This research was undertaken approximately 20 months after the introduction of alcohol brand advertising on New Zealand television, which resulted in a fourfold increase in televised alcohol advertising and a 42% increase in overall alcohol advertising. The primary aim of the research was to examine the nature of the relationships between young people's responses to televised alcohol advertising and drinking-related behaviours. The research was based on two surveys, one with l0 to 17 year olds and one with 18 to 29 year olds. The l0 to 17 survey involved 500 randomly selected face-to-face interviews in New Zealand's three largest urban areas. The 18 to 29 survey involved 1012 interviews. Respondents were randomly selected from throughout New Zealand and interviewed using a computer-assisted telephone interviewing (CATI) system. Both surveys asked about responses to specific alcohol advertisements, which were ones these age groups had been more exposed to. One of the two key response measures identified how frequently they recalled having seen the advertisement; this was labelled recalled exposure. Positive response to the advertising was measured by liking of the advertisement. Structural equation modelling (SEM) was used for the analyses, but this was preceded by correlation and regression analyses. On the basis of factor analyses that preceded the structural equation modelling, most of the modelling was based on the responses to the three beer advertisements in each study. 10 to 17 year old survey: The findings from the structural equation modelling were consistent with the hypothesis that positive responses to beer advertising (as measured by liking) were contributing to an increase in expected frequency of future drinking. The data were also consistent with the beer advertising contributing to an increased frequency of current drinking, although the relationship was just under the 0.05 level of significance. There was some limited evidence that recalled exposure may be associated with the drinking status of 10 to 13 year olds but, because of the small number of drinkers in this age group, this result needs to be interpreted with caution. The regression analyses indicated that recalled exposure was a predictor of 10 to 17 year olds' perceptions of how often their age/gender group drank and how accepting their friends were of drinking and occasional drunkenness. Other survey responses were also indicative of an influence of alcohol advertising on young people. Alcohol advertising was an important source of information about drinking, particularly for the 10 to 13 year old males. Almost half of these younger males accepted the portrayals in alcohol advertising as realistic and almost two thirds of them felt that alcohol advertising does encourage teenagers to drink. 18 to 29 year old survey: This study provided support for the hypothesis that more positive responses to televised beer advertisements resulted in larger quantities of alcohol being consumed on typical drinking occasions by 18 to 29 year old New Zealanders. It did not provide support for the hypothesis that drinking larger quantities of alcohol led to more positive responses to beer advertisements. The model showed that positive responses to beer advertisements had both a direct influence on quantity and an indirect influence, via its influence on positive beliefs. This study also provided support for the hypothesis that more positive responses to beer advertising were associated with increased alcohol-related problems. As with the 10 to 17 year olds, recalled exposure was related to perceptions of peer influence and behaviour. It was a significant predictor for female perceptions of peer quantities consumed and male and female perceptions relating to peer approval of drunkenness. The regression analyses also identified that recalled exposure was a predictor of males saying they were drinking more than the year before, however a SEM that specified reciprocal paths between these two variables found neither path to be significant. Discussion and implications This research has identified the importance of examining positive responses to alcohol advertisements. This acknowledges the active recipient of advertising who responds positively to advertising that offers valued outcomes. It also emphasises the importance of considering emotional/affective responses to advertising. However, the study also indicates that the weight of advertising is important, as reflected in the cognitive measure of recalled exposure. This appears to be having most influence on perceptions of what is normative behaviour. The results of the SEMs must be viewed as tentative, given the exploratory nature of the analyses and the limitations of cross-sectional surveys. However, as for all the previous studies, relationships have been identified between measures relating to alcohol advertising and those relating to alcohol consumption. While it is not possible to make definitive statements about directions of influence between these variables, these studies have all provided data that are consistent with the theory-based hypothesis that alcohol advertising does have an influence on alcohol consumption by young people.

Thesis aim: This thesis aims to analyse and critically evaluate the Children Activity Scanning Tool (CAST), which measures children’s physical activity (PA) engagement levels in school playgrounds and similar environments, focusing on CAST reliability and validity using data from four health promotion projects in the Northern Rivers (Move it Groove it (MIGI) project), Illawarra, Central Coast and Dubbo areas in NSW, Australia.The overall research question is whether physical activity engagement levels of large numbers of children can be validly and reliably measured in school playgrounds and similar environments using CAST.Methodology: CAST was used to scan school playgrounds and similar environments, in which unstructured rest, play and other physical activities take place. Scanning was undertaken by a team of trained observers who concurrently scanned a pre-defined area of the playground and recorded the number of children engaged in assigned physical activity intensity categories.Criterion validity was measured in three projects comparing the total number of children counted in separate physical activity categories to an independent count of the number of children in the playground using Pearson correlation coefficients. Data obtained during instrument development were used to determine criterion validity in two projects when compared to videotapes using Pearson correlation, Cronbach alphas and 95% CI around mean engagement levels.Data obtained during development and training, as well as project field data were used for reliability testing. Cronbach alpha, Pearson correlation, factor analysis and 95% CI around mean engagement levels were used to measure inter-rater reliability.Data from multi-level regression models obtained in three projects were used to calculate intra class correlation (ICC) and composite reliabilities of scan and break level physical activity engagement.Results: Criterion validity measures comparing sums of categories counts to independent counts of all children yielded Pearson correlation coefficients of 0.97, 0.81 and 0.96 in the Illawarra, Central Coast and Dubbo projects respectively. Criterion validity measures comparing field and video scores yielded Pearson correlation coefficients of 0.47, 0.52 and 0.56 respectively in the Move it Groove it (MIGI) project, and in the Illawarra study Cronbach alphas of 0.98 and 0.85, and a Pearson correlation of 0.93. There were no significant differences between the mean numbers of children who were engaged in a physical activity level when 95% CI were used except for one category in the MIGI study.Inter-rater reliability estimates in all projects were high or very high. There were no significant differences between the mean numbers of children engaged in a physical activity level when 95% CI were used. Almost 86% (12/14) of the standardised Cronbach alpha estimates were equal to or greater than 0.93. Principal component analysis values ranged from 76%-98%. ICCs obtained from field data yielded composite reliabilities of 0.77-0.94.Conclusion: It was concluded that CAST was a valid and reliable instrument to measure physical activity engagement levels of children in school playgrounds.Recommendations: The two or three categories versions CAST should be used as they produced the highest quality data when used to observe large groups in well-defined playgrounds. Further research is needed to validate other variables (eg equipment), validate a one observer CAST version, and test the feasibility of using children as observers.

Current New Zealand health policy encourages collaborative health promotion in all sectors of health service delivery. The integrated approach to the acute management of coronary heart disease in a coronary care unit, combining medical therapy and lifestyle change, supports clinical health promotion. The aim of this study was to use the grounded theory approach to discover the main concerns of nurses' promoting health in an acute coronary care setting and to explain the processes that nurses used to integrate health promotional activities into their practice. Seventeen registered nurses from three coronary care units within a large metropolitan city in New Zealand were interviewed. Data were constantly compared and analysed using Glaser's emergent approach to grounded theory.The main concern for nurses promoting health within coronary care was ritualistic practice. In this study, ritualistic practice concerns the medically-based protocols, routines, language and technology that drives nursing practice in coronary care. This concern was resolved via the socio-cultural process of attitudinal shifting that occurs over time involving three stages. The three conceptual categories, environmental pressures, practice reality and responsive action are the main components of the theory of attitudinal shifting. In environmental pressures nurses experience a tension between specialist medically-dominated nursing practice and the generalist nursing role of promoting health. In practice reality, nurses become aware that the individual needs of patients are not being met. This causes role conflict until the nurse observes colleagues who role model possibilities for practice, working with patients to promote health. Responsive action sees the nurse engaging in self-development, also focusing on the nurse-patient relationship, thereby enabling active patient involvement in individual health-promoting decisions.The findings from this research have implications for nursing practice and education. With the increasing specialisation in nursing practice, these findings may be of interest to nurses working in delegated medical roles where the reality of everyday practice precludes nurses from undertaking their essential nursing role. Health care facilities also need to ensure that there are opportunities for the personal and professional development of nursing staff. The place of health promotion within nursing undergraduate curricula needs to be examined, as many nurses found that they were ill prepared for undertaking health promotional activities.

Cardiovascular disease is a major cause of death in most Westernised countries. The prevalence of obesity, type 2 diabetes mellitus and cancers is rapidly increasing. Older people with elevated blood lipids, obesity and DNA damage are at high risk of developing these diseases. There is a plethora of research to support the claim that a healthy diet and increased physical activity can reduce the risk of increased body fatness, diabetes and generally improve health. However, most interventions require intensive one to one advice. The aim of this study was to measure the effect of a group approach to advising on changes in lifestyle with particular attention to foods high in fibre. The study spanned a period of 12 weeks with a follow up session at 52 weeks to ascertain sustainability. The study: This study was a 12 week longitudinal intervention study with a follow up after 52 weeks. Measurements of anthropometry (skin folds, girths, weight and height), blood pressure, body fat by bio impedance and fasting blood (lipids, glucose and insulin) were made at weeks 0, 3, 6, 9,1 2 and 52. The participants were asked to complete a food frequency questionnaire and a physical activity questionnaire at each of the 6 measuring sessions and to provide an indication of what the goals that they had set and if they had accomplished them after 9,12 and 52 weeks. Between measurements at weeks 0 and 3 the volunteers were left to follow their usual food and activity pattern. Then as a group they were given a diet and exercise talk and provided with written material and pedometers to increase motivation. After measurement at week 6 they were randomly divided into two groups. The first group (A) were prescribed and provided with kiwifruit at a dose of 100g/30 kg body weight for three weeks while the second group (B) continued with the changes in diet and physical activity. Following measurement at week 9 group A abstained from kiwifruit while Group B added the kiwifruit to their diet and the measurements repeated. After 52 weeks, with only emails as ongoing communication, they were remeasured. Results For this multicultural, relatively middle aged group of 53 staff (28 women, 25 men) of mean age 46 years, measurable and statistically significant metabolic gains were made in the lipid profile over 12 weeks. Total cholesterol, LDL cholesterol, triglycerides and the ratio of total cholesterol to HDL all decreased and HDL increased significantly. Total cholesterol decreased from 5.6(±1.1) mean (±SD) mmol/L at baseline to 5.3(±1.1) mmol/L at week 12 (p<0.001); LDL cholesterol decreased from 3.5(±0.97) mmol/L at baseline to 3.3(±0.94) mmol/L at week 12 (p<0.001); and total cholesterol to HDL ratio decreased from 4.0(±1.1) to 3.7(±0.9) (p<0.001). In the 36 who were measured at 52- week follow- up these changes persisted. With the other outcome measures glucose showed a statistically but not biologically significant decrease over the 12 week period and body composition, blood pressure and insulin showed no significant change. The kiwifruit crossover had no apparent affect on the measures of any of the measurements reported. The participants reported that they increased fruit and vegetable and oily fish consumption and increased physical activity. These increases took place over the initial 12 week period and were maintained over 52 weeks. Conclusion: This study has shown that changes in diet and physical activity can favourably influence blood biochemistry even without accompanying changes in percentage body fat and weight. Furthermore, small, manageable lifestyle changes can result in biochemical changes persisting over 52 weeks.

Thesis aim: This thesis aims to analyse and critically evaluate the Children Activity Scanning Tool (CAST), which measures children’s physical activity (PA) engagement levels in school playgrounds and similar environments, focusing on CAST reliability and validity using data from four health promotion projects in the Northern Rivers (Move it Groove it (MIGI) project), Illawarra, Central Coast and Dubbo areas in NSW, Australia.The overall research question is whether physical activity engagement levels of large numbers of children can be validly and reliably measured in school playgrounds and similar environments using CAST.Methodology: CAST was used to scan school playgrounds and similar environments, in which unstructured rest, play and other physical activities take place. Scanning was undertaken by a team of trained observers who concurrently scanned a pre-defined area of the playground and recorded the number of children engaged in assigned physical activity intensity categories.Criterion validity was measured in three projects comparing the total number of children counted in separate physical activity categories to an independent count of the number of children in the playground using Pearson correlation coefficients. Data obtained during instrument development were used to determine criterion validity in two projects when compared to videotapes using Pearson correlation, Cronbach alphas and 95% CI around mean engagement levels.Data obtained during development and training, as well as project field data were used for reliability testing. Cronbach alpha, Pearson correlation, factor analysis and 95% CI around mean engagement levels were used to measure inter-rater reliability.Data from multi-level regression models obtained in three projects were used to calculate intra class correlation (ICC) and composite reliabilities of scan and break level physical activity engagement.Results: Criterion validity measures comparing sums of categories counts to independent counts of all children yielded Pearson correlation coefficients of 0.97, 0.81 and 0.96 in the Illawarra, Central Coast and Dubbo projects respectively. Criterion validity measures comparing field and video scores yielded Pearson correlation coefficients of 0.47, 0.52 and 0.56 respectively in the Move it Groove it (MIGI) project, and in the Illawarra study Cronbach alphas of 0.98 and 0.85, and a Pearson correlation of 0.93. There were no significant differences between the mean numbers of children who were engaged in a physical activity level when 95% CI were used except for one category in the MIGI study.Inter-rater reliability estimates in all projects were high or very high. There were no significant differences between the mean numbers of children engaged in a physical activity level when 95% CI were used. Almost 86% (12/14) of the standardised Cronbach alpha estimates were equal to or greater than 0.93. Principal component analysis values ranged from 76%-98%. ICCs obtained from field data yielded composite reliabilities of 0.77-0.94.Conclusion: It was concluded that CAST was a valid and reliable instrument to measure physical activity engagement levels of children in school playgrounds.Recommendations: The two or three categories versions CAST should be used as they produced the highest quality data when used to observe large groups in well-defined playgrounds. Further research is needed to validate other variables (eg equipment), validate a one observer CAST version, and test the feasibility of using children as observers.

This research was undertaken approximately 20 months after the introduction of alcohol brand advertising on New Zealand television, which resulted in a fourfold increase in televised alcohol advertising and a 42% increase in overall alcohol advertising. The primary aim of the research was to examine the nature of the relationships between young people's responses to televised alcohol advertising and drinking-related behaviours. The research was based on two surveys, one with l0 to 17 year olds and one with 18 to 29 year olds. The l0 to 17 survey involved 500 randomly selected face-to-face interviews in New Zealand's three largest urban areas. The 18 to 29 survey involved 1012 interviews. Respondents were randomly selected from throughout New Zealand and interviewed using a computer-assisted telephone interviewing (CATI) system. Both surveys asked about responses to specific alcohol advertisements, which were ones these age groups had been more exposed to. One of the two key response measures identified how frequently they recalled having seen the advertisement; this was labelled recalled exposure. Positive response to the advertising was measured by liking of the advertisement. Structural equation modelling (SEM) was used for the analyses, but this was preceded by correlation and regression analyses. On the basis of factor analyses that preceded the structural equation modelling, most of the modelling was based on the responses to the three beer advertisements in each study. 10 to 17 year old survey: The findings from the structural equation modelling were consistent with the hypothesis that positive responses to beer advertising (as measured by liking) were contributing to an increase in expected frequency of future drinking. The data were also consistent with the beer advertising contributing to an increased frequency of current drinking, although the relationship was just under the 0.05 level of significance. There was some limited evidence that recalled exposure may be associated with the drinking status of 10 to 13 year olds but, because of the small number of drinkers in this age group, this result needs to be interpreted with caution. The regression analyses indicated that recalled exposure was a predictor of 10 to 17 year olds' perceptions of how often their age/gender group drank and how accepting their friends were of drinking and occasional drunkenness. Other survey responses were also indicative of an influence of alcohol advertising on young people. Alcohol advertising was an important source of information about drinking, particularly for the 10 to 13 year old males. Almost half of these younger males accepted the portrayals in alcohol advertising as realistic and almost two thirds of them felt that alcohol advertising does encourage teenagers to drink. 18 to 29 year old survey: This study provided support for the hypothesis that more positive responses to televised beer advertisements resulted in larger quantities of alcohol being consumed on typical drinking occasions by 18 to 29 year old New Zealanders. It did not provide support for the hypothesis that drinking larger quantities of alcohol led to more positive responses to beer advertisements. The model showed that positive responses to beer advertisements had both a direct influence on quantity and an indirect influence, via its influence on positive beliefs. This study also provided support for the hypothesis that more positive responses to beer advertising were associated with increased alcohol-related problems. As with the 10 to 17 year olds, recalled exposure was related to perceptions of peer influence and behaviour. It was a significant predictor for female perceptions of peer quantities consumed and male and female perceptions relating to peer approval of drunkenness. The regression analyses also identified that recalled exposure was a predictor of males saying they were drinking more than the year before, however a SEM that specified reciprocal paths between these two variables found neither path to be significant. Discussion and implications This research has identified the importance of examining positive responses to alcohol advertisements. This acknowledges the active recipient of advertising who responds positively to advertising that offers valued outcomes. It also emphasises the importance of considering emotional/affective responses to advertising. However, the study also indicates that the weight of advertising is important, as reflected in the cognitive measure of recalled exposure. This appears to be having most influence on perceptions of what is normative behaviour. The results of the SEMs must be viewed as tentative, given the exploratory nature of the analyses and the limitations of cross-sectional surveys. However, as for all the previous studies, relationships have been identified between measures relating to alcohol advertising and those relating to alcohol consumption. While it is not possible to make definitive statements about directions of influence between these variables, these studies have all provided data that are consistent with the theory-based hypothesis that alcohol advertising does have an influence on alcohol consumption by young people.

Thesis (Ph. D.)--University of Alabama at Birmingham, 2006. / Title from first page of PDF file (viewed Feb. 14, 2008). Includes bibliographical references (p. 97-100).

Diss. (sammanfattning) Linköping : Linköpings universitet, 2007. / Härtill 5 uppsatser.

Diss. (sammanfattning) Linköping : Univ., 2002. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 4 uppsatser.