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Acute coronary syndrome (ACS), the acute manifestation of coronary heart disease (CHD), is the leading cardiovascular cause of mortality and morbidity globally, and represents one of the most common causes of acute medical admissions to Australian hospitals. Following medical and/or surgical management of ACS, lifestyle modification to reduce the underlying risk factors that contribute to the progression of the disease remains vital. Cardiac rehabilitation (CR) has been widely accepted as an intervention that can reduce mortality and modify risk factors for subsequent coronary events and cardiovascular disease. While the benefits of cardiac rehabilitation programs have been demonstrated, participation and adherence to these programs remain low for various reasons, particularly among patients whose treatment includes revascularisation with percutaneous coronary intervention. This method of revascularisation has become increasingly common due its immediate success, rapid procedural technique, short hospital stay and early return to work for patients of working age. The aim of this study was to develop and test the feasibility of an evidence-based health-related lifestyle management program for risk factor modification in patients with ACS undergoing percutaneous coronary intervention. Four distinct yet interrelated studies were undertaken as part of the Development and evaluation of a Health-related Lifestyle self-Management (HeLM) intervention for patients with ACS Project. Three of these studies informed the development of the HeLM intervention, which was based on the principles of chronic disease self-management and evidence-based practice that included best evidence from the literature, clinical expertise and patient preferences. The first study was a systematic review of the literature to identify the best available evidence of the effect of brief interventions for lifestyle modification in patients with CHD. Findings from the 17 trials included in the systematic review, although inconclusive suggest that brief structured interventions can have beneficial effects on risk factor modification and consequently on progression of CHD. The second study was a qualitative interview of CR coordinators to identify from their clinical expertise the influence of the Reducing Risk in Heart Disease guidelines on practice: the Implementation of the Cardiac Evidence-Based Reducing Risk in Heart Disease Guidelines (ICEBRG) study. Findings from this study indicated limited implementation of the guidelines due to various barriers relating to health services, CR programs, professional practice and the patient and their families. Despite these barriers, it was evident that CR coordinators were striving to overcome these odds and provide evidence-based care. The third study undertaken to identify patient preferences for CR was the Follow-up After percutaneous Coronary Treatment (FACT) Study. The findings indicated that although the majority of the participants had two or more risk factors, they lacked knowledge of the link between risk factors and CHD, and less than a third had attended CR. The main reasons for nonattendance included timing, distance to travel, length of program, work commitments and lack of motivation to attend the programs. Their suggestions for improvement included telephone follow-up and flexibility of the CR programs. This study also informed the development of a tool that can be used by clinicians to flag patients who are unlikely to attend traditional CR. Identification of these people will allow alternate strategies to reduce risk factors to be tailored to their needs. The findings from these three studies were used to develop the HeLM intervention. The final study was undertaken to assess the feasibility of the HeLM intervention that was based on evidence compared to standard treatment for promoting lifestyle modification. This study was undertaken in 51 participants who were followed up two weeks following the completion of the intervention. The findings demonstrated that patients found the information beneficial and were pleased to receive it in their homes. The telephone support was also extremely well received. The study enabled the program and the process for implementation to be refined and indicated that a large multicentre trial would be feasible. The HeLM may be a strategy that could reach patients who have thus far eluded traditional CR programs and support them to make the necessary lifestyle changes. It may also be an adjunct to traditional CR and have a synergistic effect in facilitating health-promoting behaviours in CHD patients. Studies of interventions for risk factor modification in participants with CHD require longer term follow-up to assess the effect of the intervention in the sustainability of behaviour modification. Further research is necessary to evaluate the long-term effects as well as the cost effectiveness of the intervention. / Doctor of Philosophy (PhD)

This final thesis deals with an analysis of segment of LOHAS (Lifestyles of Health and Sustainability) consumers on the Czech market. It investigates the existence of the consumer life style LOHAS, specifically in the South Bohemian region, which has been confirmed. Further it focuses on the main characteristic features which are typical for this segment. One of them primarily is the focus on proven brands, quality, design, smaller packaging of the products and responsible production of products preferably by local producers. It also addresses the fact the ?Lohasians? live in the area of the south Bohemia, they prefer foodstuffs/drinks based on natural sources and energetic efficient electrical devices. They think in an ecological and modern way, they like walking and while travelling they like not only having fun and enjoy adventure but they also like nature and its protection. At the same time the thesis provides information the south Bohemian followers of LOHAS are still influenced by price, marketing and sudden impulses. They don?t tend to use e.g. solar panels or hybrid cars either. It explains as well that it?s the consumers in the first place who are numerously represented in the age category over 56 years. Finally it deals with recommendations which the producers should follow if they wish this segment of consumers with large potential to be addressed.

(in English) In the text of this diploma thesis, the author deals with the realization of healthy lifestyle education within the family and the school. Firstly, this thesis sorts accessible information about health and a healthy lifestyle. It looks into the family and school environments, their interaction, and the possibilities to a healthy lifestyle. It describes the main principles of the "Healthy School" program, a health support program, in the following areas: environment, healthy teaching and learning, and open partnership. The aim of the thesis was to determine whether the elementary school Lesní in Liberec still employs the Healthy School program, which it has been involved in since 2002, for its healthy lifestyle teaching. Structured observation via observation sheets, in-depth interview and school documents analysis were used in the case study. The findings are stated in the practical part of the thesis which brings a real perspective on the healthy lifestyle education on the particular school and the issues that may be connected with it.