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Walking interventions focused on increasing step counts are typically associated with salutary effects on glycemia, fasting insulin, insulin resistance and blood lipids which may be in turn associated with improvements in cardiorespiratory fitness (peak oxygen uptake – VO2peak) and vascular stiffness. We hypothesized that a novel 4-month, behavioral economics-based walking intervention would have favorable effects on glucose homeostasis and blood lipids and that these in turn would be related to VO2peak and vascular stiffness (carotid femoral pulse wave velocity – cfPWV).
We carried out secondary analyses on a subsample of sedentary, overweight/obese adults who participated in a 4-month, 2x2, randomized-controlled walking intervention examining the effects of goal setting (static v. adaptive goals) and rewards (immediate v. delayed) on steps/day (N=96). Fasting blood samples (n=58) were collected from participants before and after the intervention. Premenopausal females were in the follicular phase of their menstrual cycles. Lipid and glucose levels were measured using an automated chemistry analyzer, while insulin was measured using radio-immunoassay. Homeostatic model of insulin resistance (HOMA-IR) was calculated using the following formula (HOMA-IR=glucose x insulin / 405). We examined associations [partial correlations (adjusted for age)] between changes in blood biomarkers and VO2peak and cfPWV, irrespective of group, and we used linear mixed models to examine between-group differences in levels of and change in biomarker outcomes.
Groups did not differ in overall levels of, or degree of change in, biomarker outcomes (all p>0.05). Mean changes, irrespective of group, in biomarkers were as follows: glucose Δ= 0.74± 4.5mg/dl; insulin Δ= 0.09 ± 4.1 µU/ml; total cholesterol Δ= 0.24 ± 20.6 mg/dl; HDL-C Δ= 0.27 ± 5.1 mg/dl; LDL-C Δ= 1.3 ± 19.9 mg/dl; triglycerides Δ= 1.7 ± 27.2 mg/dl; HOMA-IR Δ = -.0548 ± 1.05). We found no significant associations between change in biomarker levels and change in VO2peak or change in cfPWV (all correlation coefficients < 0.15; p > 0.05).
A 4-month, behavioral economics-based mHealth intervention focused on increasing steps/day did not bring about favorable changes on markers of glycemia, insulin resistance and blood lipids.
We carried out secondary analyses on a subsample of sedentary, overweight/obese adults who participated in a 4-month, 2x2, randomized-controlled walking intervention examining the effects of goal setting (static v. adaptive goals) and rewards (immediate v. delayed) on steps/day (N=96). Fasting blood samples (n=58) were collected from participants before and after the intervention. Premenopausal females were in the follicular phase of their menstrual cycles. Lipid and glucose levels were measured using an automated chemistry analyzer, while insulin was measured using radio-immunoassay. Homeostatic model of insulin resistance (HOMA-IR) was calculated using the following formula (HOMA-IR=glucose x insulin / 405). We examined associations [partial correlations (adjusted for age)] between changes in blood biomarkers and VO2peak and cfPWV, irrespective of group, and we used linear mixed models to examine between-group differences in levels of and change in biomarker outcomes.
Groups did not differ in overall levels of, or degree of change in, biomarker outcomes (all p>0.05). Mean changes, irrespective of group, in biomarkers were as follows: glucose Δ= 0.74± 4.5mg/dl; insulin Δ= 0.09 ± 4.1 µU/ml; total cholesterol Δ= 0.24 ± 20.6 mg/dl; HDL-C Δ= 0.27 ± 5.1 mg/dl; LDL-C Δ= 1.3 ± 19.9 mg/dl; triglycerides Δ= 1.7 ± 27.2 mg/dl; HOMA-IR Δ = -.0548 ± 1.05). We found no significant associations between change in biomarker levels and change in VO2peak or change in cfPWV (all correlation coefficients < 0.15; p > 0.05).
A 4-month, behavioral economics-based mHealth intervention focused on increasing steps/day did not bring about favorable changes on markers of glycemia, insulin resistance and blood lipids.
ContributorsHook, Benjamin E. (Author) / Angadi, Siddhartha (Thesis director) / Gaesser, Glenn (Committee member) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
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 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.
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
Description
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
Description
Exercise is a great boon to both the health of individuals and the national as a whole. Exercise provides a wide range of significant and well established benefits to both physical and psychological health, with many benefits that are still being discovered. The effects of exercise on health are somewhat unique, as exercise is one of a limited number of ways to improve health that is not harm a reduction strategy, but instead increases health through direct benefit, rather than increasing health by decreasing damage and harm. Support is also given to the proposal that individuals are in best position to determine the intensity of exercise and to choose primary activities to participate in, in order to provide near maximum physical and psychological benefit, with the understanding that frequency of exercise is of the upmost importance for benefit. The accessibility of exercise and the tremendous health benefit of exercise, makes exercise a huge asset in reducing the exorbitant health care spending and improving mediocre health outcomes in this country; a reasonable goal as numerous countries have better health the United States, even though the United States spends the more than any other country on health.
ContributorsRael, Ashur Scott (Author) / Kashiwagi, Dean (Thesis director) / Kashiwagi, Jacob (Committee member) / Barrett, The Honors College (Contributor) / Department of Chemistry and Biochemistry (Contributor) / School of Film, Dance and Theatre (Contributor)
Created2015-05
Description
With an excessive amount of resources in the United States healthcare system being spent on the treatment of diseases that are largely preventable through lifestyle change, the need for successful physical activity interventions is apparent. Unfortunately an individual's physical activity and health goals are often not supported by the social context of their daily lives. This single-case design study, Walking Intervention through Text messaging for CoHabiting individuals (WalkIT CoHab), looks at the efficacy of a text based adaptive physical activity intervention to promote walking over a three month period and the effects of social support in intervention performance in three pairs of cohabiting pairs of individuals (n=6). Mean step increase from baseline to intervention ranged from 1300 to 3000 steps per day for all individuals, an average 45.87% increase in physical activity. Goal attainment during the intervention ranged from 43.96% to 71.43%, meaning all participants exceeded the 40% success rate predicted by 60th percentile goals. Social support scores for study partners, unlike social support scores for family and friends, were often in the high social support range and had a moderate increase from pre to post visits for most participants. Although there was variation amongst participants, there was a high correlation in physical activity trends and successful goal attainment in each pair of participants. Less ambitious percentile goals and more personalized motivational text messages might be beneficial to some participants. An extended intervention, something the majority of participants expressed interest in, would further support the efficacy of this behavioral intervention and allow for possible long term benefits of social support in the intervention to be investigated.
ContributorsFernandez, Jacqueline Alyssa (Author) / Adams, Marc (Thesis director) / Angadi, Siddhartha (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2015-05
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 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.
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
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 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
Description
Physical activity as a health or nutrition related intervention might stimulate appetite and increase hunger due to increased energy expenditure. This study analyzed the effect of a postprandial 15-minute walk on the hunger and energy intake of 10 obese, pre-diabetic adults. Subjects participated in three 4-hour trials: a walk treatment (consume highly glycemic meal, walk for 15 minutes at a moderate pace, and rest for 4 hours), a fiber treatment (consume highly glycemic meal enriched with soluble fiber and rest for 4 hours), and a control treatment (consume highly glycemic meal without fiber and rest for 4 hours). The effects of each treatment on hunger and energy intake were measured using a Likert scale analysis (ranging from "completely satisfied" to "extremely hungry") at 4 hours post-treatment and pre/ post 24-hour dietary logs. The results showed no significant increase or decrease on hunger or energy intake for both the walk and the fiber treatment compared to the control treatment. This denies the idea that physical activity might increase short-term hunger, and supports the use of physical activity as a viable nutrition related intervention tool.
ContributorsTerrell, Alayna Franci (Author) / Johnston, Carol (Thesis director) / Vega Lopez, Sonia (Committee member) / Barrett, The Honors College (Contributor) / Department of Chemistry and Biochemistry (Contributor)
Created2015-05
Description
Adaptive behavior consists of the social, conceptual and practical skills an individual must execute to function independently in their everyday life. Individuals with Down syndrome have limitations in their adaptive behavior due to cognitive and physical deficits. The aim of this study was to examine if an exercise program would improve the adaptive behavior skills in persons with Down syndrome. The exercise intervention, Exercise for Adults with Down Syndrome (ExDS), was a semester long program where adults with Down syndrome participate in twice weekly workouts planned and executed by Arizona State University students. The workouts consisted of an aerobic warm up, aerobic exercises, resistance exercises, balance exercises and stretches. The participants' adaptive behavior and cognitive planning ability were assessed before ExDS and after ExDS. The Adaptive Behavior Assessment System Second Edition (ABAS-II) was used to measure adaptive behavior. The ABAS-II consisted of a forum that addressed the Social, Conceptual and Practical domains of adaptive behavior and was filled out by the participants' caregiver. The Tower of London (ToL) was used to measure cognitive planning ability. The change in the ABAS-II scores from pre- to post-testing were statistically insignificant. The change from pre- to post-testing in the ToL scores approached statistical significance. Limitations included bias caregiver perception and respondent inconsistency. There is a need for further research on the effect of exercise on the adaptive behavior in adults with Down syndrome.
ContributorsRoss, Alexandra Jill (Author) / Holzapfel, Simon (Thesis director) / Ringenbach, Shannon (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
Description
The purpose of this thesis project was to examine the trajectories of physical activity among newly-diagnosed Obstructive Sleep Apnea (OSA) patients within the UC+WS group of the SleepWell24 study across the first 60 days of CPAP use, alone and based on Apnea-Hypopnea Index (AHI), Body Mass Index (BMI), sex, and age. The study utilizes objective data from the SleepWell24 randomized controlled trial conducted by a collaborative research team at Arizona State University and Mayo Clinic Arizona and Rochester. Participants use wearable sensors to track activity behaviors, such as sleep, sedentary behavior, light-intensity physical activity (LPA), and moderate-vigorous physical activity (MVPA). The primary aim of the study was to examine the physical activity trajectories among newly-diagnosed OSA patients over the first 8 weeks of CPAP use, utilizing the physical activity data from wearable sensors. The secondary aim was to assess the trajectories of physical activity between categories of AHI, BMI, sex, and age. Multilevel modeling was used to account for clustering within participants considering between and within subject variations, and week was used as a level 1 predictor in the model for LPA, and MVPA, and total activity (sum of LPA and MVPA), while between subject factors of BMI, sex, age, and AHI were also included in the model. It was found that there were no statistically significant trajectories of LPA, MVPA or total activity over the first 8 weeks of CPAP use within the sample of 30 participants. However, a few notable differences in physical activity were seen between categories of age, sex, and BMI. Also, there was a significant interaction found between BMI and each week that influenced the trajectory of physical activity within obese patients, as compared to participants considered overweight or with a lower BMI. Ultimately, this study provides insight into patterns of physical activity seen in a clinical population of OSA patients over the initial period of CPAP use.
ContributorsDavis, Kiley Lynn (Author) / Buman, Matthew P. (Thesis director) / Petrov, Megan (Committee member) / Dean, W.P. Carey School of Business (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05