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Description
Children are five times more likely to be overweight at the age of 12 years if they are overweight during the preschool period, and 60% of overweight preschoolers are overweight at the age of 12 years (Matusik & Malecka-Tendera, 2011). Primary care interventions are urgently needed to improve healthy lifestyle

Children are five times more likely to be overweight at the age of 12 years if they are overweight during the preschool period, and 60% of overweight preschoolers are overweight at the age of 12 years (Matusik & Malecka-Tendera, 2011). Primary care interventions are urgently needed to improve healthy lifestyle behaviors in families. Parental influence plays an important factor in the development of healthy behaviors in children. Cognitive behavioral interventions have demonstrated preliminary success in promoting healthy lifestyle behaviors in both adults and children. Mobile technology used to supplement interventions aimed at behavior change offers an outlet to bridge gaps in health disparities and generate innovative evidence. Therefore, the purpose of this research was to establish the feasibility, acceptability, and preliminary effects of a cognitive-behavioral intervention (TEXT2COPE) synergized with mobile technology on the healthy lifestyle behaviors of parents of overweight and obese preschoolers. Primary aims of the proposed pilot study were to (a) examine the feasibility and acceptability of the TEXT2COPE program among parents of overweight or obese preschoolers with mobile phones; (b) evaluate the preliminary effects of the TEXT2COPE program on healthy lifestyle behaviors in families with overweight or obese preschoolers; and (c) evaluate the relationship among the study variables (i.e., cognitive beliefs, perceived difficulty, and healthy lifestyle behaviors). Findings indicate that this program is feasible and acceptable in this population. The intervention improved healthy lifestyle beliefs and behaviors in parents. Further supported are the interconnected relationships between parental beliefs, thoughts, and behaviors.
ContributorsMilitello, Lisa K (Author) / Melnyk, Bernadette M (Thesis advisor) / Small, Leigh (Committee member) / Hekler, Eric (Committee member) / Jacobson, Diana (Committee member) / Arizona State University (Publisher)
Created2014
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Description
An intervention study was conducted with elementary physical education teachers and their use of a newly developed series of fitness segments called Knowledge in Action (KIA). This study was designed to enable teachers to teach healthy behavior knowledge (HBK) in their classes without sacrificing physical activity levels. This study has

An intervention study was conducted with elementary physical education teachers and their use of a newly developed series of fitness segments called Knowledge in Action (KIA). This study was designed to enable teachers to teach healthy behavior knowledge (HBK) in their classes without sacrificing physical activity levels. This study has two phases. First, the intervention was conducted to determine the effectiveness of the KIA fitness segment intervention. Second, teachers' perceptions of both teaching HBK and the KIA fitness segments were investigated. Ten teacher participants were randomly assigned to the intervention or control group. Intervention teachers participated in professional development, provided with all teaching materials, and YouTube videos that modeled the teaching of the KIA fitness segments. Teacher fidelity was measured through observations. Student physical activity patterns were measured in randomly selected teachers' classes (both intervention and control) to determine potential physical activity pattern differences between groups. Teachers were interviewed from one to three times across the project in order to determine perceptions of teaching HBK and the KIA fitness segments. Researchers used constant comparison method to uncover possible common themes. Student knowledge was assessed pre/post using PE Metrics Standard 3 cognitive test to determine HBK changes. Data analysis included General liner models (GLM) at the student level (gender) and Hierarchical linear models (HLM) at the school level (treatment, school). There was a moderate mean teacher fidelity score (77.9%) found among the intervention teachers. HLM results showed students in the intervention group had a 3.4(20%) greater improvement in HBK scores when compared with their control counterparts (p<0.001). Student activity levels were found to be similar in both groups with 871.33 and 822.22 steps in the intervention and control groups, respectively. Although all of the teachers thought it was important to teach HBK they were not spending time on it during classes at pretest. Three common themes were discovered: (a) Effective Teacher Training of the Segments, (b), Teachers Learned a Novel Strategy, and (c) Teachers Recommended Modifications. In summary, the KIA fitness segments received favorable views and gave teachers a way to teach HBK without reducing physical activity time.
ContributorsHodges, Michael (Author) / Kulinna, Pamela (Thesis advisor) / Van Der Mars, Hans (Committee member) / Lee, Chong (Committee member) / Arizona State University (Publisher)
Created2013
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Description
Background: Limited physical activity (PA) is a key factor contributing to obesity and independently protects from diseases in youth and later in life. Students spend most of their time in schools sedentary and have limited opportunities to engage in PA. By making changes to the school environment and developing a

Background: Limited physical activity (PA) is a key factor contributing to obesity and independently protects from diseases in youth and later in life. Students spend most of their time in schools sedentary and have limited opportunities to engage in PA. By making changes to the school environment and developing a school culture that actively supports and reinforces PA behavior, Comprehensive School Physical Activity Programs are designed to make PA engagement throughout each school day the accepted social norm. The purpose of this study was to determine the effects of environmental and behavioral modifications to school-level PA participation for girls and boys.

Methods: This study used a hybrid reversal design by alternating baseline phases with two intervention phases that provided increased access and opportunity to PA, and behavioral prompting and reinforcing plus access and opportunity, for all students to engage in PA during lunch. Physical activity and contextual data were collected using a previously validated instrument (System for Observing Play and Leisure Activity in Youth; SOPLAY). Behavioral data were collected using a novel instrument (System for Observing Behavioral Ecology for Youth in Schools; SOBEYS) developed to measure prompting and reinforcement contingencies of PA participation consistent with the Behavioral Ecological Model.

Data Analysis: The number of students engaged in moderate-to-vigorous PA (MVPA) and the proportion of students in MVPA were analyzed using visual analysis of graphic data and general linear statistical models, with environmental and behavioral variables as predictors.

Results: Increases in the number of girls and boys in MVPA were seen visually and statistically during the environmental and the environmental plus behavioral intervention phases compared to baseline. No differences were seen visually or statistically between intervention phases. Intervention effects were larger for boys than girls. The SOBEYS instrument was able to produce valid and reliable data regarding prompting and reinforcement of PA. However, environmental factors appear to have a greater influence on PA than behavioral factors.

Conclusion: Modifying the school environment to increase access and opportunity for PA during lunch can lead to positive changes in MVPA during the school day, with special consideration needed to engage more girls.
ContributorsLorenz, Kent Arnold (Author) / Van Der Mars, Hans (Thesis advisor) / Hodges Kulinna, Pamela (Committee member) / Ainsworth, Barbara E (Committee member) / Hovell, Melbourne F (Committee member) / Arizona State University (Publisher)
Created2014
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Description
This study utilized targeted messages and expert and referent sources in an effort to promote physical activity behavior in college students. College students aged 18-25, excluding collegiate athletes, were randomized into three conditions using their current physical activity level. Two of the conditions received targeted messages highlighting three primary components

This study utilized targeted messages and expert and referent sources in an effort to promote physical activity behavior in college students. College students aged 18-25, excluding collegiate athletes, were randomized into three conditions using their current physical activity level. Two of the conditions received targeted messages highlighting three primary components of social cognitive theory - self-efficacy, outcome expectations, and goals - while the third condition received no messages. In addition, the experimental conditions received the messages from either an expert (i.e., a personal trainer) or a referent (i.e., a close friend). In this way, this experiment analyzed whether receiving social cognitive theory messages increased physical activity indicators compared to the control condition, as well as if the message source caused differences in the physical activity indicators. Moreover, participants completed Time 1 and Time 2 measures to determine if receiving messages or not caused changes over a one week time period. Seven physical activity indicators were assessed: self-efficacy, positive outcome expectations, negative outcome expectations, attitudes, response-efficacy, intentions, and physical activity behavior. Results revealed that both the personal trainer and close friend conditions had significantly higher scores than the control condition for intentions at Time 1 and Time 2, as well as physical activity behavior at Time 2. Moreover, the personal trainer condition had significantly higher positive outcome expectations compared to both the friend and control conditions. No other significant differences were found across conditions for Time 1 attitudes, response-efficacy, negative outcome expectations, self-efficacy, and Time 2 attitudes, and self-efficacy. Overall, targeted messages were effective in increasing physical activity intentions and behavior regardless of the message source.
ContributorsMarmo, Jennifer Lauren (Author) / Roberto, Anthony J. (Thesis advisor) / Mongeau, Paul A. (Committee member) / Ainsworth, Barbara E. (Committee member) / Arizona State University (Publisher)
Created2012
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Description
Cardiovascular disease (CVD) is the leading cause of mortality in the U.S. While physical activity can reduce CVD risk, most adults do not engage in adequate physical activity to maintain or improve health. Older adults are less likely to participate in physical activity and experience a greater burden

Cardiovascular disease (CVD) is the leading cause of mortality in the U.S. While physical activity can reduce CVD risk, most adults do not engage in adequate physical activity to maintain or improve health. Older adults are less likely to participate in physical activity and experience a greater burden of CVD compared to younger adults. Despite knowledge of motivators and barriers to physical activity, the challenge to reduce cardiovascular risk in the older adult population remains unmet. Older adults face unique and complex barriers to physical activity, including limited social contextual resources and behavioral change processes. Interventions to enhance wellness motivation have demonstrated potential in promoting health behavior change among older adults.

The purpose of this study was to examine the feasibility of the Yoga for HEART (Health Empowerment and Realizing Transformation) Intervention to increase motivation for physical activity and improve cardiovascular health in older adults. A pilot randomized controlled trial design was used. The Intervention group received Yoga for HEART, a 12-week program to foster motivation for health behavior change. The Control group received a 12-week group yoga program that did not contain theory-based components. The intervention was based on Wellness Motivation Theory, conceptualizing health behavior change as dynamic process of intention formation and goal-directed behavior leading to the development of new and positive health patterns. Critical inputs (i.e., empowering education, motivational support, social network support) were designed to promote social contextual resources and behavioral change processes to increase motivation for physical activity and improve cardiovascular health.

Specific Aims were to: (a) examine intervention acceptability, demand, and fidelity, and (b) evaluate intervention efficacy in promoting physical activity and improving cardiovascular health through increased social contextual resources and behavioral change processes. Participants in the Intervention group realized a significant reduction in body mass index (BMI) from baseline to 12 weeks when compared to participants in the Control group. Intervention group participants demonstrated improvement in theoretical mechanisms (i.e., self-knowledge, motivation appraisal, self-regulation, environmental resources) and intended outcomes (i.e., body composition) when compared to Control group participants. Findings from this study support the feasibility of the Yoga for HEART Intervention in older adults.
ContributorsBarrows, Jennifer Leigh (Author) / Fleury, Julie (Thesis advisor) / Komnenich, Pauline (Committee member) / Belyea, Michael (Committee member) / Arizona State University (Publisher)
Created2018
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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
There are significant and wide-ranging health benefits of physical activity, yet the majority of adolescents in the United States do not engage in the recommended amount. This poses a significant public health challenge. Parents have a substantial influence on adolescents' levels of activity, indicating that parenting may be an especially

There are significant and wide-ranging health benefits of physical activity, yet the majority of adolescents in the United States do not engage in the recommended amount. This poses a significant public health challenge. Parents have a substantial influence on adolescents' levels of activity, indicating that parenting may be an especially salient target of interventions designed to promote physical activity. The current study tested the hypothesis that a family intervention to promote effective parenting would have a positive collateral effect on adolescent physical activity. This study also tested whether the increase in activity was mediated by changes in parental monitoring and family relationship quality. Furthermore, the current study assessed whether adolescent gender moderated the relationship between parental monitoring and physical activity, such that increased parental monitoring predicted increases in physical activity for girls, but not for boys. Participants were 232 adolescents at risk for behavior problems drawn from a larger randomized controlled trial of the Family Check-Up. Adolescents completed questionnaires and participated in a family assessment with their caregivers in the 6th through 9th grades. Youth randomized to the intervention reported significantly more physical activity at follow-up relative to controls. Results failed to confirm the role of family factors as mediators of the effect of the intervention on physical activity. When gender was considered as a moderator, it appeared that parental monitoring was strongly and positively correlated with physical activity for girls, but not for boys. While the mechanism by which the Family Check-Up leads to increased physical activity remains unclear, its robust effects suggest that family intervention can be used to promote physical activity and might therefore have further-reaching health benefits.
ContributorsRudo-Stern, Jenna (Author) / Dishion, Thomas J (Thesis advisor) / Wolchik, Sharlene (Committee member) / Aiken, Leona (Committee member) / Arizona State University (Publisher)
Created2015
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Description
Background: This study examines how pro-vaccine flu messages, guided by the Extended Parallel Process Model (EPPM), affect parents’ intentions to vaccinate their children.

Methods: Parents of children six months to five years old (N = 975) were randomly exposed to one of four high-threat/high-efficacy messages (narrative, statistical, combined, control) and completed

Background: This study examines how pro-vaccine flu messages, guided by the Extended Parallel Process Model (EPPM), affect parents’ intentions to vaccinate their children.

Methods: Parents of children six months to five years old (N = 975) were randomly exposed to one of four high-threat/high-efficacy messages (narrative, statistical, combined, control) and completed a follow-up survey. Differences between message conditions were assessed with one-way ANOVAs, and binary logistic regressions were used to show how constructs predicted intentions.

Results: There were no significant differences in the ANOVA results at p = .05 for EPPM variables or risk EPPM variables. There was a significant difference between message conditions for perceived manipulation (p = 0.026), authority, (p = 0.024), character (p = 0.037), attention (p < .000), and emotion (p < .000). The EPPM model and perceptions of message model (positively), and the risk EPPM model and fear control model (negatively), predicted intentions to vaccinate. Significant predictor variables in each model at p < .05 were severity (aOR = 1.83), response efficacy (aOR = 4.33), risk susceptibility (aOR = 0.53), risk fear (aOR = 0.74), issue derogation (aOR = 0.63), perceived manipulation (aOR = 0.64), character (aOR = 2.00), and personal relevance (aOR = 1.88). In a multivariate model of the significant predictors, only response efficacy significantly predicted intentions to vaccinate (aOR = 3.43). Compared to the control, none of the experimental messages significantly predicted intentions to vaccinate. The narrative and combined conditions significantly predicted intentions to search online (aOR = 2.37), and the combined condition significantly predicted intentions to talk to family/friends (aOR = 2.66).

Conclusions: The EPPM may not be effective in context of a two-way threat. Additional constructs that may be useful in the EPPM model are perceptions of the message and fear control variables. One-shot flu vaccine messages will be unlikely to directly influence vaccination rates; however they may increase information-seeking behavior. The impact of seeking more information on vaccination uptake requires further research. Flu vaccine messages should be presented in combined form. Future studies should focus on strategies to increase perceptions of the effectiveness of the flu vaccine.
ContributorsHall, Sarah (Author) / Jehn, Megan (Thesis advisor) / Mongeau, Paul (Committee member) / Hruschka, Daniel (Committee member) / Margolis, Eric (Committee member) / Arizona State University (Publisher)
Created2015
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Description
The purpose of this phenomenological study was to explore the cultural, social, environmental, and gender factors that may influence physical activity (PA) in older Mexican American (MA) men living in Tucson, Arizona. The Mexican origin population is the fastest growing Hispanic subgroup in our nation, increasing from 20.6 million in

The purpose of this phenomenological study was to explore the cultural, social, environmental, and gender factors that may influence physical activity (PA) in older Mexican American (MA) men living in Tucson, Arizona. The Mexican origin population is the fastest growing Hispanic subgroup in our nation, increasing from 20.6 million in the year 2000 to 31.8 million in 2010. Arizona has the sixth largest Hispanic population in the United States and the Mexican origin population accounts for 91% of Arizona's Hispanics. Despite the fast growing Mexican population, there are a limited number of studies that examine MAs and PA. There are even fewer interventions created to foster PA among older (≥65 years old) MA men. Fourteen individual interviews were conducted with older MA men living in Tucson, Arizona. Data was collected, organized, and analyzed according to the methodologies of Clark Moustakas and the Social Ecology Model for Health Promotion framework. Six themes emerged which reflected the older MA male's perception of health, masculinity, and physical activity: a) Retirement promotes self-care behaviors, b) Women, health care providers, and the Internet are important in promoting health, c) Aging changes physical activity, d) I take care of myself, e) Physical activity is a personal choice and lifestyle, and f) I learn and make adjustments as needed. Themes were used to create textural and structural descriptions of their experiences. Descriptions were formed into the essence of the phenomenon. The results of this study increase our understanding of health, masculinity, and physical activity in older MA men. This research will inform the development of an evidence-based PA intervention to promote cardiovascular (CV) health in older MA men that may be implemented in a variety of community-based settings.
ContributorsDowling, Evangeline M (Author) / Hooker, Steven (Thesis advisor) / Grando, Victoria (Committee member) / Der Ananian, Cheryl (Committee member) / Larkey, Linda (Committee member) / Arizona State University (Publisher)
Created2015
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Description
Chronic diseases are the leading causes of death in the United States. Dietary behaviors influence the risk of developing multiple chronic diseases. The U.S. population consumes too few fruits and vegetables and too much sugar sweetened beverages (SSB) and fast food. The Social Ecological Model (SEM) was created as a

Chronic diseases are the leading causes of death in the United States. Dietary behaviors influence the risk of developing multiple chronic diseases. The U.S. population consumes too few fruits and vegetables and too much sugar sweetened beverages (SSB) and fast food. The Social Ecological Model (SEM) was created as a framework for health promotion interventions. The SEM organizes factors that can influence health into five layers: intrapersonal factors, interpersonal processes, institutional/organizational factors, community factors, and public policy. Each layer can influence dietary behaviors and other layers.

This work aims to understand how the community layer, represented by the food environment, moderates the association of two other layers and dietary behaviors: the interpersonal layer, represented by receiving health care provider’s (HCP) advice to lose weight, and the policy layer, represented by participation in the Supplemental Nutrition Assistance Program (SNAP), and a policy change within the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

Participant data were obtained from a household telephone survey of 2,211 adults in four cities in New Jersey from two cross-sectional panels in 2009-10 and 2014. Community food data were purchased and classified according to previously established protocol. Interaction and stratified analyses determined the differences in the association between HCP advice, SNAP participation, and time (for WIC participants) and eating behaviors by the food environment.

Interaction and stratified analyses revealed that HCP advice was associated with a decrease in SSB consumption when participants lived near a small grocery store, or far from a supermarket, limited service restaurant (LSR), or convenience store. SNAP participation was associated with a higher SSB consumption when respondents lived close to a small grocery store, supermarket, and LSR. There were no differences in fruit and vegetable consumption between two time points among WIC participants, or by food outlet.

The food environment, part of the community layer of SEM, moderated the relationship between the interpersonal layer and dietary behaviors and the policy layer and dietary behaviors. The association between HCP advice and dietary behaviors and SNAP participation and dietary behaviors were both influenced by the food environment in which participants lived.
ContributorsLorts, Cori Elizabeth (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Adams, Marc (Committee member) / Hooker, Steven (Committee member) / Roberto, Anthony (Committee member) / Tasevska, Natasha (Committee member) / Arizona State University (Publisher)
Created2017