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- Creators: Hekler, Eric
Enhancing motivation for physical activity to reduce fall risk among community dwelling older adults
Description
Unintentional falls among community dwelling older adults are a common, serious and potentially preventable public health problem. In the United States, the annual incidence of fall related injuries per 100,000 persons was 4,616 in 2001, rising to 5,252 in 2008. The annual incidence of fall related deaths per 100,000 persons was 29.3 in 2000, rising to 41.86 in 2006. Older adults are particularly vulnerable to falls as they age. Potential consequences include fractures, emergency room, hospital and nursing home admissions, dependence, confusion, immobilization, depression, and death. Significant modifiable fall risk factors include muscle weakness, gait problems, and balance problems. While researchers have demonstrated the positive effects of balance and leg-strengthening physical activities, the majority of older adults do not engage in them, and the rate of falls continues to increase. Older adults participate in regular physical activity and fitness activities less often than younger populations; disparities are greater among those who are poor and living in rural communities. While knowledge about causes, risk factors, and efficacious physical activity to prevent falls has grown exponentially in the last several decades, bridging the gap between research and practice continues to be a challenge. As a strategy to address the gap between research and practice, this feasibility study utilized a tested theory, the wellness motivation theory, to address motivation for behavioral change in combination with instruction for physical activities proven to reduce fall risk. The study sample included rural, community dwelling older adults at risk of falls. The study included an innovative mobile computer to measure physical activity behavior and to augment motivational content of the intervention. Specific aims of this feasibility study were to: (a) examine the acceptability, demand, and implementation of the wellness motivation intervention (WMI) as well as the technology augmenting the WMI; and (b) evaluate the efficacy of the WMI to influence awareness of social contextual resources, behavioral change processes, physical activity, and fall risk. The WMI delivered in combination with proven multicomponent balance and strength activities was feasible and effectively increased motivation for behavioral change (social support from friends, awareness of social contextual resources, behavioral change processes) and physical activity behavior, and decreased fall risk among rural, community-dwelling older adults at risk of falls in this study. This study is the first step in a program of research focusing on enhancing motivation for physical activity that reduces falls and frailty among older adults.
ContributorsMcMahon, Siobhan (Author) / Fleury, Julie (Thesis advisor) / Belyea, Michael (Committee member) / Shearer, Nelma (Committee member) / Wyman, Jean (Committee member) / Hekler, Eric (Committee member) / Arizona State University (Publisher)
Created2012
Description
Children are five times more likely to be overweight at the age of 12 years if they are overweight during the preschool period, and 60% of overweight preschoolers are overweight at the age of 12 years (Matusik & Malecka-Tendera, 2011). Primary care interventions are urgently needed to improve healthy lifestyle behaviors in families. Parental influence plays an important factor in the development of healthy behaviors in children. Cognitive behavioral interventions have demonstrated preliminary success in promoting healthy lifestyle behaviors in both adults and children. Mobile technology used to supplement interventions aimed at behavior change offers an outlet to bridge gaps in health disparities and generate innovative evidence. Therefore, the purpose of this research was to establish the feasibility, acceptability, and preliminary effects of a cognitive-behavioral intervention (TEXT2COPE) synergized with mobile technology on the healthy lifestyle behaviors of parents of overweight and obese preschoolers. Primary aims of the proposed pilot study were to (a) examine the feasibility and acceptability of the TEXT2COPE program among parents of overweight or obese preschoolers with mobile phones; (b) evaluate the preliminary effects of the TEXT2COPE program on healthy lifestyle behaviors in families with overweight or obese preschoolers; and (c) evaluate the relationship among the study variables (i.e., cognitive beliefs, perceived difficulty, and healthy lifestyle behaviors). Findings indicate that this program is feasible and acceptable in this population. The intervention improved healthy lifestyle beliefs and behaviors in parents. Further supported are the interconnected relationships between parental beliefs, thoughts, and behaviors.
ContributorsMilitello, Lisa K (Author) / Melnyk, Bernadette M (Thesis advisor) / Small, Leigh (Committee member) / Hekler, Eric (Committee member) / Jacobson, Diana (Committee member) / Arizona State University (Publisher)
Created2014
Description
PURPOSE: This study aimed to identify whether increased Pokémon GO use resulted in increased daily steps, compared to days when an individual did not play. In addition, this study examined Pokémon GO as a use case for for the study of gamification, particularly whether traditionally identified game mechanics in gamification literature were successfully identified as elements players enjoy when playing Pokémon GO. METHODS: A mixed methods approach, with 17 participants taking part in a daily physical activity tracking study and 14 participants participating in semi-structured interviews. In the use study, participant steps were tracked for one week using the Apple Health Kit application, and participants were also asked to provide daily answers to a variety of questions assessing game preferences and daily use of Pokémon GO - using the application called PACO. The semi-structured interviews examined self-reported physical activity, and asked questions pertaining to use of Pokémon GO, such as motivation to play. RESULTS: Results assessed by t-test indicate a small but non-significant trend towards increased steps taken on days when a participant played vs. did not play (t(72)=- .56, p=.57, mplay=5,0153220, mnonplay=4,5152,959). This was confirmed with a mixed model test showing that when controlling for time and participant’s baseline level of steps, there was no significant effect on steps/day. Results from the daily surveys and also the semi-structured interviews, indicated that nostalgia (i.e., catching ones’ favorite childhood Pokémon), was a strong motivator for many to play the game, which was counter to theoretical expectations. In line with previous theory, results suggested that operant conditioning principles appeared to be at work in terms of fostering game play use. DISCUSSION: Results of this study, which was a primarily hypothesis generating endeavor, indicated possible trends toward increased steps on days when a person plays Pokémon G), but - with such a small sample, and short-term length of study - no firm conclusions can be drawn. Further, results indicate the particular value of nostalgia as a driver towards game play for Pokémon GO.
ContributorsBiel, Alexander M (Author) / Hekler, Eric (Thesis advisor) / Ainsworth, Barbara (Committee member) / Buman, Matthew (Committee member) / Arizona State University (Publisher)
Created2016
Description
It is widely documented and accepted that athletes have difficulty maintaining adequate hydration status and that dehydration is a key risk factor for the heat-related illnesses commonly observed among athletes. Research has also suggested that hydration status can influence cognitive performance. Educational interventions focused on rehydration strategies have had minimal success reducing dehydration rates; hence, alternative interventions promoting adequate hydration status in athletes should be explored. This trial examined the efficacy of a commercial hydration mobile application (app) for reducing dehydration rates in campus athletes. Fifty-eight college students aged 18-40 y, who participated in club-level collegiate athletics were recruited from a large Southwestern university and randomized by team to one of two study arms, the Standard of Care – Education (EDU) or the hydration mobile app (APP), to determine if app technology improved hydration status as compared to traditional education messaging. Twenty-three (79%) in the EDU group and twenty (69%) in the APP group were mildly-dehydrated at baseline based on the three-day averages of hydration assessment (USG 1.010). Moreover, 31% (n=9) and 28% (n=8) of the EDU and APP groups, respectively, were dehydrated (USG 1.020). No significant differences were found between the EDU and APP groups following the intervention. Three-day average post-intervention USG testing showed 76% (n=22) and 72% (n=21) of the EDU and APP groups respectively were at best mildly-dehydrated. Additionally, 28% (n=8) and 17% (n=5) were considered dehydrated. Neither intervention improved hydration status after four weeks of treatment. Further analyses of cognitive measures were conducted by hydration assessment groups at baseline and post-intervention: hydrated (HYD) (USG < 1.020) or dehydrated (DEH) (USG 1.020). No significant differences between hydration status were found between intervention groups. Additionally, no significant improvements were seen for either group, which indicates there is still a need for a novel way to improve hydration status in this population. Multi-dimensional interventions and individualized interventions to improve hydration status in this at-risk population may be more effective. Additional research should be conducted to determine if there is any cognitive performance enhancement associated with dehydration or mild-dehydration by reassessing previous data and conducting future trials.
ContributorsZemek, Kate A (Author) / Johnston, Carol (Thesis advisor) / Hekler, Eric (Committee member) / Mayol-Kreiser, Sandra (Committee member) / Ransdell, Lynda (Committee member) / Swan, Pamela (Committee member) / Arizona State University (Publisher)
Created2017
Description
Background: Smartphone diet tracking applications (apps) are increasing in popularity but may not adequately address the important concerns of proper intake and of diet quality. Two novel weight loss apps were designed based on the popular dietary frameworks: MyPlate and FoodLists. MyPlate, the dietary guidelines put forth by the U.S. government, encourages a balanced diet from five primary food groups, but does not specify intake limits. The Food Lists set upper intake limits on all food groups except vegetables, and these guidelines extend to include fats, sweets, and alcohol.
Objective: The purpose of this randomized controlled trial was to determine whether adherence to a weight loss app providing intake limits and more food group detail (the Food Lists app) facilitated more weight loss and better diet quality than adherence to a weight loss app based on the MyPlate platform. An additional objective was to examine whether higher app adherence would lead to greater weight loss.
Design: Thirty seven adults from a campus population were recruited, randomized, and instructed to follow either the Food Lists app (N=20) or the MyPlate app (N=17) for eight weeks. Subjects received one 15 minute session of diet and app training at baseline, and their use of the app was tracked daily. Body mass was measured at baseline and post-test.
Participants/setting: Healthy adults from a university campus population in downtown Phoenix, Arizona with BMI 24 to 40, medically stable, and who owned a smartphone.
Main outcome measures: Outcome measures included weight change, days of adherence, and diet quality change. Secondary measures included BMI, fat %, and waist circumference.
Statistical analysis: Descriptive statistics (means and standard errors); Repeated measures ANOVAs analyzing weight, diet quality, and BMI; Pearson and Spearman correlations analyzing adherence and weight loss.
Results: Repeated measures ANOVAs and correlations revealed no significant mean differences in primary outcome variables of weight loss, adherence, or diet quality (P=0.140; P=0.790; P=0.278). However, there was a significant mean reduction of BMI favoring the group using the Food Lists app (P=0.041).
Conclusion: The findings strengthen the idea that intake limits and food group detail may be associated with weight loss. Further investigation is warranted to determine whether longer use of the Food Lists app can produce more significant dieting successes and encourage healthier behavioral outcomes.
Objective: The purpose of this randomized controlled trial was to determine whether adherence to a weight loss app providing intake limits and more food group detail (the Food Lists app) facilitated more weight loss and better diet quality than adherence to a weight loss app based on the MyPlate platform. An additional objective was to examine whether higher app adherence would lead to greater weight loss.
Design: Thirty seven adults from a campus population were recruited, randomized, and instructed to follow either the Food Lists app (N=20) or the MyPlate app (N=17) for eight weeks. Subjects received one 15 minute session of diet and app training at baseline, and their use of the app was tracked daily. Body mass was measured at baseline and post-test.
Participants/setting: Healthy adults from a university campus population in downtown Phoenix, Arizona with BMI 24 to 40, medically stable, and who owned a smartphone.
Main outcome measures: Outcome measures included weight change, days of adherence, and diet quality change. Secondary measures included BMI, fat %, and waist circumference.
Statistical analysis: Descriptive statistics (means and standard errors); Repeated measures ANOVAs analyzing weight, diet quality, and BMI; Pearson and Spearman correlations analyzing adherence and weight loss.
Results: Repeated measures ANOVAs and correlations revealed no significant mean differences in primary outcome variables of weight loss, adherence, or diet quality (P=0.140; P=0.790; P=0.278). However, there was a significant mean reduction of BMI favoring the group using the Food Lists app (P=0.041).
Conclusion: The findings strengthen the idea that intake limits and food group detail may be associated with weight loss. Further investigation is warranted to determine whether longer use of the Food Lists app can produce more significant dieting successes and encourage healthier behavioral outcomes.
ContributorsScholtz, Cameron (Author) / Johnston, Carol (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / Hekler, Eric (Committee member) / Arizona State University (Publisher)
Created2016