Psychological impact of DAFNE training in adults with Type 1 diabetes

This thesis investigated the psychological impact of an education intervention, Dose Adjustment for Normal Eating (DAFNE), in adults with type 1 diabetes. The results demonstrated that the education programme improved participants' subjective wellbeing, self-efficacy and reduced diabetes-related distress compared to a comparison group that engaged in usual care. The portfolio examined the use of mindfulness-based strategies, in particular Acceptance and Commitment Therapy (ACT) in four case studies which illustrated that the impact of the therapy is directly related to the the willingness of the client to engage in the practices.

Parental socialisation of preschool children's food preferences

The research examined parental socialisation of preschool children's food preferences. The findings indicated that parents' beliefs, child characteristics and parents' feeding behaviours contribute to children's food preferences. In particular, parents' self-efficacy beliefs and beliefs about why children reject foods on the one hand, and children's food neophobia on the other hand appear to influence children's everyday food preferences.

Effects of physical activity on depression and anxiety in children

This thesis study examined the direct and indirect effects of physical activity, self-efficacy and peer relations in depression and anxiety in children. No direct relationships between physical activity and symptoms of depression or anxiety were found for either sex. The portfolio, using four clinical health psychology case studies, provides an illustration of the clinical application of the transtheoretical model to four different health issues.

Readiness for substance abuse treatment amongst Victorian prisoners

The thesis examined treatment readiness in offender rehabilitation. Findings empirically refuted the notion that treatment readiness occurs in sequential progression through stages. Instead the study offered two treatment readiness models based on concurrent states of thought and behaviour. Furthermore, the treatment readiness models were found to be significantly predicted by offenders' cognitive styles and self-efficacy. The portfolio seeks to demonstrate, through four case studies, how different variables within the three-part ecological framework can either promote or constrain the reintegration process of ex-prisoners and ex-offenders.

Personal, social and environmental correlates of resilience to physical inactivity among women from socio-economically disadvantaged backgrounds

While sex and socio-economic disparities in physical activity have been well documented, not all disadvantaged women are inactive. This study aimed to examine correlates of achieving recommended levels of physical activity among women of low socio-economic position. In 2005, a population-based sample of 291 women with low educational attainment provided survey data on leisure time physical activity (LTPA). Participants reported potential personal (enjoyment and self-efficacy; barriers; intentions; guilt and priorities; routines and scheduling; occupational physical activity; television viewing), social (support from family/friends; social participation; sport/recreation club membership; dog ownership) and environmental (aesthetics; safety; local access; footpaths; interesting walks; busy roads to cross; heavy traffic) correlates of physical activity. Nearly 40% of participants achieved recommended LTPA (150 min week–1). Multivariable analyses revealed that higher levels of self-efficacy for walking [prevalence ratio (PR) 2.05, 95% confidence interval (CI) 1.19–3.53], higher enjoyment of walking (PR 1.48, 95% CI 1.04–2.12), greater intentions to be active (PR 1.97, 95% CI 1.12–3.45) and having set routines for physical activity (PR 1.91, 95% CI 1.18–3.09) were significantly associated with achieving recommended LTPA. Personal factors were the characteristics most strongly associated with achieving recommended levels of LTPA among women from socio-economically disadvantaged backgrounds.

Can social cognitive theory constructs explain socio-economic variations in adolescent eating behaviours? A mediation analysis

Adolescents of low socio-economic position (SEP) are less likely than those of higher SEP to consume diets in line with current dietary recommendations. The reasons for these SEP variations remain poorly understood. We investigated the mechanisms underlying socio-economic variations in adolescents’ eating behaviours using a theoretically derived explanatory model. Data were obtained from a community-based sample of 2529 adolescents aged 12–15 years, from 37 secondary schools in Victoria, Australia. Adolescents completed a web-based survey assessing their eating behaviours, self-efficacy for healthy eating, perceived importance of nutrition and health, social modelling and support and the availability of foods in the home. Parents provided details of maternal education level, which was used as an indicator of SEP. All social cognitive constructs assessed mediated socio-economic variations in at least one indicator of adolescents’ diet. Cognitive factors were the strongest mediator of socio-economic variations in fruit intakes, while for energy-dense snack foods and fast foods, availability of energy-dense snacks at home tended to be strong mediators. Social cognitive theory provides a useful framework for understanding socio-economic variations in adolescent's diet and might guide public health programmes and policies focusing on improving adolescent nutrition among those experiencing socio-economic disadvantage.

User-centered evaluation of a virtual environment training system : utility of user perception measures

This study assessed the utility of measures of Self-efficacy (SelfEfficacy) and Perceived VE efficacy (PVEefficacy) for quantifying how effective VEs are in procedural task training. SelfEfficacy and PVEefficacy have been identified as affective construct potentially underlying VE efficacy that is not evident from user task performance. The motivation for this study is to establish subjective measures of VE efficacy and investigate the relationship between PVEefficacy, SelfEfficacy and User task performance. Results demonstrated different levels of prior experience in manipulating 3D objects in gaming or computer environment (LOE3D) effects on task performance and user perception of VE efficacy. Regression analysis revealed LOE3D, SelfEfficacy,
PVEefficacy explain significant portions of the variance in VE efficacy. Results of the study provide further evidence that task performance may share relationships with PVEefficacy and SelfEfficacy, and that affective constructs, such as PVEefficacy, and SelfEfficacy may serve as alternative, subjective measures of task performance that account for VE efficacy.

An evaluation of the beyondblue depression training program for aged care workers

Background: The prevalence of depression among older people receiving care is high, yet the rate of treatment of this disorder is low. One way to improve the pathway to care is to train care staff to recognize the symptoms of depression and raise their confidence in responding to them. In this study we evaluated the efficacy of the beyondblue Depression Training Program to achieve this aim.
Methods: Staff (N=148) from low level care facilities and community care facilities in metropolitan Melbourne completed the beyondblue Depression Training Program, while staff in other facilities (N = 96) acted as controls. Pre-program, post-program and follow-up questionnaire data were collected and referrals for depression by staff were recorded.
Results: Training improved carers’ knowledge about depression, their self-efficacy in responding to signs of depression and their attitudes towards working with depressed aged care recipients. In addition, training increased the number of referrals for depression made by carers.
Conclusion: Training aged care staff in depression can improve the pathways to care for depressed care recipients, and has the potential to improve the quality of life of older people.

Individual, social and environmental correlates of physical activity among women living in socioeconomically disadvantaged neighbourhoods

Women living in socioeconomically disadvantaged neighbourhoods are at heightened risk for physical inactivity, but little is known about the correlates of physical activity among this group. Using a social-ecological framework, this study aimed to determine the individual, social and neighbourhood environmental correlates of physical activity amongst women living in such neighbourhoods. During 2007–2008 women (n = 4108) aged 18–45 years randomly selected from urban and rural neighbourhoods of low socioeconomic status in Victoria, Australia completed the International Physical Activity Questionnaire (long). They reported on individual (self-efficacy, enjoyment, intentions, outcome expectancies, skills), social (childcare, social support from family and friends/colleagues, dog ownership) and neighbourhood environmental (neighbourhood cohesion, aesthetics, personal safety, ‘walking environment’) factors. Multinomial logistic regression was used to examine the odds of increasing categories of leisure time physical activity (LTPA) and transport-related physical activity (TRPA) for each individual, social and environmental factor. In partially adjusted analyses, all individual, social and environmental variables were positively associated with LTPA, while all individual factors, family and friend support and the walking environment were positively associated with TRPA. In fully adjusted multivariable models, all individual and social factors remained significantly associated with LTPA, while self-efficacy, enjoyment, intentions, social support, and neighbourhood ‘walking environment’ variables remained significantly associated with TRPA. In conclusion, individual and social factors were most important for LTPA, while individual, social and neighbourhood environmental factors were all associated with TRPA. Acknowledging the cross-sectional design, the findings highlight the importance of different levels of potential influence on physical activity in different domains, which should be considered when developing strategies to promote physical activity amongst women living in socioeconomically disadvantaged neighbourhoods.

Physical activity correlates in young women with depressive symptoms : a qualitative study

Background
Young women are at high risk for developing depression and participation in physical activity may prevent or treat the disorder. However, the influences on physical activity behaviors of young women with depression are not well understood. The aim of this study was to gather in-depth information about the correlates of physical activity among young women with and without depressive symptoms.

Methods
A sample of 40 young women (aged 18-30 years), 20 with depressive symptoms (assessed using the CES-D 10) and 20 without depressive symptoms participated in one-on-one semi-structured interviews. A social-ecological framework was used, focusing on the individual, social and physical environmental influences on physical activity. Thematic analyses were performed on transcribed interview data.

Results
The results indicated several key themes that were unique to women with depressive symptoms. These women more often described negative physical activity experiences during their youth, more barriers to physical activity, participating in more spontaneous than planned activity, lower self-efficacy for physical activity and being influenced by their friends' and family's inactivity.

Conclusions
Interventions designed to promote physical activity in this important target group should consider strategies to reduce/overcome early life negative experiences, engage support from family and friends and plan for activity in advance.

Parental correlates of young children's dietary intakes : a review

Evidence suggests that parental modeling, use of feeding strategies, nutrition knowledge, self-efficacy for providing healthy foods and food availability are all likely to be important correlates in determining the dietary habits of young children. This paper reviews the literature regarding parental correlates of the dietary intakes of young children and provides insights regarding areas which may be important in early life but have as yet not been well researched.

Comparing British and Australian fear of terrorism pre and post the Iraqi war

Public attitudes to terrorism influence government positions in opinion polls and highlight the effectiveness of terrorism as a political strategy. British (N = 47) and Australian (N = 42) participants' fear of terrorism at the onset of. and after, the Iraqi war were measured. Self-efficacy, locus of control, media consumption, belief in a just world and war opinions were also measured. Initially, the British were more fearful of terrorism than Australians. However, British fear declined after the war. It is postulated that fear of terrorism is influenced by war opinions with a pro-war attitude protecting against fear.

Cross cultural validation of the preventive health model for colorectal cancer screening : an Australian study

We investigated whether the five-factor structure of the Preventive Health Model for colorectal cancer screening, developed in the United States, has validity in Australia. We also tested extending the model with the addition of the factor Self-Efficacy to Screen using Fecal Occult Blood Test (SESFOBT). Randomly selected men and women aged between 50 and 76 years (n = 414) responded to a survey. Confirmatory factor analyses indicated that the U.S. model provided adequate fit for the group as a whole and for men and women separately, thereby demonstrating cross-cultural validity for measuring factors influencing the decision to screen. The inclusion of SESFOBT in the model resulted in a comparable, but less parsimonious, fit. However, self-efficacy is a demonstrated mediator of intention and action, and it is argued that the addition of SESFOBT as a sixth factor may have utility for the design of strategies to increase actual uptake of FOBT.

Religion, faith and the empowerment process : stories of Iranian people with diabetes

Empowerment concerning people with diabetes is well researched. However, few researchers specifically focus on the barriers to and facilitators of empowerment in Iranian people with diabetes. Understanding the factors could help health professionals facilitate self-empowerment more effectively. This study aims to determine the barriers to and facilitators of empowerment in Iranian people with diabetes. A qualitative exploratory study was conducted using in-depth interviews to collect the data from 11 women and men in 2007. Themes were identified using constant comparative analysis method. Common barriers to empowerment were similar to other chronic diseases: prolonged stress, negative view about diabetes, ineffective health-care systems, poverty and illiteracy. Diabetes education, fear of diabetes’ complications, self-efficacy and hope for a better future emerged as being crucial to empowerment. Facilitators specific to Iranians were: the power of religion and faith, the concept of the doctor as holy man, accepting diabetes as God’s will, caring for the body because it was God’s gift and support from families especially daughters. Empowerment was strongly influenced by cultural and religious beliefs in Iran and the power of faith emerged as an important facilitator of diabetes empowerment. The findings will help health professionals understand how Iranian people with diabetes view life and the factors that facilitate empowerment.

Intervention for depression among palliative care patients and their families : a study protocol for evaluation of a training program for professional care staff

Background: Clinical depression is highly prevalent yet under-detected and under-treated in palliative care settings and is associated with a number of adverse medical and psychological outcomes for patients and their family members. This article presents a study protocol to evaluate a training intervention for non-physician palliative care staff to improve the recognition of depression and provide support for depressed patients and their family members. Details of the hypotheses and expected outcomes, study design, training program development and evaluation measures are described.
Methods and Design: A randomised controlled trial will be implemented across two palliative care services to evaluate the “Training program for professional carers to recognise and manage depression in palliative care settings”. Pre-, post- and three-month follow-up data will be collected to assess: the impact of the training on the knowledge, attitudes, self-efficacy and perceived barriers of palliative care staff when working with depression; referral rates for depression; and changes to staff practices. Quantitative and qualitative methods, in the form of self-report questionnaires and interviews with staff and family members, will be used to evaluate the effectiveness of the intervention.
Discussion: This study will determine the effectiveness of an intervention that aims to respond to the urgent need for innovative programs to target depression in the palliative care setting. The expected outcome of this study is the validation of an evidence-based training program to improve staff recognition and appropriate referrals for depression, as well as improve psychosocial support for depressed patients and their family members.