New Zealand women often experience a narrow focus on weight or body size as a barrier
to health. This dominant Western “weight-centred” discourse conflates health with weight and
disempowers women from gaining control and autonomy over their health. This thesis aimed to
design, implement and evaluate Next Level Health (NLH); a strengths-based programme founded
on values of empowerment and holistic health. NLH aims to empower women over their health
through incremental behaviour change within the context of their daily lives across six domains:
physical activity, sleep, nutrition, eating behaviour, self-care and stress management.
Fifty-eight women, aged 18-40 years completed NLH. A mixed-methods convergent
design guided the evaluation of women’s outcomes and programme implementation. Data were
collected via a series of surveys and physical measures. The outcomes assessed were women’s
health-promoting behaviours (HPBs), physical, mental and social health and participant perceived
outcomes. Process evaluation comprised the programme’s reach, fidelity and participant
satisfaction. The findings were then analysed and integrated to determine women’s empowerment
over their health.
Collectively, the outcomes women experienced after NLH contributed to their
empowerment by increasing their capacity for HPBs, adopting and experiencing a holistic health
approach and enhancing their autonomy regarding their HPBs, health development and ability to
generate a sense of success. Additionally, eight factors were identified that were key attributes of
the programme that contributed to women’s empowerment or were vital for evaluating their
success: (1) a small goals approach; (2) dialogue; (3) social support; (4) a multidisciplinary
approach; (5) a strengths-based approach; (6) a weight-neutral approach, (7) assessment across
multiple health dimensions and (8) a mixed-methods design for evaluation.
In sum, the findings suggest that NLH successfully empowered women to gain greater
control over their health. NLH overcomes common shortcomings of dominant health interventions
by using a positive, multidisciplinary and empowering approach to promote women’s health that
was adaptable to individual contexts, and exhibits potential for producing sustainable change. The
current study contributes a novel programme and comprehensive evaluation providing evidence
for a small, yet growing, body of empowerment research to promote women’s health.
Copyright permission has been granted for the use of Figures 1 (p.12), 2 (p.13), & 3 (p.18).