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A mobility-impairing disability includes difficulty moving and maintaining body positions, handling, and moving objects, moving around in the environment, and difficulty with transportation. The negative impact of mobility impairments on daily life is profound and can lead to long-term negative health consequences. Mobility-impairing disabilities are associated with reduction in glucose

A mobility-impairing disability includes difficulty moving and maintaining body positions, handling, and moving objects, moving around in the environment, and difficulty with transportation. The negative impact of mobility impairments on daily life is profound and can lead to long-term negative health consequences. Mobility-impairing disabilities are associated with reduction in glucose tolerance, difficulty accessing healthy food, and physical inactivity. This dissertation investigated physical activity in people with mobility-impairing disabilities. First, Chapter 2 investigated the relationship between glucose disposal and physical activity in people with mobility-impairing disabilities. Chapter 3 explored collected survey data regarding physical access to food in a sample of 85 adults with mobility-impairing disabilities. The relationship between difficulty performing specific activities of daily living pertaining to food access and participation in muscle-strengthening activity was investigated. Chapter 4 consisted of an analysis of health-related outcomes to a 12-week self-guided Tai Chi and Qigong intervention compared to a video health information only control group. Results regarding the effects of physical activity on insulin sensitivity (Chapter 2) in people with mobility impairments were mixed. Self-reported muscle strengthening exercise frequency (Chapter 3) was negatively associated with difficulty loading or unloading groceries or other items from a car or transportation and difficulty with store check-out process. The results from Chapter 4 indicated no significant differences in handgrip strength following 12-weeks of self-guided Tai Chi and Qigong when compared to the control group. In sum, the overall results of this research indicated that physical activity is important for individuals with mobility impairments but that interventions to increase muscle strength in this group may need to be more specific or create more overload to elicit muscle-strengthening stimulus. Furthermore, the feasibility of conducting a remotely delivered exercise intervention in individuals with mobility impairments was confirmed; however, future research on a larger sample population is needed to determine the efficacy of this type of intervention on strength outcomes. Clinicians should continue to recommend regular exercise in people with mobility impairments due to the large body of research supporting its use across a variety of populations.
ContributorsSantana, Robert Scott (Author) / Lee, Rebecca E. (Thesis advisor) / Swan, Pamela D. (Thesis advisor) / Larkey, Linda (Committee member) / Bowles, John (Committee member) / Arizona State University (Publisher)
Created2022
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Description
The 24-hour day is spent engaging in activities that include light-physical activity (LPA), moderate-vigorous physical activity (MVPA), sedentary time (i.e., sitting/lying/reclining posture with energy expenditure <1.5 METs, while awake), and sleep. These behaviors are mutually exclusive and time spent in one behavior affects the time spent in another. The time

The 24-hour day is spent engaging in activities that include light-physical activity (LPA), moderate-vigorous physical activity (MVPA), sedentary time (i.e., sitting/lying/reclining posture with energy expenditure <1.5 METs, while awake), and sleep. These behaviors are mutually exclusive and time spent in one behavior affects the time spent in another. The time among these 24-hour behaviors is also associated with cardiometabolic health outcomes, including adiposity. Assessing specific behavioral contexts and their relationship within the 24-hour day is underdeveloped, this includes recreational sedentary screen time (rSST). rSST is sedentary time with televisions, computers, smartphones, tablets, inactive video games, and its relationship with other 24-hour behaviors is underdeveloped. This dissertation works evaluates the relationship between rSST and 24-hour behaviors, and adiposity in adults. The first study reviewed the existing observational and experimental evidence for rSST and its relationship with 24-hour behaviors by conducting a scoping review. From the 75 experimental and observational studies included, the evidence supported an overall positive association between rSST and non-screen sedentary behavior, an overall negative association between rSST with physical activity, and overall positive and negative associations between rSST with various sleep variables. The second study assessed the daily associations between rSST and 24-hour behaviors and how associations are influenced by age, sex, chronotype, and week- or weekend days. The findings include significant negative associations at between- and within-person levels for rSST with non-screen sedentary time, standing, LPA, MVPA, and sleep that were differentially influenced by age, chronotype, and week- or weekend day. The third study examined reallocating time between rSST and 24-hour behaviors and the associations with adiposity (i.e., body mass index, body fat percentage, and waist circumference). The results showed significant associations of replacing non-screen sedentary time with MVPA for both body fat percentage and waist circumference; and no significant associations between rSST and 24-hour behaviors for body mass index. Overall, this dissertation work provides important insights into the relationships between rSST and 24-hour behaviors and their relation to adiposity. These findings can be used to inform future intervention development targeting multiple behavior changes and improving health outcomes.
ContributorsHasanaj, Kristina (Author) / Buman, Matthew P (Thesis advisor) / Petrov, Megan E (Thesis advisor) / Sears, Dorothy D (Committee member) / Yu, Fang (Committee member) / Keadle, Sarah K (Committee member) / Arizona State University (Publisher)
Created2023
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Description
College students experience a considerable amount of stress. Unmanaged stress is associated with poor academic performance, health risk behaviors (i.e., inadequate sleep and physical activity, alcohol consumption, poor dietary behaviors), and poor mental health. Coping with stress has become a priority among universities. The most tested stress-related programs to date

College students experience a considerable amount of stress. Unmanaged stress is associated with poor academic performance, health risk behaviors (i.e., inadequate sleep and physical activity, alcohol consumption, poor dietary behaviors), and poor mental health. Coping with stress has become a priority among universities. The most tested stress-related programs to date have been mindfulness-based and face-to-face. These programs demonstrated significant improvements in stress, mindfulness, and self-compassion among college students. However, they may be burdensome to students as studies report low attendance and low compliance due to class conflicts or not enough time. Few interventions have used more advanced technologies (i.e., mobile apps) as a mode of delivery. The purpose of this study is to report adherence to a consumer-based mindfulness meditation mobile application (i.e., Calm) and test its effects on stress, mindfulness, and self-compassion in college students. We will also explore what the relationship is between mindfulness and health behaviors.

College students were recruited using fliers on college campus and social media. Eligible participants were randomized to one of two groups: (1) Intervention - meditate using Calm, 10 min/day for eight weeks and (2) Control – no participation in mindfulness practices (received the Calm application after 12-weeks). Stress, mindfulness, and self-compassion and health behaviors (i.e., sleep disturbance, alcohol consumption, physical activity, fruit and vegetable consumption) were measured using self-report. Outcomes were measured at baseline and week eight.

Of the 109 students that enrolled in the study, 41 intervention and 47 control participants were included in analysis. Weekly meditation participation averaged 38 minutes with 54% of participants completing at least half (i.e., 30 minutes) of meditations. Significant changes between groups were found in stress, mindfulness, and self-compassion (all P<0.001) in favor of the intervention group. A significant negative association (p<.001) was found between total mindfulness and sleep disturbance.

An eight-week consumer-based mindfulness meditation mobile application (i.e., Calm) was effective in reducing stress, improving mindfulness and self-compassion among undergraduate college students. Mobile applications may be a feasible, effective, and less burdensome way to reduce stress in college students.
ContributorsGlissmann, Christine (Author) / Huberty, Jennifer (Thesis advisor) / Sebren, Ann (Committee member) / Larkey, Linda (Committee member) / Lee, Chong (Committee member) / Arizona State University (Publisher)
Created2018
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Description
Through three investigations, this dissertation examined properties of the family and early care and education center (ECEC) environments related to preschool-aged children’s cardiovascular fitness (CVF) and gross locomotor skills (GLS). Investigation one used a systematic review and meta-analysis to synthesize the effectiveness of school-based interventions at improving CVF, in preschool-aged

Through three investigations, this dissertation examined properties of the family and early care and education center (ECEC) environments related to preschool-aged children’s cardiovascular fitness (CVF) and gross locomotor skills (GLS). Investigation one used a systematic review and meta-analysis to synthesize the effectiveness of school-based interventions at improving CVF, in preschool-aged children. For investigations two and three product- and process-based measures of GLS were collected from children in ECECs (n=16), using the progressive aerobic cardiovascular endurance run (PACER; n=144) and the CHAMPS motor skill protocol (CMSP; n=91), respectively. Investigation two and three examined family factors and ECEC factors for associations with measures of GLS, respectively.

Investigation one revealed a moderate-to-large effect size for school-based interventions (n=10) increasing CVF (g=0.75; 95%CI [0.40-1.11]). Multi-level interventions (g=.79 [0.34-1.25]) were more effective than interventions focused on the individual (g=0.67 [0.12-1.22]). In investigations two and three children (78.3% Hispanic; mean ± SD age 53.2±4.5 months) completed a mean ± SD 3.7±2.3 PACER laps and 19.0±5.5 CSMP criteria. Individual and family factors associated with PACER laps included child sex (B=-0.96, p=0.03) and age (B=0.17, p<0.01), parents’ promotion of inactivity (B=0.66, p=0.08) and screen time (B=0.65, p=0.05), and parents’ concern for child’s safety during physical activity (B=-0.36, p=0.09). Child age (B=0.47, p<0.01) and parent employment (B=2.29, p=0.07) were associated with CMSP criteria. At the ECEC level, policy environment quality (B=-0.17; p=0.01) was significantly associated with number of PACER laps completed. Outdoor play environment quality (B=0.18; p=0.03), outdoor play equipment total (B=0.32; p<0.01) and screen time environment quality (B=0.60; p=0.02) were significantly associated with CMSP criteria. Researchers, ECEC teachers and policy makers should promote positive environmental changes to preschool-aged children’s family and ECEC environments, as these environments have the potential to improve CVF and GLS more than programs focused on the child alone.
ContributorsSzeszulski, Jacob (Author) / Lee, Rebecca E (Thesis advisor) / Buman, Matthew P (Committee member) / Hooker, Steven P (Committee member) / Vega-Lopez, Sonia (Committee member) / Shaibi, Gabriel Q (Committee member) / Arizona State University (Publisher)
Created2019
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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
Myeloproliferative neoplasm (MPN) patients suffer from fatigue and a reduced overall quality of life, both of which are not resolved with current pharmacologic therapy. The purpose of this study was to examine the effects of a 12-week online-streamed yoga intervention on fatigue and QoL in MPN patients as compared to

Myeloproliferative neoplasm (MPN) patients suffer from fatigue and a reduced overall quality of life, both of which are not resolved with current pharmacologic therapy. The purpose of this study was to examine the effects of a 12-week online-streamed yoga intervention on fatigue and QoL in MPN patients as compared to a wait-list control group as well as to determine the feasibility of remotely collecting blood and saliva samples in a national sample. MPN patients were asked to complete 60 min/week of online yoga for 12 weeks. MPN fatigue and QoL were assessed online with single-item questions taken from the MPN SAF (fatigue and QoL) and NIH PROMIS (QoL) at baseline, week 7, and week 12. The practicality of the blood and saliva measures were defined as >70% completion rate at both baseline and week 12. Fidelity of the intervention (i.e., weekly yoga participation) was assessed via both self-report (i.e., daily log) and objective measurement (i.e., Clicky). Of the 62 MPN patients that enrolled in the study, 48 completed the intervention with 27 participating in the yoga group and 21 participating in the wait-list control group. Weekly yoga participation averaged ~41 min/week as measured objectively, whereas self-report yoga participation averaged ~56 min/week. The blood draw was determined to be practical with a 92.6% completion rate at baseline and a 70.4% completion rate at week 12. There were no significant differences from baseline to week 12 in MPN SAF fatigue (ES=0.18; p=0.724) or MPN SAF QoL (ES=-0.53; p=0.19), however, NIH PROMIS QoL was significantly improved from baseline to week 12 (ES=0.7; p=0.031) when compared to the control group. This study builds upon the findings from a prior feasibility study in demonstrating the feasibility of online yoga as well as its preliminary effects of improving total symptom burden, fatigue, pain, depression, anxiety, and sleep disturbance in MPN patients. Given the effects of yoga demonstrated both in the feasibility study and the current pilot study, a future randomized controlled trial with a larger sample size is warranted in order to further investigate the effectiveness of online yoga for MPN patient symptom burden and QoL.
ContributorsEckert, Ryan (Author) / Huberty, Jennifer (Thesis advisor) / Mesa, Ruben (Committee member) / Gowin, Krisstina (Committee member) / Dueck, Amylou (Committee member) / Kosiorek, Heidi (Committee member) / Larkey, Linda (Committee member) / Arizona State University (Publisher)
Created2017
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Description
This body of research sought to explore relationships between parenting practices, physical activity resources, and Hispanic children’s physical activity. Guided by the Family Ecological Model (FEM) and the Ecological Model of Physical Activity (EMPA) this study examined the influence of parents on children’s physical activity through an integrative review. A

This body of research sought to explore relationships between parenting practices, physical activity resources, and Hispanic children’s physical activity. Guided by the Family Ecological Model (FEM) and the Ecological Model of Physical Activity (EMPA) this study examined the influence of parents on children’s physical activity through an integrative review. A cross sectional study was conducted to investigate potential relationships between parental perception safety at school, gender, and children’s physical activity. A cross sectional study was also utilized to examine potential correlations between parenting practices, physical activity resources, and children’s physical activity. Parental role modeling of physical activity and parental support for physical activity emerged as parenting practices that have considerable potential to impact children’s physical activity. Gender differences among children’s physical activity were also a key finding of this study with boys participating in more physical activity than boys. While quality of physical activity resources did not have significant associations with parenting practices or children’s physical activity, more research is needed to determine how resources for physical activity may impact parenting practices, and children’s physical activity.
ContributorsHutchens, Amy (Author) / Lee, Rebecca E (Thesis advisor) / Todd, Michael (Committee member) / Lyles, Ann Marie (Committee member) / Holtzclaw, Barbara (Committee member) / Arizona State University (Publisher)
Created2017
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Description
This body of research sought to explore relationships between cognitive function and physical activity (PA), sedentary behavior (SB), and sleep, independently and in conjunction, in mid-life to older adults with no known cognitive impairment. Aging is associated with cognitive decline, and lifestyle behaviors such as PA, SB, and sleep, may

This body of research sought to explore relationships between cognitive function and physical activity (PA), sedentary behavior (SB), and sleep, independently and in conjunction, in mid-life to older adults with no known cognitive impairment. Aging is associated with cognitive decline, and lifestyle behaviors such as PA, SB, and sleep, may mitigate this decline. First, a systematic review and meta-analysis was conducted to examine the effect of aerobic PA interventions on memory and executive function in sedentary adults. Second, a longitudinal study was conducted to examine the association between SB and odds of incident cognitive impairment, and SB and cognitive decline in older adults. Last, a cross-sectional study was conducted to examine the joint associations between different levels of sleep with levels of PA, and sleep with levels of sedentary time on memory and executive function. This body of research provided evidence to support the association between aerobic PA and improved cognitive function, SB and incident cognitive impairment and cognitive function declines, and the joint association of sleep and different levels of PA and ST on cognitive function by hypertension status.
ContributorsHoffmann, Nicole M (Author) / Lee, Rebecca E (Thesis advisor) / Petrov, Megan E (Thesis advisor) / Marek, Karen (Committee member) / Arizona State University (Publisher)
Created2020
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Description
Background: Unmanaged stress is a major contributing factor to the development of disease in both men and women. Middle-aged adults (40-64) have some of the highest stress of all age groups and the use of meditation may provide relief for conditions such as stress. A smartphone application (app) may hel

Background: Unmanaged stress is a major contributing factor to the development of disease in both men and women. Middle-aged adults (40-64) have some of the highest stress of all age groups and the use of meditation may provide relief for conditions such as stress. A smartphone application (app) may help limit the magnitude of the perceived challenges of meditation. The purpose of this study is to determine the feasibility of a consumer-based meditation app (i.e., Calm) to reduce stress in middle-aged adults who self-report elevated stress. The preliminary effects of Calm on stress and health outcomes related to stress were explored as well as the preliminary effects of Calm on mindfulness and coping behaviors for stress were explored.

Methods: Adults were recruited to a 4-week app-based health and well-being study. Participants were randomized into either a mindfulness meditation (i.e. Calm) group or a health education (POD) control group. Participants were asked to participate at least 10 minutes per day. Assessments were conducted for stress, anxiety, depression, mindfulness, physical activity, eating habits, and coping behaviors at pre- and post-intervention and voluntary phone interviews were held post-intervention. App usage data were collected subjectively through weekly participation logs and through objective app usage data provided by Calm.

Results: Eighty-three participants were enrolled into the study and 60 completed the intervention and were analyzed. Feasibility and demand benchmarks were met with 96% of participants satisfied with the intervention and 93% found it enjoyable, appropriate, and useful. There was a 70% adherence (minutes/week) to the meditation intervention. Recruitment of men into the intervention group was 38.1% and retention of men was 81.3%. Significant changes were not observed in stress, anxiety, depression, or mindfulness, physical activity, eating habits, and coping behaviors.

Conclusion: The findings of this study support the feasibility of a 4-week, mobile app-based mindfulness meditation intervention (i.e. Calm) in middle-aged adults. These finding do not demonstrate preliminary efficacy of Calm to reduce stress, anxiety, and depression or improvement of mindfulness, physical activity, eating habits, or coping behaviors among middle-aged adults who report elevated stress. These results can be applied for improved design of future studies.
ContributorsLaird, Breanne Michelle (Author) / Huberty, Jennifer (Thesis advisor) / O'Rourke, Holly (Committee member) / Larkey, Linda (Committee member) / Arizona State University (Publisher)
Created2020