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- All Subjects: Health Sciences
- Creators: Der Ananian, Cheryl
Description
Purpose: This study explored the potential correlates of exercise self-efficacy among older adults with a self-reported diagnosis of arthritis. Methods: This study was a secondary data analysis and used a cross-sectional design. Data was collected from a convenience sample of Non-Hispanic White and Non-Hispanic Black individuals between 2006-2008 (N=208). Descriptive statistics were run to assess means and frequencies within the sample. Bivariate statistics (Pearson and Spearman correlations, T-tests and one-way analysis of variance) were run to examine relationships between the independent and dependent variables. Multiple linear regression analyses were conducted to examine independent predictors of self-efficacy for exercise (SEE) and barriers self-efficacy for exercise (BSE). Results: Participants were predominantly female (85.6%), white (62.9%), retired (58.1%) and had a mean age of 66.6 [10.7] years. For education level, 23.4% reported a Master’s degree or higher and 18.6% reported they had at most a high school degree or GED. Nearly 47% of the sample were classified as obese based on self-reported body mass index (BMI) and 68.3% of the sample were not meeting the American College of Sports Medicine physical activity (PA) recommendations. Participants reported a relatively high BSE (22.6) and an average SEE (22.7). Significant positive associations were seen with outcome expectation for exercise (EOE), social support, and total minutes of PA and negative associations with BMI, physical function, pain, and negative affect with SEE and BSE. Meeting the PA guidelines (t134.5=4.60, 95%CI= 4.7(6.71-2.68), p<0.001) and being white (t164=2.82, 95%CI=2.82(0.57-5.08), p=0.014) were associated with SEE and BSE (t165=3.42, 95%CI= 4.37(6.89-1.85), p=0.001) and (t164=2.34, 95%CI= 2.95(0.46-5.43), p=0.021), respectively. In regression analyses, significant predictors of SEE were education (p=.006), physical function (p=.006) and EOE (p<.001). Significant predictors of BSE were physical function (p=.020), social support (p=.031), EOE (p=<.001), education level (p=.037), and total minutes of PA (p=.022). The variables in the SEE model accounted for 50.5% (R=.737, R2=.505) of the total variance and the variables in BSE model accounted for 41.1% (R=.672, R2=.411) of the total variance of the model. Discussion: EOE appears to be an important predictor of SEE and BSE. Examining the temporal relationship between EOE and SEE is warranted.
ContributorsDhālīwāla, Simarana (Author) / Der Ananian, Cheryl (Thesis advisor) / Sebren, Ann (Committee member) / Hrncir, Shawn (Committee member) / Arizona State University (Publisher)
Created2016
Description
There are limited studies exploring the direct relationship between coconut oil and cholesterol concentrations. Research in animals and a few intervention trials suggest that coconut oil increases the good cholesterol (high density lipoprotein, HDL) and thus reduces the risk of cardiovascular disease. Preliminary research at Arizona State University (ASU) has found similar results using coconut oil as a placebo, positive changes in HDL cholesterol concentrations were observed.
The goal of this randomized, double blind, parallel two arm study, was to further examine the beneficial effects of a 2g supplement of coconut oil taken each day for 8 weeks on cholesterol concentrations, specifically the total cholesterol to HDL cholesterol ratio, compared to placebo.
Forty-two healthy adults between 18-40 years of age, exercising less than 150 minutes each week, non smoking, BMI between 22-35 and not taking any medications that could effect blood lipids were recruited from the ListServs at ASU. Participants were randomized to receive either a placebo capsule of flour or a coconut oil capsule (Puritan’s Pride brand, coconut oil softgels, 2g each) and instructed to take the capsules for 8 weeks.
Results indicated no significant change in total cholesterol to HDL ratio between baseline and 8 weeks in the coconut oil and placebo groups (p=0.369), no significant change in HDL (p=0.648), no change in LDL (p=0.247), no change in total cholesterol (p=0.216), and no change in triglycerides (p=0.369).
Blood lipid concentrations were not significantly altered by a 2g/day dosage of coconut oil over the course of 8 weeks in healthy adults, and specifically the total cholesterol to HDL ratio did not change or improve.
The goal of this randomized, double blind, parallel two arm study, was to further examine the beneficial effects of a 2g supplement of coconut oil taken each day for 8 weeks on cholesterol concentrations, specifically the total cholesterol to HDL cholesterol ratio, compared to placebo.
Forty-two healthy adults between 18-40 years of age, exercising less than 150 minutes each week, non smoking, BMI between 22-35 and not taking any medications that could effect blood lipids were recruited from the ListServs at ASU. Participants were randomized to receive either a placebo capsule of flour or a coconut oil capsule (Puritan’s Pride brand, coconut oil softgels, 2g each) and instructed to take the capsules for 8 weeks.
Results indicated no significant change in total cholesterol to HDL ratio between baseline and 8 weeks in the coconut oil and placebo groups (p=0.369), no significant change in HDL (p=0.648), no change in LDL (p=0.247), no change in total cholesterol (p=0.216), and no change in triglycerides (p=0.369).
Blood lipid concentrations were not significantly altered by a 2g/day dosage of coconut oil over the course of 8 weeks in healthy adults, and specifically the total cholesterol to HDL ratio did not change or improve.
ContributorsShedden, Rachel (Author) / Johnston, Carol (Thesis advisor) / Lespron, Christy (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2017
Description
Curcumin is an active ingredient of Curcuma longa (Turmeric) and is studied extensively for its antioxidant, anti-inflammatory, anti-bacterial, anti-viral, and anti-cancer properties. The purpose of this study was to examine the effects of turmeric on blood glucose and plasma insulin levels. The study utilized a placebo-controlled, randomized cross-over design with participants serving as their own control. Eight glucose tolerant healthy participants completed the full study. Three-weeks washout period was kept in between six-weeks. Prior to the test meal day, participants were asked to eat a bagel with their evening dinner. During the day of the test meal, participants reported to the test site in a rested and fasted state. Participants completed mashed potato meal tests with 500 mg of turmeric powder or placebo mixed in water, followed by 3 weeks of 500 mg turmeric or placebo supplement ingestion at home. During this visit blood glucose finger picks were obtained at fasting, 30, 60, 90, and 120 min post-meal. Blood plasma insulin at fasting and at 30 min after the test meal were also obtained. During week 4, participants reported to the test site in a rested and fasted state where fasting blood glucose finger pricks and blood plasma insulin were measured. During week 5 to 7, participants were given a washout time-period. During week 8, entire process from week 1 to 4 was repeated by interchanging the groups. Compared to placebo, reduction in postprandial blood glucose and insulin response were non-significant after ingestion of turmeric powder. Taking turmeric for 3 weeks had no change in blood glucose and insulin levels. However, taking turmeric powder supplements for 3 weeks, showed a 4.4% reduction in blood glucose. Change in insulin at 30 min were compared with baseline insulin level showing no significant change between placebo and turmeric group. Fasting insulin after 3-weeks consumption of turmeric did not show any significant change, but showed a larger effect size (0.08). Future research is essential to examine the turmeric powder supplement benefits over a long period of time in healthy adults and whether it is beneficial in preventing the occurrence of type 2 diabetes.
ContributorsOza, Namrata (Author) / Johnston, Carol (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / Lespron, Christy (Committee member) / Arizona State University (Publisher)
Created2017
Description
The promulgation of the thin-ideal is associated with bulimia, dieting, supplement use, negative affect, and body dissatisfaction. “Fitspiration” was created as an “antidote” to the thin-ideal through the promotion of healthy eating and exercise; however, research indicates Fitspiration continues to promote the thin-ideal with similarly detrimental outcomes. Recently, research has shifted from a focus on body disturbance to concepts of positive body image (Halliwell, 2015), often researched through the concept of body appreciation. While the research is limited, a few studies have shown increases in body appreciation and mood after viewing body positive images. Therefore, the purpose of this study was to experimentally examine the impact of exposure to body positive and Fitspiration Instagram images on the body satisfaction, body appreciation, and mood of undergraduate women. Participants were 98 female undergraduate students (18-29 years old) currently attending Arizona State University. Participants were randomly assigned to view Fitspiration, Body Positive, or appearance neutral Instagram images. Dependent variables of state body appreciation, state body dissatisfaction, and state mood were measured using Visual Analogue Scales. Trait thin-ideal internalization, trait social comparison, and body mass index (BMI) were included as covariates. Qualitative short-answer questions were included as an exploratory aim. A one-way analysis of covariance (ANCOVA) was used to examine group differences in post-test scores followed by post-hoc analyses using the Bonferroni correction when significant. After controlling for baseline score, trait thin-ideal internalization, trait social comparison, and BMI, post-test body appreciation scores within Fitspiration condition were significantly lower than the control (MD= 9.818, SE=3.743, p=.031) and Body Positive condition (MD=9.372, SE=3.492, p=0.26). After controlling for baseline score, trait thin-ideal internalization, trait social comparison, and BMI, the Body Positive condition demonstrated significantly higher post-test body satisfaction scores than the control (MD= 11.134, SE=3.093, p=.002) and Fitspiration condition (MD=17.312, SE=3.092, p=<.001). After controlling for baseline scores, mean post-test positive mood scores within the Fitspiration group were significantly lower than the Body Positive condition (MD=-0.378, SE=.135, p=.019). There were no differences in post-test negative mood across conditions. Findings suggest short-term exposure to body positive images may improve body appreciation, Body Positivity, and positive mood among undergraduate females.
ContributorsSerlin, Danielle Nicole (Author) / Der Ananian, Cheryl (Thesis advisor) / Chisum, Jack (Committee member) / Sebren, Ann (Committee member) / Arizona State University (Publisher)
Created2020
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: 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.
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
Description
Background: Down syndrome is the leading genetic cause of intellectual disabilities. Executive function is an area that people with Down syndrome have a diminished capacity compared to those in the general population. In recent years it has been determined that acute and chronic exercise has a small but positive effect on measures of executive function in typically developed individuals. The effect has been recorded separately in both aerobic, high-rate passive and resistance exercises in adolescents with DS but has not been compared between exercise types in adults with DS. Methods: A randomized crossover study was utilized to determine the effect of resistance exercise, assisted cycling therapy, and no exercise on executive function and enjoyment in adults with Down syndrome. Resistance Training (RT)- participants completed a total of 16- repetitions of approximately 75% of a 1-RM in the leg press, chest press, seated row, and latissimus pulldown. ACT- participants completed 30-minutes of cycling at 35% above voluntary (e.g., self-selected pace) rate. No-Training (NT)- participants spent 35-minutes playing board games. Cognitive assessments were recorded pre- and post- intervention. The Physical Activity Enjoyment Survey was collected post-intervention. Statistics: The cognitive measures and Physical Activity Self-efficacy scale were analyzed using the delta scores (pre-post) in a Linear mixed models analyais. The main effect of sequence (A, B, C) and intervention (RT, ACT, NT), and visit were assessed. Significance level was set with α=0.05. If any differences were detected, the Bonferroni post-hoc test was used to determine differences. Physical Activity Enjoyment Scale post scores were compared using a General Linear Model. Alpha was set at 0.05 with a Bonferroni post-hoc test to determine differences. A secondary analysis was conducted investigating the effect of participants that completed testing individually compared to those that completed the testing in a group setting. Results: There were no significant difference in the delta score of any of the measures. The secondary analysis also found no significant difference but showed a trend that those tested individually had opposite results than those tested in a group.
ContributorsArnold, Nathaniel (Author) / Ringenbach, Shannon (Thesis advisor) / Lee, Chong (Committee member) / Der Ananian, Cheryl (Committee member) / Holzapfel, Simon (Committee member) / Bosch, Pamela (Committee member) / Arizona State University (Publisher)
Created2021
Description
Background: Studies show that rural schools may be less supportive of student fruit/vegetable (FV) consumption, but few studies have investigated the relationship between school locale and FVs. The aim of this research is to analyze the relationship between school locale (rural vs. urban) and students’ FV selection, consumption, and waste in elementary, middle, and high schools. Methods: A cross-sectional analysis of 37 Arizona schools evaluated differences in the selection, consumption, and waste of fresh FVs from students (n=2525; 45.7% female; 41% non-white; mean age=11.6±3.3; 23.5% rural) using objective plate waste measures. Zero-inflated negative binomial regressions examined differences in FV grams selected, consumed, and wasted by urban vs. rural locale, adjusted for sociodemographics and school.
Results: The percent of students who selected, consumed, and wasted zero grams of FVs were 14%, 21%, 20%, respectively. Among students with some (non-zero amounts), the average selected, consumed, and wasted FVs were 115.0±81.4g, 51.7.5±65.1g, 65.2±66.7g, respectively. Rural students (versus urban) had lower odds of selecting (OR=0.75), consuming (OR=0.78), and wasting (OR=0.71) any FVs, after adjusting for covariates. However, among students with some FVs on their plates, rural students selected (IRR=1.40), consumed (IRR=1.18) and wasted (IRR=1.62) more grams of FVs.
Conclusions: Rural students had reduced odds of selecting and consuming any FVs, but with lower odds of waste, perhaps due to reduced selection. Once some FVs were on the tray, likelihood of consumption and waste by rural students were greater. Results support interventions targeting rural students’ FV intake to reduce waste.
ContributorsJepson, Molly Eilish (Author) / Bruening, Meg (Thesis advisor) / Adams, Marc (Committee member) / Grgich, Traci (Committee member) / Arizona State University (Publisher)
Created2021
Description
The ability to walk while completing a secondary task, dual-task walking (DTW), poses notable challenges for individuals affected by neurological disorders, such as multiple sclerosis (MS), who experience both cognitive and motor problems secondary to their disease. However, DTW is an everyday activity that has putative importance for optimal function. Although some research in the past decade has begun to examine changes in DTW in MS, there is still limited work to understand the predictors of DTW, the factors that might moderate relationships between baseline cognitive and motor function and DTW ability, and its consequences (e.g., for quality of life [QoL] or fall risk). To contribute to the understanding of these phenomena and their intersections, three secondary data analyses of two relatively large data sets in the area were conducted to address five major aims. The first step was to identify of the most relevant of these inherently involved domains (cognitive [aim 1] and motor [aim 2] abilities). Lasso regression for inference was performed to address this question for both cognitive (South Shore Neurologic Associates, PC data) and motor (University of Kansas Medical Center [KUMC] data) domains. Next, evaluations to explore the moderating role of the psychological impacts that are common in MS (e.g., depression and falls self-efficacy) were undertaken to determine whether the relationships between cognitive and motor function and DTW ability are different for individuals with different levels of these factors using regression with factor scores performed with each data set (aim 3). As a final step, relationships between DTW and distal outcomes like QoL (cross-sectionally using both data sets and factor score regression; aim 4) and falls (cross-sectionally and longitudinally using KUMC data and negative binomial regression; aim 5). These studies contribute to the corpus of knowledge about DTW in MS in needed ways.
ContributorsVan Liew, Charles (Author) / Peterson, Daniel S (Thesis advisor) / Ofori, Edward (Committee member) / Der Ananian, Cheryl (Committee member) / McNeish, Daniel (Committee member) / Dibble, Leland (Committee member) / Arizona State University (Publisher)
Created2021