Matching Items (56)
Description
While type 2 diabetes (T2D) rates have soared, the number of Americans classified as ‘prediabetic’ has also increased. Despite this, current preventative approaches are costly and often not without undue side-effects. Instead, behavioral lifestyle approaches hold promise in reducing conversion rates of T2D as the latest treatment option that could mitigate and transform disease management. However, present interventions do not possess the scope necessary for implementation in a realistic, scalable way that can target the large at-risk population.
The application (app) “BeWell24” mitigates this diabetes risk through targeting sleep, physical activity, sedentary behavior, and diet, and is being delivered through mHealth technology to attenuate the higher-risk of the prediabetic Veteran population. In order for full scale dissemination, this thesis examines a provider perspective of the ‘Post-intervention interview guide’, performed with a Phoenix Veterans Affairs Health Care System (PVAHCS) provider. It then suggests revisions to the interview guide based on the provider’s interview and existing literature. This thesis also emphasizes the rationale behind these proposed changes to be organized in line with the iPARIHS framework (integrated Promoting Action on Research Implementation in Health Services).
Overall, the provider responded positively to BeWell24 and the ‘Post-intervention interview guide’, with constructive suggestions for each question in the interview guide. The main theme of the provider’s answers and comments were to prioritize efficiency and preserve standard clinical flow. A revised interview guide is provided, which prospectively presents as a more brief and focused interview organized by the iPARIHS framework. This revised interview guide could aid in the clarity of provider responses, specifically for the prospective interviews of the ongoing larger BeWell24 study and future studies.
The application (app) “BeWell24” mitigates this diabetes risk through targeting sleep, physical activity, sedentary behavior, and diet, and is being delivered through mHealth technology to attenuate the higher-risk of the prediabetic Veteran population. In order for full scale dissemination, this thesis examines a provider perspective of the ‘Post-intervention interview guide’, performed with a Phoenix Veterans Affairs Health Care System (PVAHCS) provider. It then suggests revisions to the interview guide based on the provider’s interview and existing literature. This thesis also emphasizes the rationale behind these proposed changes to be organized in line with the iPARIHS framework (integrated Promoting Action on Research Implementation in Health Services).
Overall, the provider responded positively to BeWell24 and the ‘Post-intervention interview guide’, with constructive suggestions for each question in the interview guide. The main theme of the provider’s answers and comments were to prioritize efficiency and preserve standard clinical flow. A revised interview guide is provided, which prospectively presents as a more brief and focused interview organized by the iPARIHS framework. This revised interview guide could aid in the clarity of provider responses, specifically for the prospective interviews of the ongoing larger BeWell24 study and future studies.
ContributorsWojtas, Abby Ann (Author) / Buman, Matthew (Thesis director) / Larouche, Miranda (Committee member) / Epstein, Dana (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
Mobile health or "mHealth" defines a broad spectrum of medical or public health practice supported by mobile devices. The patient's perception of mobile health applications is the key point in confronting whether or not patients will utilize the tools at their disposal As such, the primary aim of this study was to examine participant feedback through quantitative and qualitative measures using the Therapy Evaluation Questionnaire and a patient interview, respectively, to further understand the patient rated acceptability of using BeWell24 and SleepWell24 for improving health outcomes. For BeWell24, it was hypothesized that patients who received the Multicomponent version would report higher acceptability scores than those randomized to the Health Education version. Furthermore, in regard to SleepWell24, it was hypothesized that the SleepWell24 patient would provide positive feedback and suggestions regarding their own experience with the SleepWell24 app. Data from this thesis was pulled from two ongoing randomized controlled trials currently being conducted at the Phoenix Veteran Affairs Health Care Service (PVACHS) and Mayo Clinic hospitals. Means, standard deviations, frequencies, and percentages were commuted to summarize demographics and TEQ scores. In addition, key concepts from a qualitative interview with a SleepWell24 participant were derived. The results showed a greater acceptability of the multicomponent versions of BeWell24 and SleepWell24 but a lower TEQ score of perceived usability. mHealth implementations pose a potential to become an important part of the health sector for establishing innovative approaches to delivering care, and while benefits have been highly praised, it is clear that the perceptions of mHealth must be positive if the technology is to transcend into a practical clinical setting.
ContributorsJimenez, Asael (Author) / Buman, Matthew (Thesis director) / Epstein, Dana (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Sleep diaries and actigraphy are two common methods used to assess sleep subjectively and objectively, respectively. Compared to the gold standard of sleep assessment, polysomnography, sleep diaries and actigraphic methods are more cost-effective and simpler to use. This study aimed to compare the sleep parameters derived from actigraphy and sleep diaries (total sleep time, sleep onset latency, number of awakenings, wake after sleep onset, percentage of time awake, and sleep efficiency). Based on results from previous similar studies, it was hypothesized that the sleep diaries would overestimate the total sleep time parameter and underestimate wake parameters. Twenty healthy young adults without sleep problems volunteered to participate. The participants wore an Actiwatch 2 on their wrist and filled out a sleep diary every morning for the duration of six days. A high intraclass correlation coefficient value between subjective and objective sleep was found for the parameter total sleep time, even though total sleep time was found to be slightly overestimated by the sleep diaries. Sleep onset latency, wake after sleep onset, number of awakenings, percentage of time awake, and sleep efficiency were underestimated by the sleep diaries and did not have high correlation values. Based off of the ICC results, there does not seem to be a strong correlation between the Actiwatch 2 and the sleep diaries, but looking at the Bland Altman plots, there seems to be agreement between the methods.
ContributorsRameshkumar, Aarthi (Author) / Buman, Matthew (Thesis director) / Petrov, Megan (Committee member) / Diaz-Piedra, Carolina (Committee member) / School of Molecular Sciences (Contributor) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2016-12
Description
Recent research has confirmed and revealed many physical and mental benefits of yoga. The practice of yoga has spread throughout the western world, where it is widely used for the purpose of exercise and fitness. Due to its rise in popularity, there is a need for research regarding the energy expenditure required for different types of yoga. The majority of the literature cites yoga as being an effective exercise for light intensity activity, but there are not as many studies attempting to determine if there are postures and sequences that can meet the requirements for moderate physical activity. In addition, there is a need to validate mobile devices with which to measure energy expenditure (EE) that are compatible with the dynamic movements that occur during yoga. The purpose of this study was to measure energy expenditure of twenty-two yoga practitioners of varying experience during a 30-minute Vinyasa flow yoga practice and from this data collection determine: if an ashtanga-based vinyasa yoga class meets the criteria for moderate intensity physical activity, the reliability between the Actigraph and Oxycon Mobile and the validity of an Actigraph GT3X device worn on the hip in estimating energy expenditure for ashtanga-based vinyasa flow yoga. The Actigraph GT3X and the Oxycon mobile were used to measure energy expenditure. Mean values for energy expenditure recorded by the Oxycon and Actigraph were 3.19 ± 0.42 METs and 1.16 ± 0.23 METs respectively, exhibiting a significant difference in data collection. There was no correlation between the values recorded by the two devices, indicating that the Actigraph was not consistent with the Oxycon Mobile (previously validated for measurement of EE). Results of this study indicate that this Vinyasa flow yoga sequence does satisfy the criteria for moderate intensity physical activity as defined by ACSM with an average EE of 3.19 ± 0.42 METs, and that the Actigraph GT3X is not an accurate device for measurement of EE for yoga.
ContributorsHand, Lindsay Gabrielle (Author) / Huberty, Jennifer (Thesis director) / Buman, Matthew (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
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
Description
This dissertation research project developed as an urgent response to physical inactivity, which has resulted in increased rates of obesity, diabetes, and metabolic disease worldwide. Incorporating enough daily physical activity (PA) is challenging for most people. This research aims to modulate the brain's reward systems to increase motivation for PA and, thus, slow the rapid increase in sedentary lifestyles. Transcranial direct current stimulation (tDCS) involves brain neuromodulation by facilitating or inhibiting spontaneous neural activity. tDCS applied to the dorsolateral prefrontal cortex (DLPFC) increases dopamine release in the striatum, an area of the brain involved in the reward–motivation pathways. I propose that a repeated intervention, consisting of tDCS applied to the DLPFC followed by a short walking exercise stimulus, enhances motivation for PA and daily PA levels in healthy adults. Results showed that using tDCS followed by short-duration walking exercise may enhance daily PA levels in low-physically active participants but may not have similar effects on those with higher levels of daily PA. Moreover, there was a significant effect on increasing intrinsic motivation for PA in males, but there were no sex-related differences in PA. These effects were not observed during a 2-week follow-up period of the study after the intervention was discontinued. Further research is needed to confirm and continue exploring the effects of tDCS on motivation for PA in larger cohorts of sedentary populations. This novel research will lead to a cascade of new evidence-based technological applications that increase PA by employing approaches rooted in biology.
ContributorsRuiz Tejada, Anaissa (Author) / Katsanos, Christos (Thesis advisor) / Neisewander, Janet (Committee member) / Sadleir, Rosalind (Committee member) / Buman, Matthew (Committee member) / Arizona State University (Publisher)
Created2023
Description
The relationship between sleep and physical activity is an area of growing scientific interest, particularly in the context of older adults. The importance of examining long sleep duration and its influence on physical activity in this demographic becomes increasingly relevant given rising healthcare costs. This dissertation aims to investigate this intricate relationship via secondary analysis by examining the effects of moderate time-in-bed (TIB) restriction (60 minutes per night)) on various intensities of physical activity (sedentary, light, moderate, vigorous, moderate-vigorous physical activity) in older adults classified as long sleepers and average duration sleepers. It was hypothesized that moderate TIB restriction would result in differential changes in physical activity levels across various intensities, with long sleepers exhibiting increased physical activity and average sleepers displaying decreased activity, potentially influenced by alterations in TST (total sleep time) and SE (sleep efficiency). Utilizing a randomized controlled trial design, this study examined the effect of treatment changes in objectively measures activity (waist actigraphy) and subjects physical activity levels as measured by the Godin Leisure-Time Exercise Questionnaire . Eligible participants were long sleepers (sleeping > 9 hours per night) and average sleepers (sleeping 7-9 hours per night). Both types of sleepers were either randomized to TIB restriction or asked to maintain their average sleep patterns. Mean TIB restriction compared with baseline was 39.5 minutes in average sleepers and 52.9 minutes in long sleepers randomized to TIB restriction . Contrary to the original hypothesis, no significant effect of TIB restriction was observed across all physical activity levels in either long sleepers or average sleepers. However, a notable association was found between increased sleep efficiency (+0.09% [SD = ± 4.64%]) and light physical activity (±31 minutes [SD = ± 104.81, R=0.445, P < 0.007]) in long sleepers undergoing TIB restriction. While this study presents several methodological limitations, including its nature as a secondary analysis and the less-than-intended achievement of TIB restriction, it adds a valuable layer to the existing body of research on sleep and physical activity in older adults. The findings suggest that moderate TIB restriction may not be sufficiently impactful to change behavior in physical activity levels, thus highlighting the need for more nuanced, targeted research in this domain.
ContributorsPerry, Christopher (Author) / Youngstedt, Shawn D (Thesis advisor) / Petrov, Megan (Committee member) / Swan, Pamela (Committee member) / Buman, Matthew (Committee member) / Ringenbach, Shannon (Committee member) / Arizona State University (Publisher)
Created2023
Description
The purpose of this investigation was to evaluate the influence of tap water safety perceptions on plain water intake (PWI) and hydration status in US Latinx adults. Participants (n=492; age, 28±7 y; 37.4% female) completed an Adapted Survey of Water Issues in Arizona and household watersecurity experience-based scales. A sub-sample (n=55; age, 33±14 y; body mass index, 27.77±6.60 kg·m2) completed dietary recalls on two weekdays and one weekend day via Automated Self-Administered 24-hour Dietary Assessment Tool to determine average PWI and total water intake (TWI). A 24-h urine sample was collected on one recall day and analyzed for urine osmolality (UOsm). Binary logistic regression determined odds ratios (OR) for the odds of perceiving tap water to be unsafe. Hierarchical linear regression was employed with 24-h UOsm and PWI as primary outcomes for the sub-sample. Overall, 51.2% of all participants and 52.7% of the sub-sample mistrust their tap water safety. The odds of mistrusting tap water were significantly greater (P<0.05) for each additional favorable perception of bottled over tap water (OR=1.94, 95% CI=1.50, 2.50), each additional negative home tap water experience (OR=1.32, 95% CI=1.12, 1.56), each additional use of alternatives and/or modifications to home tap water (OR=1.25, 95% CI=1.04, 1.51), and decreased water quality and acceptability (OR=1.21, 95% CI=1.01, 1.45). The odds of mistrusting tap water were significantly lower (P<0.05) for those whose primary source of drinking water is the public supply (municipal) (OR=0.07, 95% CI=0.01, 0.63) and for those with decreased water access (OR=0.56, 95% CI=0.48, 0.66). There were no differences (n=55, P>0.05) in TWI (2,678±1,139 mL), PWI (1,357±971), or 24-h UOsm (460±234 mosm·kg-1). Tap water safety perceptions did not significantly explain variance in PWI or 24-h UOsm (P > 0.05). In conclusion, Latinx mistrust in tap water safety is prevalent. Mistrust appears to be influenced by organoleptic perceptions and to lead to reliance on alternatives to the home drinking water system. Perceptions of tap water safety do not appear to be related to PWI, TWI, or hydration status in Latinx adults.
ContributorsColburn, Abigail (Author) / Kavouras, Stavros (Thesis advisor) / Buman, Matthew (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Vega-Lopez, Sonia (Committee member) / Wutich, Amber (Committee member) / Arizona State University (Publisher)
Created2022
Description
The research shows that existing interventions that attempt to reduce sedentary behavior are effective. The purposes of this review were to examine: (1) how adherent individuals are to workplace sedentary behavior interventions in the short and long term and (2) how the use of incentives impact adherence in the short and long term. It was found that short-term studies showed higher rates of adherence than medium-term studies. Studies that used incentives showed lower rates of adherence than studies that did not use incentives. Medium-term studies that used incentives showed the same rates of adherence as short-term studies that used incentives, indicating that incentives can benefit adherence in longer term interventions.
ContributorsLitevsky, Gabriella (Author) / Buman, Matthew (Thesis director) / Leonard, Krista (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2022-05
Description
High fiber diets have been associated with improved cardiometabolic health with specific efforts to lower circulating levels of low-density lipoprotein (LDL cholesterol). Whole grain and grain-based foods are major contributors of dietary fiber in the American diet, of which wheat has been extensively studied. Corn, however, has not been well studied for its cholesterol-lowering properties. Further, the mechanisms by which grains improve cardiometabolic health require further exploration with regard to the human microbiome. The objective of this single-blind randomized controlled, crossover trial was to assess the impact of three different corn flours (whole grain, refined, and bran-enhanced refined flour mixture) on serum LDL cholesterol and the gut microbiota diversity and composition. Twenty-three participants were recruited, between the ages of 18-70 with hypercholesterolemia (Male = 10, Female = 13, LDL >120 mg/dL) who were not taking any cholesterol-lowering medications. Participants consumed each flour mixture for 4 weeks prepared as muffins and pita breads. At the beginning and end of each 4-week period serum for cholesterol assessment, anthropometrics, and stool samples were obtained. Serum cholesterol was assessed using a clinical analyzer. Stool samples were processed, and microbial DNA extracted and sequenced based on the 16S rRNA gene. A generalized linear model demonstrated a significant treatment effect (p=0.016) on LDL cholesterol and explained a majority of the variance (R-squared= 0.89). Post hoc tests revealed bran-enhanced refined flour had a significant effect on cholesterol in comparison to whole grain flour (p=0.001). No statistically significant differences were observed for gut microbial community composition (Jaccard and weighted Unifrac) after corn consumption. However, relative abundance analysis (LEfSE) identified Mycobacterium celatum (p=0.048 FDR=0.975) as a potential marker of post-corn consumption with this microbe being differentially less abundant following bran-enhanced flour treatment. These data suggest that corn flour consumption may be beneficial for individuals with hypercholesterolemia but the role of gut microbiota in this relationship requires further exploration, especially given the small sample size. Further research and analysis of a fully powered cohort is needed to more accurately describe the associations and potential mechanisms of corn-derived dietary fiber on circulating LDL cholesterol and the gut microbiota.
ContributorsWilson, Shannon L (Author) / Whisner, Corrie M (Thesis advisor) / Sears, Dorothy (Committee member) / Buman, Matthew (Committee member) / Dickinson, Jared (Committee member) / Zhu, Qiyun (Committee member) / Arizona State University (Publisher)
Created2022