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Extensive research has clearly revealed that people of all ages can enhance their health by simply incorporating moderate levels of physical activity into their daily routine. Physical activity significantly reduces the risk of morbidity and mortality from coronary heart disease while providing protective benefits from hypertension, diabetes mellitus, osteoporosis, and colon cancer. Physical activity can lead to positive psychological improvements by decreasing levels of anxiety and depression, and enhancing self-esteem. However, despite the tremendous physical and mental health benefits, 60% of American adults do not regularly engage in physical activity and 25% are completely inactive. Moreover, only 34 % of Virginians engage in regular physical activity. Immense progress has been made in terms of understanding physical activity behavior. Many techniques based on theoretical models have been developed for intervening with physical activity behaviors and designing of programs. The Transtheoretical model is considered one of the most promising approaches for enhancing physical activity behavior. This model integrates current behavioral status with a person's intention to change his/her behavior and suggests that individuals attempting to adopt a health behavior progress through five stages of change: precontemplation, contemplation, preparation, action, and maintenance. The concepts of self-efficacy (degree of confidence) and decisional balance (perceived benefits and barriers) are often used in conjunction with the stages of change for physical activity interventions to help individuals progress through the five stages of change. A survey was conducted among 243 Family and Consumer Sciences educators and clientele in Virginia's Cooperative Extension program. Attitudes, preferences, stages of change, perceived incentives and barriers, along with desired education channels and activities were analyzed to provide a basis for development of effective Extension publications and programs aimed to increase and improve levels of physical activity. Results from this study indicate that almost half of the respondents are not regularly engaging in physical activity and 31% are not engaging in any activity. Data revealed significant relationships between the stages of exercise change with respondents' levels of confidence (p<.0001) and with decisional balance scores (p<.0001). Participants who lead sedentary lifestyles or participate occasionally in physical activity (precontemplation contemplation, and preparation stages) viewed the barriers of physical activity to surpass the benefits. Consequently, these participants had low confidence in their ability to participate in physical activity. On the other hand, participants who exercised on a regular basis (action and maintenance stages) perceive the benefits for physical activity to outweigh the barriers. Furthermore, these participants had high confidence in their ability to exercise in challenging situations. Results from this study also suggest that stage of exercise change may be related to an individual's educational level. Regardless of age and gender, educational channels in which respondents selected to receive physical activity information were brochures and newsletters. In addition, activities in which respondents were most frequently engaging were walking and yard work. The activity that subjects selected as a means to increase physical activity levels was also walking. The results from this study can help Extension agents and specialists develop appealing physical activity educational materials and programs that meet the needs of FCS clients. These programs may help FCS clients incorporate regular physical activity in their daily lives, moving closer to achieving the State's objective for increasing physical activity among Virginia adults and, thus, leading to improved quality of life. / Master of Science

<p>Syftet var att undersöka fyra hälsovägledares uppfattningar och strategier för att motivera individer till viktminskning. Avsikten var även att utreda vad de bygger sina uppfattningar och strategier på, samt att jämföra deras strategier med befintliga teorier om beteendeförändring såsom Motiverande samtal, Stages of change, Social learning theory och Health belief model. Teorierna valdes då de belyser hur en beteendeförändring kan gå till samt att de varit fram­gångsrika i tidigare forskning. Studien är kvalitativ och genomfördes med ostrukturerade intervjuer där respondenterna valdes genom ett bekvämlighetsurval. De fyra hälsovägledarna arbetade med att motivera individer till viktnedgång, alla hade utbildning inom hälso­främjande arbete som varierade mellan en vecka till flera år. Resultatet visade på att hälso­vägledarna använder sig av befintliga teorier samt av strategier som bygger på deras utbildning och egna erfarenheter. De förändrar sin arbetsmetod efterhand som de får ny kunskap samt då de reflekterar över sitt arbetssätt, vilket tyder på att de är reflekterande praktiker.</p>

Syftet var att undersöka fyra hälsovägledares uppfattningar och strategier för att motivera individer till viktminskning. Avsikten var även att utreda vad de bygger sina uppfattningar och strategier på, samt att jämföra deras strategier med befintliga teorier om beteendeförändring såsom Motiverande samtal, Stages of change, Social learning theory och Health belief model. Teorierna valdes då de belyser hur en beteendeförändring kan gå till samt att de varit fram­gångsrika i tidigare forskning. Studien är kvalitativ och genomfördes med ostrukturerade intervjuer där respondenterna valdes genom ett bekvämlighetsurval. De fyra hälsovägledarna arbetade med att motivera individer till viktnedgång, alla hade utbildning inom hälso­främjande arbete som varierade mellan en vecka till flera år. Resultatet visade på att hälso­vägledarna använder sig av befintliga teorier samt av strategier som bygger på deras utbildning och egna erfarenheter. De förändrar sin arbetsmetod efterhand som de får ny kunskap samt då de reflekterar över sitt arbetssätt, vilket tyder på att de är reflekterande praktiker.

Bakgrund: Narkotikamissbruk har sedan 1960-talet ansetts vara ett allvarligt samhällsproblem som ökar risken för sjukdom och social utsatthet. Varje år dör omkring 900 personer i Sverige av läkemedels- och narkotikaförgiftningar. Personer som utvecklat ett narkotikamissbruk kan hamna i en ond spiral där de negativa konsekvenserna ökar och medför en risk att förlora allt så som jobb, hem och familj. Detta kan i sig öka de socioekonomiska skillnaderna i befolkningen. När en person bryter sitt missbruk sker en process som i denna studie förklarats utifrån modellen Stages of change. Syfte: Syftet med studien är att skildra betydelsefulla faktorer i förändringsprocessen för individer som tagit sig ur narkotikamissbruk. Metod: Studien var av kvalitativ karaktär och genomfördes med semistrukturerade intervjuer. I studien kombinerades induktiv och deduktiv ansats. Resultat: Resultatet visade att socialt stöd var en viktig faktor genom förändringsprocessen, framförallt under faserna action och maintenance. Olika strategier som att bryta gamla beteenden och mönster var betydande. Den egna viljan ansågs vara essentiell för att inleda och genomföra en förändring. Genom behandling fick informanterna verktyg att hantera sin vardag. De jobbade hårt med sig själva genom de olika förändringsfaserna i Stages of change för att uppnå ett vidmakthållande och minimera risken för återfall. Konklusion: Studiens resultat visar att när en person är i behov av hjälp, och uttrycker detta, då behöver familj och samhälle erbjuda stöd. För de individer som inte har det sociala nätverket bakom sig, där synliggörs ett större behov av att samhällsinsatser måste finnas tillgängliga för att bidra till jämlik hälsa. / Background: Since the 1960s, drug abuse has been considered a serious societal issue that increases the risk of illness and social exclusion. In Sweden approximately 900 people die from drug intoxication annually. People who develop a drug addiction can end up in a negative spiral with consequences such as loss of work, home and family. Consequences that can increase the socio-economic differences within the population. When a person decides to end their addiction a process of change takes place, in this study explained using the Stage of change model. Purpose: The purpose of the study is to describe significant factors during the process of change within individuals who have recovered from drug abuse. Method: The study design was qualitative and was conducted using a semi-structured interview guide. The study combined inductive and deductive analysis. Results: The results indicated that social support was an important factor throughout the process of change, especially during the phases action and maintenance. Various strategies such as breaking old habits and patterns were also significant. Self-determination was considered essential to initiate and implement change. During treatment, the informants were given coping strategies to handle their everyday lives. They worked hard with themselves throughout the various stages in Stages of change to achieve sustainability and minimize the risk of relapse. Conclusion: The study's result implies that when a person is in need of help, and expresses this, family and community need to offer support. Individuals who do not have the social network requires more interventions from the community to enable a healthy life.

Doctor of Philosophy / Department of Human Nutrition / Edgar Chambers IV / Because healthy food products do not have a specific tool used for consumer screening based on consumers’ diet or degree of healthy eating habits, this study aimed to determine a set of questions that could classify consumers who belong in a different status according to the Stages of Change model, including those who have a different diet quality based on their Healthy Eating Index (HEI) score. The surveys were conducted in the United States (US) and Thailand in order to determine applicability to varying countries. The Food Neophobia Scale (FNS), Food Involvement Scale (FIS), and Health and Taste Attitude Scale (HTAS) were included in the questionnaire together with a set of Stages of Change questions and a 7-day, self-administered food recall questionnaire. The HEI interpretation of US and Thai consumer scores illustrated that the majority of both belonged to the Need Improvement group. The Stages of Change model indicated most consumers thought they had healthy diets. According to FNS, FIS, and HTAS, US consumers are more involved in food activities and are more open to trying new foods or unfamiliar foods than Thais. Furthermore, consumers who belong in different groups, according to the Stages of Change model, responded differently to some HTAS subscales. However, statements from FNS, FIS, and HTAS were not capable of distinguishing consumers belonging in different groups according to HEI scores or belonging in different stages according to the Stages of Change Model. Considering all possible methods from those listed above for screening consumers, the Stages of Change model may be the best way to segment consumers interested in healthier eating. Using the Stages of Change required less time and the least effort from consumers because there were only three questions; and interpreting results does not require calculation or analysis.

Esta tesis doctoral denominada “Motivaciones y etapas de preparación para el cambio de comportamiento ante la actividad físico-deportiva en Monterrey (N. L., México)”, pretende aportar resultados que ayuden a diseñar estrategias y desarrollar programas eficaces que fomenten la reanudación, adherencia, persistencia y mantenimiento de la práctica de las actividades físicas y deportivas durante el tiempo libre. El objetivo principal fue analizar a través de la teoría de la autodeterminación, la motivación de los diferentes comportamientos para la actividad física, su relación con el nivel y las etapas de cambio de la práctica física durante el tiempo libre y conocer las diferencias por sexo, edad y nivel de estudios en una muestra de 1,118 sujetos mayores de 15 años de la población del municipio de Monterrey, Nuevo León, México. Además, se presentan las propiedades psicométricas, la fiabilidad y los análisis factoriales exploratorios y confirmatorios de las diferentes escalas utilizadas. / This doctoral thesis named “Motivations and preparation stages for the change of behavior toward the physical-sport activity in Monterrey (N.L. Mexico),” seeks to provide results helping to design effective strategies and to develop programs to promote the reanimation, adherence, persistence and maintenance of the physical and sport practices in the leisure time. The principal aim was to analyze through the self-determination theory, the motivation of the different behaviors for the physical activity, its relation with the level and the stages of change of the physical practice during leisure time and to know the differences between gender, age and educational level in a sample of 1,118 subjects older than 15 years from the population of Monterrey city, Nuevo Leon, Mexico. Also, are presented the psychometric properties, the reliability, and the exploratory and confirmatory factorials analysis from the different scales used.

Cardiovascular disease (CVD) is the leading cause of death among women in the US, and African American women (AAW) have a disproportionately high rate of deaths from CVD. Physical inactivity plays a major role in CVD development. It has been reported that some rural women have low rates of physical activity; 39% of White women and 57% of women of color are reported to be physically inactive. Rural AAW have a high mortality and morbidity rate related to CVD and a high rate of physical inactivity. The purpose of this study was to describe rural AAW’s perception of wellness in conjunction with their stage of change for engaging in exercise. A questionnaire was designed to obtain demographic information and reliable and valid questionnaires were used to measure perceived wellness and current stage of change for exercise. Using a descriptive, cross-sectional design, a convenience sample of 162 rural AAW was recruited from four rural churches in Selma, Alabama. A one-time meeting was conducted and questionnaires were completed by the participants. Statistical analyses including independent samples t-tests and one-way and two-way ANOVA’s were conducted to determine if there were associations among demographic characteristics, self-reported presence of CVD, perceived wellness, and stage of change for exercise. Findings indicated that there was no relationship between perceived wellness and stages of change for exercise among rural AAW; no relationship was found between perceived wellness and CVD, or CVD and stage of change for exercise. However, 51.3% of the sample reported they were physically active, and 21.6% planned to increase their activity within 30 days. Annual household income and employment status were positively correlated with perceived wellness, suggesting a greater sense of wellness is related to income and employment among these rural AAW. These findings have implications for nursing practice in the areas of facilitating health promoting behaviors and development of exercise and wellness programs for rural AAW.