Matching Items (29)
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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:

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.
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
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Description

This study aimed to investigate the effects of specific macronutrient feedings on competitive golf performance and perceived levels of fatigue and alertness. Participants played three, nine hole rounds of golf, consuming an isocaloric beverage as a control (CON), with the addition of carbohydrate (CHO), or combination of protein and carbohydrate

This study aimed to investigate the effects of specific macronutrient feedings on competitive golf performance and perceived levels of fatigue and alertness. Participants played three, nine hole rounds of golf, consuming an isocaloric beverage as a control (CON), with the addition of carbohydrate (CHO), or combination of protein and carbohydrate (COM). Physiological and performance measurements were taken before, during, and following each nine hole round. Performance measurements include driving accuracy (DA), driving distance (DD), iron accuracy (IA), chipping accuracy (CA), and putting accuracy (PA). Pre-golf hydration status (urine specific gravity [USG]) and Sweat Rate during golf performance showed no significant differences between trials. All nine hole rounds were performed in ~2 hours. Environmental conditions were similar for all three testing days (mean WBGT=10.946). No significant differences were seen in Driving Distance, Driving Accuracy, and Iron Accuracy for all nine holes between groups receiving different macronutrient feedings. Chipping Accuracy was significantly better in CON trial compared to CHO (p=0.004) and COM (p=0.019). No significant differences were seen in putting make percentages. COM trial significantly lowered Perceived Levels of Fatigue (p=0.019) compared to CON. The CHO trial showed significant improvements in DA compared to CON (13.7 vs. 44.1, p=0.012) and COM (13.7 vs. 33.6, p=0.004) in the first four holes. In the last five holes, the COM trial showed significant improvements in DA compared to CHO (17.5 vs. 29.7, p=0.007). Low Handicap golfers (3 +/- 3) performed significantly better than High Handicap golfers (14 +/- 3.6) in DD (265 vs. 241, p<0.001), DA (15.0 vs. 29.3, p=0.004), IA (15.2 vs. 25.2, p<0.001), CA (52.0 vs. 61.5, p=0.027), and PA 5ft (64% vs. 40%, p=0.003). High Handicap players showed no significant differences between the three trials for any golf performance measurements. Low Handicap players showed significant improvements in DA for COM trial compared to CON trial (13.6 vs. 27.6, p=0.003). The results suggest that carbohydrates at the start and a combination of carbohydrate and protein is beneficial at the second part of 9 holes to improve golf performance and maintain levels of fatigue, however, it needs to be investigated how this knowledge will relate to playing more holes.

ContributorsThompsett, Daniel James (Author) / Wardenaar, Floris (Thesis advisor) / Der Ananian, Cheryl (Committee member) / Hondula, David M. (Committee member) / Arizona State University (Publisher)
Created2020
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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.

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
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Description
The health benefits of sufficient moderate-to-vigorous physical activity (MVPA) and sleep arewell-supported, with established links to decreased cancer risk, cardiometabolic health, all-cause mortality, and psychiatric symptomatology—including stress-related phenomena—for those who engage in 150 min MVPA/week and get at least 7 hours sleep/night. The latter outcome has rapidly become a major

The health benefits of sufficient moderate-to-vigorous physical activity (MVPA) and sleep arewell-supported, with established links to decreased cancer risk, cardiometabolic health, all-cause mortality, and psychiatric symptomatology—including stress-related phenomena—for those who engage in 150 min MVPA/week and get at least 7 hours sleep/night. The latter outcome has rapidly become a major public health concern as our nation grapples with the impact of prolonged COVID-19 pandemic stress, which has triggered an onslaught of depression, anxiety, and PTSD throughout the population. Thus, while strategies to decrease stress are desperately needed, many Americans fall short of the very MVPA and sleep recommendations that have been shown to increase their capacity to cope. The purpose of the present study was to explore time-varying associations of MVPA and sleep with momentary perceived stress in adults forced to work from home due to the COVID-19 pandemic. Thirty remote-working adults (86.7% women; mean age 37.5 years, SD = 10.4 years) wore GENEActiv accelerometers on the wrist to capture MVPA and sleep data, and answered four Ecological Momentary Assessments (EMAs) per day regarding perceived stress, for fourteen days straight. Between- and within-person variations in MVPA, sleep quality rating (SQR), total sleep time (TST), and sleep efficiency (SE) were analyzed via multilevel models to determine whether certain changes in these parameters might lead to decreased perceived momentary stress. Between-person models revealed a significant negative effect of SQR on perceived stress levels the next day, beta= -.651, SE= .303, P= .04. Mean MVPA, TST, and SE were not significant inter-individual predictors of momentary stress. However, within persons, higher than normal MVPA (beta= -.005, SE= .002, P= .015), SQR (beta= -.277, SE= .071, P <.001), TST (beta= -.001, SE= .000, P = .004), and SE (beta= -.524, SE= .242, P = .031) were all associated with significant decreases in momentary stress, with individuals experiencing incremental benefits with each additional minute of MVPA and TST. In conclusion, daily fluctuations in MVPA and sleep habits correlate more strongly with momentary stress than do typical levels of these behaviors; this presents an attainable strategy for individuals to enhance their capacity to cope.
ContributorsLyons, Rachel Crosley (Author) / Buman, Matthew P (Thesis advisor) / Der Ananian, Cheryl (Committee member) / McCracken, Kasondra (Committee member) / Arizona State University (Publisher)
Created2021
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Description
This study examines cognitive and motor function in typical older adults following acute exercise. Ten older adults (Mage = 65.1) completed a single session of assisted cycling (AC) (i.e., exercise accomplished through the use of a motor), voluntary cycling (VC) (self-selected cadence), and a no cycling (NC) control group.

This study examines cognitive and motor function in typical older adults following acute exercise. Ten older adults (Mage = 65.1) completed a single session of assisted cycling (AC) (i.e., exercise accomplished through the use of a motor), voluntary cycling (VC) (self-selected cadence), and a no cycling (NC) control group. These sessions were randomized and separated by approximately one week. Both ACT and VC groups rode a stationary bicycle for 30-minutes each session. These sessions were separated by at least two days. Participants completed cognitive testing that assessed information processing and set shifting and motor testing including gross and fine motor performance at the beginning and at the end of each session. Consistent with our hypothesis concerning manual dexterity, the results showed that manual dexterity improved following the ACT session more than the VC or NC sessions. Improvements in set shifting were also found for the ACT session but not for the VC or NC sessions. The results are interpreted with respect to improvements in neurological function in older adults following acute cycling exercise. These improvements are balance, manual dexterity, and set shifting which have a positive effects on activities of daily living; such as, decrease risk of falls, improve movements like eating and handwriting, and increase ability to multitask.
ContributorsSemken, Keith (Author) / Ringenbach, Shannon (Thesis advisor) / Der Ananian, Cheryl (Committee member) / Buman, Matthew (Committee member) / Arizona State University (Publisher)
Created2015
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Description
Food insecurity is an economic and social condition involving limited or uncertain access to food. The problem of food insecurity in communities is influenced by economic conditions, food deserts, and barriers to accessing healthy food. Individuals experiencing food insecurity often endure concurrent problems of financial instability, hunger, and poor mental

Food insecurity is an economic and social condition involving limited or uncertain access to food. The problem of food insecurity in communities is influenced by economic conditions, food deserts, and barriers to accessing healthy food. Individuals experiencing food insecurity often endure concurrent problems of financial instability, hunger, and poor mental and physical health. Public and non-profit services in the U.S., such as the federally supported Supplemental Nutrition Assistance Program (SNAP) and community food banks, provide food-related assistance to individuals who are at a high risk of experiencing food insecurity. Unfortunately, many individuals who qualify for these services still experience food insecurity due to barriers preventing them from accessing food, which may include inadequate finances, transportation, skills, and information. Effective approaches for removing barriers that prevent individuals from accessing food are needed to mitigate the increased risk of hunger, nutritional deficiencies, and chronic disease among vulnerable populations. This dissertation tested a novel food insecurity intervention using informational nudges to promote food security through the elimination of information barriers to accessing food. The intervention used in this mixed-methods feasibility study consisted of informational nudges in the form of weekly text messages that were sent to food pantry clients experiencing food insecurity. The study aims were to test the efficacy and acceptability of the intervention by examining whether the informational nudges could enhance food pantry utilization, increase SNAP registration, and promote food security. Quantitative study results showed a lower prevalence of food insecurity in the intervention group than the control group. Qualitative findings revealed how the intervention group found the text messages to be helpful and informative. These study findings can enhance future food insecurity interventions aiming to eliminate barriers that prevent individuals who are food insecure from accessing healthy food.
ContributorsRoyer, Michael F. (Author) / Wharton, Christopher (Thesis advisor) / Buman, Matthew (Committee member) / Der Ananian, Cheryl (Committee member) / MacKinnon, David (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Arizona State University (Publisher)
Created2023
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Description
Physical inactivity is a continuing public health crisis because of its negative effects on health (e.g. hypertension, cardiovascular disease, type II diabetes). To combat the rising prevalence of these non-communicable diseases, physical activity (PA) promotion is a public health priority. However, current programs seem to be ineffective in the long-term

Physical inactivity is a continuing public health crisis because of its negative effects on health (e.g. hypertension, cardiovascular disease, type II diabetes). To combat the rising prevalence of these non-communicable diseases, physical activity (PA) promotion is a public health priority. However, current programs seem to be ineffective in the long-term promotion of PA. Resultingly new, effective interventions are needed. Recent studies have established a link between mindfulness and PA engagement. Based on the current literature, the present study sought to investigate the associations between trait mindfulness, behavioral regulation towards exercise, exercise intention, stress, and self-reported PA. This study also examined whether trait mindfulness was independently associated with meeting weekly, leisure-time, moderate-to-vigorous PA [MVPA] recommendations in university undergraduate students after controlling for demographic characteristics, past PA experience, exercise intention, stress, and motivation.

The study used a cross-sectional design and participants consisted of 180 undergraduate university students (aged 18 to 24 years). Participants completed a one-time survey that assessed demographic characteristics, trait mindfulness, behavioral regulation toward exercise, exercise intention, perceived stress and PA. Bivariate associations between the variables were assessed with Pearson or Spearman correlations. A logistic regression analysis was conducted to determine which variables were independently associated with meeting weekly, leisure-time MVPA guidelines. Results of this study found weak positive associations between the mindfulness domain of acceptance and leisure time MVPA ( = .168, p < .05), no associations between mindfulness and transportation PA, and negative associations between mindfulness (MAAS,  = –.238, p < .01; acceptance,  = –.175, p < .05) and sitting time. Results of logistic regression found that only relative autonomy (OR = 1.085, 95% CI [1.008, 1.168], p = .030) and intention (OR = 2.193, 95% CI [1.533, 3.138], p < .0001) were independently associated with meeting weekly, leisure- time MVPA recommendations. The results of this study show that while there is only a weak direct relationship between trait mindfulness and PA, mindfulness may be related with other factors associated with PA. More research is needed in order to better understand the potential mechanisms behind the results found in this, and past, studies.
ContributorsNapolitano, Vinson (Author) / Der Ananian, Cheryl (Thesis advisor) / Sebren, Ann (Committee member) / Ainsworth, Barbara (Committee member) / Arizona State University (Publisher)
Created2019
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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

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
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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

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