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Objective: Obesity is the fifth leading cause of global death and is preventable. It affects all body systems and causes major chronic illnesses such as diabetes, heart diseases, stroke, and some cancers. The goal of this transtheoretical stages of changes (TSOC) theory-based project are as follows: To educate the

Objective: Obesity is the fifth leading cause of global death and is preventable. It affects all body systems and causes major chronic illnesses such as diabetes, heart diseases, stroke, and some cancers. The goal of this transtheoretical stages of changes (TSOC) theory-based project are as follows: To educate the participants of the project to be aware of obesity and its complications; motivate them to use community resources, and improve their body mass indexes (BMI), waist circumference (WC), motivation, quality of life (QOL) and lifestyle. Methods: Twenty-three participants were recruited in a primary care clinic. Six participants dropped out during the project. All the randomly selected participants who met the criteria of obesity signed written informed consent and were provided a 4-digit code to maintain anonymity. Participants were motivated and educated using a handout, two pre-and post-project in-person nursing visits, and five telemedicine weekly nursing follow-ups visits. Pre- and post-surveys collected during in-person visits include data such as weight, BMI, WC, demographic data, comorbidities, lifestyle, motivation, QOL, TSOC, and utilization of community resources. Results: Descriptive analysis and paired t-test is done utilizing Intellectus statistics software to measure the outcome. The results show improvement in dietary choices, physical activity, motivation, QOL, use of community resources, decrease in BMI, and WC. In paired t tests, results show clinical and statistical significance in BMI, WC, MOT and clinical significance in QOL. There was increase in the revenue at the project site due to reimbursement of the services provided for the patients. Conclusion: The results are expected to develop practice change in preventing and treating obesity. More evidence-based projects and studies with large sample size are needed to develop improvement in the knowledge base of providers and current practice.
Created2022-04-28
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The number of adolescents who are overweight are suffering from diseases once thought to only occur in adults, such as diabetes mellitus type 2, coronary heart disease, and liver disease with cases increasing exponentially. This may be correlated with adolescents making unhealthy choices in life resulting in depression in obese

The number of adolescents who are overweight are suffering from diseases once thought to only occur in adults, such as diabetes mellitus type 2, coronary heart disease, and liver disease with cases increasing exponentially. This may be correlated with adolescents making unhealthy choices in life resulting in depression in obese adolescents. Healthcare providers must continuously explore novel ways to empower teens to make healthy lifestyle changes. The Creating Opportunities for Personal Empowerment (COPE) Thinking, Emotions, Exercise, and Nutrition (TEEN) program was delivered to three adolescent participants in a primary care pediatric clinic in Southwest Arizona. The 15 sessions were provided weekly in the pediatrician’s office using the COPE TEEN manual. The participants completed the HABITS questionnaire and the Patient Health Questionnaire-9 (PHQ-9) before starting the program and after program cessation and kept confidential. The survey results were compared using descriptive analysis and paired t-tests to analyze the data collected. Due to a small sample size (n=3), statistical significance could not be calculated. However, clinical significance was found as evidenced by lower depression scores and improvement in healthy habits. A cognitive behavior skills-building program such as the COPE TEEN program has the potential to empower adolescents to make healthy decisions in life. These healthy choices lead to a long, happy life free from diseases caused by unhealthy choices. This program positively impacts the clinical care of adolescents who are overweight or obese by offering providers an alternative manner of educating adolescents.
Created2022-04-29
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Current obesity statistics exceed national goals with Hispanics disproportionately affected. Evidence suggests a family centered methodology focusing on culture can positively improve weight loss, client satisfaction and participation. This project will evaluate use of culturally tailored resources for primary care providers to educate Hispanics on weight loss. Eight providers in

Current obesity statistics exceed national goals with Hispanics disproportionately affected. Evidence suggests a family centered methodology focusing on culture can positively improve weight loss, client satisfaction and participation. This project will evaluate use of culturally tailored resources for primary care providers to educate Hispanics on weight loss. Eight providers in a small practice in the Southwestern US were recruited to complete a pre- and postEBPAS tool after an educational session. A BMI form tracked provider use of the fotonovela intervention against preferred methods.

Feedback on time spent educating and overall perception were collected. Four providers completed the pre-EBPAS, three completed the post-, one participated in the intervention, and six contributed project feedback. Descriptive statistics revealed an aggregate provider decrease of five-points post-educational session for attitude toward adopting EBP. The BMI documentation form demonstrated a 53% (n = 8) use of the fotonovela. However, there were five undocumented fotonovelas taken/given out postintervention. Key themes noted by providers included poor timing of the project, satisfaction with workflow and resources, and overall discontent for the fotonovela. Future implications include re-evaluating the project in a practice not undergoing significant changes with specific focus on timing of the intervention.

ContributorsMunson, Megan A. (Author) / Bay, Sarah (Thesis advisor)
Created2018-04-30
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This study answers the question, “In Adult Hispanic BMI ≥ 30 (P), how does development of a weight loss program that utilizes Motivational Interviewing (I) compared to counseling and educational materials only (C) affect weight loss over the period of three months (T).” There are limited published systematic reviews and

This study answers the question, “In Adult Hispanic BMI ≥ 30 (P), how does development of a weight loss program that utilizes Motivational Interviewing (I) compared to counseling and educational materials only (C) affect weight loss over the period of three months (T).” There are limited published systematic reviews and randomized control trials to evaluate the effectiveness of Motivational Interviewing (MI), in conjunction with diet and exercise to promote weight loss. Participants (n = 5) were Latino patients of a local community health care center who were overweight and medically at risk due to unhealthy lifestyles that were determined through a screening test.

The 4-week clinical pathway program used motivational interviewing in one-on-one sessions every other week, and implemented the “Your Heart, Your Life” curriculum the other weeks. One expected outcome included lower anthropometric measurement numbers of participants’ WL, BMI, WC, and BP. Another expected outcome was an increase in physical activity. Participants were also expected to earn a higher score on a post-test about nutrition and healthy living. A paired t-test and power analyses were used to assess its effectiveness.

Results indicated significant decrease in weight loss (t [5] = 3.68, p = .0211, Cohen’s dz=1.647). For heart healthy habits, there were significant increases all three categories: weight management (t [5] = - 3.36, p = .0211), cholesterol and fat (t [5] = - 3.138, p =.035, salt and sodium (t [5] = - 4.899, p = .008). In addition, there was an increase in knowledge (t [5] = - 4.000, p = .016). Every participant showed small gains. Future implications should include more participants, including males, a control group, innovative activities that help to motivate a community of learners and more flexibility in allotted time for interventions.

ContributorsLedesma, Nadia (Author) / Thrall, Charlotte (Thesis advisor)
Created2016-05-06
Description

PowerPoint presentation to the Santa Fe Institute, October 2004.

ContributorsBarton, C. Michael (Author)
Created2004
Description

Dramatic changes in land use were associated with the rise of agriculture in the mid Holocene in the Mediterranean region. Both surface properties and drainage networks were changed along with direct modifications to surface properties (vegetation removal and change, sediment liberation and compaction); consequent drainage alteration (terracing, canals) and u

Dramatic changes in land use were associated with the rise of agriculture in the mid Holocene in the Mediterranean region. Both surface properties and drainage networks were changed along with direct modifications to surface properties (vegetation removal and change, sediment liberation and compaction); consequent drainage alteration (terracing, canals) and up and downstream responses in the watersheds communicated these changes throughout the landscape.

The magnitude, rate, and feedbacks with the growing human populations are critical questions in our effort to assess human-landscape interactions. To investigate these relationships, recent field work in the Penaguila Valley of southeast Spain included landform mapping, alluvial deposit description, and sample collection emphasizing areas of active erosion, remnant land surfaces and their relation to archaeological sites.

We have updated our geomorphic maps by refining the delineation of alluvial terraces, steep-walled (40m deep) drainages ("barrancos"), and hollows ("barrancos de fondo plano"). Hollows are curved, elongate, flat-bottomed gullies with steep walls (2-30m tall) and extend headward from the main barrancos. This work enables more accurate terrace correlations necessary for both landscape evolution modeling and interpretation of the development history of the basin.

Alluvial terraces are crucial to this research because they record periods of past stable topography. In the Penaguila, sites dating back to late Mesolithic and early Neolithic (around 6600 BP) and subsequent periods (Chalcolithic and Bronze Age) are exposed on a prominent terrace surface mapped as Terrace A. This broad low relief surface is scarred by deep barrancos and hollow formation that expose bedrock marls and overlying alluvial deposits. Stratigraphic profiles and texture analyses of Terrace A deposits reveal overland flow facies and channel networks in reworked and CaCO3-encrusted marls, and several organic-rich paleosols. Small remnant surfaces mapped as Terrace Z (below Terrace A) were observed within the main barrancos and indicate a later, brief accumulation period with subsequent incision to the modern channel.

Holocene landscape development in the Penaguila appears to have progressed from a period of stability to slope denudation with aggradation (stream infilling) followed by rapid incision which initiated sometime near the time of occupation. This change from a low relief alluvial surface to one cut by narrow channels may have been an important shift for local populations. Their response to that environmental modification may be associated with the horticulturalist to agricultural intensification noted in the archaeological record. Tighter chronology and better understanding of the driving processes for barranco incision and hollow formation will improve our ability to correlate the changing landscape with land use practices. Such an improved correlation leads to better understanding of human-landscape interactions.

ContributorsDiMaggio, E. N. (Author) / La Roca, N. (Author) / Arrowsmith, J. Ramon (Author) / Diez-Castillo, A. (Author) / Bernabeu, J. (Author) / Barton, C. Michael (Author)