Matching Items (15)
Filtering by
- All Subjects: Health Sciences
- All Subjects: public health
- Genre: Academic theses
- Creators: Buman, Matthew
Description
The purpose of this pilot randomized control trial was to test the initial efficacy of a 10 week social cognitive theory (SCT)-based intervention to reduce workplace sitting time (ST). Participants were currently employed adults with predominantly sedentary occupations (n=24) working in the Greater Phoenix area in 2012-2013. Participants wore an activPAL (AP) inclinometer to assess postural allocation (i.e., sitting vs. standing) and Actigraph accelerometer (AG) to assess sedentary time for one week prior to beginning and immediately following the completion of the 10 week intervention. Self-reported measures of sedentary time were obtained via two validated questionnaires for overall (International Physical Activity Questionnaire [IPAQ]) and domain specific sedentary behaviors (Sedentary Behavior Questionnaire [SBQ]). SCT constructs were also measured pre and post via adapted physical activity questionnaires. Participants were randomly assigned to receive either (a) 10 weekly social cognitive-based e-newsletters focused on reducing workplace ST; or (b) similarly formatted 10 weekly e-newsletters focusing on health education. Baseline adjusted Analysis of Covariance statistical analyses were used to examine differences between groups in time spent sitting (AP) and sedentary (AG) during self-reported work hours from pre- to post- intervention. Both groups decreased ST and AG sedentary time; however, no significant differences were observed. SCT constructs also did not change significantly between pretest and post test in either group. These results indicate that individualized educational approaches to decreasing workplace sitting time may not be sufficient for observing long term change in behaviors. Future research should utilize a larger sample, measure main outcomes more frequently, and incorporate more environmental factors throughout the intervention.
ContributorsGordon, Amanda (Author) / Buman, Matthew (Thesis advisor) / Der Ananian, Cheryl (Committee member) / Swan, Pamela (Committee member) / Arizona State University (Publisher)
Created2013
Description
INTRODUCTION: Exercise performed at moderate to vigorous intensities has been shown to generate a post exercise hypotensive response. Whether this response is observed with very low exercise intensities is unclear. PURPOSE: To compare post physical activity ambulatory blood pressure (ABP) response to a single worksite walking day and a normal sedentary work day in pre-hypertensive adults. METHODS: Participants were 7 pre-hypertensive (127 + 8 mmHg / 83 + 8 mmHg) adults (3 male, 4 female, age = 42 + 12 yr) who participated in a randomized, cross-over study that included a control and a walking treatment. Only those who indicated regularly sitting at least 8 hours/day and no structured physical activity were enrolled. Treatment days were randomly assigned and were performed one week apart. Walking treatment consisted of periodically increasing walk time up to 2.5 hours over the course of an 8 hour work day on a walking workstation (Steelcase Company, Grand Rapids, MI). Walk speed was set at 1 mph. Participants wore an ambulatory blood pressure cuff (Oscar 2, SunTech Medical, Morrisville, NC) for 24-hours on both treatment days. Participants maintained normal daily activities on the control day. ABP data collected from 9:00 am until 10:00 pm of the same day were included in statistical analyses. Linear mixed models were used to detect differences in systolic (SBP) and diastolic blood pressure (DBP) by treatment condition over the whole day and post workday for the time periods between 4 -10 pm when participants were no longer at work. RESULTS:BP was significantly lower in response to the walking treatment compared to the control day (Mean SBP 126 +7 mmHg vs.124 +7 mmHg, p=.043; DBP 80 + 3 mmHg vs. 77 + 3 mmHg, p = 0.001 respectively). Post workday (4:00 to 10:00 pm) SBP decreased 3 mmHg (p=.017) and DBP decreased 4 mmHg (p<.001) following walking. CONCLUSION: Even low intensity exercise such as walking on a walking workstation is effective for significantly reducing acute BP when compared to a normal work day.
ContributorsZeigler, Zachary (Author) / Swan, Pamela (Thesis advisor) / Buman, Matthew (Committee member) / Gaesser, Glenn (Committee member) / Arizona State University (Publisher)
Created2013
Description
Cardiovascular disease (CVD) is the number one cause of death in the United States and type 2 diabetes (T2D) and obesity lead to cardiovascular disease. Obese adults are more susceptible to CVD compared to their non-obese counterparts. Exercise training leads to large reductions in the risk of CVD and T2D. Recent evidence suggests high-intensity interval training (HIT) may yield similar or superior benefits in a shorter amount of time compared to traditional continuous exercise training. The purpose of this study was to compare the effects of HIT to continuous (CONT) exercise training for the improvement of endothelial function, glucose control, and visceral adipose tissue. Seventeen obese men (N=9) and women (N=8) were randomized to eight weeks of either HIT (N=9, age=34 years, BMI=37.6 kg/m2) or CONT (N=8, age=34 years, BMI=34.6 kg/m2) exercise 3 days/week for 8 weeks. Endothelial function was assessed via flow-mediated dilation (FMD), glucose control was assessed via continuous glucose monitoring (CGM), and visceral adipose tissue and body composition was measured with an iDXA. Incremental exercise testing was performed at baseline, 4 weeks, and 8 weeks. There were no changes in weight, fat mass, or visceral adipose tissue measured by the iDXA, but there was a significant reduction in body fat that did not differ by group (46±6.3 to 45.4±6.6%, P=0.025). HIT led to a significantly greater improvement in FMD compared to CONT exercise (HIT: 5.1 to 9.0%; CONT: 5.0 to 2.6%, P=0.006). Average 24-hour glucose was not improved over the whole group and there were no group x time interactions for CGM data (HIT: 103.9 to 98.2 mg/dl; CONT: 99.9 to 100.2 mg/dl, P>0.05). When statistical analysis included only the subjects who started with an average glucose at baseline > 100 mg/dl, there was a significant improvement in glucose control overall, but no group x time interaction (107.8 to 94.2 mg/dl, P=0.027). Eight weeks of HIT led to superior improvements in endothelial function and similar improvements in glucose control in obese subjects at risk for T2D and CVD. HIT was shown to have comparable or superior health benefits in this obese sample with a 36% lower total exercise time commitment.
ContributorsSawyer, Brandon J (Author) / Gaesser, Glenn A (Thesis advisor) / Shaibi, Gabriel (Committee member) / Lee, Chong (Committee member) / Swan, Pamela (Committee member) / Buman, Matthew (Committee member) / Arizona State University (Publisher)
Created2013
Description
Purpose: The purpose of this study was to examine the acute effects of two novel intermittent exercise prescriptions on glucose regulation and ambulatory blood pressure. Methods: Ten subjects (5 men and 5 women, ages 31.5 ± 5.42 yr, height 170.38 ± 9.69 cm and weight 88.59 ± 18.91 kg) participated in this four-treatment crossover trial. All subjects participated in four trials, each taking place over three days. On the evening of the first day, subjects were fitted with a continuous glucose monitor (CGM). On the second day, subjects were fitted with an ambulatory blood pressure monitor (ABP) and underwent one of the following four conditions in a randomized order: 1) 30-min: 30 minutes of continuous exercise at 60 - 70% VO2peak; 2) Mod 2-min: twenty-one 2-min bouts of walking at 3 mph performed once every 20 minutes; 3) HI 2-min: eight 2-min bouts of walking at maximal incline performed once every hour; 4) Control: a no exercise control condition. On the morning of the third day, the CGM and ABP devices were removed. All meals were standardized during the study visits. Linear mixed models were used to compare mean differences in glucose and blood pressure regulation between the four trials. Results: Glucose concentrations were significantly lower following the 30-min (91.1 ± 14.9 mg/dl), Mod 2-min (93.7 ± 19.8 mg/dl) and HI 2-min (96.1 ± 16.4 mg/dl) trials as compared to the Control (101.1 ± 20 mg/dl) (P < 0.001 for all three comparisons). The 30-min trial was superior to the Mod 2-min, which was superior to the HI 2-min trial in lowering blood glucose levels (P < 0.001 and P = 0.003 respectively). Only the 30-min trial was effective in lowering systolic ABP (124 ± 12 mmHg) as compared to the Control trial (127 ± 14 mmHg; P < 0.001) for up to 11 hours post exercise. Conclusion: Performing frequent short (i.e., 2 minutes) bouts of moderate or high intensity exercise may be a viable alternative to traditional continuous exercise in improving glucose regulation. However, 2-min bouts of exercise are not effective in reducing ambulatory blood pressure in healthy adults.
ContributorsBhammar, Dharini Mukeshkumar (Author) / Gaesser, Glenn A (Thesis advisor) / Shaibi, Gabriel (Committee member) / Buman, Matthew (Committee member) / Swan, Pamela (Committee member) / Lee, Chong (Committee member) / Arizona State University (Publisher)
Created2013
Description
Research provides increasing support of self-worth, non-physical motives, and body image for predicting physical activity in women. However, no empirical tests of these associations have been conducted. Ecological momentary assessment (EMA) has been recognized as useful for understanding correlates of physical activity. This study tested the feasibility of a novel EMA protocol and explored temporal relationships between daily self-worth and physical activity in middle-aged women. Women aged 35-64 years (N=63; M age=49.2±8.2 years) received text message prompts to an Internet-based mobile survey three times daily for 28 days. The survey assessed momentary activity, self-worth (knowledge, emotional, social, physical, general), and self-efficacy. Women concurrently wore an accelerometer on their non-dominant wrist. Feasibility was assessed via accelerometer wear-time estimates, survey completion rates, and participant feedback. Multilevel models examined the predictive influence of self-worth on daily activity counts. Self-efficacy was also tested due to known relationships with self-worth and physical activity in women. Wear time was high (952.92 ± 100.99 min per day), with only 141 observations lost to non-wear. However, 449 were lost to accelerometer malfunction. Women completed 80.8% of surveys. After excluding missing physical activity data, 67.5% of observations (N=3573) were analyzed. Although women thought the survey was easy to complete, perceptions of the accelerometer were mixed. Approximately 34% of the variance in daily counts was within individuals (ICC=0.66). Average self-efficacy (β=0.005, p=0.009), daily fluctuations in self-efficacy (β=0.001, p<0.001), and daily fluctuations in general self-worth (β=0.04, p=0.003) predicted daily activity. There were significant individual differences in relationships between daily fluctuations in emotional (β=0.006, p=0.02) and general self-worth (β=0.005, p=0.02) and daily activity. The use of text message prompts and an Internet-based mobile survey was feasible for conducting EMA in middle-aged women. Research identifying optimal methods of behavior monitoring in longitudinal studies is needed. Results provide support for small but significant associations among daily fluctuations in self-efficacy and general self-worth and daily activity in middle-aged women. The impact of emotional self-worth may differ across women. Further research examining the transient natures of self-efficacy and general self-worth, improving self-worth scales, and testing momentary strategies to increase women's self-worth and physical activity is warranted.
ContributorsEhlers, Diane K. (Author) / Huberty, Jennifer L (Thesis advisor) / Todd, Michael (Committee member) / Vreede, Gert-Jan de (Committee member) / Hooker, Steven (Committee member) / Buman, Matthew (Committee member) / Arizona State University (Publisher)
Created2014
Description
A core principle in multiple national quality improvement strategies is the engagement of chronically ill patients in the creation and execution of their treatment plans. Numerous initiatives are underway to use health information technology (HIT) to support patient engagement however the use of HIT and other factors such as health literacy may be significant barriers to engagement for older adults. This qualitative descriptive study sought to explore the ways that older adults with multi-morbidities engaged with their plan of care. Forty participants were recruited through multiple case sampling from two ambulatory cardiology practices. Participants were English-speaking, without a dementia-related diagnosis, and between the ages of 65 and 86. The older adults in this study performed many behaviors to engage in the plan of care, including acting in ways to support health, managing health-related information, attending routine visits with their doctors, and participating in treatment planning. A subset of patients engaged in active decision-making because of the point they were at in their chronic disease. At that cross roads, they expressed uncertainly over which road to travel. Two factors influenced the engagement of older adults: a relationship with the provider that met the patient's needs, and the distribution of a Meaningful Use clinical summary at the conclusion of the provider visit. Participants described the ways in which the clinical summary helped and hindered their understanding of the care plan.
Insights gained as a result of this study include an understanding of the discrepancies between what the healthcare system expects of patients and their actual behavior when it comes to the creation of a care plan and the ways in which they take care of their health. Further research should examine the ability of various factors to enhance patient engagement. For example, it may be useful to focus on ways to improve the clinical summary to enhance engagement with the care plan and meet standards for a health literate document. Recommendations for the improvement of the clinical summary are provided. Finally, this study explored potential reasons for the infrequent use of online health information by older adults including the trusting relationship they enjoyed with their cardiologist.
Insights gained as a result of this study include an understanding of the discrepancies between what the healthcare system expects of patients and their actual behavior when it comes to the creation of a care plan and the ways in which they take care of their health. Further research should examine the ability of various factors to enhance patient engagement. For example, it may be useful to focus on ways to improve the clinical summary to enhance engagement with the care plan and meet standards for a health literate document. Recommendations for the improvement of the clinical summary are provided. Finally, this study explored potential reasons for the infrequent use of online health information by older adults including the trusting relationship they enjoyed with their cardiologist.
ContributorsJiggins Colorafi, Karen (Author) / Lamb, Gerri (Thesis advisor) / Marek, Karen (Committee member) / Greenes, Robert (Committee member) / Evans, Bronwynne (Committee member) / Arizona State University (Publisher)
Created2015
Description
Background and purpose: Regular physical activity (PA) provides benefits for cognitive health and helps to improve or maintain quality of life among older adults. Objective PA measures have been increasingly used to overcome limitations of self-report measures. The purpose of this study was to investigate the association of objectively measured PA and sedentary time with cognitive function among older adults.
Methods: Participants were recruited from the parent REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. ActicalTM accelerometers provided estimates of PA variables, including moderate-to-vigorous PA (MVPA), high light PA (HLPA), low light PA (LLPA) and sedentary time, for 4-7 consecutive days. Prevalence and incidence of cognitive impairment were defined by the Six-Item Screener. Letter fluency, animal fluency, word list learning and Montreal Cognitive Assessment (orientation and recall) were conducted to assess executive function and memory.
Results: Of the 7,339 participants who provided accelerometer wear data > 4 days (70.1 ± 8.6 yr, 54.2% women, 31.7% African American), 320 participants exhibited impaired cognition. In cross-sectional analysis, participants in the highest MVPA% quartile had 39% lower odds of cognitive impairment than those in the lowest quartile (OR: 0.61, 95% C.I.: 0.39-0.95) after full adjustment. Further analysis shows most quartiles of MVPA% and HLPA% were significantly associated with executive function and memory (P<0.01). During 2.7 ± 0.5 years of follow-up, 3,385 participants were included in the longitudinal analysis, with 157 incident cases of cognitive impairment. After adjustments, participants in the highest MVPA% quartile had 51% lower hazards of cognitive impairment (HR: 0.49, 95% C.I.: 0.28-0.86). Additionally, MVPA% was inversely associated with change in memory z-scores (P<0.01), while the highest quartile of HLPA% was inversely associated with change in executive function and memory z-scores (P<0.01).
Conclusion: Higher levels of objectively measured MVPA% were independently associated with lower prevalence and incidence of cognitive impairment, and better memory and executive function in older adults. Higher levels of HLPA% were also independently associated with better memory and executive function. The amount of MVPA associated with lower risk of cognitive impairment (259 min/week) is >70% higher than the minimal amount of MVPA recommended by PA guidelines.
Methods: Participants were recruited from the parent REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. ActicalTM accelerometers provided estimates of PA variables, including moderate-to-vigorous PA (MVPA), high light PA (HLPA), low light PA (LLPA) and sedentary time, for 4-7 consecutive days. Prevalence and incidence of cognitive impairment were defined by the Six-Item Screener. Letter fluency, animal fluency, word list learning and Montreal Cognitive Assessment (orientation and recall) were conducted to assess executive function and memory.
Results: Of the 7,339 participants who provided accelerometer wear data > 4 days (70.1 ± 8.6 yr, 54.2% women, 31.7% African American), 320 participants exhibited impaired cognition. In cross-sectional analysis, participants in the highest MVPA% quartile had 39% lower odds of cognitive impairment than those in the lowest quartile (OR: 0.61, 95% C.I.: 0.39-0.95) after full adjustment. Further analysis shows most quartiles of MVPA% and HLPA% were significantly associated with executive function and memory (P<0.01). During 2.7 ± 0.5 years of follow-up, 3,385 participants were included in the longitudinal analysis, with 157 incident cases of cognitive impairment. After adjustments, participants in the highest MVPA% quartile had 51% lower hazards of cognitive impairment (HR: 0.49, 95% C.I.: 0.28-0.86). Additionally, MVPA% was inversely associated with change in memory z-scores (P<0.01), while the highest quartile of HLPA% was inversely associated with change in executive function and memory z-scores (P<0.01).
Conclusion: Higher levels of objectively measured MVPA% were independently associated with lower prevalence and incidence of cognitive impairment, and better memory and executive function in older adults. Higher levels of HLPA% were also independently associated with better memory and executive function. The amount of MVPA associated with lower risk of cognitive impairment (259 min/week) is >70% higher than the minimal amount of MVPA recommended by PA guidelines.
ContributorsZhu, Wenfei (Author) / Hooker, Steven P (Thesis advisor) / Wadley, Virginia (Committee member) / Ainsworth, Barbara (Committee member) / Der Ananian, Cheryl (Committee member) / Buman, Matthew (Committee member) / Arizona State University (Publisher)
Created2015
Description
PURPOSE: Lean hypertension (HTN) is characterized by a mechanistically different HTN when compared to obese HTN. The purpose of this study is to assess whether body phenotype influences blood pressure (BP) responses following both acute and chronic exercise. METHODS: Obese (body mass index (BMI) > 30 kg/m2) and lean (BMI < 25 kg/m2) men with pre-hypertension (PHTN) (systolic BP (SBP) 120 - 139 or diastolic BP (DBP) 80 - 89 mm Hg) were asked to participate in a two-phase trial. Phase 1 assessed differences in post-exercise hypotension between groups in response to an acute exercise bout. Phase 2 consisted of a two-week aerobic exercise intervention at 65-70% of heart rate (HR) max on a cycle ergometer. Primary outcome measures were: brachial BP, central (aortic) BP, cardiac output (CO), and systemic vascular resistance (SVR) measured acutely after one exercise session and following two weeks of training. RESULTS: There were no differences between groups for baseline resting brachial BP, central BP, age, or VO2 peak (all P > 0.05). At rest, obese PHTN had greater CO compared to lean PHTN (6.3 ± 1 vs 4.7 ± 1 L/min-1, P = 0.005) and decreased SVR compared to lean PHTN (1218 ± 263 vs 1606 ± 444 Dyn.s/cm5, P = 0.003). Average 60-minute post-exercise brachial and central SBP reduced by 3 mm Hg in Lean PHTN in response to acute exercise (P < 0.005), while significantly increasing 4 mm Hg for brachial and 3 mm Hg for central SBP (P < 0.05). SVR had a significantly greater reduction following acute exercise in lean PHTN (-223 Dyn·s/cm5) compared to obese PHTN (-75 Dyn·s/cm5, P < 0.001). In lean subjects chronic training reduced brachial BP by 4 mm Hg and central BP by 3 mm Hg but training had no effect on the BP’s in obese subjects. Resting BP reduction in response to training was accompanied by reductions in SVR within lean (-169 Dyn·s/cm5, P < 0.001), while obese experienced increased SVR following training (47 Dyn·s/cm5, P < 0.001). CONCLUSION: Hemodynamic response to both acute and chronic exercise training differ between obese and lean individuals.
ContributorsZeigler, Zachary (Author) / Swan, Pamela (Thesis advisor) / Gaesser, Glenn (Committee member) / Buman, Matthew (Committee member) / Angadi, Siddhartha (Committee member) / Farouk, Mookadam (Committee member) / Arizona State University (Publisher)
Created2016
Description
Physical activity, sedentary behaviors, and sleep are often associated with cardiometabolic biomarkers commonly found in metabolic syndrome. These relationships are well studied, and yet there are still questions on how each activity may affect cardiometabolic biomarkers. The objective of this study was to examine data from the BeWell24 studies to evaluate the relationship between objectively measured physical activity and sedentary behaviors and cardiometabolic biomarkers in middle age adults, while also determining if sleep quality and duration mediates this relationship. A group of inactive participants (N = 29, age = 52.1 ± 8.1 years, 38% female) with increased risk for cardiometabolic disease were recruited to participate in BeWell24, a trial testing the impact of a lifestyle-based, multicomponent smartphone application targeting sleep, sedentary, and more active behaviors. During baseline, interim (4 weeks), and posttest visits (8 weeks), biomarker measurements were collected for weight (kg), waist circumference (cm), glucose (mg/dl), insulin (uU/ml), lipids (mg/dl), diastolic and systolic blood pressures (mm Hg), and C reactive protein (mg/L). Participants wore validated wrist and thigh sensors for one week intervals at each time point to measure sedentary behavior, physical activity, and sleep outcomes. Long bouts of sitting time (>30 min) significantly affected triglycerides (beta = .15 (±.07), p<.03); however, no significant mediation effects for sleep quality or duration were present. No other direct effects were observed between physical activity measurements and cardiometabolic biomarkers. The findings of this study suggest that reductions in long bouts of sitting time may support reductions in triglycerides, yet these effects were not mediated by sleep-related improvements.
ContributorsLanich, Boyd (Author) / Buman, Matthew (Thesis advisor) / Ainsworth, Barbara (Committee member) / Huberty, Jennifer (Committee member) / Arizona State University (Publisher)
Created2017
Description
High fiber diets have been associated with improved cardiometabolic health with specific efforts to lower circulating levels of low-density lipoprotein (LDL cholesterol). Whole grain and grain-based foods are major contributors of dietary fiber in the American diet, of which wheat has been extensively studied. Corn, however, has not been well studied for its cholesterol-lowering properties. Further, the mechanisms by which grains improve cardiometabolic health require further exploration with regard to the human microbiome. The objective of this single-blind randomized controlled, crossover trial was to assess the impact of three different corn flours (whole grain, refined, and bran-enhanced refined flour mixture) on serum LDL cholesterol and the gut microbiota diversity and composition. Twenty-three participants were recruited, between the ages of 18-70 with hypercholesterolemia (Male = 10, Female = 13, LDL >120 mg/dL) who were not taking any cholesterol-lowering medications. Participants consumed each flour mixture for 4 weeks prepared as muffins and pita breads. At the beginning and end of each 4-week period serum for cholesterol assessment, anthropometrics, and stool samples were obtained. Serum cholesterol was assessed using a clinical analyzer. Stool samples were processed, and microbial DNA extracted and sequenced based on the 16S rRNA gene. A generalized linear model demonstrated a significant treatment effect (p=0.016) on LDL cholesterol and explained a majority of the variance (R-squared= 0.89). Post hoc tests revealed bran-enhanced refined flour had a significant effect on cholesterol in comparison to whole grain flour (p=0.001). No statistically significant differences were observed for gut microbial community composition (Jaccard and weighted Unifrac) after corn consumption. However, relative abundance analysis (LEfSE) identified Mycobacterium celatum (p=0.048 FDR=0.975) as a potential marker of post-corn consumption with this microbe being differentially less abundant following bran-enhanced flour treatment. These data suggest that corn flour consumption may be beneficial for individuals with hypercholesterolemia but the role of gut microbiota in this relationship requires further exploration, especially given the small sample size. Further research and analysis of a fully powered cohort is needed to more accurately describe the associations and potential mechanisms of corn-derived dietary fiber on circulating LDL cholesterol and the gut microbiota.
ContributorsWilson, Shannon L (Author) / Whisner, Corrie M (Thesis advisor) / Sears, Dorothy (Committee member) / Buman, Matthew (Committee member) / Dickinson, Jared (Committee member) / Zhu, Qiyun (Committee member) / Arizona State University (Publisher)
Created2022