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- Creators: Arizona State University
- Creators: Maienschein, Jane
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
Objectives: Although childhood obesity has received growing attention, parents still fail to recognize overweight and obesity in their children. Accurate identification of overweight or obesity in their child is associated with the parent's responsiveness to interventions aimed at preventing weight-related health issues. Recent research shows that a child's age and gender are associated with parental misperception of their child's weight status, but little is known about the interaction of these factors across various age groups. This study examined the association between a wide range of parent, child, and household factors and the accuracy of parental perception of their child's body weight status compared to parent-measured body weight status. Methods: Data were collected from a random-digit-dial telephone survey of 1708 households located in five low-income New Jersey cities with large minority populations. A subset of 548 children whose parents completed the survey and returned a worksheet of parent-measured heights and weights were the focus of the analysis. Bivariate and multivariate analyses were performed to determine the factors significantly associated with parental perception of their child's body weight status. Results: Based on parent-measure heights and weights, 36% of the children were overweight or obese (OWOB). Only 21% of OWOB children were perceived by their parents as OWOB. Child gender, child body mass index (BMI) and parent BMI were significant independent predictors of parents' accuracy at perceiving their child's body weight status. Conclusion: Boys, OWOB children, and children of OWOB parents had significantly greater odds of parental underestimation of their body weight status. Parents had better recognition of OWOB in their daughters, especially older daughters, than in their sons, suggesting parental gender bias in identifying OWOB in children. Further research is needed regarding parental gender bias and its implications in OWOB identification in children.
ContributorsBader, Wendy (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Lloyd, Kristen (Committee member) / Crespo, Noe (Committee member) / Arizona State University (Publisher)
Created2013
Description
This dissertation explores vulnerability to extreme heat hazards in the Maricopa County, Arizona metropolitan region. By engaging an interdisciplinary approach, I uncover the epidemiological, historical-geographical, and mitigation dimensions of human vulnerability to extreme heat in a rapidly urbanizing region characterized by an intense urban heat island and summertime heat waves. I first frame the overall research within global climate change and hazards vulnerability research literature, and then present three case studies. I conclude with a synthesis of the findings and lessons learned from my interdisciplinary approach using an urban political ecology framework. In the first case study I construct and map a predictive index of sensitivity to heat health risks for neighborhoods, compare predicted neighborhood sensitivity to heat-related hospitalization rates, and estimate relative risk of hospitalizations for neighborhoods. In the second case study, I unpack the history and geography of land use/land cover change, urban development and marginalization of minorities that created the metropolitan region's urban heat island and consequently, the present conditions of extreme heat exposure and vulnerability in the urban core. The third study uses computational microclimate modeling to evaluate the potential of a vegetation-based intervention for mitigating extreme heat in an urban core neighborhood. Several findings relevant to extreme heat vulnerability emerge from the case studies. First, two main socio-demographic groups are found to be at higher risk for heat illness: low-income minorities in sparsely-vegetated neighborhoods in the urban core, and the elderly and socially-isolated in the expansive suburban fringe of Maricopa County. The second case study reveals that current conditions of heat exposure in the region's urban heat island are the legacy of historical marginalization of minorities and large-scale land-use/land cover transformations of natural desert land covers into heat-retaining urban surfaces of the built environment. Third, summertime air temperature reductions in the range 0.9-1.9 °C and of up to 8.4 °C in surface temperatures in the urban core can be achieved through desert-adapted canopied vegetation, suggesting that, at the microscale, the urban heat island can be mitigated by creating vegetated park cool islands. A synthesis of the three case studies using the urban political ecology framework argues that climate changed-induced heat hazards in cities must be problematized within the socio-ecological transformations that produce and reproduce urban landscapes of risk. The interdisciplinary approach to heat hazards in this dissertation advances understanding of the social and ecological drivers of extreme heat by drawing on multiple theories and methods from sociology, urban and Marxist geography, microclimatology, spatial epidemiology, environmental history, political economy and urban political ecology.
ContributorsDeclet-Barreto, Juan (Author) / Harlan, Sharon L (Thesis advisor) / Bolin, Bob (Thesis advisor) / Hirt, Paul (Committee member) / Boone, Christopher (Committee member) / Arizona State University (Publisher)
Created2013
Community-based development: scaling up the correct use of misoprostol at home births in Afghanistan
Description
Globally, more than 350 000 women die annually from complications during pregnancy and childbirth (UNFPA, 2011). Nearly 99% of these, according to World Health Organization (WHO) trends (2010) occur in the developing world outside of a hospital setting with limited resources including emergency care (WHO, 2012; UNFPA, 2011). The most prevalent cause of death is postpartum hemorrhage (PPH), accounting for 25% of deaths according to WHO statistics (2012). Conditions in Afghanistan are reflective of the scope and magnitude of the problem. In Afghanistan, maternal mortality is thought to be among the highest in the world. The Afghan Mortality Survey (AMS) data implies that one Afghan woman dies about every 2 hours from pregnancy-related causes (AMS, 2010). Lack of empowerment, education and access to health care resources increase a woman's risk of dying during pregnancy (AMS, 2010). This project aims to investigate the prospects of scaling-up the correct use of misoprostol, a prostaglandin E1 analogue, to treat PPH in developing countries where skilled assistance and resources are scant. As there has been little published on the lessons learned from programs already in place, this study is experience-driven, based on the knowledge of industry experts. This study employs a concurrent triangulation approach to synthesize quantitative data obtained from previous studies with qualitative information gathered through the testimonies of key personnel who participated in pilot programs involving misoprostol. There are many obstacles to scaling-up training initiatives in Afghanistan and other low-resource areas. The analysis concludes that the most crucial factors for scaling-up community-based programs include: more studies analyzing lessons learns from community driven approaches; stronger partnerships with community health care workers; overcoming barriers like association with abortion, misuse and product issues; and a heightened global and community awareness of the severity of PPH without treatment. These results have implications for those who actively work in Afghanistan to promote maternal health and other countries that may use Afghanistan's work as a blueprint for reducing maternal mortality through community-based approaches. Keywords: Afghanistan, community-based interventions, community-driven, maternal mortality, MDG5, misoprostol, postpartum hemorrhage, reproduction, scale-up
ContributorsCristy, Candice (Author) / Grossman, Gary (Thesis advisor) / Parmentier, Mary-Jane (Committee member) / Byrd, Denise (Committee member) / Arizona State University (Publisher)
Created2013
Description
In October, 2009, participants of the Arizona Special Supplemental Nutrition Program for Women, Infants and Children (WIC) began receiving monthly Cash Value Vouchers (CVV) worth between six and 10 dollars towards the purchase of fresh fruits and vegetables. Data from the Arizona Department of Health Services (ADHS) showed CVV redemption rates in the first two years of the program were lower than the national average of 77% redemption. In response, the ADHS WIC Food List was expanded to also include canned and frozen fruits and vegetables. More recent data from ADHS suggest that redemption rates are improving, but variably exist among different WIC sub-populations. The purpose of this project was to identify themes related to the ease or difficulty of WIC CVV use amongst different categories of low-redeeming WIC participants. A total of 8 focus groups were conducted, four at a clinic in each of two Valley cities: Surprise and Mesa. Each of the four focus groups comprised one of four targeted WIC participant categories: pregnant, postpartum, breastfeeding, and children with participation ranging from 3-9 participants per group. Using the general inductive approach, recordings of the focus groups were transcribed, hand-coded and uploaded into qualitative analysis software resulting in four emergent themes including: interactions and shopping strategies, maximizing WIC value, redemption issues, and effect of rule change. Researchers identified twelve different subthemes related to the emergent theme of interactions and strategies to improve their experience, including economic considerations during redemption. Barriers related to interactions existed that made their purchase difficult, most notably anger from the cashier and other shoppers. However, participants made use of a number of strategies to facilitate WIC purchases or extract more value out of WIC benefits, such as pooling their CVV. Finally, it appears that the fruit and vegetable rule change was well received by those who were aware of the change. These data suggest a number of important avenues for future research, including verifying these themes are important within a larger, representative sample of Arizona WIC participants, and exploring strategies to minimize barriers identified by participants, such as use of electronic benefits transfer-style cards (EBT).
ContributorsBertmann, Farryl M. W (Author) / Wharton, Christopher (Christopher Mack), 1977- (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Johnston, Carol (Committee member) / Hampl, Jeffrey (Committee member) / Dixit-Joshi, Sujata (Committee member) / Barroso, Cristina (Committee member) / Arizona State University (Publisher)
Created2013
Description
In the past three decades alone, the United States has witnessed a dramatic rise in the prevalence of obesity and overweight in adults and children. Efforts towards obesity mitigation and prevention have produced promising recommendations and researchers and practitioners alike acknowledge that real solutions must match the complexity of the problem. Comprehensive approaches that target environmental, economic, socio-cultural, and knowledge-based factors that influence diet and physical activity are highly recommended. However, the literature yields little in the way of what such comprehensive obesity interventions actually entail and how they ought to be developed. In particular, there are knowledge gaps in how various stakeholder groups can bridge institutional barriers to collaborate in ways that maximize resources, build upon synergies, and avoid duplication of efforts; and how specific recommendations are actually implemented. This thesis aims to contribute to an emerging body of literature that fills this gap by presenting a practical case study on how to create a playground obesity intervention in the Gateway District of Phoenix, Arizona, in collaboration with researchers, health professionals, neighborhood residents, and city officials. The objectives were two-fold: 1. To outline concrete steps that will allow an organization to create a playground linked with healthy kids education program that aims to increase physical activity, perceptions of safety, and community cohesion; 2. To outline how diverse stakeholders can collaborate effectively to create such a cohesive, complex obesity intervention. A detailed, actionable intervention manual was drafted through semi-structured interviews, literature review, a survey, a stakeholder workshop, and an extended peer-review. The manual describes the sequence of actions necessary for creating an innovative playground that reinforces learning, encourages creative play, and increases physical activity. The sequence of actions was linked with existing local assets, stakeholder roles and responsibilities, costs, and potential barriers. This manual, as well as the process itself, can serve as a transferable model for helping organizations come together to build the capacity required in order to tackle complex health challenges.
ContributorsXiong, Angela (Author) / Wiek, Arnim (Thesis advisor) / Golub, Aaron (Committee member) / Otu, Essen (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
The entire history of HIV-1 is hidden in its ten thousand bases, where information regarding its evolutionary traversal through the human population can only be unlocked with fine-scale sequence analysis. Measurable footprints of mutation and recombination have imparted upon us a wealth of knowledge, from multiple chimpanzee-to-human transmissions to patterns of neutralizing antibody and drug resistance. Extracting maximum understanding from such diverse data can only be accomplished by analyzing the viral population from many angles. This body of work explores two primary aspects of HIV sequence evolution, point mutation and recombination, through cross-sectional (inter-individual) and longitudinal (intra-individual) investigations, respectively. Cross-sectional Analysis: The role of Haiti in the subtype B pandemic has been hotly debated for years; while there have been many studies, up to this point, no one has incorporated the well-known mechanism of retroviral recombination into their biological model. Prior to the use of recombination detection, multiple analyses produced trees where subtype B appears to have first entered Haiti, followed by a jump into the rest of the world. The results presented here contest the Haiti-first theory of the pandemic and instead suggest simultaneous entries of subtype B into Haiti and the rest of the world. Longitudinal Analysis: Potential N-linked glycosylation sites (PNGS) are the most evolutionarily dynamic component of one of the most evolutionarily dynamic proteins known to date. While the number of mutations associated with the increase or decrease of PNGS frequency over time is high, there are a set of relatively stable sites that persist within and between longitudinally sampled individuals. Here, I identify the most conserved stable PNGSs and suggest their potential roles in host-virus interplay. In addition, I have identified, for the first time, what may be a gp-120-based environmental preference for N-linked glycosylation sites.
ContributorsHepp, Crystal Marie, 1981- (Author) / Rosenberg, Michael S. (Thesis advisor) / Hedrick, Philip (Committee member) / Escalante, Ananias (Committee member) / Kumar, Sudhir (Committee member) / Arizona State University (Publisher)
Created2013
Description
Despite the arid climate of Maricopa County, Arizona, vector-borne diseases have presented significant health challenges to the residents and public health professionals of Maricopa County in the past, and will continue to do so in the foreseeable future. Currently, West Nile virus is the only mosquitoes-transmitted disease actively, and natively, transmitted throughout the state of Arizona. In an effort to gain a more complete understanding of the transmission dynamics of West Nile virus this thesis examines human, vector, and environment interactions as they exist within Maricopa County. Through ethnographic and geographic information systems research methods this thesis identifies 1) the individual factors that influence residents' knowledge and behaviors regarding mosquitoes, 2) the individual and regional factors that influence residents' knowledge of mosquito ecology and the spatial distribution of local mosquito populations, and 3) the environmental, demographic, and socioeconomic factors that influence mosquito abundance within Maricopa County. By identifying the factors that influence human-vector and vector-environment interactions, the results of this thesis may influence current and future educational and mosquito control efforts throughout Maricopa County.
ContributorsKunzweiler, Colin (Author) / Boone, Christopher (Thesis advisor) / Wutich, Amber (Committee member) / Brewis-Slade, Alexandra (Committee member) / Arizona State University (Publisher)
Created2013
Description
Food system and health characteristics were evaluated across the last Waorani hunter-gatherer group in Amazonian Ecuador and a remote neighboring Kichwa indigenous subsistence agriculture community. Hunter-gatherer food systems like the Waorani foragers may not only be nutritionally, but also pharmaceutically beneficial because of high dietary intake of varied plant phytochemical compounds. A modern diet that reduces these dietary plant defense phytochemicals below levels typical in human evolutionary history may leave humans vulnerable to diseases that were controlled through a foraging diet. Few studies consider the health impact of the recent drastic reduction of plant phytochemical content in the modern global food system, which has eliminated essential components of food because they are not considered "nutrients". The antimicrobial and anti-inflammatory nature of the food system may not only regulate infectious pathogens and inflammatory disease, but also support beneficial microbes in human hosts, reducing vulnerability to chronic diseases. Waorani foragers seem immune to certain infections with very low rates of chronic disease. Does returning to certain characteristics of a foraging food system begin to restore the human body microbe balance and inflammatory response to evolutionary norms, and if so, what implication does this have for the treatment of disease? Several years of data on dietary and health differences across the foragers and the farmers was gathered. There were major differences in health outcomes across the board. In the Waorani forager group there were no signs of infection in serious wounds such as 3rd degree burns and spear wounds. The foragers had one-degree lower body temperature than the farmers. The Waorani had an absence of signs of chronic diseases including vision and blood pressure that did not change markedly with age while Kichwa farmers suffered from both chronic diseases and physiological indicators of aging. In the Waorani forager population, there was an absence of many common regional infectious diseases, from helminthes to staphylococcus. Study design helped control for confounders (exercise, environment, genetic factors, non-phytochemical dietary intake). This study provides evidence of the major role total phytochemical dietary intake plays in human health, often not considered by policymakers and nutritional and agricultural scientists.
ContributorsLondon, Douglas (Author) / Tsuda, Takeyuki (Thesis advisor) / Beezhold, Bonnie L (Committee member) / Hruschka, Daniel (Committee member) / Eder, James (Committee member) / Arizona State University (Publisher)
Created2012