This study aims to find out how the way out of homelessness can look and be experienced and in what way persons with experience of being homeless might think about our society´s different solutions to this problem. The study is based on five half-structured qualitative interviews with persons who have experience of being homeless. The theoretical perspectives used to analyze the empirism are “Stages of Change” and “The Process of Role Exit”, both dealing with changing processes. Our results show that the way out of homelessness can be long and very hard to achieve, and the change in housing situation can be either a process towards a more and more stable housing or through an opportunity that suddenly appears. Another result shows that people with the experience of being homeless can be negative to the solutions offered by our society but be positive to the idea of Housing First. One conclusion is that a housing of your own can mean more for the individual than just somewhere to sleep. To have a housing of your own can lead to personal development such as trying to get rid of one´s addiction or get better relations with one´s family.

The purposes of this study were to examine (a) health promoting behaviors, (b) physical activity levels, (c) exercise stages of change levels, and (d) exercise preferences of students who had just entered the university by gender and residence. Participants were 438 students from Middle East Technical University (METU) English Preparatory school. Adolescent Health Promotion Scale (AHPS), International Physical Activity Questionnaire (IPAQ), Physical Activity Stages of Change Questionnaire (PASCQ), and Physical Activity Preferences Check-list were used for the data collection. Descriptive statistics, nonparametric statistical methods (Mann Whitney U test, Pearson chi-square test), and a one-way MANOVA were used for the data analysis. According to AHPS results, female students&amp / #8217 / health promoting behaviors were better than those of male students except exercise behavior. Students living at home had higher scores on nutrition behavior and students living in dormitory had higher scores on stress management behavior (p &lt / .05). According to the IPAQ results, male students were more physically active than female counterparts. Students who were living in dormitory had higher physical activity levels than students living at home (p &lt / .05). PASCQ findings indicated no significant differences on the exercise stages of change levels by gender and residence (p &gt / .05). In general, students were at pre-contemplation 9.2%, contemplation 39.3%, preparation 27.8%, action 14.5%, and maintenance 9.2% stages. Swimming, walking, and table tennis were the three most frequently preferred physical activities. In conclusion, female students had better health promoting behaviors than those of male students except exercise behavior. Female students and students living at home were more at risk of inactivity. Approximately 80% of the METU English Preparatory school students&amp / #8217 / physical activity levels were not satisfactory for a healthy life. University physical activity facilities, extracurricular programs and the courses should be reconsidered to support the health promoting behaviors of these students.

The aim of the present study was to examine the effects of the cinematherapy technique on the treatment of alcohol dependent patients. In terms of change, selfefficacy, decisional balance and motivation levels of participants were examined. 94 alcoholic patients from a state hospital, and 14 members of Alcoholics Anonymous&rsquo / Istanbul groups participated in the study. Participants were either inpatients in the dependence treatment center, or alcohol dependent patients who had been clean and sober for various periods of time. The cinematherapy technique was applied as an adjunct to alcohol dependence treatment. It included the presentation of a movie with an alcohol dependence theme followed by an elaboration session. Participants in the experimental group received two sessions of cinematherapy. On the other hand, control group A participants watched one movie unrelated with alcohol dependence. It was followed by an elaboration session with a non-alcoholic theme. Control group B participants watched two movies unrelated with alcohol dependence. Any elaboration session was not made with control group B participants. Decisional balance, self-efficacy, treatment motivation and stages of change were used as the main outcome measures in the pre-treatment and posttreatment assessments. Since the experimental and control groups sample sizes were small, non-parametric tests were used in data analysis. According to results, cons of alcohol and self-efficacy increased for the overall sample after cinematherapy sessions. In addition, the cinematherapy group showed higher identification than the control groups. Stages of change differences were gained for pros of alcohol use and self-efficacy in line with literature.

The purposes of this study were to test the effect of four-week PACE&copy / program in increasing participants&rsquo / physical activity level and stages of change and examine the relationship between physical activity level and stages of change. A controlled trial, experimental design was applied. Physical activity level and stages of change were recorded at baseline and at study conclusion. For the data collection What is Your PACE Score Questionnaire, FADA Questionnaire and Physical Activity Readiness Questionnaire (PAR&ndash / Q) were used. Descriptive statistics, one way repeated measures of ANOVA and simple linear correlation were used to analyze data. Participants were 182 women Middle East Technical University personnel from different units. Study participants were randomized into intervention and control groups. 87 women received the PACE&copy / program were compared 95 women in the control group who did not receive PACE&copy / program. The intervention group received PACE&copy / program with respect to their stages and a booster phone call or e-mail two weeks later after counseling. After 4 weeks, all participants were reassessed for stages of change and physical activity level. There was a significant difference in measurement of physical activity level and stages of change between intervention and control group before and after intervention. The intervention group&rsquo / physical activity level (p &lt / .05) and stages of change (p &lt / .10) increased but the control group decreased. Besides, changes in physical activity level were moderately and positively correlated with stages of change.

PHYSICAL ACTIVITY BEHAVIORS AND NEIGHBORHOOD WALKABILITY PERCEPTIONS OF TURKISH WOMEN IN LOW AND HIGH SOCIO-ECONOMIC ENVIRONMENTS Yildirim, G&uuml / lsen M.S., Department of Physical Education and Sports Supervisor: Assoc. Prof. Dr. Mustafa Levent nce September 2010, 65 pages The purposes of this study were to compare (a) the physical activity (PA) levels, (b) exercise stages of change levels and (c) neighborhood walkability perceptions of Turkish women who are living in Low and High socio-economic (SES) environments. Initially, Low SES and High SES neighborhoods in Ankara were identified by using the classification of Turkish Statistical Institute. Participants were randomly selected 394 women (Low SES=188, High SES=206) between the ages of 18-65 living in these neighborhoods. For data collection, International Physical Activity Questionnaire-Short Form (IPAQ) / Physical Activity Stages of Change Questionnaire (PASCQ), and Neighborhood Environment Walkability Scale- Abbreviated (NEWS-A) were used. Descriptive statistics, nonparametric statistical methods (Mann Whitney U test, Pearson chi-square test) and MANOVA were used for the data analysis. According to the IPAQ results, there was no significant difference in walking and vigorous levels by women&rsquo / s neighborhood SES (p&gt / 0.05). However / moderate and total PA level of women living in High SES neighborhoods were significantly higher than the related levels of women living in Low SES neighborhoods (p&lt / 0.05). The results on exercise stages of change levels indicated that the women in Low SES neighborhoods had a higher percentage at precontemplation stage than those of women in High SES neighborhoods (p&lt / 0.05). On he other hand, a higher percentage of women in High SES neighborhoods were at maintenance stage (p&lt / 0.05). NEWS-A results revealed that there were significant differences in women&rsquo / s neighborhood walkability perception by their neighborhood SES, Wilk&rsquo / s = .33, F (8,382) = 97.57, p &lt / .05, 2 = .67. According to further univariate analyses, there were significant differences in all NEWS-A subscales by neighborhood SES in favor of High SES neighborhood, except for the &ldquo / pedestrian/traffic safety&rdquo / subscale (p&lt / 0.05). There were no significant difference in pedestrian/traffic safety scale by neighborhood SES (p&gt / 0.05). In conclusion, women who live in Low SES neighborhood have a higher risk of physical inactivity.Moreover, perceptions of neighborhood environment for the promotion and support of PA were lower in Low SES neighborhood residents as compared to their High SES neighborhood counterparts. Intervention programs for women living in these areas should be provided by considering their PA level, exercise stages of change level and neighborhood walkability perceptions.

Zielsetzung: Die Gültigkeit des Modells der Stadien der Veränderung von Prochaska und DiClemente für die stationäre Alkoholentwöhnungstherapie empirisch zu prüfen. Methoden: Reliabilität, Faktorstruktur und Konstruktvalidität der Veränderungsstadienskala (VSS) wurden an Alkoholpatienten querschnittlich (N = 265) und längsschnittlich (N = 108) untersucht. Ergebnisse: Die Reliabilität der VSS fiel befriedigend aus mit Ausnahme der Skala «Precontemplation», die sich auf nicht motivierte Patienten bezieht. Die faktorielle Validität war insbesondere für die Skalen «Contemplation» und «Maintenance» unzureichend. Clusteranalysen ergaben eine nicht modellkonforme Drei-Cluster-Lösung einschließlich «uninvolvierter » Patienten. VSS-Werte waren durchgängig mit der Therapiemotivation korreliert. Prädiktive Validität (Behandlungsdauer, Rückfallvorhersage) konnte nicht belegt werden. Schlussfolgerungen: Der Ansatz bestätigt seinen heuristischen Wert, kann aber noch nicht valide für praktische Entscheidungen in der Alkoholentwöhnungsbehandlung herangezogen werden. Spezifische Modelle für verschiedene Behandlungsgruppen und -settings scheinen Erfolg versprechender. / Aim: The validity of the ”Stages of Change” approach was tested in alcohol inpatient long-term treatment. Methods: Reliability, factor structure, and construct validity of the University of Rhode Island Change Assessment Scale (URICA, German version) was examined using cross-sectional (N = 265) and longitudinal data (N = 108). Results: Scale reliability proved to be satisfying, except for the precontemplation scale. Factorial validity was insufficient for the contemplation and the maintenance scale. Cluster analyses revealed a threecluster solution not in accordance with the model and included a cluster of ”uninvolved patients”. URICA-scores were correlated with therapy motivation, but predictive validity with respect to duration of treatment and prediction of relapse was not confirmed. Conclusions: The model proved to be of heuristic value but is not yet a valid basis for practical decisions. Models which are directed more specifically towards a particular treatment group or setting are expected to be more successful. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Abstract The aim of this study was to describe the characteristic features of weight management and lifestyle changes of people of working age at risk of type 2 diabetes. Seventy-four persons at high risk of type 2 diabetes, 33 men and 41 women, took part in the study. They attended group counselling sessions led by a dietician either at distance or face-to-face. There were 5 distance groups, with the counselling given by a dietician via a videoconferencing link to participants who met in the meeting room of their local health care centre. There were 6 personal groups where the dietician and the group participants met face-to-face at the same location. Each group had 5 to 9 participants. The following were used as study material: videotaped group discussions on the benefits and barriers of lifestyle changes at the beginning of the counselling process, weight management at the beginning and at the end of the process, and weight management and the preconditions and risk factors of successful weight management at the follow-up visit 1.5 years after the end of the process. In addition, study data were gathered before the first and last interventions and before the follow-up visit with a questionnaire sent to the subjects. The subjects were weighed at the beginning and at the end of the counselling process as well as at the follow-up visit. The video material was analysed using both inductive and deductive content analysis. The data were analysed also using SPSS 16.0 software for Windows. At the beginning of the counselling process, 68%, 9% and 14% of the subjects were at the contemplation, preparation and action stages, respectively, the corresponding percentages at the end of the counselling process being 24%, 33% and 40%. Forty subjects had made progress in their lifestyle change stage, 18 had remained where they had been, while 5 had regressed. One and a half year after the end of the counselling process, about half of the subjects were at the maintenance phase in terms of various lifestyle factors (restricting the amount of food, eating regular meals, increasing the intake of nutritional fibre, unsaturated fat and physical activity, restricting alcohol intake). Twenty-one subjects reported relapses, most often in terms of restricting the amount of food intake. Improved health and functional ability were seen as the benefit of lifestyle change. A change in lifestyle calls for effort and resources. The preconditions of successful weight management were one.s own actions, motivation and resources. Weight management was made more difficult by lack of commitment to one’s own actions and lack of goals, self-discipline and motivation. The information obtained with the study may be utilised in developing interventions aimed at persons at risk of type 2 diabetes as well as their contents and methods. The results can also be made use of in improving the counselling skills of health-care students and professionals. / Tiivistelmä Tutkimuksen tarkoituksena oli kuvata tyypin 2 diabeteksen riskiryhmään kuuluvien työikäisten henkilöiden painonhallinnan ja elintapamuutoksen tunnuspiirteitä. Tutkimukseen osallistui 74 työikäistä tyypin 2 diabeteksen korkean riskin henkilöä. Tutkittavista 33 oli miehiä ja 41 naisia He osallistuivat ravitsemusterapeutin ryhmäohjaukseen joko etä- tai lähiryhmässä. Etäryhmiä oli 5. Niissä ohjaus toteutui siten, että ohjaaja oli videoneuvottelulaitteiden avulla yhteydessä ryhmäläisiin, jotka olivat kokoontuneet oman kuntansa terveyskeskuksen kokoustilaan. Lähiryhmiä oli 6. Niissä ohjaus toteutettiin siten, että ohjaaja ja ryhmäläiset olivat samassa tilassa. Kussakin ryhmässä oli 5–9 osallistujaa. Tutkimusaineistona käytettiin videoituja keskusteluaineistoja, joissa ryhmään osallistuneet kuvasivat elintapamuutoksen hyötyjä ja haittoja ohjausprosessin alussa, painonhallintatilannettaan ohjausprosessin alussa, lopussa ja seurantakäynnillä sekä painonhallinnan onnistumisen edellytyksiä ja riskitekijöistä seurantakäynnillä 1,5 vuotta ohjausprosessin päättymisen jälkeen. Lisäksi tutkimusaineistoa kerättiin ennen ensimmäistä ja viimeistä ohjauskertaa sekä ennen seurantakäyntiä tutkittaville lähetetyllä kyselyllä. Paino mitattiin ohjausprosessin alussa, lopussa ja seurantakäynnillä. Videoaineisto analysoitiin sekä induktiivisella että deduktiivisella sisällönanalyysilla. Aineiston analysoinnissa käytettiin myös SPSS 16.0 for Windows -ohjelmaa. Ohjausprosessin alussa tutkittavista 68 % oli harkintavaiheessa, 9 % valmistautumis- ja 14 % toimintavaiheessa ja ohjausprosessin lopussa 24 % oli harkinta-, 33 % valmistautumis- ja 40 % toimintavaiheessa. Tutkittavista 40 edistyi elintapamuutosvaiheessaan, 18 pysyi ennallaan ja 5 taantui. Puolentoista vuoden kuluttua ohjausprosessin päättymisestä noin puolet tutkittavista oli ylläpitovaiheessa jonkun elintavan suhteen (kuidun ja rasvan käyttö, ruokamäärä, ateriarytmi, liikunta, alkoholin käyttö). Repsahduksista raportoi 21 henkilöä. Niitä oli tapahtunut eniten ruokamäärän rajoittamisen suhteen. Elintapamuutoksen hyötynä nähtiin terveyden ja toimintakyvyn paraneminen. Elintapamuutos vaatii vaivannäköä ja voimavaroja. Painonhallinnan onnistumisen edellytyksiä olivat oma toiminta, motivaatio ja voimavarat. Sitoutumattomuus omaan toimintaan, tavoitteiden, itsekurin ja motivaation puute vaikeuttivat painonhallintaa. Tutkimuksen avulla saatua tietoa voidaan käyttää kehitettäessä tyypin 2 diabeteksen riskiryhmiin kuuluvien henkilöiden ohjauksen sisältöä ja menetelmiä. Tuloksia voidaan hyödyntää myös terveydenhuollon opiskelijoiden ja ammattihenkilöiden ohjaustaitojen kehittämisessä.

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