Public Health Commons^™

Nutrition And Exercise Resources For Uninsured Patient Populations, Sabrina Marie Paparo, Samantha Plasner, Runi Patel, Wendy Briaguez

Rowan-Virtua Research Day

Proper nutrition and exercise is integral for the prevention and management of chronic diseases such as type two diabetes, hypertension, high cholesterol, and cardiovascular disease. However, health care disparities in the United States, such as lack of access to primary health care, has been an ever growing problem. The purpose of this study is to determine if there is a correlation between being uninsured and having worse health outcomes, and to determine if there is a need for accessible nutrition and/or exercise resources for this population. To conduct this research, a survey was distributed at the Cherry Hill Free Clinic …

Health Disparities Among Adults With Disabilities, Kirsten Carlberg, Madison Plone, Chrismely Castro, Nayarith Lopez

Rowan-Virtua Research Day

Background: According to the Centers for Disease Control (CDC), 27% of adults in the United States (US) live with a disability. These disabilities are often accompanied by poorer health outcomes with adults with disabilities reporting higher rates of obesity, diabetes, and cardiovascular disease. This review aims to characterize rates of disability among young adults in Camden County, New Jersey.

Methods: Data was collected from the CDC and United States Census and analyzed using Microsoft Excel 365.

Results: In 2022, 9.7% of residents of Camden County aged 18-34 were reported as disabled while the rate was 8.3% of US residents nationwide. …

Diet, Physical Activity, And Stress Among Wheelchair Users With Multiple Sclerosis: Examining Individual And Co-Occurring Behavioral Risk Factors, Stephanie L Silveira, Brenda Jeng, Gary Cutter, Robert W Motl

Journal Articles

OBJECTIVE: This study examined individual and co-occurring behavioral risk factors (diet, exercise, and stress) in wheelchair users with multiple sclerosis (MS) and potential association with MS symptoms (ie, fatigue, depression, anxiety, pain, sleep, and health-related quality of life [HRQOL]).

DESIGN: Survey.

SETTING: General Community.

PARTICIPANTS: One hundred twenty-three wheelchair users with MS completed this study (N=123).

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Participants were mailed instructions for accessing online questionnaires (demographic and clinical characteristics, Godin Leisure-Time Exercise Questionnaire, Perceived Stress Scale, Automated Self-Administered 24-Hour Dietary Assessment Tool, and MS symptoms).

RESULTS: Standard cut-points were used to categorize behavioral risk factors …

A Lifestyle Management Coaching Intervention For Fear Of Cancer Recurrence In Young Breast Cancer Survivors, Lisa R. Murphy

DNP Research Projects

Abstract

Objective: A significant challenge facing young breast cancer (BC) survivors is learning how to manage fear of cancer recurrence (FCR) during survivorship. Limited tailored FCR interventions and age-appropriate support exist. This Doctor of Nursing (DNP) project, based upon best practice guidelines, aimed to evaluate how a Lifestyle Management Coaching Intervention (LMCI) could help young female BC survivors learn how to decrease and manage their FCR more effectively and experience improved health outcomes.

Method: Eligible participants were female BC survivors aged 18-59 with Stage I-III BC demonstrating elevated baseline FCR screening scores during the extended survival period recruited from the …

Cost Analysis Of Implementing An Exercise Program For Fall And Fracture Prevention In Older Adults On Proton Pump Inhibitor Therapy, Thomas Adam Wichelmann, Nhan Dang, David H. Kruchko, Sufyan Abdulmujeeb, Eli D. Ehrenpreis

Journal of Patient-Centered Research and Reviews

Purpose: Falls have significant financial impact. Proton pump inhibitor (PPI) therapy is associated with an increased risk of falls and fractures. Exercise programs have been shown to decrease risk of falls in the elderly population and are recommended by the U.S. Preventive Services Task Force for patients over age 65 to reduce falls. Our study aimed to explore the potential financial benefit of implementing three different Centers for Disease Control and Prevention-recommended exercise-based interventions for fall prevention (Tai Chi, Stepping On, and Otago Exercise Program) in ≥ 65-year-old patients on PPI therapy.

Methods: A Markov model was developed to predict …

Association Of Disease Outcomes With Physical Activity In Multiple Sclerosis: A Cross-Sectional Study, Trinh L T Huynh, Stephanie L Silveira, Brenda Jeng, Robert W Motl

Journal Articles

UNLABELLED: Purpose/Objective Research: This study examined combinations of disease outcomes (i.e., walking, cognition, and symptoms) as correlates of physical activity subgroups (insufficiently active vs. sufficiently active) in persons with multiple sclerosis (MS).

RESEARCH METHOD/DESIGN: This study included 213 participants who completed walking and cognitive function tests and self-report measures of symptoms and physical activity. Multivariate analysis of variance and discriminant function analysis identified combinations of MS outcomes associated with physical activity.

RESULTS: The sample had a mean age of 49.6 years (

CONCLUSION/IMPLICATIONS: The findings identified walking endurance and limitations, processing speed, depression, and fatigue as primary correlates of physical …

Diet, Exercise, Self-Monitoring, Technology, And Motivational Interviewing For Weight Loss In Adults, Ashleigh D. Warburton

Evidence-Based Practice Project Reports

Obesity, an epidemic in the United States (US), affected 42.4% of adults as of 2017-2018 (Hales, 2020). Comorbidities associated with obesity, such as cardiovascular disease, cancer, and diabetes (Orringer et al., 2020), are some of the leading causes of death in the US (Kochanek et al., 2020). The purpose of this evidence-based practice (EBP) project was to answer the following PICOT question: In adult patients aged 19 years or older who are considered overweight or obese as measured by body mass index (BMI) of ≥ 25 kg/m2 (P), how effective is diet and exercise combined with self-monitoring, a phone application, …

The Impact Of The Covid-19 Pandemic On Pediatric Obesity In School-Aged Children, Amaani Faizal, Maryanna Schweininger, Suzanna Hosein

Rowan-Virtua Research Day

The prevalence of childhood obesity in those aged 2-19 in the United States was 19.3% in 2017-2018. Childhood obesity is a major health concern with growing rates of incidence. Being overweight or obese put children at risk for developing several chronic conditions such as coronary artery disease, type 2 diabetes mellitus, hypertension and asthma at a younger age. Studies have shown that higher BMI numbers in childhood added an increased risk of being obese as an adult.

The pathophysiology of developing obesity includes several complex factors ranging from nutrition, physical activity, genetic background and lifestyle preferences. Among children, nutrition and …

The Effects Of Wearing A Mask On An Exercise Regimen, Ryan Gericke, Adarsh Gupta

Rowan-Virtua Research Day

Implementation of masks has impacted everyone worldwide

Properly wearing a mask requires covering both mouth and nose, putting a barrier between air and lungs

Exercise relies on cardiopulmonary function, so this barrier could potentially exacerbate the already altered physiology due to exercise alone

It is predicted that the addition of a mask will have negative implications on physiology

If there is evidence that people do not work out as effectively while wearing a mask, it would be important to find other ways to keep people physically active

Walking Is Worthy: Walking For Hypertension, Ashleigh Y. Peterson

Evidence-Based Practice Project Reports

Elevated blood pressure (BP), or hypertension (HTN), can cause a cascade of detrimental effects to the body. It is associated with increased risk of stroke, angina, myocardial infarction, heart failure, peripheral artery disease, end-stage renal disease, and abdominal aortic aneurysms (Whelton et al., 2018). HTN is also a major risk factor for the development of cardiovascular disease (CVD), which is the United States’ (U.S.) leading cause of death in men and women (U.S. Preventive Services Task Force [USPSTF], 2020). The PICOT question for this project was: does an eight-week (T) structured walking program utilizing a smartwatch for step counts and …

Increasing Physical Activity In Women With Obesity To Promote Weight Loss, Ashley N. Kohler

Evidence-Based Practice Project Reports

Obesity is a chronic disease associated with a multitude of lifelong chronic illnesses. Obesity impacts more than 42% of the United States population (CDC, 2021b). Physical inactivity is a major determinant of obesity (Muerer et al., 2019). The purpose of this evidence-based practice (EBP) project was to promote a greater reduction in body mass index (BMI) of the participants enrolled in an existing wellness program at the EBP practice site by increasing the physical activity level of the participants compared to standard protocol. The existing wellness program’s standard protocol included diet modifications, physical activity encouragement, and medication management. The EBP …

Parents' Reports Of Children's Physical And Sedentary Behavior Engagement Among Parents In Weight Management, Catherine Van Fossen, Haley Kiser, Callie Lambert Brown, Joseph Skelton, Keeley Jean Pratt

Department of Psychiatry and Human Behavior Faculty Papers

Background: The purpose of this study was to explore the associations between demographics, family exercise participation, family discouragement of exercise, and the children's physical and sedentary behaviors to identify specific areas of physical activity intervention for children with parents engaged in medical weight management (MWM).

Methods: Parents (n = 294) of children aged 2-18 years old were recruited from two university MWM programs to complete a one-time survey. Bivariate analyses tested associations.

Results: Parents reported that sedentary activity was higher for children who identified as racial minorities (t(141) = -2.05, p < 0.05). Mobile phone and tablet use was higher for adolescents compared to school age and young children (H(2) = 10.96, p < 01) Exercise game use was higher for racial minority children compared to white children (U = 9440.5, z = 2.47, p ≤ 0.03). Male children (t(284) = 1.83, p < 0.07), children perceived to have a healthy weight status (t(120) = 4.68, p < 0.00), and younger children (t(289) = 1.79, p < 0.08) all engaged in more strenuous physical activity. Family exercise participation (t(162) = -2.93, p < 0.01) and family discouragement of exercise (U = 7813.50, z = -2.06, p ≤ 0.04) were significantly higher for children in racial minority families.

Conclusions: Future work should determine methods to engage children …

Active Living After Cancer: Adaptation And Evaluation Of A Community-Based Physical Activity Program For Minority And Medically Underserved Breast Cancer Survivors, Irene M Tami-Maury, Yue Liao, Maria L Rangel, Leticia A Gatus, Eileen H Shinn, Ashley Alexander, Karen Basen-Engquist

Journal Articles

BACKGROUND: An expanding body of research documents the benefits of physical activity for cancer survivors' physical functioning and quality of life, but few successful models provide community-based physical activity programs to cancer survivors. This report presents an evaluation of Active Living After Cancer, an evidence-based physical activity program for breast cancer survivors, adapted for community delivery to minority and medically underserved survivors.

METHODS: Survivors were recruited from health care and community settings. The program consisted of 12 weekly group sessions providing training in cognitive and behavioral skills for behavior change, brief physical activity, and cancer survivorship-related content. At the baseline …

Perceptions Of Physical Activity Guidelines Among Wheelchair Users With Multiple Sclerosis, Stephanie L Silveira, Brenda Jeng, Gary Cutter, Robert W Motl

Journal Articles

BACKGROUND: Physical activity guidelines provide prescriptive resources for population-level promotion of behavior change to improve health outcomes. The National Multiple Sclerosis Society (NMSS) recently created and disseminated physical activity guidelines for persons with multiple sclerosis (MS) across the disease spectrum.

OBJECTIVE: This study aimed to assess perceptions of the updated NMSS Physical Activity Guidelines among wheelchair users with MS.

METHODS: One hundred thirty-four wheelchair users with MS participated in a cross-sectional study examining health behaviors. Outcomes were measured using an online questionnaire that included items related to demographic and clinical characteristics and a battery of questions regarding perceptions of the …

Tackling Access To A Healthier Life, Edom Alemayehu Girma

Family Medicine Clerkship Student Projects

Obesity is a known risk factor for complications during childhood and later in adult life. While numerous factors play a role in the prevalence of obesity, this project focused on better intervention for obesity management in the family medicine clinic located in Plattsburgh, NY. Interviews and literature searches were conducted to determine possible strategies to better assist patients in attaining their sustainable weight loss goals and an overall healthier lifestyle.

Changes Of Exercise, Screen Time, Fast Food Consumption, Alcohol, And Cigarette Smoking During The Covid-19 Pandemic Among Adults In The United States, Liwei Chen, Jian Li, Tong Xia, Timothy A. Matthews, Tung-Sung Tseng, Lu Shi, Donglan Zhang, Zhuo Chen, Xuesong Han, Yan Li, Hongmei Li, Ming Wen, Dejun Su

School of Public Health Faculty Publications

Objective: To investigate the impact of the COVID-19 pandemic on multiple lifestyle changes among adults in the United States (USA). Methods: We conducted a survey, the Health, Ethnicity, and Pandemic (HEAP) Study, in October 2020 among USA adults. Participants were selected from the United States using 48 sampling strata, including age, race, ethnicity, education, and gender, and were asked to report five lifestyle behaviors (i.e., exercise time, screen time, fast-food meal consumption, alcohol drinking, and cigarette smoking) before and during the COVID-19 pandemic. The associations of sociodemographic factors with each lifestyle change were estimated using weighted multivariable logistic regression models. …

Community-Dwelling Older Adult Fall Prevention Improvement Project, Evan Edminster Bsn, Rn, Cfrn, Tcrn, Cen, Nhdp-Bc

Master's Projects and Capstones

Abstract

Problem: Ground-level falls among community-dwelling adults 60 years and older are significant and contribute to adverse health outcomes such as fractures, functional decline, disability, and death. Additionally, falls among community-dwelling older adults are the number one mechanism of injury seen at a Northern California Level II trauma center. Falls often lead to post-fall fear, activity restriction, and physical deconditioning, further compounding fall risk.

Context: When trauma centers provide targeted outreach and screening for unmanaged health risks such as falls, they reduce unnecessary disability and premature death in the local population. Reducing total fall victim numbers and fall recidivism also …

The Impact Of Exercise On Pregnant Women Aged 18-40 And Fetal Development, Jinisha Patwa

Rowan-Virtua Research Day

68% of those who performed minimum level exercise prior to pregnancy stopped completely during early pregnancy.

Women stop exercising during pregnancy due to worries about the impact it may have on the development of the fetus.

Starting moderate-intensity, weight-bearing exercise early in pregnancy increases placental growth rate and volume.

Exercise reduces the risks of excess gestational weight gain and high maternal body weight before pregnancy.

Physical exercise reduces the risk of gestational diabetes mellitus.

Dancing During Labor: Social Media Trend Or Future Practice?, Caroline P. Toberna, Drew Horter, Kayla Heslin, Marie M. Forgie, Emily Malloy, Jessica J. F. Kram

Journal of Patient-Centered Research and Reviews

Over the past 30 years, medical interventions in pregnancy and childbirth have increased. Some pregnant women seek less invasive and nonpharmacological options to manage discomforts during labor. While exercise during pregnancy is recommended, less is known about exercise, specifically dancing, during labor. While anecdotal evidence is supportive, little is known about the implications of exercise and dance during the first stage of labor for pain reduction and labor progression. Some movements common in dance, such as expanding hip circles that loosen and relax muscles of the pelvic floor, may be beneficial to women during labor. Available evidence suggests that dancing …

Is Physical Activity During Late Pregnancy Related To Infant Body Composition At Birth?, Brenna Menke

Masters Theses & Specialist Projects

Exercise is typically regarded as having a positive impact on maternal and infant health. However, the relationship between maternal physical activity and infant body composition is unclear. The aim of this project was to determine how a physically active lifestyle during late pregnancy influences infant anthropometrics at birth. Pregnant women (34-39 weeks gestation) with low-risk pregnancies were given the Pregnancy Physical Activity Questionnaire (PPAQ) and an accelerometer to wear on their non-dominant wrist for seven consecutive days. Approximately 24-48 hours after delivery, infant body composition was assessed utilizing air displacement plethysmography at the patients’ bedside. Fifty-five pregnant women participated (age: …

Assessing Physical Activity In People With Mental Illness: 23-Country Reliability And Validity Of The Simple Physical Activity Questionnaire (Simpaq), S Rosenbaum, R Morell, A Abdel-Baki, M Ahmadpanah, T V. Anilkumar, L Baie, A Bauman, S Bender, Zahra Hoodbhoy, Romaina Iqbal, Ayesha Mian

Department of Paediatrics and Child Health

Background: Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness.
Methods: The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in …

Addressing Barriers To Physical Activity In Vermont's Geriatric Population, Stephanie Udawatta

Family Medicine Clerkship Student Projects

A wide array of barriers exist which prevent many geriatric patients from engaging in regular physical activity. This project addresses the barriers unique to Vermont's population of geriatric patients and explores potential solutions.

Promoting Physical Activity In School-Aged Children During The Covid-19 Pandemic, Abigail H. Belser

Family Medicine Clerkship Student Projects

Due to the COVID-19 pandemic, children and adolescents are engaging in less physical activity and are increasing their sedentary behavior. These changes can lead to long-lasting negative lifestyle behaviors, which increases risk of health complications.

To ensure safety during the pandemic, guidelines have created restrictions on physical education and sports, which are both primary physical activity outlets for children and adolescents. Children and adolescents have to find alternate ways and resources to meet the recommended 60 minutes of physical activity daily.

An informational pamphlet was created to educate parents and children of current physical activity recommendations, with resources and ideas …

Development And Cross-Validation Of A Cadence-Based Metabolic Equation For Walking, Christopher C. Moore

Masters Theses

The ACSM Metabolic Equation is a widely recognized equation for predicting metabolic intensity from walking speed. However, an equation that uses an observable metric (i.e., cadence [steps/min]), accounts for individual characteristics, and is validated across walking conditions may enable more accessible and accurate predictions of walking intensity. PURPOSE: To develop metabolic equations that predict metabolic intensity (oxygen consumption; mL/kg/min) from cadence using a large treadmill walking dataset (Study One) and cross-validate these equations during overground unconstrained and cadence-constrained walking conditions (Study Two). METHODS: In Study One, 193 adults (21-81 years) completed treadmill walking bouts while oxygen consumption was measured with …

The Benefits And Accessibility Of Integrative Exercise In Geriatric Populations, Elizabeth Nisper

Honors Projects

There are many physical and mental benefits of conventional exercise and they have been well-studied. However, integrative exercise practices aim to encompass more than physical fitness. There is also a spiritual/ethical component when taking into account aspects such as meditation and mindfulness. By examining a number of different health domains, we can study whether the benefits of yoga and tai chi extend beyond the benefits of exercise more broadly. While the short-term physical fitness benefits of other cardio and strength training may exceed those of integrative practices, yoga and tai chi appear to be equally as beneficial in the long …

Physical Activity And Fall Prevention In Older Adults, An Educational Intervention, Caleb Daniel Knight

Family Medicine Clerkship Student Projects

Falls in adults over 65 years of age constitute a significant health burden in our country, and this age group is growing rapidly. Falls are addressed with a multifactorial approach, addressing comorbidities, medications, and the physical environment, however, an effective point of intervention accessible by most older adults is physical activity. A brief educational presentation about the morbidity and mortality associated with falls, and the protective effects of physical activity, was provided to Meadowbrook Healthcare subacute nursing home residents in Plattsburgh, NY. Questions were encouraged and answered afterwards, and copies of the presentation were left for the residents to review …

Within-Person Associations Of Young Adolescents' Physical Activity Across Five Primary Locations: Is There Evidence Of Cross-Location Compensation?, Jordan A. Carlson, Tarrah B. Mitchell, Brian E. Saelens, Vincent S. Staggs, Jacqueline Kerr, Lawrence D. Frank, Jasper Schipperijn, Terry L. Conway, Karen Glanz, Jim E. Chapman, Kelli L. Cain, James F. Sallis

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Youth are active in multiple locations, but it is unknown whether more physical activity in one location is associated with less in other locations. This cross-sectional study examines whether on days with more physical activity in a given location, relative to their typical activity in that location, youth had less activity in other locations (i.e., within-person associations/compensation).

METHODS: Participants were 528 adolescents, ages 12 to 16 (M = 14.12, SD = 1.44, 50% boys, 70% White non-Hispanic). Accelerometer and Global Positioning System devices were used to measure the proportion of time spent in moderate-to-vigorous physical activity (MVPA) in five …

Case Study Of Persons With Cancer Participating In A Community-Based Exercise Program: An Exploration Of Meaning And Change, Barbara K. Haas, Melinda Hermanns, Christina Melin-Johansson

The Qualitative Report

Increasingly, research supports the importance of incorporating exercise into the cancer care paradigm. While quantitative studies have substantiated the significant effects of exercise on physical functioning, the individual’s perspective of participating in an exercise program has rarely been considered. The purpose of this study was to explain the impact of a community based exercise program on the lives of persons with cancer and their caregivers. Based on Bandura’s Social Cognitive Theory, a single explanatory case study with multiple embedded units of analyses was conducted. Interviews were conducted with 10 individuals representing participants with cancer, their caregivers, and health care providers. …

Assessment Of Obesity Management In A Primary Care Setting, Katie Diffenderfer

DNP Projects

Purpose: The purpose of this study was to evaluate the current practices related to obesity in the primary care setting in University of Kentucky’s Healthcare System. The specific aims were to: 1) Determine the proportion of obese patients who had an ICD-9/10 diagnosis code for obesity, 2) Determine the proportion of obese patients who received interventions related to their obesity, 3) Determine whether obesity diagnosis and interventions varied based on patient demographics, and 4) Compare actual obesity interventions to those outlined in the clinical practice guidelines.

Methods: A retrospective chart review of male and female patients between the ages of …

Comparison Of Affect And Cardiorespiratory Training Responses Between Structured Gym Activities And Traditional Aerobic Exercise In Children., David A. White, S D. Rothenberger, L A. Hunt, F L. Goss

Manuscripts, Articles, Book Chapters and Other Papers

Physical activities (PA) that are pleasurable are likely to be repeated. Structured gym activities (SGA) are defined as dodging, chasing, and fleeing games. Traditional aerobic exercises (TAE) are defined as treadmill, cycle ergometer, and elliptical exercise. The purpose of this investigation was to compare affect and cardiorespiratory training responses between SGA and TAE in children. Thirty-two participants (9.3±0.2) were randomized to either the SGA or TAE group. Exercise training was seven weeks, with two sessions per week, for 35 minutes per session. Affect was measured by the (+5 (pleasurable) to -5 (displeasurable)) feelings scale. Affect was recorded at the mid-point …