Matching Items (15)
Description
A core principle in multiple national quality improvement strategies is the engagement of chronically ill patients in the creation and execution of their treatment plans. Numerous initiatives are underway to use health information technology (HIT) to support patient engagement however the use of HIT and other factors such as health literacy may be significant barriers to engagement for older adults. This qualitative descriptive study sought to explore the ways that older adults with multi-morbidities engaged with their plan of care. Forty participants were recruited through multiple case sampling from two ambulatory cardiology practices. Participants were English-speaking, without a dementia-related diagnosis, and between the ages of 65 and 86. The older adults in this study performed many behaviors to engage in the plan of care, including acting in ways to support health, managing health-related information, attending routine visits with their doctors, and participating in treatment planning. A subset of patients engaged in active decision-making because of the point they were at in their chronic disease. At that cross roads, they expressed uncertainly over which road to travel. Two factors influenced the engagement of older adults: a relationship with the provider that met the patient's needs, and the distribution of a Meaningful Use clinical summary at the conclusion of the provider visit. Participants described the ways in which the clinical summary helped and hindered their understanding of the care plan.
Insights gained as a result of this study include an understanding of the discrepancies between what the healthcare system expects of patients and their actual behavior when it comes to the creation of a care plan and the ways in which they take care of their health. Further research should examine the ability of various factors to enhance patient engagement. For example, it may be useful to focus on ways to improve the clinical summary to enhance engagement with the care plan and meet standards for a health literate document. Recommendations for the improvement of the clinical summary are provided. Finally, this study explored potential reasons for the infrequent use of online health information by older adults including the trusting relationship they enjoyed with their cardiologist.
Insights gained as a result of this study include an understanding of the discrepancies between what the healthcare system expects of patients and their actual behavior when it comes to the creation of a care plan and the ways in which they take care of their health. Further research should examine the ability of various factors to enhance patient engagement. For example, it may be useful to focus on ways to improve the clinical summary to enhance engagement with the care plan and meet standards for a health literate document. Recommendations for the improvement of the clinical summary are provided. Finally, this study explored potential reasons for the infrequent use of online health information by older adults including the trusting relationship they enjoyed with their cardiologist.
ContributorsJiggins Colorafi, Karen (Author) / Lamb, Gerri (Thesis advisor) / Marek, Karen (Committee member) / Greenes, Robert (Committee member) / Evans, Bronwynne (Committee member) / Arizona State University (Publisher)
Created2015
Description
This body of research sought to explore relationships between parenting practices, physical activity resources, and Hispanic children’s physical activity. Guided by the Family Ecological Model (FEM) and the Ecological Model of Physical Activity (EMPA) this study examined the influence of parents on children’s physical activity through an integrative review. A cross sectional study was conducted to investigate potential relationships between parental perception safety at school, gender, and children’s physical activity. A cross sectional study was also utilized to examine potential correlations between parenting practices, physical activity resources, and children’s physical activity. Parental role modeling of physical activity and parental support for physical activity emerged as parenting practices that have considerable potential to impact children’s physical activity. Gender differences among children’s physical activity were also a key finding of this study with boys participating in more physical activity than boys. While quality of physical activity resources did not have significant associations with parenting practices or children’s physical activity, more research is needed to determine how resources for physical activity may impact parenting practices, and children’s physical activity.
ContributorsHutchens, Amy (Author) / Lee, Rebecca E (Thesis advisor) / Todd, Michael (Committee member) / Lyles, Ann Marie (Committee member) / Holtzclaw, Barbara (Committee member) / Arizona State University (Publisher)
Created2017
Description
This paper will use a national cross-sectional survey approach to look at the association between trainable mind-body qualities (mindfulness and self-compassion) with well-being and resilience in 111 college students across the U.S.. Specifically, it will investigate (1) the relationship between trainable qualities (mindfulness, self-compassion) and the resilience, and subjective well-being in students, and (2) compare how these variables were distributed based on enrollment in a college course on compassion. After examination of descriptive statistics and Pearson correlations, comparative analyses were also employed to determine whether enrollment in compassion college courses had any relationship to one’s scores. Results: Respondents included 12 students enrolled in Compassion college course, and 99 students who were not. Both mindfulness and self-compassion showed significant positive correlations with well-being and resilience in all students, and in subgroups based on enrollment at p < .01. Additionally, students enrolled in the course averaged 3 points higher scores across all measures except resilience, where scores were about the same. Conclusions: In all college students, regardless of their enrollment in Compassion, well-being and resilience are positively correlated with both mindfulness and self-compassion. Furthermore, scores based on enrollment in “Compassion” yielded higher levels of mindfulness, self-compassion, resilience, and well-being.
ContributorsBrown, Evaline (Author) / Pipe, Teri (Thesis director) / Gueci, Nika (Committee member) / Jimenez, Manuela (Committee member) / Sanford School of Social and Family Dynamics (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
This body of research sought to explore relationships between cognitive function and physical activity (PA), sedentary behavior (SB), and sleep, independently and in conjunction, in mid-life to older adults with no known cognitive impairment. Aging is associated with cognitive decline, and lifestyle behaviors such as PA, SB, and sleep, may mitigate this decline. First, a systematic review and meta-analysis was conducted to examine the effect of aerobic PA interventions on memory and executive function in sedentary adults. Second, a longitudinal study was conducted to examine the association between SB and odds of incident cognitive impairment, and SB and cognitive decline in older adults. Last, a cross-sectional study was conducted to examine the joint associations between different levels of sleep with levels of PA, and sleep with levels of sedentary time on memory and executive function. This body of research provided evidence to support the association between aerobic PA and improved cognitive function, SB and incident cognitive impairment and cognitive function declines, and the joint association of sleep and different levels of PA and ST on cognitive function by hypertension status.
ContributorsHoffmann, Nicole M (Author) / Lee, Rebecca E (Thesis advisor) / Petrov, Megan E (Thesis advisor) / Marek, Karen (Committee member) / Arizona State University (Publisher)
Created2020
Description
Through three investigations, this dissertation examined properties of the family and early care and education center (ECEC) environments related to preschool-aged children’s cardiovascular fitness (CVF) and gross locomotor skills (GLS). Investigation one used a systematic review and meta-analysis to synthesize the effectiveness of school-based interventions at improving CVF, in preschool-aged children. For investigations two and three product- and process-based measures of GLS were collected from children in ECECs (n=16), using the progressive aerobic cardiovascular endurance run (PACER; n=144) and the CHAMPS motor skill protocol (CMSP; n=91), respectively. Investigation two and three examined family factors and ECEC factors for associations with measures of GLS, respectively.
Investigation one revealed a moderate-to-large effect size for school-based interventions (n=10) increasing CVF (g=0.75; 95%CI [0.40-1.11]). Multi-level interventions (g=.79 [0.34-1.25]) were more effective than interventions focused on the individual (g=0.67 [0.12-1.22]). In investigations two and three children (78.3% Hispanic; mean ± SD age 53.2±4.5 months) completed a mean ± SD 3.7±2.3 PACER laps and 19.0±5.5 CSMP criteria. Individual and family factors associated with PACER laps included child sex (B=-0.96, p=0.03) and age (B=0.17, p<0.01), parents’ promotion of inactivity (B=0.66, p=0.08) and screen time (B=0.65, p=0.05), and parents’ concern for child’s safety during physical activity (B=-0.36, p=0.09). Child age (B=0.47, p<0.01) and parent employment (B=2.29, p=0.07) were associated with CMSP criteria. At the ECEC level, policy environment quality (B=-0.17; p=0.01) was significantly associated with number of PACER laps completed. Outdoor play environment quality (B=0.18; p=0.03), outdoor play equipment total (B=0.32; p<0.01) and screen time environment quality (B=0.60; p=0.02) were significantly associated with CMSP criteria. Researchers, ECEC teachers and policy makers should promote positive environmental changes to preschool-aged children’s family and ECEC environments, as these environments have the potential to improve CVF and GLS more than programs focused on the child alone.
Investigation one revealed a moderate-to-large effect size for school-based interventions (n=10) increasing CVF (g=0.75; 95%CI [0.40-1.11]). Multi-level interventions (g=.79 [0.34-1.25]) were more effective than interventions focused on the individual (g=0.67 [0.12-1.22]). In investigations two and three children (78.3% Hispanic; mean ± SD age 53.2±4.5 months) completed a mean ± SD 3.7±2.3 PACER laps and 19.0±5.5 CSMP criteria. Individual and family factors associated with PACER laps included child sex (B=-0.96, p=0.03) and age (B=0.17, p<0.01), parents’ promotion of inactivity (B=0.66, p=0.08) and screen time (B=0.65, p=0.05), and parents’ concern for child’s safety during physical activity (B=-0.36, p=0.09). Child age (B=0.47, p<0.01) and parent employment (B=2.29, p=0.07) were associated with CMSP criteria. At the ECEC level, policy environment quality (B=-0.17; p=0.01) was significantly associated with number of PACER laps completed. Outdoor play environment quality (B=0.18; p=0.03), outdoor play equipment total (B=0.32; p<0.01) and screen time environment quality (B=0.60; p=0.02) were significantly associated with CMSP criteria. Researchers, ECEC teachers and policy makers should promote positive environmental changes to preschool-aged children’s family and ECEC environments, as these environments have the potential to improve CVF and GLS more than programs focused on the child alone.
ContributorsSzeszulski, Jacob (Author) / Lee, Rebecca E (Thesis advisor) / Buman, Matthew P (Committee member) / Hooker, Steven P (Committee member) / Vega-Lopez, Sonia (Committee member) / Shaibi, Gabriel Q (Committee member) / Arizona State University (Publisher)
Created2019
Description
In past decades, adverse childhood experiences (ACEs) rapidly gained attentionas a public health crisis due to dose-response relationships with a range of health and
social problems, and early mortality. Converging studies show that ACEs are a pandemic
in the general population of the United States—even in middle to upper-middle class
families that are considered to be ‘better off’. There have been collaborative efforts in
public health to target root-causes of childhood adversity and increase resilient
adaptation in individuals and families at risk. Due to the importance of fostering positive
adaptation in the midst of adversity, this dissertation sought to examine both
vulnerability and protective factors in children’s proximal ecology—e.g., parents and
caring adults at school. A population-based study in this dissertation revealed that
parents’ emotional well-being, measured as negative feelings toward parenting, greatly
influences developing children, so as support and resources for parenting. The presence
of caring adults as a protective factor in teens with highly competitive settings—a newly
identified at-risk group due to high pressure to achieve and internalizing/externalizing
problems. Lastly, this dissertation discusses conceptual and methodological limitations
in current ways of measuring ACEs and provide future directions for research, practice,
and policy. Suggestions include frequent assessments on reaching consensus on how to
define ACEs, expanding the concept of ACEs, considering the duration, timing, and
severity of the event. Healthcare professionals have important roles in public health;
they incorporate frequent assessments on parents’ emotional wellbeing and needs for
parenting as a part of care. Ongoing support from multiple disciplines is necessary to
reduce the impact of ACEs and strengthen resilience development of children and
families.
ContributorsSuh, Bin (Author) / Luthar, Suniya (Thesis advisor) / Pipe, Teri (Thesis advisor) / Castro, Felipe (Committee member) / Arizona State University (Publisher)
Created2022
Description
This dissertation studied the feasibility and acceptability of Through Alzheimer's Eyes, an easy-to-access psychoeducational and skill-building intervention that incorporates information and communication technologies (ICT) that can help to prepare caregivers of persons with Alzheimer’s and related dementias to improve communication skills and manage behavioral issues. Using a Modular Dissertation format, the dissertation includes three manuscripts covering the intervention underpinnings, results, and environmental impact. The first manuscript describes the rationale, protocol, and design of the intervention Through Alzheimer's Eyes. The second manuscript explores the feasibility and acceptability of study results from a mixed-methods approach. The third manuscript offers the impact of a virtual intervention on carbon emissions and potential savings for caregivers of people with dementia. Together, the three manuscripts describe the intervention design, results, and future directions for research and practice.
ContributorsGómez Morales, Abigail (Author) / Coon, David W (Thesis advisor) / Pipe, Teri (Committee member) / Joseph, Rodney P (Committee member) / Arizona State University (Publisher)
Created2022
Description
This descriptive research used social network analysis to explore the influence of relationships and communication among hospital nursing (RN, LPN, CNA) and discharge planning staff on adherence to evidence-based practices (EBP) for reducing preventable hospital readmissions. Although previous studies have shown that nurses are a valued source of research information for each other, there have been few studies concerning the role that staff relationships and communication play in adherence to evidence-based practice. The investigator developed the Relational Model of Communication and Adherence to EBP from diffusion of innovation theory, social network theories, relational coordination theory, and quality improvement literature.
The study sample consisted of 10 adult-medical surgical units, five home care agencies and six long-term care facilities. A total of 273 hospital nursing and discharge planning staff and 69 post-acute staff participated. Hospital staff completed a survey about communication patterns for patient care and patient discharge and about communication quality on the unit. Hospital and post-acute care staff completed surveys about relationship quality and demographic characteristics. Evidence-based practice adherence rates for risk assessment, medication reconciliation, and discharge summary were measured as documented in the electronic medical record.
Social network analysis was used to analyze the communication patterns for patient care communication at the unit. These findings were correlated with (1) aggregate responses for communication quality, (2) aggregate responses for relationship quality, and (3) EBP adherence. Statistically significant relationships were found between communication patterns, and communication quality and relationship quality. There were
ii
two significant relationships between communication quality, and EBP adherence. Limitations in response rates and missing data prevented the analysis of all of the hypothesized relationships.
The findings from this study provide empirical support for the role of social networks and relationships among staff in adoption of, and adherence to, EBP. Social network theory and social network analysis, especially the concept of knowledge sharing, provide ways to understand and leverage the influence of peer relationships. Future studies are needed to better understand the contribution that relationships among staff (social networks) have in the adoption of and adherence to EBP among nursing staff. Further model development and multilevel studies are
The study sample consisted of 10 adult-medical surgical units, five home care agencies and six long-term care facilities. A total of 273 hospital nursing and discharge planning staff and 69 post-acute staff participated. Hospital staff completed a survey about communication patterns for patient care and patient discharge and about communication quality on the unit. Hospital and post-acute care staff completed surveys about relationship quality and demographic characteristics. Evidence-based practice adherence rates for risk assessment, medication reconciliation, and discharge summary were measured as documented in the electronic medical record.
Social network analysis was used to analyze the communication patterns for patient care communication at the unit. These findings were correlated with (1) aggregate responses for communication quality, (2) aggregate responses for relationship quality, and (3) EBP adherence. Statistically significant relationships were found between communication patterns, and communication quality and relationship quality. There were
ii
two significant relationships between communication quality, and EBP adherence. Limitations in response rates and missing data prevented the analysis of all of the hypothesized relationships.
The findings from this study provide empirical support for the role of social networks and relationships among staff in adoption of, and adherence to, EBP. Social network theory and social network analysis, especially the concept of knowledge sharing, provide ways to understand and leverage the influence of peer relationships. Future studies are needed to better understand the contribution that relationships among staff (social networks) have in the adoption of and adherence to EBP among nursing staff. Further model development and multilevel studies are
ContributorsSolomons, Nan M (Author) / Lamb, Gerri (Thesis advisor) / Verran, Joyce (Committee member) / Marek, Karen (Committee member) / Arizona State University (Publisher)
Created2016
Description
Background – Among influential education reports, there is clear consensus that an expansive range of intrapersonal (e.g. self-regulation) and interpersonal competencies (e.g. empathy) highly influence educational and career success. Research on teaching and learning these competencies is limited in engineering education.
Purpose/Hypothesis – This dissertation study explores the impacts of a mindfulness training program on first-year engineering students and aims to understand potential impacts on the development of intrapersonal and interpersonal competencies.
Design/Method – A four-session mindfulness-based training program was designed, developed, and facilitated to cultivate intrapersonal and interpersonal competencies. This study employed a multiphase mixed method design in which quantitative and qualitative data was collected from a total of 35 different students through a post survey (n=31), 3-month follow-up survey (n=29), and interviews (n=18). t-tests were used to evaluate the statistical significance of the program and a rigorous thematic analysis process was utilized to help explain the quantitative data.
Results – The results suggest that the majority of students became more mindful, which led to improved intrapersonal competencies (i.e. self-management, critical-thinking, focus, resilience, and well-being) and interpersonal competencies (i.e. empathy, communication, teamwork, and leadership).
Discussion / Conclusions – The study provides compelling evidence that mindfulness training can support the development of intrapersonal and interpersonal skills among engineering students, which can support their overall academic experience, as well as personal and professional development. Future design and development work will be needed to evaluate the integration and scalability potential of mindfulness training within engineering programs.
Purpose/Hypothesis – This dissertation study explores the impacts of a mindfulness training program on first-year engineering students and aims to understand potential impacts on the development of intrapersonal and interpersonal competencies.
Design/Method – A four-session mindfulness-based training program was designed, developed, and facilitated to cultivate intrapersonal and interpersonal competencies. This study employed a multiphase mixed method design in which quantitative and qualitative data was collected from a total of 35 different students through a post survey (n=31), 3-month follow-up survey (n=29), and interviews (n=18). t-tests were used to evaluate the statistical significance of the program and a rigorous thematic analysis process was utilized to help explain the quantitative data.
Results – The results suggest that the majority of students became more mindful, which led to improved intrapersonal competencies (i.e. self-management, critical-thinking, focus, resilience, and well-being) and interpersonal competencies (i.e. empathy, communication, teamwork, and leadership).
Discussion / Conclusions – The study provides compelling evidence that mindfulness training can support the development of intrapersonal and interpersonal skills among engineering students, which can support their overall academic experience, as well as personal and professional development. Future design and development work will be needed to evaluate the integration and scalability potential of mindfulness training within engineering programs.
ContributorsHuerta, Mark Vincent (Author) / McKenna, Anna (Thesis advisor) / Pipe, Teri (Committee member) / Carberry, Adam (Committee member) / Arizona State University (Publisher)
Created2019
Description
This dissertation was guided by the Ecological Model of Physical Activity and Ecological Model of Obesity and sought to determine the relationship between active transportation (AT), physical activity, and cardiometabolic health among adults and ethnic minority women. Chapter 2 presents an investigation into the relationship between walking for AT and cardiometabolic health among adults through systematic review. Chapter 3 presents an exploration of the cross-sectional relationships of AT and moderate-to-vigorous physical activity (MVPA) with cardiometabolic health among African American (AA) and Hispanic/Latina (HL) women from Texas. Chapter 4 presents an investigation into the cross-sectional relationship of AT on cardiometabolic health and physical activity among primarily HL women.
In Chapter 2, walking for AT was found to be related to smaller waist circumference, lower blood pressure, and lower prevalence of abdominal obesity and hypertension, and that differences may exist based on sex. Walking for AT was not clearly defined, and criteria used to determine the presence of cardiometabolic outcomes were inconsistent. No significant relationships between AT and cardiometabolic health were found in Chapter 3 or 4; however, AT users had slightly better cardiometabolic health. AT users had significantly higher levels of self-reported total physical activity compared to those who did not use AT in Chapter 3. Furthermore, a significant relationship was found between MVPA and diastolic blood pressure. Associations differed by ethnicity, with MVPA being inversely related to body fat in both AA and HL women, but to body mass index only in AA women. AT users were found to be seven times more likely to meet 2018 national MVPA recommendations than non-AT users in Chapter 4. Across all studies, measures of AT were subjective and of low quality, potentially limiting the ability to detect significant findings.
High quality randomized controlled studies should be conducted using clearly defined, objective measures of AT, and analyzed based on sex and race/ethnicity. Clinicians should recommend AT use to promote meeting MVPA recommendations where appropriate, potentially resulting in improved cardiometabolic health. Policymakers should advocate for changes to the built environment to encourage AT use and MVPA to improve public health.
In Chapter 2, walking for AT was found to be related to smaller waist circumference, lower blood pressure, and lower prevalence of abdominal obesity and hypertension, and that differences may exist based on sex. Walking for AT was not clearly defined, and criteria used to determine the presence of cardiometabolic outcomes were inconsistent. No significant relationships between AT and cardiometabolic health were found in Chapter 3 or 4; however, AT users had slightly better cardiometabolic health. AT users had significantly higher levels of self-reported total physical activity compared to those who did not use AT in Chapter 3. Furthermore, a significant relationship was found between MVPA and diastolic blood pressure. Associations differed by ethnicity, with MVPA being inversely related to body fat in both AA and HL women, but to body mass index only in AA women. AT users were found to be seven times more likely to meet 2018 national MVPA recommendations than non-AT users in Chapter 4. Across all studies, measures of AT were subjective and of low quality, potentially limiting the ability to detect significant findings.
High quality randomized controlled studies should be conducted using clearly defined, objective measures of AT, and analyzed based on sex and race/ethnicity. Clinicians should recommend AT use to promote meeting MVPA recommendations where appropriate, potentially resulting in improved cardiometabolic health. Policymakers should advocate for changes to the built environment to encourage AT use and MVPA to improve public health.
ContributorsLorenzo, Elizabeth (Author) / Lee, Rebecca E (Thesis advisor) / Todd, Michael (Committee member) / Shin, Cha-Nam (Committee member) / Arizona State University (Publisher)
Created2019