Background: The prevalence of adult overweight and obesity is increasing worldwide. Innovative weight reduction interventions are needed to decrease the physical, psychological, and financial costs associated with this condition. Individually-adapted physical activity interventions delivered by Health Educators in a primary care setting have shown promise in addressing adult overweight and obesity. Process evaluations are needed to clarify results obtained from randomized controlled trials and to provide insight regarding optimal programming strategies for obesity reduction interventions. Purpose: To investigate the process evaluation components dose, fidelity, and quality of implementation of the PROACTIVE intervention to increase physical activity among overweight and obese adults in a primary care setting. Methods: One hundred ninety-four overweight or obese adults (135 women, mean age = 51.3 years, SD = 10.8; 59 men, mean age = 54.3 years, SD = 10.6) were randomized to attend 22 individualized behavioural counselling sessions over 12 months. The Physical Activity Recall questionnaire, Session Summary Forms, and Health Care Climate Questionnaire were utilized to measure physical activity and intervention dose, fidelity, and quality. Hierarchical multiple regressions were conducted. Results: Overall physical activity and total active hours did not significantly change after 6 and 12 months of participation in PROACTIVE; however, physical activity intensity did significantly change. Light intensity physical activity decreased while moderate intensity physical activity increased from baseline to 6 months; this shift was maintained from 6 to 12 months. Dose and fidelity of implementation did not predict physical activity involvement at 6 and 12 months. Three-quarters of the intervention was implemented as planned and women received a significantly greater percentage of intervention content then men. Quality of the Health Educator-client relationship significantly predicted total number of hours spent being physically active at 12 months, but should be interpreted with caution due to the small sample size. Conclusion: Preliminary results suggest that dose and fidelity do not predict physical activity involvement and that additional research is warranted to investigate quality. It is recommended that future studies examine the critical intervention content that correlates to an increase in physical activity among overweight and obese adults. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2009-06-26 23:21:43.09

The workplace has been accepted by health professionals and planners as a 'setting' for health promotion. With a paucity of information about health promoting action in the Scottish workplace, this study sought to identify information which would assist health promoters to develop this area of work. Two inter-related investigations were directed to the Ultimate Decision Makers in a range of Scottish business: first, a postal survey to identify the nature and occurrence of health promotion; and second, a series of interviews to explore those factors which encourage and/or deter action in a selection of high and low health promoting businesses. The study showed that whilst there are health promoting actions occurring, they are predominantly mechanistic in nature - to conform to laws, solve a problem or avoid litigation. Beyond these influences, the nature and extent to which health is promoted is very dependent on the personal characteristics of the ultimate decision maker, and to a lesser degree, a variety of other key decision makers. The decision makers' concepts of health and its promotion rarely coincided with those of the health professionals in that action was more likely to be based on coping with the absence of health rather than its enhancement. The business in the study lacked staff with knowledge and skills concerning health promotion and the methods used by professionals to make contact with workplace personnel did not appear to coincide with the way businesses are organised. Moreover changes in the Business world are enabling employers to exploit the 'healthy worker' effect AND avoid long term responsibility for employees. Thus the motivation to promote the health of the workforce is reduced. As a consequence, the factors which made the workplace attractive to health professionals as a 'setting' for health promotion may be disappearing.

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In recent years, an increasing number of companies around the world are offering workplace health promotion (WHP) programmes. They describe various activities that promote healthier lifestyles. Companies using WHP operate under two assumptions. First, they recognise that it is less expensive to prevent illness than to cure it and, second, that good health can be achieved through improved personal lifestyles. Employer benefits for the company include reductions in absenteeism rates and increased staff productivity while employees learn to change unhealthy behaviour patterns and make efforts to prevent illness. / Thesis (DBA(DoctorateofBusinessAdministration))--University of South Australia, 2006.

Thesis (MBus)--University of South Australia, 1998

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