This study assesses practices of college students (N=913) toward alternative medicine, relationships of students' health locus of control with practices of alternative medicine, and relationships of students' attitudes toward alternative medicine and health locus of control. A principal components factor analysis established construct validity of the author-designed Attitude Toward Alternative Medicine Scale, extracting three factors: Holistic Attitude/Control, Safety, and Satisfaction. Holistic Attitude/Control predicted use of alternative medicine (Wald =61.9, p < .01). A principal components factor analysis established construct validity of the Multidimensional Health Locus of Control Scale, extracting three factors: Internal Health Locus of Control, External-Chance, and External-Powerful Others. Internal Health Locus of Control significantly correlated with Holistic Attitude/Control (r = .35, p =.01).

Master of Science

Background: Evidence has indicated a high prevalence of physical inactivity and insufficient consumption of fruit and vegetables among Chinese college students. As college students are in a crucial transition stage from adolescent to adulthood, such unhealthy lifestyle behaviors at this stage can result in nemerous negative consequences for both individuals and society. Therefore, it is urgently necessary to promote health-enhancing physical activity (HEPA) and fruit-vegetable consumption (FVC) among Chinese college students. Interventions focused on multiple health behavior change (MHBC) have shown advantages over those targeting only a single health behavior, and have therefore gained popularity over the last decade. Despite the increasing use of Internet technology and apparent promise of web-based MHBC interventions, there have been few such interventions for HEPA and FVC among Chinese college students. In addition, within the overarching scope of web-based MHBC interventions, there are several remaining questions that need to be addressed, including the timing of MHBC intervention delivery, the high dropout rate of participants, and the psychological mechanisms behind MHBC. Purpose: The main purposes of the thesis were to (1) examine the comparative effectiveness of sequentially delivered web-based MHBC interventions for HEPA and FVC in Chinese college students from both quantitative and qualitative perspectives; (2) investigate characteristics of dropouts (using quantitative method) and the underlying reasons (using qualitative method); and (3) identify the active ingredients ("key mediators") of successful health interventions for changing single health behavior (HEPA or FVC), and examine the psychological mechanisms of MHBC (HEPA and FVC) in Chinese college students based on an integrated social-cognitive model. Method: In Study 1, two web-based MHBC interventions were developed based on the health action process approach (HAPA) model. In a randomized controlled trial (RCT), 552 eligible college students (M = 19.99 years, SD = 1.04, 58.3% female) were randomly assigned to one of three groups: HEPA-first (4 weeks of HEPA followed by 4 weeks of FVC intervention), FVC-first (4 weeks of FVC followed by 4 weeks of HEPA intervention), and a control group (8 weeks of placebo treatment unrelated to HEPA or FVC). All of the participants were asked to complete online questionnaires at four time-points: at baseline (T1, the beginning of the intervention), after 4 weeks (T2, after the first behavior intervention), after 8 weeks (T3, after the second behavior intervention), and after 12 weeks (T4, 1-month post-intervention follow-up). The questionnairs addressed health behaviors (HEPA and FVC), social- cognitive determinants of behavior change (intention, self-efficacy, planning, and social support for each behavior) and health outcomes (BMI, depression and perceived quality of life). All of the data were analyzed using IBM SPSS 25.0, applying a series of generalized linear mixed models (GLMMs) to evaluate the intervention effectiveness. The mediation analysis was performed using IBM SPSS Process, with residualized change scores and the bias-corrected bootstrap approach (5000 resamples). Following the quantitative intervention study, to further evaluate the effects of aforementioned web-based MHBC interventions and to address dropout issues from a qualitative perspective, 30 students (M = 19.53 years, SD = 0.92, 56.7% female) who had participanted in Study 1 (18 completers and 12 dropouts), were invited to attend one-to-one and face-to-face semi-structured interviews (Study 2). The interviews covered three topics: 1) students' perceptions about their changes after participating in the web-based health program, 2) students' user experience and suggestions related to the design of the intervention content and the website layout and functionality, and 3) the reasons for dropping out. The audio-recorded interview data was transcribed orthographically and organized using QSR NVivo 11. Thematic analysis was adopted to analyze the qualitative data. In addition, a two-layer integrated social-cognitive model was hypothesized in Study 3 based on the HAPA model and Carry-over and Compensatory Action Model (CCAM). With a prospective design, 322 college students (M = 19.47 years, SD = 0.99, 55.6% female) were invited to report their past HEPA and FVC behavior, HEPA and FVC intentions, and demographics at baseline. After two months, an online questionnaire survey was used to collect data on their compensatory cognitions, combined volitional predictors of behavior change (self-efficacy + planning), and current HEPA and FVC behavior. All of the data were analyzed using Mplus 8.0. The proposed model was examined using structural equation modeling (SEM) with path analysis approach. Results: (1) Both the quantitative and the qualitative data fully supported the effectiveness of the web-based MHBC interventions for HEPA and FVC behavior. In addition, the effects on social-cognitive determinants of behavior change were partially supported by the quantitative data, and fully supported by the qualitative data. For health outcomes, the quantitative data supported the intervention effects on body mass index (BMI), and the qualitative data supported the effffects on both BMI and perceived quality of life. Moreover, the two delivery sequences did not show significantly different effects on HEPA after either 8 weeks or 12 weeks, whereas the FVC-first sequence showed superior effects over the HEPA-first sequence for FVC behavior after 12 weeks. (2) In terms of dropout, more male than female students withdrew from the interventions, and the dropouts showed lower HEPA self-efficacies, lower FVC planning, and inferior BMI status than completers. The interview results indicated two themes of dropout reasons: internal reasons (e.g., participants perceiving the health interventions as less necessary and less important) and external reasons (e.g., unfavorable living surroundings and problems with the program's delivery mode, intervention content, and technology). (3) In terms of the mediators of successful interventions for changing each single health behavior, the RCT results indicated that self-efficacy and intention mediated the effectiveness of the intervention on immediate changes (after 8 weeks) in HEPA and FVC, and that intention had a mediating effect on sustained change (after 12 weeks) in both HEPA and FVC. In addition, the prospective study found that the two- layer integrated social-cognitive model proposed in this thesis successfully explained the psychological mechanisms of MHBC in Chinese college students. In particular, the first layer identified the mediating effects of the volitional predictors on the intention-behavior relation for each type of health behavior. The second layer identified a positive association between volitional predictors of HEPA and volitional predictors of FVC, as well as a mediating effect of compensatory cognition between FVC intention and HEPA behavior. Discussion and Conclusions: To the best of our knowledge, this is the first study to examine the comparative effectiveness of sequentially delivered web-based MHBC interventions on HEPA and FVC in Chinese college students, and the first to identify the psychological mechanisms of MHBC in a Chinese context. The findings provide both theoretical and practical implications for future research and the application of MHBC. Future studies should more comprehensively compare simultaneous vs. sequential designs, more systematically examine dropout and its determinants, and further explore the psychological mechanisms of MHBC, especially the transfer mechanisms between the volitional predictors of one health behavior on another

Atherosclerosis is a disease of the arteries and is defined as a form of arteriosclerosis in which fatty lesions called atheromatous plaques form on the intima of arteries. The formation of these plaques begins early, within the first two decades of life, and may be started by damage to the endothelial cells and intima of the artery walls (Guyton, 1981). A number of factors may cause the initial damage, including physical abrasion of the endothelium, abnormal substances in the blood or pulsating arterial pressure on the vessel wall (Guyton, 1981). There is a growing body of epidemiologic, genetic, experimental, and clinical evidence to support the hypothesis that there is a cause and effect relationship between high blood levels of cholesterol and the development of atherosclerosis in humans. The purpose of this study was to determine the relationship of exercise and diet in predicting the total cholesterol/high density lipoprotein-cholesterol (TC/HDL-C) ratio in college age males and females. Variables controlled for included age, gender, smoking, medication use, contraceptive use, hormone use and intense physical activity.

abstract / toc / Education / Master / Master of Education

This study examines two groups -international and domestic students at Portland State University (PSU) - in terms of their motivations to seek university-health services, and their satisfaction with university-health services. The Theory of Motivated Information Management (W. A. Afifi & Weiner, 2004) served as the foundation for this study to examine the preferences of students in terms of the ways they seek information about their health concerns. Differences in international and domestic students' anxiety, efficacy, and satisfaction with physicians were supported. International students reported more anxiety than domestic students. Domestic students reported being more efficacious than international students when talking to a medical provider about a current medical issue. Also, international students reported higher satisfaction with a medical provider at their last university health services visit. First, subjects were asked if they currently have a medical concern for which they might consider consulting a physician at PSU health services. If this scenario applied, subjects were asked to rate a variety of possible, theoretically informed motivations for seeking medical information by consulting a physician, to test the Theory of Motivated Information Management. Second, subjects were asked if they have previously consulted a physician at PSU health services. If this scenario applied, subjects were asked to provide satisfaction ratings of the physician and staff. The results contribute to the understanding of information-seeking processes and support the theory's effectiveness in this situation, explaining where international and domestic students are significantly different in regard to their responses.

Research has clearly shown that all individuals will benefit from regular physical activity. Unfortunately, young adults including college and university students are not physically active on a regular basis worldwide. In the developing world particularly in Sub- Saharan Africa, physical inactivity along with tobacco use, poor diet and nutrition are increasingly parts of today&rsquo / s lifestyle. Physical activity declines with age and the most important decline appear to be during the transition period from high school to university and during university years. The aim of this study was to assess the level of physical activity, to investigate the perceived constraints to physical activity and to determine whether socio-demographic characteristic have an influence on participation in physical activity and perceived constraints to physical activity among paramedical institutions students in Uganda. A cross-sectional study with descriptive quantitative design was conducted. Four hundred (400) paramedical institution students were selected using a stratified random sampling technique. A self-administered questionnaire adopted from the literature was used to collect the data. A response rate of 90% was obtained. Descriptive and inferential statistics using the statistical package for social sciences were used to analyze the data. The relationships and associations between different variables were determined by carrying out significant tests using chi-square tests. Alpha level was set at 0.05. The mean age of the sample was 22.44 years (SD = 2.03). Males constituted 73.9% and females constituted 26.1% of the sample. Students from eight (8) health professional courses participated in the study. Over half (59%) of participants were classified as physically active and 41% were classified as inactive or sedentary. For male participants, lack of the right equipment to exercise and wanting to do other things in their free time were perceived as the major constraints to physical activity. For female participants, lack of motivation and tiredness after exercise were perceived as the major constraints to physical activity. The findings of this study demonstrate that there is an influence of socio-demographic characteristics such as gender, year of the study and different departments/schools on participation in physical activity and perceived constraints to physical activity. They also indicate the need of health promotion intervention aiming at promoting physical activity among paramedical institution students in Uganda.

Offering courses that promote, encourage, and support physical activity among college students has been an aim of physical education departments for the past century (Sargeant, 1900). Even so, this population has been identified in Healthy People 2010 as a target population segment in need of physical activity intervention. Historically, such coursework has almost exclusively been activity and skill-based, which made it particularly appealing to students who were already active while those who were not physically active generally avoided such courses (Scantling, Strand, Lackey, & McAleese, 1995). Over time, alternative courses and course formats began to evolve, including conceptually-based Lifetime Fitness for Health (LFH) courses (Corbin, 1969). Such courses were designed to promote wellness-related behaviors among college students, including physical activity participation. These courses have increased in popularity over the past 30 years (Hensley, 2001) and are now included by some colleges and universities as part of the students' graduation requirements (Cardinal, Jacques, & Levi, 2002). Some colleges and universities have also begun offering on-line versions of their LFH courses (Conlee, 2000), but little research has been done on the effectiveness of these courses and the influences delivery format (i.e. face-to-face vs. web-based) may have. The purpose of this study was to determine the relative effectiveness of a theoretically-based, LFH course on college students' behavioral and psychological physical activity orientation. The independent variables were course format (i.e., face-to-face vs. web-based vs. control) and time (i.e., baseline and post-intervention). The study was conducted over 10 weeks, using intact groups. The dependent variables were exercise behavior, and self-efficacy, decisional balance, and the behavioral and cognitive processes of change (all from the Transtheoretical Model). Of the initial 151 people enrolled in the study, 109 (72.2%) returned post-intervention questionnaires and were therefore retained in the study. Retention rates did not differ across groups (p>.30). The majority of participants were female (60.3%), Caucasian (81.5%), and held either freshman or sophomore class standing (80.1%). Participants were, on average, 21.3 (SD = 5.7) years old, with a Body Mass Index (BMI) of 24.3 (SD=5.4). The majority of participants were in the preparation stage of change (45.7%), followed by maintenance (35.1%), action (12.6%), contemplation (5.3%), and precontemplation (1.3%). Exercise behavior improved significantly over time (p<.0 1); however, the main effect for groups (p=.06), and the group by time interaction were not significant (p=.31). Significant main effects were observed between groups (p<.01), and over time (p<.01) for the vector of means comprised of self-efficacy, decisional balance, and the cognitive and behavioral processes of change. The group by time interaction for the vector of means was not significant (p=.17). Follow-up F-tests revealed the group differences were due to differences in the cognitive (p<.05) and behavioral (p<.05) processes of change, with no differences observed for either self-efficacy (p=.35) or decisional balance (p=96). Time effects were observed for self-efficacy (p<.05), and the cognitive (p<.001) and behavioral (p<.01)processes of change, with no difference observed on decisional balance (p=.39). While not entirely supportive, the results due suggest some promising strategies for enhancing the efficacy of LFH courses, regardless of delivery format. / Graduation date: 2004

Syftet med studien är att identifiera framgångsfaktorer, samt att påvisa hinder för att uppnå en fungerande elevhälsoorganisation, samt att visa hur Elevhälsans olika yrkeskompetenser bidrar till ett framgångsrikt elevhälsoarbete på en skola. Studien har genomförts med hjälp av kvalitativa djupintervjuer av Elevhälsans personal i åk 6-9 på en skola i en mellansvensk kommun, som enligt Skolverket anses ha en väl fungerande Elevhälsa. Resultaten grundar sig även på samtal med annan personal på skolan, samt på observationer i olika klassrum. Data från intervjuer, samtal och observationer har analyserats utifrån aktivitetsteorin, där fokus ligger på beskrivning av Elevhälsans olika yrkeskategoriers mål, handlingar och operationer. Undersökningen visar hur Elevhälsans olika yrkeskompetensers individuella arbete, samt samarbete sinsemellan bidrar till en fungerande elevhälsoorganisation. Elevhälsans arbete med eleverna kretsar kring hälsofrämjande arbete och arbete för att eleverna ska nå kunskapskraven. Detta bygger på värdegrundsarbete där det satsats mycket kraft på relationsbyggande och gott bemötande mellan elever, samt mellan personal och elever på skolan. Det finns dessutom en tydlig ledning och struktur i organisationen där rutiner och ansvarsfördelning är väl kända och accepterade av personalen. Det förebyggande arbetet bland personal och elever är betydelsefullt. Beslutsprocessen är snabb och dokumentationen upplevs som betydelsefull och användbar i praktiken. Det utgår stöd till elever i svårigheter utifrån deras individuella behov där lärarna visar att de tror på elevens förmåga att lyckas. Arbetet har sin grund i att det råder en positiv stämning bland både personal och elever, där det förebyggande arbetet för att stärka elevernas självkänsla och självtillit är betydelsefullt.   De hinder eller svårigheter som kan finnas för utvecklingsarbetet med Elevhälsan är att det inte finns något facit på hur verksamheten ska organiseras, varje skola måste hitta sin egen modell utifrån sina förutsättningar. Brist på tid, långdragen beslutsprocess och komplicerad dokumentation av elevärenden kan vara andra hinder. En otydlig ledningsorganisation kring Elevhälsans arbete utgör dessutom hinder för att utveckla en fungerande Elevhälsa. / The aim of this study is to find factors for success, and indicated impediments to achieving a well-functioning organization for students’ health. The study was carried out with qualitative in-depth interviews with the staff of the Students’ Health Organization for grade 6-9 at a school in the middle of Sweden, which according to the Swedish National School Board (Skolverket) is considered to have a well-functioning organization for student’s health. The results are also based on conversations held with other staff members of the school and observations made in different classrooms. Data from the interviews, conversations and observations have been analyzed based on the activity theory, focusing on descriptions of the goals, actions and operations of the different professions of the Students’ Health Organization. The study shows how the work of the different professions of the Students’ Health Organization, as well as the cooperation among the different professions, contributes to a well-functioning organization for students’ health. The work of the Students’ Health Organization revolves around promoting the health of the students’ and to establish prerequisites for the students to reach the knowledge requirements. This work is based on values and ethics where much effort is put into the relationship-building and good interactions among students and students and staff. There is also a distinct leadership and a structure of the school organization where routines and distribution of responsibility is well known and accepted by all staff. The preventive work among staff and students is important. The decision procedure is quick and the documentation is experienced as significant, important and useful in everyday work. Support is given to student in need, based on their individual needs and it is shown that there is belief in the students’ abilities to succeed. The work has its foundation in a positive attitude among both staff and students, where the preventive work; to enhance the students’ self-esteem is of great importance. The impediments or difficulties that can be found for the development of a functioning students’ health organization is that there is no key or straight answer to how the work should be organized; each school has to create its own model based on its own conditions. Lack of time, protracted decision procedures and complicated documentation of students needs, abilities and how to work with them are other impediments. An indistinct leadership of the students’ health organization and their work is also an impediment to the development of a functioning students’ health organization itself.

Research suggests that depressive symptoms and financial stress are both associated with increased levels of cigarette smoking, yet not every individual who experiences depressive symptoms or financial stress smokes. The primary purpose of this study was to examine whether positive and negative religious coping moderated the influence of depressive symptoms and financial stress on current (past 30-day) cigarette smoking over and above the contributions of demographic covariates and nonreligious problem- and emotion-focused coping. Participants were drawn from a larger study comprised of a convenience sample of 1,120 post-secondary vocational/technical school students enrolled in programs such as welding, air-conditioning, and vocational nursing at two different two-year public colleges in Texas. These students are training to work in blue-collar occupations, which have higher smoking rates compared to white-collar occupations. Negative binomial regression analysis was used to test the study hypotheses. Depressive symptoms and financial stress increased the likelihood of smoking for female students, whereas financial stress decreased the likelihood of smoking for male students. Positive religious coping decreased the likelihood of smoking for females only. Consistent with religious coping theory and as expected, negative religious coping moderated the depressive symptoms-smoking relationship such that negative religious coping exacerbated the impact of depressive symptoms on cigarette smoking among females. Positive religious coping also moderated the depressive symptoms-cigarette smoking relationship for females. Contrary to expectations, positive religious coping exacerbated the likelihood of cigarette smoking among females with high levels of depressive symptoms. Negative religious coping moderated the financial stress-cigarette smoking relationship such that males who reported low financial stress and high levels of negative religious coping had the highest likelihood of smoking in the past month. For females, religious coping was associated with current cigarette use, but did not moderate the association between financial stress and smoking. Even after controlling for demographic covariates and nonreligious coping, positive and negative religious coping influenced the smoking behaviors of vocational students experiencing depressive symptoms and financial stress, and these outcomes varied by gender. Study limitations, implications, and suggestions for future directions in research are discussed. / text