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A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Kinesiology and Health Studies, University of Regina. 11, 225 p. Physical activity and social interaction are critical components in supporting health and well-being among older adults; therefore, there is significant merit in further exploration of the relationship between these concepts, particularly in rural settings where rates of physical activity are low. Social interaction is also associated with numerous health benefits to older adults; however, little research exists on the association between social interaction and physical activity among rural dwelling older adults. The current COVID-19 pandemic has also placed additional barriers on physical activity participation and social interaction, particularly among older adults who are considered a high-risk population where, in an effort to minimize transmission of the virus, self-isolation and physical distancing were recommended. The purpose of this dissertation was to explore what is known about social interaction and physical activity among older adults in rural communities through a scoping review of the literature, followed by a phenomenological study to better understand of the experience of social interaction and physical activity among the older adult population in a rural context during the COVID-19 pandemic. The scoping review produced 990 results, where 26 articles met the inclusion criteria. Although there were differences in the defining role and meaning of physical activity among the studies, findings indicated that physical activity and social interaction were important for many older adults in maintaining health; however, not all older adults preferred the social aspect of exercising with others. A rural environment often presented limited opportunities for participating in physical and social activities related to geographical location and other socio-economic factors. Using a social ecological model as a guide, data for the phenomenological study were collected from ten participants through individual telephone-based interviews. Findings revealed the inter-related aspects of individual and social factors that influence health promoting behaviours. For many, physical activity was socially motivated. The environment also had an impact on older adults’ physical and social interaction, both positively and negatively. Participants in rural communities expressed a sense of community belonging, safety, and trust which fostered engagement; however, inhibiting factors included icy roads, lack of public transportation and limited services. COVID-19 restrictions also impacted the opportunities for many rural older adults to participate in physical activities and social events, leaving many participants feeling lonely and isolated. COVID-19 restrictions on social interaction provided some with a welcomed break from their usual daily responsibilities. Exploring social interaction and physical activity among rural dwelling older adults adds substantial value to rural-based research, targeting specific interventions that reflect the unique perceptions and experiences of rural older adults to support health and well-being throughout aging. The results of this research are useful in identifying modifiable factors to support and promote active engagement in physical and social activities; however, awareness of negative associations is needed when considering low physical activity rates and social interaction among rural older adults. As a scarcity of rural-specific studies was found in the scoping review, further research is needed to better understand the concepts in a rural environment as often physical and social interaction are experienced differently than in an urban setting. Student yes

A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Kinesiology & Health Studies, University of Regina. xii, 239 p. Accumulating evidence suggests that the risks of inactivity-related problems such as obesity are becoming a population health concern among younger age groups. High income countries show an elevated rate of physical inactivity among children. Low- and middle-income countries are beginning to experience a gradual increase in this trend. Canada is a highly industrialized multicultural society with nearly 22% of foreign-born individuals coming through the immigration process. Recent immigrants tend to experience a decline in their health status, over time as their years in Canada increase (negative acculturation effect). This phenomenon can be attributed to several factors including adaptation to the new sociocultural environment. While a great deal of research has focused on children, there is paucity of research in this area among West African children in Canada. With Saskatchewan being one of the fastest growing populations in Canada, this study sought to gain a deeper understanding of the perspectives of West African immigrant families in Saskatchewan and assess the impact of the sociocultural environment on active living among their adolescent children. Using purposive sampling, a total of 15 families residing in Saskatchewan were interviewed. Children between 10 to 17 years and their parents were interviewed in each family. A grounded theory methodological approach by Charmaz (2014) was used in this study. This involved an immersion phase, a conceptual phase, and a constant comparative analytical process. The analysis allowed for emergence of themes. Both the children and their parents reported having experiential knowledge of physical activity and benefits. The children and their parents also showed some negative acculturative experiences associated with active living. They reported facilitators of physical activity for the children such as school influence, peer influence, and parental role-modelling. The children showed an inherent interest in engaging in risky play. Both the children and their parents reported beneficial outcomes of engaging in physical activity together as a family. Finally, parental positive and negative reinforcements was reported in relation to domestic activities. This study contributes to a conceptual understanding of the knowledge regarding internal, external, and transitional factors impacting the active living and well-being of West African children in Canada. Student yes

A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Master of Science in Kinesiology & Health Studies, University of Regina. viii, 159 p. In the field of gerontology, it is recognized that older adults want to remain at home, even when their needs change. Over the past decade, research has grown in the field of independent senior living. The use of technology, ranging from cell phones and assistive devices to smart homes, may enable older adults to age in place. The goal of this research was to explore the role of Information and Communications Technology (ICT), and to understand whether such technology can help facilitate aging in place for older adults living in a prairie city in Canada. Data was collected through 20 semistructured interviews with adults (65 or older) living in Regina, SK. This research explored ICT use by older adults and found that it contributed to maintaining safety, health, and quality of life. This qualitative study was guided by grounded theory methodology, which helped to enabled emergence of themes related to the use of ICT and how it allows older adults to feel connected to their loved ones and their surroundings. Participants identified four positive attributes that make remaining at home desirable. These included: having personal domain, being able to connect to their surroundings, having connections with family and friends and being able to personalize their own space. Upkeep and home maintenance made remaining in their homes a challenge. When the participants were asked to share their insights into ICT three themes that emerged, including being connected to their family and friends, communicating with these individuals, and the positive and negative perceptions of ICT. It is hoped that this thesis will provide information for older adults, their caregivers, home builders/developers and policy makers, as it will highlight the potential role of technology in achieving the goal of keeping older adults in their homes. Student yes

A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Kinesiology and Health Studies, University of Regina. XVI, 226 p. The objectives of the study were to assess the nature of nutritional and fall risk in older adults living in LTC facilities in New Delhi, evaluate the inter-relationship of nutritional and fall risk, and assess whether depression, fear of falling, and physical function predict fall risk, and to test the reliability of nutrition and fall risk measures. Eighty five women aged 60 years and over living in six LTC facilities in New Delhi were recruited. Measures included the Mini Nutritional Assessment (MNA), Falls Efficacy Scale International (FES-I), Downton Index, SF-36 Health Survey, Geriatric Depression Scale (GDS), Mini Mental State Exam (MMSE), and a background profile and physical activity questionnaire. Mobility was assessed using Timed up and go test (TUG), and handgrip strength was assessed using Jamar hydraulic hand dynamometer. Using SPSS software (version 22.0), descriptive statistics, correlation between different variables, predictors of fall risk, and reliability measures were analysed. The mean age of participants was 74.21(5.52) years. A majority were widowed with poor educational and income level. Findings revealed that 54% of the older women were at a high level of nutritional risk. The factors that accounted for a large proportion of variance in the nutritional risk level were mobility status, intake of psychotropic medications, low dietary intake, and poor self-perception of health status. MNA scores had significant negative correlation with Downton Index scores (R= -.419, p

A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Master of Science in Kinesiology &Health Studies, University of Regina. xi, 158 p. The purpose of this study was to compare the effects of two exercise training protocols for 12 weeks in individuals with mild to moderate Multiple Sclerosis (MS). Participants were randomly assigned to one of three groups: Resistance Training (RT; n=7, males=1, females=6, 43.2±8.7 years), Whole-Body Vibration (WBV; n=9, males=2, females=7, 45.1±10.0 years) or Control Group (CON; n=5, males=0, females=5, 53.0±12.6 years). Participants in the RT and WBV groups performed supervised training sessions, two days per week for 12 weeks. The primary dependent variables assessed at baseline and after 6 and 12 weeks of training were body composition (lean tissue, fat, bone mineral), limb muscle thickness, maximal muscle strength, muscle endurance, and balance. Repeated measures ANOVA showed a group x time interaction for balance (p

A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements For the Degree of Special Case Doctor of Philosophy in Kinesiology and Health Studies, University of Regina. xiv, 340 p. Osteoporosis and its related fractures pose a major public health concern and a considerable economic burden on health care systems. There are recognized gaps, not only in care between best practice and actual care delivery as it relates to osteoporosis screening access, but also from knowledge to practice as men and women at risk of osteoporosis and fragility fractures are not engaging in adequate preventive health behaviours. A series of three studies were conducted and emphasized primary and secondary prevention of osteoporosis in effort to reduce the care gap. The purpose of Study 1 was to conduct a systematic review to identify common validated clinical risk factor assessment tools in predicting low BMD in postmenopausal women and identify which tool demonstrated the best discriminative performance. A comprehensive literature review of published data in multiple databases was performed based on standardized inclusion and exclusion criteria. Based on 22 primary articles, two independent reviewers identified six risk factor assessment tools. The OST was the simplest tool to determine postmenopausal women at increased risk of osteoporosis who would benefit from DXA screening, while still maintaining acceptable discriminatory abilities. Results of this study were used to inform Study 2. The purpose of Study 2 was to evaluate the accuracy of calcaneal QUS and OST in identifying men and women over 50 years of age with osteoporosis as defined by DXA, and to establish optimal cut-offs to determine risk. This study (N = 202, Mage = 59.7 years) assessed BMD of the lumbar spine and femoral neck using DXA and subsequent calcaneal QUS and OST assessment. Pearson’s product correlation coefficients between QUS and DXA parameters were calculated. ROC analyses were performed and optimal thresholds for QUS were defined based on sensitivity, specificity, and likelihood ratio analysis. Results showed QUS at the femoral neck in women consistently out-performed QUS at the lumbar spine and OST in men and women. QUS SI cut-off values that fall between 65 and 78 would warrant DXA screening, with a cutoff < 65 indicating high likelihood of osteoporosis. The purpose of Study 3 was to determine the influence of DXA screening combined with theory-based osteoporosis education versus usual care (DXA screening alone) on change in men and women’s health behaviours, specifically calcium and vitamin D intake, physical activity, and drug treatment initiation. A 6-month RCT was conducted in 203 men and women (Mage = 59.7 years) referred by an HCP to undergo DXA screening for the first time. Participants were randomly assigned to an intervention group (n = 102) or usual care group (n = 101) and completed a series of questionnaires. The intervention group received osteoporosis education, using the Health Belief Model as a theoretical framework. Results showed the intervention increased calcium and vitamin D intake and physical activity compared to DXA screening alone. Multivariate logistic regression analyses showed the intervention was an independent predictor of calcium intake, and DXA screening results indicating low BMD independently predicted drug treatment initiation. Overall, the series of studies provided valuable insight for practical solutions regarding improved detection of osteoporosis and informing health promotion programs for prevention and management of the disease. It is evident there is an overall need for studies evaluating osteoporosis detection, prevention, and management in older men. A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy *, University of Regina. *, * p. Student yes

A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Clinical Psychology, University of Regina. xvii, 153 l. The lifetime prevalence of intimate partner violence (IPV) in Canada is estimated to be 25% (Ellsberg & Heise, 2005; Seager, 2003). Survivors of IPV report experiencing sleep difficulties (M. A. Woods, & Hampton, 2008) that impact their health, subsequently increasing health service use (Bonomi, Andreson, Rivara, & Thompson, 2009; Colten & Altevogt, 2006; Moorcroft, 2005; Rosa, 2006; Soares, 2005). Being able to isolate the effect of IPV on health service and long term sleep disruption may shed light on the economic as well as social cost of IPV to society. The purpose of the present study was to measure the relationship between sleep, IPV, and health service use in a sample of survivors of IPV from Alberta, Saskatchewan, and Manitoba, participating in the Healing Journey Project (Social Sciences and Humanities Research Council/Community University Research Alliance). The Healing Journey Project is a longitudinal study including seven waves of data collection, and the data from the current study was drawn from Waves 1, 2, and 4. At Wave 1, 665 women participated in the study, with 595 women participating at Wave 2 and 484 at Wave 4. A subsample of 205 women who had not been in a violent intimate partner relationship since Wave 2 was created at Wave 4 to test two of the hypotheses. Overall, three hypotheses were tested: (1) sleep problems due to abuse predict frequency of health service utilization, (2) survivors of IPV experience long term sleep problems due to abuse, and (3) that long term health service use frequency is predicted by long term sleep problems due to abuse. The following information was collected to test these hypotheses: demographic characteristics (age, working status, educations status, presence of children in the home, childhood abuse, and cultural background), symptoms of post-traumatic stress disorder (PTSD) as assessed using the Post-traumatic Stress Disorder Checklist (Blanchard, Jones-Alexander, Buckley, & Forneris, 1996; Weathers, Litz, Herman, Huska, & Keane, 1993), depression symptoms as assessed using a short form of the Center for Epidemiological Studies Depression Scale (Andresen, Carter, Malmgren, & Patrick, 1994; Radloff, 1977), selfreport ratings of health status, number of injuries in the previous 12 months, IPV as assessed using the Composite Abuse Scale (Hegarty, Bush, & Sheehan, 2005), sleep problems due to abuse as assessed using a brief measure of sleep problems in survivors of IPV, and reports of frequency of health service access in the previous 12 months. The three hypotheses were each tested using hierarchical multiple regression. The second hypothesis was also tested using frequency counts and comparison between reports of sleep problems due to abuse at Waves 2 and 4. The first hypothesis, that sleep problems due to abuse predicated health service use, and the third hypothesis, that sleep problems due to abuse predicted long-term health service use, were both rejected. The second hypothesis, that past abuse predicted long-term sleep problems due to abuse, was supported. The findings suggest that health service use is not related to sleep problems due to abuse, despite evidence that survivors of IPV experience significant disruption to their sleep as a result of the violence. It appears that while survivors of IPV are not using health services in association with sleep problems due to abuse that clinicians should avoid over-treating sleep problems in survivors of IPV as not sleeping may be a protective strategy when victims of IPV are avoiding sleep to avoid danger (Colten & Altevogt, 2006; Stepanski, 2006). The implications of these findings and future direction are discussed. A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy *, University of Regina. *, * p. Student yes