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Meditation app usage is associated with decreases in stress, anxiety, and depression symptoms. Many meditation app subscribers, however, quickly abandon or reduce their app usage. This dissertation presents three manuscripts which 1) determined the behavioral, demographic, and socioeconomic factors associated with the abandonment of a meditation app, Calm, during the

Meditation app usage is associated with decreases in stress, anxiety, and depression symptoms. Many meditation app subscribers, however, quickly abandon or reduce their app usage. This dissertation presents three manuscripts which 1) determined the behavioral, demographic, and socioeconomic factors associated with the abandonment of a meditation app, Calm, during the COVID-19 pandemic, 2) determined which participant characteristics predicted meditation app usage in the first eight weeks after subscribing, and 3) determined if changes in stress, anxiety, and depressive symptoms from baseline to Week 8 predicted meditation app usage from Weeks 8-16. In Manuscript 1, a survey was distributed to Calm subscribers in March 2020 that assessed meditation app behavior and meditation habit strength, and demographic information. Cox proportional hazards regression models were estimated to assess time to app abandonment. In Manuscript 2, new Calm subscribers completed a baseline survey on participants’ demographic and baseline mental health information and app usage data were collected over 8 weeks. In Manuscript 3, new Calm subscribers completed a baseline and Week 8 survey on demographic and mental health information. App usage data were collected over 16 weeks. Regression models were used to assess app usage for Manuscripts 2 and 3. Findings from Manuscript 1 suggest meditating after an existing routine decreased risk of app abandonment for pre-pandemic subscribers and for pandemic subscribers. Additionally, meditating “whenever I can” decreased risk of abandonment among pandemic subscribers. No behavioral factors were significant predictors of app abandonment among the long-term subscribers. Findings from Manuscript 2 suggest men had more days of meditation than women. Mental health diagnosis increased average daily meditation minutes. Intrinsic motivation for meditation increased the likelihood of completing any meditation session, more days with meditation sessions, and more average daily meditation minutes. Findings from Manuscript 3 suggest improvements in stress increased average daily meditation minutes. Improvements in depressive symptoms decreased daily meditation minutes. Evidence from this three-manuscript dissertation suggests meditation cue, time of day, motivation, symptom changes, and demographic and socioeconomic variables may be used to predict meditation app usage.
ContributorsSullivan, Mariah (Author) / Stecher, Chad (Thesis advisor) / Huberty, Jennifer (Committee member) / Buman, Matthew (Committee member) / Larkey, Linda (Committee member) / Chung, Yunro (Committee member) / Arizona State University (Publisher)
Created2022
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Description
Young adult collegiate women, particularly students with adverse childhood experiences (ACEs) and who have experienced intimate partner violence (IPV) victimization, report a myriad of adverse mental health and academic difficulties. Practicing yoga has demonstrated promising findings among adults as a healing modality in the aftermath of interpersonal violence victimization and

Young adult collegiate women, particularly students with adverse childhood experiences (ACEs) and who have experienced intimate partner violence (IPV) victimization, report a myriad of adverse mental health and academic difficulties. Practicing yoga has demonstrated promising findings among adults as a healing modality in the aftermath of interpersonal violence victimization and traumatization. Less known are the associations between collegiate women’s yoga participation and their mental health, body connection, and academic well-being examined through a yoga feminist- trauma conceptual framework. Among young adult collegiate women, this study examined (1) associations amongst socio-demographics, mental health service use, IPV types, and yoga participation (2) the strength and direction of associations on measures of ACEs, mental health, body connection, and academic well-being, (3) whether yoga participation predicted students’ mental health, body connection, and academic well-being after controlling for confounding variables, including ACEs and IPV victimization, and (4) whether socio-demographics, mental health service use, ACEs, and IPV types predicted yoga participation. This study was observational, cross-sectional, and gathered self-report quantitative data. Eligible participants were current collegiate women enrolled at an urban, public university in the southwestern United States who were 18 to 24 years of age. The main sub-sample (n = 93) included students who were ever in an intimate relationship and practiced yoga within the past year. IRB approval was obtained. Findings demonstrated that yoga participation was not a significant predictor of students’ mental health, body connection, or academic well-being. Socio-demographics, mental health service use, ACEs, and IPV did not predict yoga participation. However, women with greater ACEs fared worse on measures of mental health (i.e., depression and post-traumatic stress disorder symptoms), and women with experiences of IPV harassment reported greater post-traumatic stress disorder symptoms. Further, employed women reported fewer depression symptoms and were less likely to experience emotional IPV. Lastly, students with greater body connection (more awareness) fared better academically. This research supports prior literature on the adverse mental health outcomes among young adult collegiate women with histories of interpersonal violence. Further examination is warranted into employment and body connection, particularly related to yoga, as protective factors of students' health, safety, and academic well-being.
ContributorsKappas Mazzio, Andrea Alexa (Author) / Messing, Jill T (Thesis advisor) / Mendoza, Natasha (Committee member) / Huberty, Jennifer (Committee member) / Arizona State University (Publisher)
Created2022
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Description
Transorbital surgery has gained recent notoriety due to its incorporation into endoscopic skull base surgery. The body of published literature on the field is cadaveric and observation. The pre-clinical studies are focused on the use of the endoscope only. Furthermore the methodology utilised in the published literature is inconsistent and

Transorbital surgery has gained recent notoriety due to its incorporation into endoscopic skull base surgery. The body of published literature on the field is cadaveric and observation. The pre-clinical studies are focused on the use of the endoscope only. Furthermore the methodology utilised in the published literature is inconsistent and does not embody the optimal principles of scientific experimentation. This body of work evaluates a minimally invasive novel surgical corridor - the transorbital approach - its validity in neurosurgical practice, as well as both qualitatively and quantitatively assessing available technological advances in a robust experimental fashion. While the endoscope is an established means of visualisation used in clinical transorbital surgery, the microscope has never been assessed with respect to the transorbital approach. This question is investigated here and the anatomical and surgical benefits and limitations of microscopic visualisation demonstrated. The comparative studies provide increased knowledge on specifics pertinent to neurosurgeons and other skull base specialists when planning pre-operatively, such as pathology location, involved anatomical structures, instrument maneuvrability and the advantages and disadvantages of the distinct visualisation technologies. This is all with the intention of selecting the most suitable surgical approach and technology, specific to the patient, pathology and anatomy, so as to perform the best surgical procedure. The research findings illustrated in this body of work are diverse, reproducible and applicable. The transorbital surgical corridor has substantive potential for access to the anterior cranial fossa and specific surgical target structures. The neuroquantitative metrics investigated confirm the utility and benefits specific to the respective visualisation technologies i.e. the endoscope and microscope. The most appropriate setting wherein the approach should be used is also discussed. The transorbital corridor has impressive potential, can utilise all available technological advances, promotes multi-disciplinary co-operation and learning amongst clinicians and ultimately, is a means of improving operative patient care.
ContributorsHoulihan, Lena Mary (Author) / Preul, Mark C. (Thesis advisor) / Vernon, Brent (Thesis advisor) / O' Sullivan, Michael G.J. (Committee member) / Lawton, Michael T. (Committee member) / Santarelli, Griffin (Committee member) / Smith, Brian (Committee member) / Arizona State University (Publisher)
Created2021
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A description of numerical and analytical work pertaining to models that describe the growth and progression of glioblastoma multiforme (GBM), an aggressive form of primary brain cancer. Two reaction-diffusion models are used: the Fisher-Kolmogorov-Petrovsky-Piskunov equation and a 2-population model that divides the tumor into actively proliferating and quiescent (or necrotic)

A description of numerical and analytical work pertaining to models that describe the growth and progression of glioblastoma multiforme (GBM), an aggressive form of primary brain cancer. Two reaction-diffusion models are used: the Fisher-Kolmogorov-Petrovsky-Piskunov equation and a 2-population model that divides the tumor into actively proliferating and quiescent (or necrotic) cells. The numerical portion of this work (chapter 2) focuses on simulating GBM expansion in patients undergoing treatment for recurrence of tumor following initial surgery. The models are simulated on 3-dimensional brain geometries derived from magnetic resonance imaging (MRI) scans provided by the Barrow Neurological Institute. The study consists of 17 clinical time intervals across 10 patients that have been followed in detail, each of whom shows significant progression of tumor over a period of 1 to 3 months on sequential follow up scans. A Taguchi sampling design is implemented to estimate the variability of the predicted tumors to using 144 different choices of model parameters. In 9 cases, model parameters can be identified such that the simulated tumor contains at least 40 percent of the volume of the observed tumor. In the analytical portion of the paper (chapters 3 and 4), a positively invariant region for our 2-population model is identified. Then, a rigorous derivation of the critical patch size associated with the model is performed. The critical patch (KISS) size is the minimum habitat size needed for a population to survive in a region. Habitats larger than the critical patch size allow a population to persist, while smaller habitats lead to extinction. The critical patch size of the 2-population model is consistent with that of the Fisher-Kolmogorov-Petrovsky-Piskunov equation, one of the first reaction-diffusion models proposed for GBM. The critical patch size may indicate that GBM tumors have a minimum size depending on the location in the brain. A theoretical relationship between the size of a GBM tumor at steady-state and its maximum cell density is also derived, which has potential applications for patient-specific parameter estimation based on magnetic resonance imaging data.
ContributorsHarris, Duane C. (Author) / Kuang, Yang (Thesis advisor) / Kostelich, Eric J. (Thesis advisor) / Preul, Mark C. (Committee member) / Crook, Sharon (Committee member) / Gardner, Carl (Committee member) / Arizona State University (Publisher)
Created2023
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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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Background: Although childhood engagement in physical activity has received growing attention, most children still do not meet the recommended daily 60 minutes of moderate to vigorous physical activity [MVPA]. Children of ethnic minorities are less likely to meet the guidelines. Interventions have been implemented in various settings to increase child

Background: Although childhood engagement in physical activity has received growing attention, most children still do not meet the recommended daily 60 minutes of moderate to vigorous physical activity [MVPA]. Children of ethnic minorities are less likely to meet the guidelines. Interventions have been implemented in various settings to increase child physical activity levels, yet these efforts have not yielded consistent results. The purpose of this study was to assess the preliminary effects of a community-based intervention on light physical activity and MVPA among 6-11 year old children. Methods: The present study was part of a larger study called Athletes for Life [AFL], a family-based, nutrition-education and physical activity intervention. The present study focused on physical activity data from the first completed cohort of participants (n=29). This study was a randomized control trial in which participating children were randomized into a control (n=14) or intervention (n=15) group. Participants wore accelerometers at two time points. Intervention strategies were incorporated to increase child habitual physical activity. Analyses of covariance were performed to test for post 12-week differences between both groups on the average minutes of light physical activity and MVPA minutes per day.

Results: The accelerometer data demonstrated no significant difference in light physical activity or MVPA mean minutes per day between the groups. Few children reported engaging in activities sufficient for meeting the physical activity guidelines outside the AFL program. Of the 119 total distributed child physical activity tracker sheets (7 per family), 55 were returned. Of the 55 returned physical activity tracker sheets, parents reported engaging in physical activity with their children only 7 times outside of the program over seven weeks.

Conclusion: The combined intervention strategies implemented throughout the 12-week study did not appear to be effective at increasing habitual mean minutes per day spent engaging in light and MVPA among children beyond the directed program. Methodological limitations and low adherence to intervention strategies may partially explain these findings. Further research is needed to test successful strategies within community programs to increase habitual light physical activity and MVPA among 6-11 year old children.
ContributorsQuezada, Blanca (Author) / Crespo, Noe (Thesis advisor) / Huberty, Jennifer (Committee member) / Vega-Lopez, Sonia (Committee member) / Arizona State University (Publisher)
Created2015
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Pitchers are a vital part of the game of baseball and may account for up to two-thirds of the variance in win percentage. As they rise through the ranks of competition, physical skill set becomes less of a factor when compared to mentality. Pitchers are the “first line of defense”

Pitchers are a vital part of the game of baseball and may account for up to two-thirds of the variance in win percentage. As they rise through the ranks of competition, physical skill set becomes less of a factor when compared to mentality. Pitchers are the “first line of defense” for keeping opponents from having an opportunity to score, as well as for holding onto their own team’s lead. Baseball pitchers not only face pressure to perform, but also experience stress from factors such as low pay, adjusting to higher levels of competition, and internal team competition for a limited number of spots. Athletes are often resistant to seeking aid from sport psychologists and often turn to unfavorable means to cope (i.e. drugs/alcohol, excessive exercise) with stress instead. Meditation has been shown to have beneficial effects on psychological factors associated with performance including emotional regulation, anxiety, confidence, focus, and mindfulness. Mobile applications have become a popular means of delivering mindfulness. The purpose of this study was to determine the feasibility and preliminary effectiveness of delivering a mindful meditation intervention using a mobile meditation application to improve psychological factors associated with performance (i.e. emotional regulation, anxiety (somatic and cognitive), confidence, focus, mindfulness) to minor league baseball pitchers. Pitchers in instructional league (Phase one) and off season (Phase two) were asked to meditate daily for 10-minutes each day for three weeks (Phase one) and eight weeks (Phase two). Pitchers were asked to complete self-report questionnaires and satisfaction surveys at pre- and post-intervention. Pitchers in phase one reported enjoying meditation, had improvements in self-confidence and sport confidence, and reported moderate decreases in cognitive anxiety and concentration disruption. Pitchers in phase two also enjoyed meditating (94.7%) and had improvements in self-confidence and moderate decreases in somatic anxiety. Low adherence due to timing (off-season) of intervention may have been a contributing factor to fewer outcomes. Future research should explore the feasibility and effectiveness of implementing meditation during the baseball season.
ContributorsDowling, Tiffany (Author) / Huberty, Jennifer (Thesis advisor) / Ransdell, Lynda (Committee member) / Buman, Matthew (Committee member) / Michel, Jesse (Committee member) / Arizona State University (Publisher)
Created2018
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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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Physical activity, sedentary behaviors, and sleep are often associated with cardiometabolic biomarkers commonly found in metabolic syndrome. These relationships are well studied, and yet there are still questions on how each activity may affect cardiometabolic biomarkers. The objective of this study was to examine data from the BeWell24 studies to

Physical activity, sedentary behaviors, and sleep are often associated with cardiometabolic biomarkers commonly found in metabolic syndrome. These relationships are well studied, and yet there are still questions on how each activity may affect cardiometabolic biomarkers. The objective of this study was to examine data from the BeWell24 studies to evaluate the relationship between objectively measured physical activity and sedentary behaviors and cardiometabolic biomarkers in middle age adults, while also determining if sleep quality and duration mediates this relationship. A group of inactive participants (N = 29, age = 52.1 ± 8.1 years, 38% female) with increased risk for cardiometabolic disease were recruited to participate in BeWell24, a trial testing the impact of a lifestyle-based, multicomponent smartphone application targeting sleep, sedentary, and more active behaviors. During baseline, interim (4 weeks), and posttest visits (8 weeks), biomarker measurements were collected for weight (kg), waist circumference (cm), glucose (mg/dl), insulin (uU/ml), lipids (mg/dl), diastolic and systolic blood pressures (mm Hg), and C reactive protein (mg/L). Participants wore validated wrist and thigh sensors for one week intervals at each time point to measure sedentary behavior, physical activity, and sleep outcomes. Long bouts of sitting time (>30 min) significantly affected triglycerides (beta = .15 (±.07), p<.03); however, no significant mediation effects for sleep quality or duration were present. No other direct effects were observed between physical activity measurements and cardiometabolic biomarkers. The findings of this study suggest that reductions in long bouts of sitting time may support reductions in triglycerides, yet these effects were not mediated by sleep-related improvements.
ContributorsLanich, Boyd (Author) / Buman, Matthew (Thesis advisor) / Ainsworth, Barbara (Committee member) / Huberty, Jennifer (Committee member) / Arizona State University (Publisher)
Created2017
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Introduction: Less than half of U.S. adults meet the aerobic physical activity guidelines to exercise at least 150 minutes a week. An individual's decision to be physically active is influenced by their perceptions of physical activity. To address perceptions, interventions need to be implemented where adults spend one third of

Introduction: Less than half of U.S. adults meet the aerobic physical activity guidelines to exercise at least 150 minutes a week. An individual's decision to be physically active is influenced by their perceptions of physical activity. To address perceptions, interventions need to be implemented where adults spend one third of their day; the workplace. A number of physical activity interventions have been conducted and few have been successful at improving physical activity; therefore, there is a need to explore novel approaches to improve physical activity in the worksite. The purpose of this pilot study was to examine the impact of a seven-day gratitude intervention on perceptions of physical activity and happiness in the workplace. Methods: Full-time employees at two worksites participated in a seven-day online journaling study. Participants were randomized into the intervention (gratitude) or control group and were assessed for perceptions of physical activity and happiness at baseline, immediate post-test (day 7) and one-week follow-up (day 14). Results: Results of this study indicate that the seven-day gratitude intervention may not significantly improve perceptions of physical activity or increase happiness. Future research should consider assessing the individual's readiness for change at baseline, increasing the length of the intervention, testing participant level of gratitude at baseline and employing a larger sample size.
ContributorsRowedder, Lacey (Author) / Huberty, Jennifer (Thesis advisor) / Chisum, Jack (Committee member) / Lee, Chong (Committee member) / Arizona State University (Publisher)
Created2014