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Description
Many individual-level behavioral interventions improve health and well-being. However, most interventions exhibit considerable heterogeneity in response. Put differently, what might be effective on average might not be effective for specific individuals. From an individual’s perspective, many healthy behaviors exist that seem to have a positive impact. However, few existing tools

Many individual-level behavioral interventions improve health and well-being. However, most interventions exhibit considerable heterogeneity in response. Put differently, what might be effective on average might not be effective for specific individuals. From an individual’s perspective, many healthy behaviors exist that seem to have a positive impact. However, few existing tools support people in identifying interventions that work for them, personally.

One approach to support such personalization is via self-experimentation using single-case designs. ‘Hack Your Health’ is a tool that guides individuals through an 18-day self-experiment to test if an intervention they choose (e.g., meditation, gratitude journaling) improves their own psychological well-being (e.g., stress, happiness), whether it fits in their routine, and whether they enjoy it.

The purpose of this work was to conduct a formative evaluation of Hack Your Health to examine user burden, adherence, and to evaluate its usefulness in supporting decision-making about a health intervention. A mixed-methods approach was used, and two versions of the tool were tested via two waves of participants (Wave 1, N=20; Wave 2, N=8). Participants completed their self-experiments and provided feedback via follow-up surveys (n=26) and interviews (n=20).

Findings indicated that the tool had high usability and low burden overall. Average survey completion rate was 91%, and compliance to protocol was 72%. Overall, participants found the experience useful to test if their chosen intervention helped them. However, there were discrepancies between participants’ intuition about intervention effect and results from analyses. Participants often relied on intuition/lived experience over results for decision-making. This suggested that the usefulness of Hack Your Health in its current form might be through the structure, accountability, and means for self-reflection it provided rather than the specific experimental design/results. Additionally, situations where performing interventions within a rigorous/restrictive experimental set-up may not be appropriate (e.g., when goal is to assess intervention enjoyment) were uncovered. Plausible design implications include: longer experimental and phase durations, accounting for non-compliance, missingness, and proximal/acute effects, and exploring strategies to complement quantitative data with participants’ lived experiences with interventions to effectively support decision-making. Future work should explore ways to balance scientific rigor with participants’ needs for such decision-making.
ContributorsPhatak, Sayali Shekhar (Author) / Buman, Matthew P (Thesis advisor) / Hekler, Eric B. (Committee member) / Huberty, Jennifer L (Committee member) / Johnston, Erik W., 1977- (Committee member) / Swan, Pamela D (Committee member) / Arizona State University (Publisher)
Created2019
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Description
The purpose of this dissertation was 1) to develop noninvasive strategies to assess skeletal muscle size, architecture, and composition in young and old adults (study #1) and 2) evaluate the impact of chemotherapeutic treatment on skeletal muscle satellite cells and capillaries (study #2). For study #1 ultrasound images were obtained

The purpose of this dissertation was 1) to develop noninvasive strategies to assess skeletal muscle size, architecture, and composition in young and old adults (study #1) and 2) evaluate the impact of chemotherapeutic treatment on skeletal muscle satellite cells and capillaries (study #2). For study #1 ultrasound images were obtained from the quadriceps muscles of young (8 m, 8 f) and older (7 m, 5 f) participants on two occasions, separated by 5-15 days. Images were collected while the participants were both standing and supine, and were analyzed for muscle thickness, pennation angle, and echogenicity. In addition, test-retest reliability and ICCs were evaluated for each posture and when imaging sites remained marked or were re-measured from visit #1 to visit #2. Generally, in both younger and older adults muscle thickness was greater and echogenicity was lower in the anterior quadriceps when images were collected standing versus supine. Maintaining the imaging site between visits did not influence test re-test reliability for either age group. Older adults exhibited smaller muscle thickness, lower pennation angle and increased echogenicity. Further, variability for the use of ultrasound to determine muscle thickness and pennation angle was greater in older versus younger adults. Findings from study #1 highlight several methodological considerations for US-based assessment of skeletal muscle characteristics that should be considered for improving reproducibility and generalizability of US to assess skeletal muscle characteristics and function across the aging spectrum. This is particularly relevant given the emerging use of ultrasound to assess skeletal muscle characteristics in healthy and clinical populations. In the second study, ovariectomized female Sprague-Dawley rats were randomized to receive three bi-weekly intraperitoneal injections of the chemotherapeutic drug, Doxorubicin (DOX) (4mg/kg; cumulative dose 12mg/kg) or vehicle (VEH; saline). Animals were euthanized 5d following the last injection, and the soleus (SOL) and extensor digitorum longus (EDL) muscles were dissected and prepared for immunohistochemical and RT-qPCR analyses. Relative to VEH, cross-sectional area (CSA) of the SOL and EDL muscle fibers were 26% and 33% smaller, respectively, in DOX animals (P<0.05). In the SOL satellite cell and capillary densities were 39% and 35% lower, respectively, in DOX animals (P<0.05), whereas in the EDL satellite cell and capillary densities were unaffected by DOX administration (P>0.05). In the SOL MYF5 mRNA expression was increased in DOX animals (P<0.05), while in the EDL MGF mRNA expression was reduced in DOX animals (P<0.05). Chronic DOX administration is associated with reduced fiber size in multiple skeletal muscles, however DOX appears to impact the satellite cell and capillary densities in a muscle-specific manner. These findings from study #2 highlight that therapeutic targets to protect skeletal muscle from DOX may vary across muscles. Collectively, these findings 1) improve the ability to examine muscle size and function in younger and older adults, and 2) identify promising therapeutic targets to protect skeletal muscle from the harmful effects of chemotherapy treatment.
ContributorsD'Lugos, Andrew (Author) / Dickinson, Jared M (Thesis advisor) / Buman, Matthew P (Committee member) / Gaesser, Glenn A (Committee member) / Huentelman, Matthew J (Committee member) / Katsanos, Christos S (Committee member) / Arizona State University (Publisher)
Created2018
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Description
The winter holiday period has been highlighted as a major risk period for weight gain due to excess caloric intake in the form of fat and sugar. Furthermore, diets high in fat and sugar have been implicated in the pathogenesis of diabetes and cardiovascular disease. Exercise aids in the prevention

The winter holiday period has been highlighted as a major risk period for weight gain due to excess caloric intake in the form of fat and sugar. Furthermore, diets high in fat and sugar have been implicated in the pathogenesis of diabetes and cardiovascular disease. Exercise aids in the prevention of weight/fat gain, and prevents deleterious changes in cardiometabolic function. The objective of this study was to examine the effects of a fat-sugar supplemented diet, with and without two different exercise training protocols, on body composition, glycemic control and other markers of cardiovascular disease in an at-risk population of overweight and obese males. Twenty-seven, healthy overweight/obese (BMI >25 kg/m2) males were fed 2 donuts per day, 6 days/week, for four weeks, while maintaining their current diet. In addition, all subjects were randomized to one of the following conditions: sedentary control, 1,000 kcal/week moderate-intensity continuous training (MICT) (50% of peak oxygen consumption), or 1,000 kcal/week high-intensity interval training (HIIT) (90-95% of peak heart rate). Supervised exercise training was performed 4 days/week on a cycle ergometer. Changes in body weight and composition, endothelial function, arterial stiffness, glycemic control, blood lipids and cardiorespiratory fitness (CRF) were assessed before and after the intervention. Body weight, lean mass and visceral fat increased significantly in HIIT (p<0.05) and were unchanged in MICT. There was a trend for a significant increase in body weight (p=0.07) and lean mass (p=0.11) in control. Glycemic control during the 2-h OGTT improved significantly in MICT and control, with no change in HIIT. Hepatic insulin resistance index (IRI) and 30-min insulin during the OGTT improved significantly after MICT and worsened following control (p=0.03), while HIIT was unchanged. CRF increased significantly in both HIIT and MICT, with no change in control (p<0.001). There were no significant changes in other markers of cardiovascular disease. The addition of a fat-sugar supplement (~14,500 kcal) over a 4-week period was not sufficient to induce deleterious changes in body composition and cardiometabolic health in overweight/obese young males. Exercise training did not afford overweight/obese males additional health benefits, with the exception of improvements in fitness and hepatic IRI.
ContributorsTucker, Wesley Jack (Author) / Gaesser, Glenn A (Thesis advisor) / Angadi, Siddhartha S (Committee member) / Whisner, Corrie M (Committee member) / Buman, Matthew P (Committee member) / Shaibi, Gabriel (Committee member) / Arizona State University (Publisher)
Created2016
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Description
Physical activity is critical for optimal health and has emerged as a viable option to improve sleep. Moderate- and vigorous-intensity physical activity comparisons to improve sleep in non-exercising adults with sleep problems is limited. The purpose was to determine the effects of moderate- or vigorous-intensity exercise on sleep outcomes and

Physical activity is critical for optimal health and has emerged as a viable option to improve sleep. Moderate- and vigorous-intensity physical activity comparisons to improve sleep in non-exercising adults with sleep problems is limited. The purpose was to determine the effects of moderate- or vigorous-intensity exercise on sleep outcomes and peripheral skin temperature compared to a no-exercise control. The exercise intensity preference also was determined.

Eleven women (46.9±7.0 years) not participating in regular exercise and self-reporting insomnia completed a graded maximal exercise test followed by a crossover trial of three randomly assigned conditions separated by a 1-week washout. Participants performed moderate-intensity [MIC, 30 minutes, 65-70% maximum heart rate (HRmax)] or high-intensity (HIT, 20 minutes, 1-minute bouts at 90-95% HRmax alternating with 1-minute active recovery) treadmill walking or a no-exercise control (NEC) on two consecutive weekdays 4-6 hours prior to typical bed time. A dual-function wrist-worn accelerometer/temperature monitor recorded movement and skin temperature from which sleep-onset latency (SOL), sleep maintenance, sleep efficiency, total sleep time (TST), and peripheral skin temperature changes were calculated. Participants self-reported sleep outcomes weekly, enjoyment of exercise the morning after HIT and MIC, and exercise intensity preference upon completing all conditions. Mixed models analysis of variance examined differences between and within conditions controlling for demographic characteristics and habitual physical activity.

HIT resulted in up to a 90-minute TST increase on night four (448 minutes, 95% CI 422.4-474.2) compared to nights one-three. MIC nights three (43.5 minutes, 95% CI 30.4-56.6) and four (42.1 minutes 95% CI 29.0-55.2) showed nearly a 30-minute SOL worsening compared to nights one-two. No other actigraphy-measured sleep parameters differenced within or between conditions. Self-reported sleep outcomes, peripheral skin temperature change, and exercise enjoyment between conditions were similar (p>0.05). More participants preferred lower (n=3) to higher (n=1) intensity activities.

Early evening high-intensity and moderate-intensity exercise had no effect on sleep outcomes compared to a control in non-exercising adults reporting sleep complaints. Sleep benefits from HIT may require exercise on successive days. Participants indicated partiality for lower intensity exercise. More information on timing and mode of physical activity to improve sleep in this population is warranted.
ContributorsKurka, Jonathan M (Author) / Ainsworth, Barbara E (Thesis advisor) / Adams, Marc A (Committee member) / Angadi, Siddhartha (Committee member) / Buman, Matthew P (Committee member) / Youngstedt, Shawn D (Committee member) / Arizona State University (Publisher)
Created2016
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Description

Purpose: This qualitative research aimed to create a developmentally and gender-appropriate game-based intervention to promote Human Papillomavirus (HPV) vaccination in adolescents. <br/>Background: Ranking as the most common sexually transmitted infection, about 80 million Americans are currently infected by HPV, and it continues to increase with an estimated 14 million new

Purpose: This qualitative research aimed to create a developmentally and gender-appropriate game-based intervention to promote Human Papillomavirus (HPV) vaccination in adolescents. <br/>Background: Ranking as the most common sexually transmitted infection, about 80 million Americans are currently infected by HPV, and it continues to increase with an estimated 14 million new cases yearly. Certain types of HPV have been significantly associated with cervical, vaginal, and vulvar cancers in women; penile cancers in men; and oropharyngeal and anal cancers in both men and women. Despite HPV vaccination being one of the most effective methods in preventing HPV-associated cancers, vaccination rates remain suboptimal in adolescents. Game-based intervention, a novel medium that is popular with adolescents, has been shown to be effective in promoting health behaviors. <br/>Methods: Sample/Sampling. We used purposeful sampling to recruit eight adolescent-parent dyads (N = 16) which represented both sexes (4 boys, 4 girls) and different racial/ethnic groups (White, Black, Latino, Asian American) in the United States. The inclusion criteria for the dyads were: (1) a child aged 11-14 years and his/her parent, and (2) ability to speak, read, write, and understand English. Procedure. After eligible families consented to their participation, semi-structured interviews (each 60-90 minutes long) were conducted with each adolescent-parent dyad in a quiet and private room. Each dyad received $50 to acknowledge their time and effort. Measure. The interview questions consisted of two parts: (a) those related to game design, functioning, and feasibility of implementation; (b) those related to theoretical constructs of the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB). Data analysis. The interviews were audio-recorded with permission and manually transcribed into textual data. Two researchers confirmed the verbatim transcription. We use pre-developed codes to identify each participant’s responses and organize data and develop themes based on the HBM and TPB constructs. After the analysis was completed, three researchers in the team reviewed the results and discussed the discrepancies until a consensus is reached.<br/>Results: The findings suggested that the most common motivating factors for adolescents’ HPV vaccination were its effectiveness, benefits, convenience, affordable cost, reminders via text, and recommendation by a health care provider. Regarding the content included in the HPV game, participants suggested including information about who and when should receive the vaccine, what is HPV and the vaccination, what are the consequences if infected, the side effects of the vaccine, and where to receive the vaccine. The preferred game design elements were: 15 minutes long, stories about fighting or action, option to choose characters/avatars, motivating factors (i.e., rewards such as allowing users to advance levels and receive coins when correctly answering questions), use of a portable electronic device (e.g., tablet) to deliver the education. Participants were open to multiplayer function which assists in a facilitated conversation about HPV and the HPV vaccine. Overall, the participants concluded enthusiasm for an interactive yet engaging game-based intervention to learn about the HPV vaccine with the goal to increase HPV vaccination in adolescents. <br/>Implications: Tailored educational games have the potential to decrease the stigma of HPV and HPV vaccination, increasing communication between the adolescent, parent, and healthcare provider, as well as increase the overall HPV vaccination rate.

ContributorsBeaman, Abigail Marie (Author) / Chen, Angela Chia-Chen (Thesis director) / Amresh, Ashish (Committee member) / Edson College of Nursing and Health Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
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Description
The health benefits of sufficient moderate-to-vigorous physical activity (MVPA) and sleep arewell-supported, with established links to decreased cancer risk, cardiometabolic health, all-cause mortality, and psychiatric symptomatology—including stress-related phenomena—for those who engage in 150 min MVPA/week and get at least 7 hours sleep/night. The latter outcome has rapidly become a major

The health benefits of sufficient moderate-to-vigorous physical activity (MVPA) and sleep arewell-supported, with established links to decreased cancer risk, cardiometabolic health, all-cause mortality, and psychiatric symptomatology—including stress-related phenomena—for those who engage in 150 min MVPA/week and get at least 7 hours sleep/night. The latter outcome has rapidly become a major public health concern as our nation grapples with the impact of prolonged COVID-19 pandemic stress, which has triggered an onslaught of depression, anxiety, and PTSD throughout the population. Thus, while strategies to decrease stress are desperately needed, many Americans fall short of the very MVPA and sleep recommendations that have been shown to increase their capacity to cope. The purpose of the present study was to explore time-varying associations of MVPA and sleep with momentary perceived stress in adults forced to work from home due to the COVID-19 pandemic. Thirty remote-working adults (86.7% women; mean age 37.5 years, SD = 10.4 years) wore GENEActiv accelerometers on the wrist to capture MVPA and sleep data, and answered four Ecological Momentary Assessments (EMAs) per day regarding perceived stress, for fourteen days straight. Between- and within-person variations in MVPA, sleep quality rating (SQR), total sleep time (TST), and sleep efficiency (SE) were analyzed via multilevel models to determine whether certain changes in these parameters might lead to decreased perceived momentary stress. Between-person models revealed a significant negative effect of SQR on perceived stress levels the next day, beta= -.651, SE= .303, P= .04. Mean MVPA, TST, and SE were not significant inter-individual predictors of momentary stress. However, within persons, higher than normal MVPA (beta= -.005, SE= .002, P= .015), SQR (beta= -.277, SE= .071, P <.001), TST (beta= -.001, SE= .000, P = .004), and SE (beta= -.524, SE= .242, P = .031) were all associated with significant decreases in momentary stress, with individuals experiencing incremental benefits with each additional minute of MVPA and TST. In conclusion, daily fluctuations in MVPA and sleep habits correlate more strongly with momentary stress than do typical levels of these behaviors; this presents an attainable strategy for individuals to enhance their capacity to cope.
ContributorsLyons, Rachel Crosley (Author) / Buman, Matthew P (Thesis advisor) / Der Ananian, Cheryl (Committee member) / McCracken, Kasondra (Committee member) / Arizona State University (Publisher)
Created2021
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Description
Parkinson's Disease (PD) is a progressive neurodegenerative disorder that affects movement and balance control. Falls are a common and often debilitating consequence of PD, and reactive balance control is critical in preventing falls. This dissertation aimed to determine the adaptability and neural control of reactive balance responses in people with

Parkinson's Disease (PD) is a progressive neurodegenerative disorder that affects movement and balance control. Falls are a common and often debilitating consequence of PD, and reactive balance control is critical in preventing falls. This dissertation aimed to determine the adaptability and neural control of reactive balance responses in people with PD. Aim 1 investigated whether people with PD at risk for falls can improve their reactive balance responses through a 2-week, 6-session training protocol. The study found that reactive step training resulted in immediate and retained improvements in stepping, as measured by the anterior-posterior margin of stability (MOS), step length, and step latency during backward stepping. The second aim explored the neural mechanisms behind eliciting and learning reactive balance responses in PD. The study investigated the white matter (WM) correlates of reactive stepping and responsiveness to step training in PD. White matter was not significantly correlated with any baseline stepping outcomes. However, greater retention of step length was associated with increased fractional anisotropy (FA) within the left anterior corona radiata, left posterior thalamic radiation, and right and left superior longitudinal fasciculi. Lower radial diffusivity (RD) within the left posterior and anterior corona radiata were associated with retention of step latency improvements. These findings highlight the importance of WM microstructural integrity in motor learning and retention processes in PD. The third aim examined the role of the somatosensory system in reactive balance control in people with PD. The tactile and proprioceptive systems were perturbed using vibrotactile stimulation during backward feet-in-place balance responses. The results showed that tactile and proprioceptive stimulation had minimal impact on reactive balance responses. Small effects were observed for delayed tibialis anterior (TA) onsets with proprioceptive stimulation at a medium intensity. Overall, this dissertation provides insights into improving reactive balance responses and the underlying neural mechanisms in PD, which can potentially inform the development of targeted interventions to reduce falls in people with PD.
ContributorsMonaghan, Andrew S (Author) / Peterson, Daniel S (Thesis advisor) / Ofori, Edward (Committee member) / Daliri, Ayoub (Committee member) / Buman, Matthew P (Committee member) / Fling, Brett W (Committee member) / Arizona State University (Publisher)
Created2023