Organization, Information and Learning Sciences ETDs


Celeste Lee

Publication Date



A heuristic phenomenological approach drew out participants identified factors that initiated self-management of unhealthy weight-related chronic diseases; resulting in severity attenuation of current chronic disease(s) and lowered risk of comorbidity development. Prior to this study, there have been three omissions relating to older individuals who have unhealthy weight-related chronic diseases. First, direct first-person narratives of the process to self-management have not been reported. Second, the self-identification of the initiating factors leading to self-management has not been found in scholarly literature. Finally, cognitive reflection, an activity that results in paradigmatic shifts in adult behaviors has not been discussed from the first-person perspective (Cranton, 2006; Taylor, 2009; Taylor & Cranton, 2012). Narratives of 10 participants resulted in understanding the challenges of managing chronic health conditions and factors associated with self-management, from these first-person perspectives. Two themes of factors that initiated the self-management process were developed, emanating from each participant's conscious acknowledgment and acceptance of responsibility. The themes identified were (a) acknowledgment of the significant, 'last straw' diagnosis and (b) conscientiously accepting physical limitations resulting from respective chronic disease(s). It has been important to acknowledge the need for such a study from societal and personal perspectives. First, because individuals are living longer, the risk of developing chronic diseases such as hypertension, type-2 diabetes, cardiovascular disease is further enhanced if the individual has unhealthy weight (Ginsberg & MacCallum, 2009; Morrell, Lofgren, Burke, & Reilly, 2012). Voluntary lifestyle choices of poor nutrition and lack of routine physical activity significantly contribute to the etiology of unhealthy weight, while healthy weight can significantly reduce this risk and sustain and increase quality of life as aging proceeds (Centers for Disease Control and Prevention, 2005). While the necessity to maintain a healthy weight through aging is well documented (Centers for Disease Control and Prevention, 2014; Clark & Brancati, 2000), statistics continue to reflect increasing numbers of older individuals succumbing to unhealthy weight and concomitant chronic disease (Kart, Metress, & Metress, 1992). This study obtains information directly from participants who have experienced a paradigmatic shift to self-management of weight and concomitant chronic diseases as evidenced by participation in self-management programs and reductions of risks associated with weight and other comorbidities. Delimitations of a small homogeneous population segment do not preclude the value of the study. Limitations include employing heuristic phenomenology and a nonvalidated data collection instrument. However, this study provides a novel approach of data gathering from the first-person perspective. A future study should focus on the transformative learning process of transformative learning theory within the first phase of transtheoretical model of the stages of change theory to better understand the self-identified factors associated with how these factors initiated the self-management process. The efforts extended in this study should be of interest to individuals engaged in adult learning, healthcare and public health.

Degree Name

Organizational Learning and Instructional Technology

Level of Degree


Department Name

Organization, Information & Learning Sciences

First Advisor

Law, Victor Wai-Tung

First Committee Member (Chair)

Boverie, Patricia

Second Committee Member

Kravitz, Leonard

Third Committee Member

Torrez, Diana Jean




transformative learning theory, Husserlian heuristic phenomenology, unhealthy weight, chronic disease, initiating self-management, change, first-person narrative

Document Type