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- Member of: ASU Electronic Theses and Dissertations
Description
Type 2 diabetes mellitus (T2DM) is a chronic disease affecting more than ten percent of the U.S. adults. Approximately 50 percent of people with diabetes fail to achieve glycemic targets of A1C levels below seven percent. Poor glycemic control disproportionately affects minority populations such as Korean Americans (KAs). Successful diabetes self-management requires a comprehensive approach that takes into account depression, sleep, and acculturation to achieve good glycemic control. Therefore, the purposes of this study were to: 1) describe the levels of glycemic control, depressive symptoms, sleep quality and duration, and acculturation; 2) examine an association of depressive symptoms with glycemic control; 3) identify mediational roles of sleep quality and sleep duration of less than 6 hours between depressive symptoms and glycemic control; and 4) explore a moderation role of acculturation between depressive symptoms and glycemic control in KAs with T2DM. This is a cross-sectional, descriptive correlational study. A total of 119 first generation KAs with T2DM were recruited from Korean communities in Arizona. A1C levels, the Center for Epidemiological Studies Depression Scale, the Pittsburgh Sleep Quality Index, the Suinn-Lew Asian Self-Identity Acculturation scale, the International Physical Activity Questionnaire, and the Berlin Questionnaire were measured. Descriptive statistics, multiple regression analyses, path analyses, and the Sobel tests were conducted for data analyses of this study. Poor glycemic control (A1C ≥ 7 %), high depressive symptoms (CES-D ≥ 16), poor sleep quality (PSQI > 5), and short sleep duration (< 6 hours) were prevalent among KAs with T2DM. The mean score of acculturation (2.18) indicated low acculturation to Western culture. Depressive symptoms were revealed as a significant independent predictor of glycemic control. Physical activity was negatively associated with glycemic control, while cultural identity was positively related to glycemic control. Sleep quality and sleep duration of less than 6 hours did not mediate the relationship between depressive symptoms and glycemic control. Acculturation did not moderate the association between depressive symptoms and glycemic control. Diabetes self-management interventions of a comprehensive approach that considers depressive symptoms, sleep problems, and cultural differences in minority populations with T2DM are needed.
ContributorsJeong, Mihyun (Author) / Reifsnider, Elizabeth G. (Thesis advisor) / Belyea, Michael (Committee member) / Petrov, Megan (Committee member) / Kelly, Lesly (Committee member) / Arizona State University (Publisher)
Created2017
Description
Scientific evidence strongly indicates that there are significant health benefits of breastfeeding. Lower breastfeeding initiation, duration, and exclusivity rates are found in vulnerable populations particularly among women of low socioeconomic status, and racial minorities such as immigrant, racial, and minority cultural groups. Breastfeeding disparities can contribute to negative health outcomes for the mothers, and their infants, and families.
Muslim Arab immigrants are a fast-growing, under-studied, and underserved minority population in the United States. Little is known about breastfeeding practices and challenges facing this vulnerable population. Immigrant Muslim Arab mothers encounter breastfeeding challenges related to religion, language, different cultural beliefs, levels of acculturation, difficulties understanding health care information, and navigating the health care system.
A cross-sectional descriptive study was used to describe infant feeding practices, and identify contributors and barriers to adequate breastfeeding using the social ecological model of health promotion. A convenience sample of 116 immigrant Muslim Arab women with at least one child, 5 years or younger was recruited from a large metropolitan area in the Southwestern United States. The results indicated that immigrant Muslim Arab mothers demonstrate high breastfeeding initiation rates (99.2%), and lengthy breastfeeding duration (M=11.86), but low rates of exclusive breastfeeding at 6 months (21.6%). Facilitators to breastfeeding within the sample were high intentions to breastfeed, positive breastfeeding knowledge and beliefs related to the benefits of breastfeeding, religious teachings promoting breastfeeding, and encouragement to breastfeed from the mothers’ social support system. Several barriers to successful breastfeeding were related to lacking the specific knowledge of the benefits of breastfeeding, and discomfort with breastfeeding in public, and in front of strangers. High income and religious teachings encouraging breastfeeding were significantly associated with exclusive breastfeeding at six months. Greater maternal age and comfort with breastfeeding in public were associated with longer breastfeeding durations.
The socio-cultural context for support of breastfeeding is an important consideration by healthcare providers caring for Muslim Arab women. An ecological perspective needs to be applied to interventions targeting breastfeeding promotion to facilitate effectiveness in this population. Culturally tailored intervention to the specific breastfeeding concerns and needs of Muslim immigrant women could promote optimal breastfeeding in this population.
Muslim Arab immigrants are a fast-growing, under-studied, and underserved minority population in the United States. Little is known about breastfeeding practices and challenges facing this vulnerable population. Immigrant Muslim Arab mothers encounter breastfeeding challenges related to religion, language, different cultural beliefs, levels of acculturation, difficulties understanding health care information, and navigating the health care system.
A cross-sectional descriptive study was used to describe infant feeding practices, and identify contributors and barriers to adequate breastfeeding using the social ecological model of health promotion. A convenience sample of 116 immigrant Muslim Arab women with at least one child, 5 years or younger was recruited from a large metropolitan area in the Southwestern United States. The results indicated that immigrant Muslim Arab mothers demonstrate high breastfeeding initiation rates (99.2%), and lengthy breastfeeding duration (M=11.86), but low rates of exclusive breastfeeding at 6 months (21.6%). Facilitators to breastfeeding within the sample were high intentions to breastfeed, positive breastfeeding knowledge and beliefs related to the benefits of breastfeeding, religious teachings promoting breastfeeding, and encouragement to breastfeed from the mothers’ social support system. Several barriers to successful breastfeeding were related to lacking the specific knowledge of the benefits of breastfeeding, and discomfort with breastfeeding in public, and in front of strangers. High income and religious teachings encouraging breastfeeding were significantly associated with exclusive breastfeeding at six months. Greater maternal age and comfort with breastfeeding in public were associated with longer breastfeeding durations.
The socio-cultural context for support of breastfeeding is an important consideration by healthcare providers caring for Muslim Arab women. An ecological perspective needs to be applied to interventions targeting breastfeeding promotion to facilitate effectiveness in this population. Culturally tailored intervention to the specific breastfeeding concerns and needs of Muslim immigrant women could promote optimal breastfeeding in this population.
ContributorsKhasawneh, Wafa (Author) / Komnenich, Pauline (Thesis advisor) / Petrov, Megan (Committee member) / Reifsnider, Elizabeth G. (Committee member) / Ahmed, Azza (Committee member) / Arizona State University (Publisher)
Created2017
Description
How early life is experienced and perceived can greatly affect mental and physical health outcomes. An individual is greatly influenced by their first models of what social relationships look and feel like, and with time also learn how to survive when less favorable social experiences occur. The lessons learned may lead to healthy problem solving and resilience, or it may lead to unhealthy problem-solving habits that hinder well-being. Anxious thoughts and other mental health symptoms may accompany an individual long-term and hinder an essential need for a healthy life. The first main purpose of this thesis is to examine the impact of Adverse Childhood Experiences (ACEs) on mental health (anxiety symptoms), and on sleep quality (an essential need). The second purpose of my thesis is to investigate the impact of genetics on resilience, specifically, the mu-opioid receptor gene. The first hypothesis proposed ACEs that were perceived as more traumatic and occurred more frequently would be associated with more poor sleep quality symptoms. The second hypothesis predicted that anxiety symptoms would mediate the association. The third hypothesis (exploratory) suggested that an individual’s alleles for the mu-opioid receptor gene would moderate the mediation pathway. The study was conducted with 318 participants between the ages of 18 and 35 years old. The study demonstrated a direct effect for ACEs and sleep. Anxiety mediated the association between ACEs (exposure and severity) and sleep (insomnia, quality, sleepiness), suggesting that ACEs possibly increase feelings of anxiety which, in turn, lead to worse sleep outcomes. Finally, the moderated-mediation model with OPRM1 as the moderator, was not significant for the mediation pathway A; however, there was a significant interaction with anxiety and sleep symptoms.
ContributorsBailey, Elise (Author) / Mickelson, Kristin (Thesis advisor) / Burleson, Mary (Committee member) / Petrov, Megan (Committee member) / Arizona State University (Publisher)
Created2022
Description
Food insecurity affects more than 10 million households in the United States and has been shown to impact what and how a child is fed. Additionally, there is some evidence to suggest that food insecurity may affect how an infant is soothed (either with food or another mechanism), but no study has examined the possible relationship between soothing techniques and the incidence of food insecurity. To evaluate whether food security status and nighttime soothing techniques have a relationship, surveys were administered to a sample of mothers from various racial and socioeconomic backgrounds at 3-weeks, 8-weeks, and 3-months postpartum. Of the 69 participants sampled, 61 had data that could contribute to evaluations of food security status and soothing techniques used at night. A chi-square model was utilized to determine what, if any, relationship existed between the two variables. The chi-square model did not yield statistically significant results (Pearson Chi-Square= .506, p=.477) and descriptive statistics showed that just six of the 61 participants sampled did not use food to soothe at the time their baby was 3-weeks-old. Further examination of descriptive statistics revealed that, between breastfeeding and bottle-feeding as a means to soothe an infant, breastfeeding was used twice as much as bottle-feeding. For participants enrolled in the Special Supplemental Nutrition Program for Women, Infants, Children (WIC), the use of food to soothe increased at each of the three time points. Among participants found to be food-insecure, the use of breastfeeding and bottle-feeding as means to soothe varied from time point to time point. The physical and mental toll of the postpartum period may contribute to the high use of food-to-soothe among mothers seen in this study. Future research efforts in this area should examine whether the observations reported in this study are similar among larger samples, and if more mental health support for mothers has any effect on whether food is used to soothe.
ContributorsKoelbel, Megan (Author) / Whisner, Corrie (Thesis advisor) / Petrov, Megan (Committee member) / Bruening, Meg (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
College students are a niche of young adults, characterized by abnormal sleeping habits and inactive lifestyles. Many students entering college are as young as 18 years old and graduate by 22 years old, a window of time in which their bones are still accruing mineral. The purpose of this cross-sectional study was to determine whether sleep patterns and physical activity observed in college students (N= 52) 18-25 years old at Arizona State University influenced bone biomarkers, osteocalcin (OC) and N-terminal telopeptide of type 1 collagen (NTX-1) concentrations. Students completed various dietary and health history questionnaires including the International Physical Activity Questionnaire short form. Students wore an actigraphy watch for 7 consecutive nights to record sleep events including total sleep time, sleep onset latency and wake after sleep onset. Total sleep time had a significant, negative correlation with OC (r = -0.298, p-value =0.036) while sleep onset latency had a significant, positive correlation with NTX-1 serum concentration (r = 0.293, p-value = 0.037). Despite correlational findings, only sleep percent was found to be significant (beta coefficient = 0.271 p-value = 0.788) among all the sleep components assessed, after adjusting for gender, race, BMI and calcium intake in multivariate regression models. Physical activity alone was not associated with either bone biomarker. Physical activity*sleep onset latency interactions were significantly correlated with osteocalcin (r = 0.308, p-value =0.006) and NTX-1 (r = 0.286, p-value = 0.042) serum concentrations. Sleep percent*physical activity interactions were significantly correlated with osteocalcin (r = 0.280, p-value = 0.049) but not with NTX-1 serum concentrations. Interaction effects were no longer significant after adjusting for covariates in the regression models. While sleep percent was a significant component in the regression model for NTX-1, it was not clinically significant. Overall, sleep patterns and physical activity did not explain OC and NTX-1 serum concentrations in college students 18-25 years old. Future studies may need to consider objective physical activity devices including accelerometers to measure activity levels. At this time, college students should review sleep and physical activity recommendations to ensure optimal healthy habits are practiced.
ContributorsMahmood, Tara Nabil (Author) / Whisner, Corrie (Thesis advisor) / Dickinson, Jared (Committee member) / Petrov, Megan (Committee member) / Adams, Marc (Committee member) / Arizona State University (Publisher)
Created2019