Hoffman & Novak, 1994). Using the theory of planned behavior (Ajzen, 1988) this study explored the relationships between health educators' perceived behavioral control, attitudes, and subjective norms related to computer-mediated continuing education programs and their intentions to use, and previous experience with, computer-mediated education. Employing a cross sectional survey design, data were collected from 504 members of the Society for Public Health Education (SOPHE) (40% response rate) using an online survey instrument. Logistic regression was used to investigate the associations between attitudes, subjective norm, perceived behavioral control, and intention related to using computer-mediated continuing education programs and a proxy measure representing their computer-mediated continuing education behavior. Perceived behavioral control and attitudes were found to have significant associations with computer-mediated continuing education behavior, with intention partially mediating the association with perceived behavioral control and fully mediating the association with attitudes. When studying a subset of the group composed of respondents with a positive intention toward computer-mediated continuing education programs, respondent characteristics and barriers identified as distinguishing between individuals with positive and negative behaviors included perceived behavioral control, presence of a license or certification, a lack of programs, a lack of relevant topics for programs, and a lack of technical support for programs. These results suggest that for health education and health promotion professionals to engage in computer-mediated continuing education programs, more programs, especially ones that address topics relevant to their current functioning, need to be created and made readily available. Also, ensuring that appropriate technical support is available to assist participants, and informing potential participants of the availability of this technical assistance, may encourage more health educators and health promotion professionals to follow through on their intentions to participate in computer-mediated programs.

This is a study of the communication environment at The Amazing You, an exhibition about health and wellness with over 400 different exhibits at the Tampa Museum of Science and Industry (MOSI). The purpose of this study is to describe a multi-media, multi-vocal health communication environment which incorporates forms of intervention from various medical communities of practice into a narrative about human life stages. Describing communication at a science center as circular, complex and multi-directional allows for notions of feedback to be considered in an otherwise unilinear and unidirectional process from message to receiver. This research is about science center communication as an integrative, wrap-around process, from medical experts, to exhibit designers, to visitors, and back. In this study I have interviewed MOSI executives to find out about the purposes of the exhibition and the process of consultation, design and implementation. I have also conducted 72 surveys and 22 in-depth interviews with MOSI visitors to elicit feedback about the exhibition. This ethnographic inquiry into a health communication environment shows how visitors are urged to identify with health promotion messages which interpellate them as disease candidates. Using theoretical concepts from frame analysis, classical rhetoric and speech act theory opens up new lines of inquiry for exhibit designers, museum administrators, visitor researchers and critical communication researchers interested in multimedia health promotion.

Cancer is the second leading cause of death in the United States. Prostate cancer is the leading cause of cancer deaths among African American men, and African American men have the highest incidence of prostate cancer in the world. Limited studies have been conducted that address this critical issue. Existing literature reveals that the primary cause of increased mortality rates of prostate cancer in African American men is lack of participation in prostate cancer screening activities. The purpose of this three-phase study was to develop a valid and reliable instrument to measure prostate cancer screening intention among African American men. Three gender-specific focus groups were conducted in the first phase of the study. Twenty men from two north Florida churches participated in the focus groups. Eight dominant themes emerged from the focus groups and were utilized to develop the items for the intention instrument: fear, healthy lifestyle, hopelessness/helplessness, machismo, mistrust of healthcare providers, social/familial support, job requirements and transportation barriers. The second and third phases of the study consisted of development of the instrument and assessment of the instrument for validity and reliability. The Cancer Screening Intention Scale-Prostate (CSIS-P) consists of 43 items and was developed utilizing the results of the focus groups. The reading level of the CSIS-P was 5.6 utilizing the Flesch-Kincaid index and 7.0 utilizing the SMOG Readability Formula. The CSIS-P was assessed for content validity by a panel of oncology experts. The content validity index for the scale was .90 and internal consistency was found to be .92. The CSIS-P was evaluated for construct validity utilizing factor analysis techniques. Test-retest procedures were also conducted to assess stability of the CSIS-P and the reliability coefficient was .93. Factor analysis techniques demonstrated a three-structure model. The factors that emerged were benefits to prostate cancer screening, barriers to prostate cancer screening, and health promotion. The internal consistency of the three factors were found to be .88, .81, and .86 respectively. Factor analysis procedures reduced the CSIS-P to a 17-item scale. The CSIS-P is a parsimonious, culturally sensitive instrument that is valid and reliable in assessing prostate cancer screening intention. Recommendations for future study of the instrument include replication of the study with a more heterogeneous sample and utilization of the scale with other cancers.