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Purpose: To examine: (1) whether Non-Hispanic Blacks (NHB) and Non-Hispanic Whites (NHW) with diagnosed arthritis differed in self-reported physical activity (PA) levels, (2) if NHB and NHW with arthritis differed on potential correlates of PA based on the Social Ecological Model (Mcleroy et al., 1988), and (3) if PA participation

Purpose: To examine: (1) whether Non-Hispanic Blacks (NHB) and Non-Hispanic Whites (NHW) with diagnosed arthritis differed in self-reported physical activity (PA) levels, (2) if NHB and NHW with arthritis differed on potential correlates of PA based on the Social Ecological Model (Mcleroy et al., 1988), and (3) if PA participation varied by race/ethnicity after controlling for age, gender, education, and BMI. Methods: This study was a secondary data analysis of data collected from 2006-2008 in Chicago, IL as part of the Midwest Roybal Center for Health Promotion. Bivariate analyses were used to assess potential differences between race in meeting either ACR or ACSM PA guidelines. Comparisons by race between potential socio-demographic correlates and meeting physical activity guidelines were assessed using Chi-squares. Potential differences by race in psychosocial, arthritis, and health-related and environmental correlates were assessed using T-tests. Finally, logistic regression analyses were used to examine if race was still associated with PA after controlling for socio-demographic characteristics. Results: A greater proportion of NHW (68.1% and 35.3%) than NHB (46.5% and 20.9%) met both the arthritis-specific and the American College of Sports Medicine (ACSM) recommendations for physical activity, respectively. NHB had significantly lower self-efficacy for exercise and reported greater impairments in physical function compared to NHW. Likewise, NHB reported more crime and less aesthetics within their neighborhood. NHW were 2.56 times more likely to meet arthritis-specific PA guidelines than NHB after controlling for age, gender, education, marital status, and BMI. In contrast, after controlling for sociodemographic characteristics, age and gender were the only significant predictors of meeting ACSM PA guidelines. Discussion: There were significant differences between NHB and NHW individuals with arthritis in meeting PA guidelines. After controlling for age, gender, education, and BMI non-Hispanic White individuals were still significantly more likely to meet PA guidelines. Interventions aimed at promoting higher levels of physical activity among individuals with arthritis need to consider neighborhood aesthetics and crime when designing programs. More arthritis-specific programs are needed in close proximity to neighborhoods in an effort to promote physical activity.
ContributorsChuran, Christopher (Author) / Der Ananian, Cheryl (Thesis advisor) / Adams, Marc (Committee member) / Campbell, Kathryn (Committee member) / Arizona State University (Publisher)
Created2013
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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
It is broadly accepted that physical activity provides substantial health benefits. Despite strong evidence, approximately 60% to 95% of US adults are insufficiently active to obtain these health benefits. This dissertation explored five projects that examined the measurement properties and methodology for a variety of physical activity assessment methods. Project

It is broadly accepted that physical activity provides substantial health benefits. Despite strong evidence, approximately 60% to 95% of US adults are insufficiently active to obtain these health benefits. This dissertation explored five projects that examined the measurement properties and methodology for a variety of physical activity assessment methods. Project one identified validity evidence for the new MyWellness Key accelerometer in sixteen adults. The MyWellness Key demonstrated acceptable validity evidence when compared to a criterion accelerometer during graded treadmill walking and in free-living settings. This supports the use of the MyWellness Key accelerometer to measure physical activity. Project two evaluated validity (study 1) and test-retest reliability evidence (study 2) of the Global Physical Activity Questionnaire (GPAQ) in a two part study. The GPAQ was compared to direct and indirect criterion measures including object and subjective physical activity instruments. These data provided preliminary validity and reliability evidence for the GPAQ that support its use to assess physical activity. Project three investigated the optimal h.d-1 of accelerometer wear time needed to assess daily physical activity. Using a semi-simulation approach, data from 124 participants were used to compare 10-13 h.d-1 to the criterion 14 h.d-1. This study suggested that a minimum accelerometer wear time of 13 h.d-1 is needed to provide a valid measure of daily physical activity. Project four evaluated validity and reliability evidence of a novel method (Movement and Activity in Physical Space [MAPS] score) that combines accelerometer and GPS data to assess person-environment interactions. Seventy-five healthy adults wore an accelerometer and GPS receiver for three days to provide MAPS scores. This study provided evidence for use of a MAPS score for future research and clinical use. Project five used accelerometer data from 1,000 participants from the 2005-2006 National Health and Nutrition Examination Study. A semi-simulation approach was used to assess the effect of accelerometer wear time (10-14 h.d-1) on physical activity data. These data showed wearing for 12 h.d-1 or less may underestimate time spent in various intensities of physical activity.
ContributorsHerrmann, Stephen (Author) / Ainsworth, Barbara (Thesis advisor) / Gaesser, Glenn (Committee member) / Der Ananian, Cheryl (Committee member) / Kang, Minsoo (Committee member) / Vega-Lopez, Sonia (Committee member) / Arizona State University (Publisher)
Created2011
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Description

Health care providers (HCPs) are an important source of physical activity (PA) information. Two studies were conducted to qualitatively and quantitatively examine nurse practitioners'(NPs) and physician assistants' current PA counseling practices, knowledge and confidence to provide PA counseling and providers' perceptions about their current PA counseling practices. The specific aims

Health care providers (HCPs) are an important source of physical activity (PA) information. Two studies were conducted to qualitatively and quantitatively examine nurse practitioners'(NPs) and physician assistants' current PA counseling practices, knowledge and confidence to provide PA counseling and providers' perceptions about their current PA counseling practices. The specific aims for these two studies included quantitatively and qualitatively identifying the prevalence of PA counseling, perceived counseling knowledge and confidence, and educational training related to counseling. In study 1, survey respondents were currently practicing NPs and physician assistants. Participants completed a modified version of the Promotion of Physical Activity by Nurse Practitioners Questionnaire either online or in person during a population specific conference. The majority of both NP and physician assistant respondents reported routinely counseling patients about PA. There were no differences in perceived knowledge or confidence to provide PA counseling between the two populations. Approximately half of all respondents reported receiving training to provide PA counseling as part of their educational preparation for becoming a health practitioner. Nearly three-quarters of respondents reported interest in receiving additional PA counseling training. In study 2, five focus groups (FGs), stratified by practice type, were conducted with NPs and physician assistants. Both NPs and physician assistants reported discussing PA with their patients, particularly those with chronic illness. Participants reported that discussing lifestyle modifications with patients was the most common type of PA counseling provided. Increased confidence to counsel was associated with having PA knowledge and providing simple counseling, such as lifestyle modifications. Barriers to counseling included having more important things to discuss, lack of time during appointments, the current healthcare system, lack of reimbursement and perceived patient financial barriers. PA recommendation knowledge was highly variable, with few participants reporting specific guidelines. FG participants, while not familiar with the American College of Sports Medicines' "Exercise is Medicine" initiative indicated interest in its use and learning more about it. The findings of these two studies indicate that while NPs and physician assistants are knowledgeable, confident and currently providing some amount of PA counseling to patients, additional training in PA counseling is needed and desired.

ContributorsGrimstvedt, Megan (Author) / Der Ananian, Cheryl (Thesis advisor) / Ainsworth, Barbara (Committee member) / Keller, Colleen (Committee member) / Sebren, Ann (Committee member) / Woolf, Kathleen (Committee member) / Arizona State University (Publisher)
Created2011
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Description
Physical inactivity is a continuing public health crisis because of its negative effects on health (e.g. hypertension, cardiovascular disease, type II diabetes). To combat the rising prevalence of these non-communicable diseases, physical activity (PA) promotion is a public health priority. However, current programs seem to be ineffective in the long-term

Physical inactivity is a continuing public health crisis because of its negative effects on health (e.g. hypertension, cardiovascular disease, type II diabetes). To combat the rising prevalence of these non-communicable diseases, physical activity (PA) promotion is a public health priority. However, current programs seem to be ineffective in the long-term promotion of PA. Resultingly new, effective interventions are needed. Recent studies have established a link between mindfulness and PA engagement. Based on the current literature, the present study sought to investigate the associations between trait mindfulness, behavioral regulation towards exercise, exercise intention, stress, and self-reported PA. This study also examined whether trait mindfulness was independently associated with meeting weekly, leisure-time, moderate-to-vigorous PA [MVPA] recommendations in university undergraduate students after controlling for demographic characteristics, past PA experience, exercise intention, stress, and motivation.

The study used a cross-sectional design and participants consisted of 180 undergraduate university students (aged 18 to 24 years). Participants completed a one-time survey that assessed demographic characteristics, trait mindfulness, behavioral regulation toward exercise, exercise intention, perceived stress and PA. Bivariate associations between the variables were assessed with Pearson or Spearman correlations. A logistic regression analysis was conducted to determine which variables were independently associated with meeting weekly, leisure-time MVPA guidelines. Results of this study found weak positive associations between the mindfulness domain of acceptance and leisure time MVPA ( = .168, p < .05), no associations between mindfulness and transportation PA, and negative associations between mindfulness (MAAS,  = –.238, p < .01; acceptance,  = –.175, p < .05) and sitting time. Results of logistic regression found that only relative autonomy (OR = 1.085, 95% CI [1.008, 1.168], p = .030) and intention (OR = 2.193, 95% CI [1.533, 3.138], p < .0001) were independently associated with meeting weekly, leisure- time MVPA recommendations. The results of this study show that while there is only a weak direct relationship between trait mindfulness and PA, mindfulness may be related with other factors associated with PA. More research is needed in order to better understand the potential mechanisms behind the results found in this, and past, studies.
ContributorsNapolitano, Vinson (Author) / Der Ananian, Cheryl (Thesis advisor) / Sebren, Ann (Committee member) / Ainsworth, Barbara (Committee member) / Arizona State University (Publisher)
Created2019
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Description
Background: Exercise is Medicine (EIM) is a health promotion strategy for addressing physical inactivity in healthcare. However, it is unknown how to successfully implement the processes.

Purpose: The purpose of this study was to understand how implementing EIM influenced provider behaviors in a university-based healthcare system, using a process evaluation.

Methods:

Background: Exercise is Medicine (EIM) is a health promotion strategy for addressing physical inactivity in healthcare. However, it is unknown how to successfully implement the processes.

Purpose: The purpose of this study was to understand how implementing EIM influenced provider behaviors in a university-based healthcare system, using a process evaluation.

Methods: A multiple baseline, time series design was used. Providers were allocated to three groups. Group 1 (n=11) was exposed to an electronic medical record (EMR) systems change, EIM-related resources, and EIM training session. Group 2 (n=5) received the EMR change and resources but no training. Group 3 (n=6) was only exposed to the systems change. The study was conducted across three phases. Outcomes included asking about patient physical activity (PA) as a vital sign (PAVS), prescribing PA (ExRx), and providing PA resources or referrals. Patient surveys and EMR data were examined. Time series analysis, chi-square, and logistic regression were used.

Results: Patient survey data revealed the systems change increased patient reports of being asked about PA, χ2(4) = 95.47, p < .001 for all groups. There was a significant effect of training and resource dissemination on patients receiving PA advice, χ2(4) = 36.25, p < .001. Patients receiving PA advice was greater during phase 2 (OR = 4.7, 95% CI = 2.0-11.0) and phase 3 (OR = 2.9, 95% CI = 1.2-7.4). Increases were also observed in EMR data for PAVS, χ2(2) = 29.27, p <. 001 during implementation for all groups. Increases in PA advice χ2(2) = 140.90, p < .001 occurred among trained providers only. No statistically significant change was observed for ExRx, PA resources or PA referrals. However, visual analysis showed an upwards trend among trained providers.

Conclusions: An EMR systems change is effective for increasing the collection of the PAVS. Training and resources may influence provider behavior but training alone increased provider documentation. The low levels of documented outcomes for PA advice, ExRx, resources, or referrals may be due to the limitations of the EMR system. This approach was effective for examining the EIM Solution and scaled-up, longer trials may yield more robust results.
ContributorsBirchfield, Natasha R (Author) / Der Ananian, Cheryl (Thesis advisor) / Krasnow, Aaron (Committee member) / Doebbeling, Bradley (Committee member) / Adams, Marc (Committee member) / Swan, Pamela (Committee member) / Arizona State University (Publisher)
Created2019