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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
Accumulating evidence implicates exposure to adverse childhood experiences in the development of hypocortisolism in the long-term, and researchers are increasingly examining individual-level mechanisms that may underlie, exacerbate or attenuate this relation among at-risk populations. The current study takes a developmentally and theoretically informed approach to examining episodic childhood stressors, inherent

Accumulating evidence implicates exposure to adverse childhood experiences in the development of hypocortisolism in the long-term, and researchers are increasingly examining individual-level mechanisms that may underlie, exacerbate or attenuate this relation among at-risk populations. The current study takes a developmentally and theoretically informed approach to examining episodic childhood stressors, inherent and voluntary self-regulation, and physiological reactivity among a longitudinal sample of youth who experienced parental divorce. Participants were drawn from a larger randomized controlled trial of a preventive intervention for children of divorce between the ages of 9 and 12. The current sample included 159 young adults (mean age = 25.5 years; 53% male; 94% Caucasian) who participated in six waves of data collection, including a 15-year follow-up study. Participants reported on exposure to negative life events (four times over a 9-month period) during childhood, and mothers rated child temperament. Six years later, youth reported on the use of active and avoidant coping strategies, and 15 years later, they participated in a standardized psychosocial stress task and provided salivary cortisol samples prior to and following the task. Path analyses within a structural equation framework revealed that a multiple mediation model best fit the data. It was found that children with better mother-rated self-regulation (i.e. low impulsivity, low negative emotionality, and high attentional focus) exhibited lower total cortisol output 15 years later. In addition, greater self-regulation in childhood predicted greater use of active coping in adolescence, whereas a greater number of negative life events predicted increased use of avoidant coping in adolescence. Finally, a greater number of negative events in childhood predicted marginally lower total cortisol output, and higher levels of active coping in adolescence were associated with greater total cortisol output in young adulthood. Findings suggest that children of divorce who exhibit better self-regulation evidence lower cortisol output during a standardized psychosocial stress task relative to those who have higher impulsivity, lower attentional focus, and/or higher negative emotionality. The conceptual significance of the current findings, including the lack of evidence for hypothesized relations, methodological issues that arose, and issues in need of future research are discussed.
ContributorsHagan, Melissa (Author) / Luecken, Linda (Thesis advisor) / MacKinnon, David (Committee member) / Wolchik, Sharlene (Committee member) / Doane, Leah (Committee member) / Arizona State University (Publisher)
Created2013
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Description
In order to analyze data from an instrument administered at multiple time points it is a common practice to form composites of the items at each wave and to fit a longitudinal model to the composites. The advantage of using composites of items is that smaller sample sizes are required

In order to analyze data from an instrument administered at multiple time points it is a common practice to form composites of the items at each wave and to fit a longitudinal model to the composites. The advantage of using composites of items is that smaller sample sizes are required in contrast to second order models that include the measurement and the structural relationships among the variables. However, the use of composites assumes that longitudinal measurement invariance holds; that is, it is assumed that that the relationships among the items and the latent variables remain constant over time. Previous studies conducted on latent growth models (LGM) have shown that when longitudinal metric invariance is violated, the parameter estimates are biased and that mistaken conclusions about growth can be made. The purpose of the current study was to examine the impact of non-invariant loadings and non-invariant intercepts on two longitudinal models: the LGM and the autoregressive quasi-simplex model (AR quasi-simplex). A second purpose was to determine if there are conditions in which researchers can reach adequate conclusions about stability and growth even in the presence of violations of invariance. A Monte Carlo simulation study was conducted to achieve the purposes. The method consisted of generating items under a linear curve of factors model (COFM) or under the AR quasi-simplex. Composites of the items were formed at each time point and analyzed with a linear LGM or an AR quasi-simplex model. The results showed that AR quasi-simplex model yielded biased path coefficients only in the conditions with large violations of invariance. The fit of the AR quasi-simplex was not affected by violations of invariance. In general, the growth parameter estimates of the LGM were biased under violations of invariance. Further, in the presence of non-invariant loadings the rejection rates of the hypothesis of linear growth increased as the proportion of non-invariant items and as the magnitude of violations of invariance increased. A discussion of the results and limitations of the study are provided as well as general recommendations.
ContributorsOlivera-Aguilar, Margarita (Author) / Millsap, Roger E. (Thesis advisor) / Levy, Roy (Committee member) / MacKinnon, David (Committee member) / West, Stephen G. (Committee member) / Arizona State University (Publisher)
Created2013
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Description
Heart failure is a major worldwide health concern and is the leading cause of hospitalization among elderly Americans. Approximately 50% of those diagnosed with heart failure have heart failure with preserved ejection fraction (HFPEF). HFPEF presents a therapeutic dilemma because pharmacological strategies that are effective for the treatment of heart

Heart failure is a major worldwide health concern and is the leading cause of hospitalization among elderly Americans. Approximately 50% of those diagnosed with heart failure have heart failure with preserved ejection fraction (HFPEF). HFPEF presents a therapeutic dilemma because pharmacological strategies that are effective for the treatment of heart failure and reduced ejection fraction have failed to show benefit in HFPEF. Long term moderate intensity exercise programs have been shown to improve diastolic function in patients HFPEF. High intensity interval training (HIIT) has been shown to improve diastolic function in patients with heart failure and reduced ejection fraction. However, the effects of high intensity interval training in patients with HFPEF are unknown. Fourteen patients with HFPEF were randomized to either: (1) a novel program of high-intensity aerobic interval training (n = 8), or (2) a commonly prescribed program of moderate-intensity (MOD) aerobic exercise training (n = 6). Before and after four weeks of exercise training, patients underwent a treadmill graded exercise test for the determination of peak oxygen uptake (VO2peak), a brachial artery reactivity test for assessment of endothelium-dependent flow-mediated dilation (BAFMD), aortic pulse wave velocity assessment as an index of vascular stiffness and two-dimensional echocardiography for assessment of left ventricular diastolic and systolic function. I hypothesized that (1) high-intensity aerobic interval training would result in superior improvements in FMD, aortic pulse wave velocity, VO2peak, diastolic function and, (2) changes in these parameters would be correlated with changes in VO2peak. The principal findings of the study were that a one month long high intensity interval training program resulted in significant improvements in diastolic function as measured by two-dimensional echocardiography [pre diastolic dysfunction (DD) grade - 2.13 + 0.4 vs. post DD grade - 1.25 + 0.7, p = 0.03]. The left atrial volume index was reduced in the HIIT group compared to MOD ( - 4.4 + 6.2 ml/m2 vs. 5.8 + 10.7 ml/m2, p = 0.02). Early mitral flow (E) improved in the HIIT group (pre - 0.93 + 0.2 m/s vs. post - 0.78 + 0.3 m/s, p = 0.03). A significant inverse correlation was observed between change in BAFMD and change in diastolic dysfunction grade (r = - 0.585, p = 0.028) when all the data were pooled. HIIT appears to be a time-efficient and safe strategy for improving diastolic function in patients with heart failure and preserved ejection fraction. These data may have implications for cardiovascular risk reduction in this population.
ContributorsAngadi, Siddhartha (Author) / Gaesser, Glenn A (Thesis advisor) / Mookadam, Farouk (Committee member) / Swan, Pamela (Committee member) / Vega-Lopez, Sonia (Committee member) / Lee, Chong (Committee member) / Arizona State University (Publisher)
Created2012
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Description
Research shows that general parenting practices (e.g., support and discipline), influence adolescent substance use. However, socialization theory suggests that parental socialization occurs not only through general parenting practices, but also through parents' attempts to influence specific behaviors and values. A growing literature supports links between substance-specific parenting and adolescent substance

Research shows that general parenting practices (e.g., support and discipline), influence adolescent substance use. However, socialization theory suggests that parental socialization occurs not only through general parenting practices, but also through parents' attempts to influence specific behaviors and values. A growing literature supports links between substance-specific parenting and adolescent substance use. For adolescent alcohol use, there are considerable limitations and gaps within this literature. To address these limitations, the present study examined the factor structure of alcohol-specific parenting, investigated the determinants of alcohol-specific parenting, and explored its association with nondrinking adolescents' attitudes about alcohol use. Using a high-risk sample of nondrinking adolescents and their parents, the current study found three dimensions of alcohol-specific parenting using both adolescent and parent reports, but also found evidence of non-invariance across reporters. Results also revealed complex roles of parental alcohol use disorder (AUD; including recovered and current AUD), family history of AUD, and current drinking as determinants of the three dimensions of anti-alcohol parenting behaviors. Moreover, the current study showed that the effects of these determinants varied by the reporter of the parenting behavior. Finally, the current study found the dimensions of alcohol-specific parenting to be unique and significant predictors of nondrinking adolescents' attitudes about alcohol, over and above general parenting practices, parent AUD, and parent current drinking. Given its demonstrated distinctness from general parenting practices, its link with adolescent alcohol attitudes, and its potential malleability, alcohol-specific parenting may be an important complement to interventions targeting parents of adolescents.
ContributorsHandley, Elizabeth D (Author) / Chassin, Laurie (Thesis advisor) / MacKinnon, David (Committee member) / Crnic, Keith (Committee member) / Sandler, Irwin (Committee member) / Arizona State University (Publisher)
Created2012
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Description
With an excessive amount of resources in the United States healthcare system being spent on the treatment of diseases that are largely preventable through lifestyle change, the need for successful physical activity interventions is apparent. Unfortunately an individual's physical activity and health goals are often not supported by the social

With an excessive amount of resources in the United States healthcare system being spent on the treatment of diseases that are largely preventable through lifestyle change, the need for successful physical activity interventions is apparent. Unfortunately an individual's physical activity and health goals are often not supported by the social context of their daily lives. This single-case design study, Walking Intervention through Text messaging for CoHabiting individuals (WalkIT CoHab), looks at the efficacy of a text based adaptive physical activity intervention to promote walking over a three month period and the effects of social support in intervention performance in three pairs of cohabiting pairs of individuals (n=6). Mean step increase from baseline to intervention ranged from 1300 to 3000 steps per day for all individuals, an average 45.87% increase in physical activity. Goal attainment during the intervention ranged from 43.96% to 71.43%, meaning all participants exceeded the 40% success rate predicted by 60th percentile goals. Social support scores for study partners, unlike social support scores for family and friends, were often in the high social support range and had a moderate increase from pre to post visits for most participants. Although there was variation amongst participants, there was a high correlation in physical activity trends and successful goal attainment in each pair of participants. Less ambitious percentile goals and more personalized motivational text messages might be beneficial to some participants. An extended intervention, something the majority of participants expressed interest in, would further support the efficacy of this behavioral intervention and allow for possible long term benefits of social support in the intervention to be investigated.
ContributorsFernandez, Jacqueline Alyssa (Author) / Adams, Marc (Thesis director) / Angadi, Siddhartha (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2015-05
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Description
Walking interventions focused on increasing step counts are typically associated with salutary effects on glycemia, fasting insulin, insulin resistance and blood lipids which may be in turn associated with improvements in cardiorespiratory fitness (peak oxygen uptake – VO2peak) and vascular stiffness. We hypothesized that a novel 4-month, behavioral economics-based walking

Walking interventions focused on increasing step counts are typically associated with salutary effects on glycemia, fasting insulin, insulin resistance and blood lipids which may be in turn associated with improvements in cardiorespiratory fitness (peak oxygen uptake – VO2peak) and vascular stiffness. We hypothesized that a novel 4-month, behavioral economics-based walking intervention would have favorable effects on glucose homeostasis and blood lipids and that these in turn would be related to VO2peak and vascular stiffness (carotid femoral pulse wave velocity – cfPWV).

We carried out secondary analyses on a subsample of sedentary, overweight/obese adults who participated in a 4-month, 2x2, randomized-controlled walking intervention examining the effects of goal setting (static v. adaptive goals) and rewards (immediate v. delayed) on steps/day (N=96). Fasting blood samples (n=58) were collected from participants before and after the intervention. Premenopausal females were in the follicular phase of their menstrual cycles. Lipid and glucose levels were measured using an automated chemistry analyzer, while insulin was measured using radio-immunoassay. Homeostatic model of insulin resistance (HOMA-IR) was calculated using the following formula (HOMA-IR=glucose x insulin / 405). We examined associations [partial correlations (adjusted for age)] between changes in blood biomarkers and VO2peak and cfPWV, irrespective of group, and we used linear mixed models to examine between-group differences in levels of and change in biomarker outcomes.

Groups did not differ in overall levels of, or degree of change in, biomarker outcomes (all p>0.05). Mean changes, irrespective of group, in biomarkers were as follows: glucose Δ= 0.74± 4.5mg/dl; insulin Δ= 0.09 ± 4.1 µU/ml; total cholesterol Δ= 0.24 ± 20.6 mg/dl; HDL-C Δ= 0.27 ± 5.1 mg/dl; LDL-C Δ= 1.3 ± 19.9 mg/dl; triglycerides Δ= 1.7 ± 27.2 mg/dl; HOMA-IR Δ = -.0548 ± 1.05). We found no significant associations between change in biomarker levels and change in VO2peak or change in cfPWV (all correlation coefficients < 0.15; p > 0.05).

A 4-month, behavioral economics-based mHealth intervention focused on increasing steps/day did not bring about favorable changes on markers of glycemia, insulin resistance and blood lipids.
ContributorsHook, Benjamin E. (Author) / Angadi, Siddhartha (Thesis director) / Gaesser, Glenn (Committee member) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
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Description
An increasingly sedentary population in the United States, specifically with adolescents, is putting youth at risk of future health related trauma and disease. This single-case design study, Walking Intervention Through Text Messaging for Adolescents (WalkIT-A), was used to intervene with a 12-year old, physically inactive male, in an attempt to

An increasingly sedentary population in the United States, specifically with adolescents, is putting youth at risk of future health related trauma and disease. This single-case design study, Walking Intervention Through Text Messaging for Adolescents (WalkIT-A), was used to intervene with a 12-year old, physically inactive male, in an attempt to test the efficacy of a 12-week physical activity program that may help reduce health risks by increasing number of steps walked per day. The components of the intervention consisted of a FitBit Zip pedometer, physical activity education, text messages, monetary incentives, and goal setting that adapted personally to the participant. Mean step count increased by 30% from baseline (mean = 3603 [sd = 1983]) to intervention (mean = 4693 [sd = 2112]); then increased slightly by 6.7% from intervention to withdrawal (mean = 5009 [sd = 2152]). Mean "very active minutes" increased by 45% from baseline (mean = 8.8 [sd = 8.9]) to intervention (mean = 12.8 [sd = 9.6]); then increased by 61.7% from intervention to withdrawal (mean = 20.7 [sd = 8.4]). Weight, BMI, and blood pressure all increased modestly from pre to post. Cardiovascular fitness (estimated VO2 max) improved by 12.5% from pre (25.5ml*kg-1*min-1) to post (28.7ml*kg-1*min-1). The intervention appeared to have a delayed and residual effect on the participant's daily steps and very active minutes. Although the idealistic ABA pattern did not occur, and the participant did not meet the target of 11,500 daily steps, a positive trend toward that target behavior in the latter 1/3rd of the intervention was observed. Results suggest the need for an extended intervention over a longer period of time and customized even further to the participant.
ContributorsLamb, Nicholas Reid (Author) / Adams, Marc (Thesis director) / Ainsworth, Barbara (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2014-12
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Description
Background: Cardiovascular disease (CVD) is the leading cause of mortality in the United States and remains a great public health challenge. Unhealthy lifestyle behaviors (e.g., unhealthy diet, sedentary behavior, cigarette smoking, and obesity) are associated with a greater risk of incident CVD and all-cause mortality. From the prevention strategy, maintaining

Background: Cardiovascular disease (CVD) is the leading cause of mortality in the United States and remains a great public health challenge. Unhealthy lifestyle behaviors (e.g., unhealthy diet, sedentary behavior, cigarette smoking, and obesity) are associated with a greater risk of incident CVD and all-cause mortality. From the prevention strategy, maintaining a healthy lifestyle throughout a lifetime is a key to CVD prevention. Nonetheless, the prevalence of healthy lifestyle behaviors in US communities is low as 3 to 5%. Moreover, the prevalence of a healthy population among college students remains unknown. Objective: We investigated the prevalence of healthy lifestyle behaviors among college students. Methods: We recruited 747 undergraduate students from Arizona State University using a survey questionnaire. The survey questionnaire investigated demographic characteristics, body mass index, dietary habits, physical activity habits, and smoking habits. The chi-square test was used to investigate the frequency of ideal lifestyle behaviors in college students. Results: Prevalence of students who met all 4 ideal health behaviors (ideal cardiovascular health) is very low at 7.6%. Approximately 55.7% of students had only 2 or less ideal lifestyle behaviors (poor cardiovascular health). In addition, there were no statistical differences in combined ideal lifestyle behaviors across gender and different years of undergraduate studies. Conclusion: College students had a very low prevalence of healthy lifestyle behaviors. Increasing healthy low-risk students throughout college education is an important strategy to prevent chronic disease morbidity and mortality at individual and population level.
ContributorsConway, Jason Michael (Author) / Lee, Chong (Thesis director) / Angadi, Siddhartha (Committee member) / Barrett, The Honors College (Contributor) / Department of Supply Chain Management (Contributor) / Economics Program in CLAS (Contributor) / School of Historical, Philosophical and Religious Studies (Contributor)
Created2015-05
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Description
The WalkIT Study is a mobile health study examining the efficacy of a four month text message-based intervention for increasing physical activity among 96 overweight adults. The purpose of this thesis is to examine the potency of the different types of motivational prompt-to-action text messages used in the WalkIT Study

The WalkIT Study is a mobile health study examining the efficacy of a four month text message-based intervention for increasing physical activity among 96 overweight adults. The purpose of this thesis is to examine the potency of the different types of motivational prompt-to-action text messages used in the WalkIT Study for increasing steps per day by examining the individual messages, creating qualitative themes and comparing themed groups, and evaluating the interaction between demographic subgroups and themed groups. A total of nine themes was created. The results found that Message 13, “It doesn't matter how old you are – it's never too early or too late to become physically active so start today; only then will you start to see results!”, had the highest median step count (7129 steps) and Message 71, “It's ok if you can't reach your goal today. Just push yourself more tomorrow.”, had the lowest median step count (5054 steps). For themes, the highest median step count (6640 steps) was found in Theme 6, Challenges, and the lowest median step count (5450 steps) was found in Theme 9, Unconditional Feedback. Theme 6 (Challenges) had the highest median step count for females, Theme 7 (Everyday Tips) had the highest median step count for males, Theme 4 (Nutrition) had the highest median step count for the 18-42 group, Theme 6 (Challenges) had the highest median step count for the 43-61 group, and Theme 9 (Unconditional Feedback) had the lowest median step count for both genders and both age groups. The results suggest the usefulness of analyzing the effectiveness of individual motivational text messages, themes, and the interaction between demographic groups and themes in physical activity interventions.
ContributorsBhuiyan, Nishat Anjum (Author) / Adams, Marc (Thesis director) / Ainsworth, Barbara (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2015-05