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Unintentional falls among community dwelling older adults are a common, serious and potentially preventable public health problem. In the United States, the annual incidence of fall related injuries per 100,000 persons was 4,616 in 2001, rising to 5,252 in 2008. The annual incidence of fall related deaths per 100,000 persons

Unintentional falls among community dwelling older adults are a common, serious and potentially preventable public health problem. In the United States, the annual incidence of fall related injuries per 100,000 persons was 4,616 in 2001, rising to 5,252 in 2008. The annual incidence of fall related deaths per 100,000 persons was 29.3 in 2000, rising to 41.86 in 2006. Older adults are particularly vulnerable to falls as they age. Potential consequences include fractures, emergency room, hospital and nursing home admissions, dependence, confusion, immobilization, depression, and death. Significant modifiable fall risk factors include muscle weakness, gait problems, and balance problems. While researchers have demonstrated the positive effects of balance and leg-strengthening physical activities, the majority of older adults do not engage in them, and the rate of falls continues to increase. Older adults participate in regular physical activity and fitness activities less often than younger populations; disparities are greater among those who are poor and living in rural communities. While knowledge about causes, risk factors, and efficacious physical activity to prevent falls has grown exponentially in the last several decades, bridging the gap between research and practice continues to be a challenge. As a strategy to address the gap between research and practice, this feasibility study utilized a tested theory, the wellness motivation theory, to address motivation for behavioral change in combination with instruction for physical activities proven to reduce fall risk. The study sample included rural, community dwelling older adults at risk of falls. The study included an innovative mobile computer to measure physical activity behavior and to augment motivational content of the intervention. Specific aims of this feasibility study were to: (a) examine the acceptability, demand, and implementation of the wellness motivation intervention (WMI) as well as the technology augmenting the WMI; and (b) evaluate the efficacy of the WMI to influence awareness of social contextual resources, behavioral change processes, physical activity, and fall risk. The WMI delivered in combination with proven multicomponent balance and strength activities was feasible and effectively increased motivation for behavioral change (social support from friends, awareness of social contextual resources, behavioral change processes) and physical activity behavior, and decreased fall risk among rural, community-dwelling older adults at risk of falls in this study. This study is the first step in a program of research focusing on enhancing motivation for physical activity that reduces falls and frailty among older adults.
ContributorsMcMahon, Siobhan (Author) / Fleury, Julie (Thesis advisor) / Belyea, Michael (Committee member) / Shearer, Nelma (Committee member) / Wyman, Jean (Committee member) / Hekler, Eric (Committee member) / Arizona State University (Publisher)
Created2012
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Description
Background: Latinos have disproportionately high rates of obesity and type 2 diabetes. Family-based interventions may reduce chronic disease risk among Latinos across generations.

Purpose: To assess the efficacy of Athletes for Life (AFL), a 12-week community-and-family-based behavioral intervention, for improving diet, physical activity (PA), anthropometrics, fitness, and biochemical outcomes among

Background: Latinos have disproportionately high rates of obesity and type 2 diabetes. Family-based interventions may reduce chronic disease risk among Latinos across generations.

Purpose: To assess the efficacy of Athletes for Life (AFL), a 12-week community-and-family-based behavioral intervention, for improving diet, physical activity (PA), anthropometrics, fitness, and biochemical outcomes among mostly Latino parents.

Methods: Parents with at least one child 6-11 years of age were randomized to active AFL participation (n=14) or a wait-list control (n=14) group. AFL consisted of twice weekly 90 minute sessions (45 minutes of nutrition-focused lessons and 45 minutes of PA participation) designed to promote fruit and vegetable consumption, reduction of sugar intake, and increasing habitual PA. Data were collected prior to and immediately after the 12 week intervention.

Results: Participants (37.9±7.2y) were mostly Latino (93%), Spanish speaking (68%), and women (93%). Relative to participants in the control group, AFL participants had a significant reduction in body fat (-1.1±1.2% vs. 0.2±1.2%; p=0.014), resting (-7.6±10.2 bpm vs. +2.1±6.8 bpm; p<0.01), exercise (-8.4±8.7 bpm vs. +0.4±7.3 bpm; p<0.01), and recovery heart rate (-11.9±12.8 bpm vs. -0.3±11.4 bpm; p=0.01), and one mile run time (-1.5±1.0 min vs. -0.1±0.9 min; p<0.01), and a significant increase in estimated VO2 peak (+1.9±1.9 ml/kg/min vs. 0.0±1.8 ml/kg/min; p=0.01). AFL participants also reported an increase in the number of days/week accumulating 30 minutes of MVPA (+0.8±3.2 vs. -1.5±2.3; p=0.004) and daily servings of fruits (+1.3±1.4 vs. +0.3±1.4; p<0.05) and vegetables (+1.8±1.7 vs. +0.1±1.2; p<0.05), relative to control participants. There were no significant differences between groups in changes in diet assessed by 3-day food record, accelerometer-measured PA, weight, blood pressure, visceral fat, biomarkers for cardiovascular disease or nutritional biomarkers.

Conclusions: Despite the lack of effects on diet and PA behaviors, AFL shows promising preliminary efficacy for reducing body fat and improving fitness among adult participants. Future research aimed at improving fitness among Latino parents with family-based intervention is warranted.
ContributorsChavez, Adrian (Author) / Vega-Lopez, Sonia (Thesis advisor) / Crespo, Noe (Committee member) / Hekler, Eric (Committee member) / Shaibi, Gabriel (Committee member) / Bruening, Meg (Committee member) / Arizona State University (Publisher)
Created2015
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Description
Objective: The purpose of this study was to determine the feasibility (i.e., acceptability) of a yoga intervention implemented within a preschool with typically and atypically developing children.
Participants: 29 children between the ages of three and five years that are currently attending the Mary Lou Fulton Teacher’s College Preschool.

Methods: Children

Objective: The purpose of this study was to determine the feasibility (i.e., acceptability) of a yoga intervention implemented within a preschool with typically and atypically developing children.
Participants: 29 children between the ages of three and five years that are currently attending the Mary Lou Fulton Teacher’s College Preschool.

Methods: Children participated in eight ~15-20-minute yoga sessions consisting of an opening circle, breathing, mindful movement, and a closing circle with relaxation time. Parents completed weekly homework assignments and surveys about the homework. Parents and teachers both completed daily behavior logs to track their child’s number of outbursts, mention of yoga, and use of yoga. Additionally, parents completed a post-intervention survey to determine overall satisfaction.

Results: The Preschool Behavior Questionnaire paired t-test results did not demonstrate any significant differences in pre-intervention (M=13.00, SD±7.55) and post-intervention (M=11.95, SD±6.92) scores, t(17)=0.94, p=0.36. There were no visible correlations between outbursts and use of yoga as reported by parents, but the use of yoga increased with the number of outbursts as reported by parents. Overall, parents felt the sessions had a positive effect on their child’s behavior and felt their children enjoyed the sessions.

Conclusion: Implementing classroom-based yoga programs could be an acceptable, realistic option to manage and prevent negative behaviors in preschool children.
ContributorsColeman, Lindsey Katlin (Author) / Huberty, Jennifer (Thesis director) / Rotheram-Fuller, Erin (Committee member) / Mullady, Allison (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
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Background: The prevalence of childhood obesity has disproportionately affected Latino youth and can be seen with an increase incidence of Type 2 Diabetes. This increase in obesity can be attributed to physical inactivity. Increases in social support and self-efficacy are independently related to increases in physical activity. A lifestyle intervention

Background: The prevalence of childhood obesity has disproportionately affected Latino youth and can be seen with an increase incidence of Type 2 Diabetes. This increase in obesity can be attributed to physical inactivity. Increases in social support and self-efficacy are independently related to increases in physical activity. A lifestyle intervention can lead to increases in social support, self-efficacy and physical activity. Objective/Hypothesis: The objective of this study was to determine whether a 12-week lifestyle intervention could increase social support, self-efficacy and physical activity in obese Latino adolescents that participated in the intervention. It was hypothesized that adolescents that participated in the intervention would increase self-efficacy, social support from family and friends, and physical activity compared to their control counterparts. Study Design/Participants: In a randomized control trial, there were 125 Latino (n= 60 experimental group; n= 65 control group; mean age = 15.17 +- 1.65 Males n = 60; n = 65 females) participants included in this study. Participants were also required to have a BMI percentile >= 95th percentile for age and gender or BMI >= 30 kg/m2. Methods: The intervention, which was developed using the Social Cognitive Theory had components focusing on social support and self-efficacy and also consisted of nutrition education classes and physical activity sessions for 12 weeks. The psychosocial constructs of self-efficacy and social support were measured using the Adolescent Self-Efficacy for Diet and Activity Behaviors and Adolescent Social Support for Diet and Exercise Survey, respectively. Physical activity was assessed by the 3-day Physical Activity Recall. Results: We found significant increases in social support in family (p = 0.042) and vigorous physical activity (p = 0.001). There was also a significant difference between control and treatment group for moderate to vigorous physical activity after the intervention (p = 0.027). There were no changes in social support from friends or self-efficacy. Conclusion: We concluded that a 12-week lifestyle intervention did lead to changes in social support and physical activity behaviors. These changes could have been influenced by the intervention as they were measured these constructs pre/post intervention.
ContributorsRahman, Hanna (Author) / Shaibi, Gabriel (Thesis director) / Hoffner, Kristin (Committee member) / School of Nutrition and Health Promotion (Contributor) / School of Social and Behavioral Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
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Description
Introduction/Purpose: the purpose of this study was to explore the perception of care after stillbirth and the use of physical activity and/or mindful approaches (e.g., yoga) to cope with grief in women of racial/ethnic minority who have experienced stillbirth.
Methods: This was an exploratory qualitative research study. Participants were African

Introduction/Purpose: the purpose of this study was to explore the perception of care after stillbirth and the use of physical activity and/or mindful approaches (e.g., yoga) to cope with grief in women of racial/ethnic minority who have experienced stillbirth.
Methods: This was an exploratory qualitative research study. Participants were African American, Hispanic, Asian, and American Indian women, between the ages of 26 and 38, who have experienced stillbirth within the past 3 years. Participants completed a 20-30 minute phone interview.
Results: Fourteen women participated in the study (M age = 31.02 ± 5.97 years; M time since stillbirth = 1.47 ± 0.94 years). Women’s perceptions about physical activity and mindfulness to cope with grief were coded into the following major themes: perception of health care after stillbirth (satisfaction with the level of care provided), recommendations about inter-conception health care from physician (relating to mental, emotional, and physical health), grief (comfort with communicating with the physician), coping mechanisms, perception of the relationship between physical activity and mood, barriers to participating in physical activity (social and behavioral), pre-pregnancy physical activity, and perception of mindful approach (e.g., yoga) as a coping mechanism.
Conclusion: This was the first study to explore perceptions of health care and the use of physical activity and/or mindful approaches (e.g., yoga) to cope with grief after stillbirth in women of racial/ethnic minority. Findings from this study may help inform health care professionals alter their care practices and introduce physical activity and mindfulness based approaches as coping mechanisms to mothers of stillborn babies.
ContributorsArvayo, Jordan Michelle (Author) / Huberty, Jennifer (Thesis director) / Hoffner, Kristin (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2015-05
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Description
The WalkIT Study is a mobile health study examining the efficacy of a four month text message-based intervention for increasing physical activity among 96 overweight adults. The purpose of this thesis is to examine the potency of the different types of motivational prompt-to-action text messages used in the WalkIT Study

The WalkIT Study is a mobile health study examining the efficacy of a four month text message-based intervention for increasing physical activity among 96 overweight adults. The purpose of this thesis is to examine the potency of the different types of motivational prompt-to-action text messages used in the WalkIT Study for increasing steps per day by examining the individual messages, creating qualitative themes and comparing themed groups, and evaluating the interaction between demographic subgroups and themed groups. A total of nine themes was created. The results found that Message 13, “It doesn't matter how old you are – it's never too early or too late to become physically active so start today; only then will you start to see results!”, had the highest median step count (7129 steps) and Message 71, “It's ok if you can't reach your goal today. Just push yourself more tomorrow.”, had the lowest median step count (5054 steps). For themes, the highest median step count (6640 steps) was found in Theme 6, Challenges, and the lowest median step count (5450 steps) was found in Theme 9, Unconditional Feedback. Theme 6 (Challenges) had the highest median step count for females, Theme 7 (Everyday Tips) had the highest median step count for males, Theme 4 (Nutrition) had the highest median step count for the 18-42 group, Theme 6 (Challenges) had the highest median step count for the 43-61 group, and Theme 9 (Unconditional Feedback) had the lowest median step count for both genders and both age groups. The results suggest the usefulness of analyzing the effectiveness of individual motivational text messages, themes, and the interaction between demographic groups and themes in physical activity interventions.
ContributorsBhuiyan, Nishat Anjum (Author) / Adams, Marc (Thesis director) / Ainsworth, Barbara (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2015-05
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Description
Background: The purpose of this study was to determine the feasibility of using Facebook as compared to a discussion board in an online, web-based intervention, Fit Minded College Edition-Podcasts (FMCEP), to improve physical activity and self-worth in female college students.
Methods: Participants (n=55) were randomly assigned to either a private

Background: The purpose of this study was to determine the feasibility of using Facebook as compared to a discussion board in an online, web-based intervention, Fit Minded College Edition-Podcasts (FMCEP), to improve physical activity and self-worth in female college students.
Methods: Participants (n=55) were randomly assigned to either a private Facebook group (FB) or the Fit Minded discussion board (DB) to participate in discussion of health and wellness related podcasts. FMCEP was a 6-week intervention guided by the self-determination theory (SDT) to target autonomy, relatedness and competence. Each week participants were instructed to complete three tasks: (1) listen to an assigned podcast, (2) complete a workbook assignment, and (3) participate in FB or DB online discussion. Participants completed assessments at baseline and post-intervention (6-weeks).
Results: Self-reported physical activity (p=0.032, η2= 0.193) and physical self-worth (p<0.001, η2=0.747) increased significantly over time, but no difference was seen between the groups for both physical activity (p=0.266, η2= 0.056) and physical self-worth (p=0.485, η2=0.024). Website use (measured by mean number of engagements per day, each week) declined across the 6-week intervention in the DB group but was consistent in the FB group.
Conclusion: These findings suggest web-based interventions, guided by SDT, can improve physical activity and physical self-worth among female college students, and the Facebook group may be more feasible and effective. Future studies are needed to optimize web-based physical activity interventions in college females.
ContributorsSorteberg, Samantha Fern (Author) / Huberty, Jennifer (Thesis director) / Bruening, Meg (Committee member) / Mailey, Emily (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
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Description
Hispanic children have the highest prevalence of obesity versus other ethnic groups. This leaves this population susceptible to many adverse health risks, including hypertension, cardiovascular disease, and high blood pressure. Unfortunately, little research has been done investigating the contributing cause to this issue, specifically common sedentary behaviors in children that

Hispanic children have the highest prevalence of obesity versus other ethnic groups. This leaves this population susceptible to many adverse health risks, including hypertension, cardiovascular disease, and high blood pressure. Unfortunately, little research has been done investigating the contributing cause to this issue, specifically common sedentary behaviors in children that limit physical activity and it’s purpose in expending energy. Amongst these behaviors, amount of time spent on electronic devices has proven to have increased drastically in recent years. The relationship between screen time and electronic device use, specifically with television, video games, and computer usage, and physical activity levels, and how those affect cardiometabolic disease risk factors, were explored in this study. Participants of this study were elementary school-aged children from Maricopa County, AZ. Electronic device usage, physical activity amounts, and presence of the specific devices in the child’s were collected from the participants’ parents through self-reported survey questions. Anthropometric and biochemical markers of cardiometabolic disease risk were directly measured. The average time spent engaged in physical activity per day by these participants was 20.02 ± 21.1 minutes and the average total screen time per day was 655 ± 605 minutes. Findings showed strong significance between total screen time and computer and video game use (r=0.482; p=0.01 and r=0.784; p=0.01, respectively). Video game time in the group of children with a video game in their room (350.66 ± 445.96 min/day) was significantly higher than the sample of kids without one in their room (107.19 ± 210.0 min/day ; p=0.000). Total screen time was also significantly greater with children who had a video game system in their room (927.56 ± 928.7 min/day) versus children who did not (543.14 ± 355.11 min/day; p=0.006). Additionally, significance was found showing children with a computer in the bedroom spent more time using the computer per day (450.95 ± 377.95 min/day), compared to those children who did not have a computer in their room (333.5 ± 395.6 min/day; p=0.048). No significant association was found between metabolic markers and screen time. However, HDL-cholesterol, triglycerides, and insulin proved to be dependent on BMI percentile (r=-0.582; p=0.01, r=0.476; p=0.01, r=0.704; p=0.01 respectively). Our data suggest further research needs to be done investigating other potential sources that limit physical activity so that strategies can focus on reducing obesity incidence and the associated health risks. Future studies should use larger sample sizes to be more representative of this population, and develop more direct observations instead of self-reported values to limit bias.
ContributorsGaines, Michael Anthony (Author) / Vega-Lopez, Sonia (Thesis director) / Crespo, Noe (Committee member) / School for the Science of Health Care Delivery (Contributor) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
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It is well established that physical activity (PA) directly correlates with many health benefits, especially when active habits are formed during childhood and adolescence. PA practiced in adolescence has been seen to carry into adulthood, helping to combat a host of chronic diseases, such as obesity and diabetes. However, in

It is well established that physical activity (PA) directly correlates with many health benefits, especially when active habits are formed during childhood and adolescence. PA practiced in adolescence has been seen to carry into adulthood, helping to combat a host of chronic diseases, such as obesity and diabetes. However, in recent years there has been a steady decline in PA among adolescents, followed by a resulting rise in sedentary behavior. Walking Intervention Through Texting for Adolescents, or WalkIT-A, was an 11.5-week intervention that built upon behavioral theory to provide an incentive-based, adaptive, physical activity intervention to inactive adolescents. The goal of this study was to investigate an intervention which combined walking with pointed behavior change strategies to incite a larger increase in PA. Using single-case, reversal (ABA) design, the study was aimed at shaping physical activity behavior in adolescents aged 12-17 through a mobile health intervention that paired adaptive goal setting with financial incentives to increase step count. The intervention was delivered using a semi-automated texting, mobile-Health (mHealth) platform, which incorporated FitBit tracking technology, adaptive goals, motivational messages, performance feedback, and points/incentives. It was hypothesized that during the adaptive intervention phase participants would increase both steps per day and active minutes compared to baseline values. Upon conclusion of the study, the three adolescent participants exhibited increased steps and active minutes during the intervention period compared to baseline and withdrawal phases. However, the specific trends identified suggest the need for future research to incorporate even stronger intervention components to overcome PA "drop-off" midway through the intervention, along with other external, environmental influencers. Despite this need, the use of adaptive goal setting combined with incentives can be an effective means to incite PA behavior change in adolescents.
ContributorsVan Bussum, Courtney Jessica (Author) / Adams, Marc (Thesis director) / Forzani, Erica (Committee member) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2016-12
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Description
This study aimed to identify the emotional/affective sources of discrepancies between physical activity behavior and a widely used self-perception measure of physical activity motivation. Overweight women (body mass index [BMI] ≥ 25 kg/m2, 18-64 years of age; N=37) were recruited from Arizona State University community through flyers and online newsletters.

This study aimed to identify the emotional/affective sources of discrepancies between physical activity behavior and a widely used self-perception measure of physical activity motivation. Overweight women (body mass index [BMI] ≥ 25 kg/m2, 18-64 years of age; N=37) were recruited from Arizona State University community through flyers and online newsletters. Participants wore a SenseWear accelerometer for 6 nights and 7 days and followed their normal patterns of daily living. Participants then completed a single lab visit and verbally responded to questions from the Behavorial Regulation Exercise Questionnaire (BREQ-2) while being video and audio recorded. Captured emotional responses were evaluated with facial recognition software (Noldus FaceReader). Discrepancies between BREQ-2 responses and physical activity behavior were associated with happiness and sadness emotional responses extracted from the facial recognition software using regression-based analyses. Results indicated an association between monitored physical activities and captured emotional response - specifically sadness - and that as intensity in physical activity increases, motivation increases. Associations between happiness/sadness and physical activity were not observed for all intensities of physical activity. A marginally significant association was observed for amotivation and sedentary, light-intensity physical activity, and moderate-vigorous physical activity in the sample. This study demonstrates a proof-of-concept for the integration of an empirical evaluation of happiness and sadness emotional states into the relationship between physical activity motivation and behavior.
ContributorsBryant, Sarah (Author) / Buman, Matthew P (Thesis advisor) / Chisum, Jack W (Committee member) / Hekler, Eric (Committee member) / Arizona State University (Publisher)
Created2016