Public Health Education and Promotion Commons^™

Impact Of Community-Driven Interventions On Dietary And Physical Activity Outcomes Among A Cohort Of Adults In A Rural Appalachian County In Eastern Kentucky, 2019–2022, Heather Norman-Burgdolf, Emily M. Dewitt, Rachel Gillespie, Kathryn Cardarelli, Stacey Slone, Alison Gustafson

Dietetics and Human Nutrition Faculty Publications

Several environmental level factors exacerbate poor health outcomes in rural populations in the United States, such as lack of access to healthy food and locations to be physically active, which support healthy choices at the individual level. Thus, utilizing innovative place-based approaches in rural locations is essential to improve health outcomes. Leveraging community assets, like Cooperative Extension, is a novel strategy for implementing community-driven interventions. This prospective cohort study (n = 152), recruited in 2019 and surveyed again in 2020 and 2021, examined individual level changes in diet and physical activity in one rural Appalachian county. During this time, multiple …

Maximal Strength Training Increases Metabolic Energy Expenditure In Sedentary Adults Classified As Obese, Robert E. Anderson Iii

Theses and Dissertations--Nutrition and Food Systems

Background: Metabolic adaptations reduce resting and non-resting energy expenditure to account for approximately 120 kcal/day. Weight loss promotes greater skeletal muscle efficiency, reducing the energy cost of physical activity and is correlated with declines in skeletal muscle glucose oxidation. Maximal Strength Training (MST) has the potential to upregulate glucose utilization and may offset these metabolic adaptations. Objective: To determine if MST offsets markers of metabolic adaptation by increasing resting and non-resting energy expenditure in sedentary individuals classified as obese. Methods: Five (5) participants (2 females, 3 males), ages 18-35 years, with obesity (BMI 30–45 kg/m2) were enrolled in an 8-week …

Policy Implications Of The Covid-19 Pandemic On Food Security In Rural America: Evidence From Appalachia, Kathryn M. Cardarelli, Emily M. Dewitt, Rachel Gillespie, Rachel Hogg-Graham, Heather Norman-Burgdolf, Janet T. Mullins

Dietetics and Human Nutrition Faculty Publications

Rural communities are disproportionally affected by food insecurity, making them vulnerable to the consequences of supply disruptions caused by the COVID-19 pandemic. While access to food was initially diminished due to food supply disruptions, little is known about the mechanisms through which federal emergency assistance programs impacted food access in rural populations. Through a series of five focus groups in spring 2021, we examined the impact of the COVID-19 pandemic on food access in a rural Appalachian community in Kentucky. Data were analyzed using a Grounded Theory Approach. Findings revealed the following four primary themes: food scarcity in grocery stores; …

Sugar-Sweetened Beverage Consumption Among Adults In Rural Appalachia, Heather Norman-Burgdolf, Emily M. Dewitt, Kathryn M. Cardarelli, Rachel Gillespie, Stacey A. Slone, Alison A. Gustafson

Dietetics and Human Nutrition Faculty Publications

Sugar-sweetened beverage (SSB) consumption is decreasing nationally, yet intakes remain high in certain sub-populations as new varieties of SSBs are introduced. This study aims to expand on SSB intake patterns among adults living in Appalachia to develop policy, systems, and environmental (PSE) interventions to reduce consumption. Baseline cohort surveys were conducted to examine beverage consumption patterns of adults in one rural Appalachian county in Kentucky using a validated BEVQ-15 instrument. Ages were collapsed into three generational groups – Millennials (22–38 years), Generation X (39–54 years), and Boomers/Silents (≥55 years). Over half (n = 81; 54%) of the sample (n = …

Factors Associated With Lifestyle Modification For Type 2 Diabetes Self-Management And Prevention, Leigh Anne Koonmen

Theses and Dissertations--Nursing

Diabetes is the seventh leading cause of death in the United States, affecting roughly 13% of U.S. adults aged 18 years or older. Type 2 diabetes accounts for 90-95% of all diabetes cases and is characterized by the progressive development of insulin resistance leading to sustained elevated blood glucose levels. Management of type 2 diabetes includes risk-reduction strategies and continuous medical care to prevent the development of complications.

Lifestyle is a major contributing factor to morbidity and mortality rates in the United States. Preventative health behaviors, such as engaging in physical activity, maintaining a healthy weight, and following a healthy …

Qualitative Analysis Of Maternal Barriers And Perceptions To Participation In A Federal Supplemental Nutrition Program In Rural Appalachian North Carolina, Sydeena E. Isaacs, Lenka H. Shriver, Lauren Haldeman

Journal of Appalachian Health

Background: Little is known about barriers to and perceptions of participation in the in Women, Infants, and Children (WIC) program in rural Appalachia.

Purpose: To gain a deeper understanding of maternal barriers and perceptions related to WIC participation in rural Appalachia

Methods: Pregnant women and mothers were recruited in-person and via flyers from WIC offices in three counties in Appalachian North Carolina. Four semi-structured focus groups were conducted between May to July 2018. Each focus group was approximately 60 minutes long and included open-ended questions about the overall WIC experience in rural Appalachia. Focus groups were audio-recorded, transcribed verbatim, and …

Appalachian Environmental Health Literacy: Building Knowledge And Skills To Protect Health, Anna G. Hoover, Annie Koempel, W. Jay Christian, Kimberly I. Tumlin, Kelly G. Pennell, Steven Evans, Malissa Mcalister, Lindell E. Ormsbee, Dawn Brewer

Journal of Appalachian Health

Environmental health literacy (EHL) is an emerging, multidisciplinary field that promotes understanding of how environmental exposures can affect human health. After discussing the regional relevance of environmental health knowledge and skills, this article describes three ongoing Appalachian projects that are focused on measuring and building EHL.

Arterial Stiffness During Whole-Body Passive Heat Stress In Healthy Older Adults, Zachary J. Schlader, Yoshiyuki Okada, Stuart A. Best, Qi Fu, Craig G. Crandall

Kinesiology and Health Promotion Faculty Publications

We tested the hypothesis that whole‐body passive heat stress reduces arterial stiffness in older adults. At preheat stress (baseline) and when core temperature was elevated by 0.6 ± 0.2°C (mild) and 1.2 ± 0.3°C (moderate), arterial stiffness was measured in eight healthy younger (26 ± 5 years) and eight healthy older (70 ± 4 years) adults in the supine position. Arterial stiffness was estimated from carotid‐to‐femoral pulse wave velocity (cfPWV, applanation tonometry). cfPWV was higher at baseline in older adults (8.8 ± 2.3 m/sec vs. 5.6 ± 0.9 m/sec, P < 0.01) and this difference was maintained throughout passive heat stress (P < 0.01). cfPWV did not change (P ≥ 0.49) with passive heat stress in either …

Promotion Of Fruit And Vegetable Intake Through Recipe Card Distribution And Sampling At Farmers’ Markets Throughout Kentucky, Umaima Sidra Afsheen Syeda

Theses and Dissertations--Nutrition and Food Systems

The Center for Disease Control and Prevention (CDC) reports indicate that 8% and 6.3% of Kentuckians consume enough fruits and vegetables, respectively. The Plate It Up! Kentucky Proud (PIUKP) project is a recipe-development project that aims to boost produce consumption by incorporating local fruits and vegetables. The purpose of this study was to implement promotional strategies using PIUKP recipes at farmers’ markets and determine their effects on consumers’ intent of purchasing and preparing the produce. The study was conducted at nine farmers’ markets across Kentucky (n=300) in collaboration with Cooperative Extension agents/assistants.

The consumers’ impression of the sample was positively …

Comparison Between Kinetic And Kinetic-Kinematic Driven Knee Joint Finite Element Models, Paul O. Bolcos, Mika E. Mononen, Ali Mohammadi, Mohammadhossein Ebrahimi, Matthew S. Tanaka, Michael A. Samaan, Richard B. Souza, Xiaojuan Li, Juha-Sampo Suomalainen, Jukka S. Jurvelin, Juha Töyräs, Rami K. Korhonen

Kinesiology and Health Promotion Faculty Publications

Use of knee joint finite element models for diagnostic purposes is challenging due to their complexity. Therefore, simpler models are needed for studies where a high number of patients need to be analyzed, without compromising the results of the model. In this study, more complex, kinetic (forces and moments) and simpler, kinetic-kinematic (forces and angles) driven finite element models were compared during the stance phase of gait. Patella and tendons were included in the most complex model, while they were absent in the simplest model. The greatest difference between the most complex and simplest models was observed in the internal-external …

Statewide Dissemination And Implementation Of Physical Activity Standards In Afterschool Programs: Two-Year Results, Michael W. Beets, R. Glenn Weaver, Keith Brazendale, Gabrielle Turner-Mcgrievy, Ruth P. Saunders, Justin P. Moore, Collin Webster, Mahmud Khan, Aaron Beighle

Kinesiology and Health Promotion Faculty Publications

Background: In 2015, YMCA afterschool programs (ASPs) across South Carolina, USA pledged to achieve the YMCA physical activity standard calling for all children to accumulate 30 min of moderate-to-vigorous physical activity (MVPA) while attending their ASPs. This study presents the final two-year outcomes from the dissemination and implementation efforts associated with achieving this MVPA standard.

Methods: Twenty ASPs were sampled from all South Carolina YMCA-operated ASPs (N = 97) and visited at baseline (2015) and first (2016) and second year (2017) follow-up. All ASPs were provided training to increase MVPA during the program by extending the scheduled time for …

A Systematic Review Of Consumer Preference For E-Cigarette Attributes: Flavor, Nicotine Strength, And Type, Samane Zare, Mehdi Nemati, Yuqing Zheng

Agricultural Economics Faculty Publications

Objective

Systematic review of research examining consumer preference for the main electronic cigarette (e-cigarette) attributes namely flavor, nicotine strength, and type.

Method

A systematic search of peer-reviewed articles resulted in a pool of 12,933 articles. We included only articles that meet all the selection criteria: (1) peer-reviewed, (2) written in English, and (3) addressed consumer preference for one or more of the e-cigarette attributes including flavor, strength, and type.

Results

66 articles met the inclusion criteria for this review. Consumers preferred flavored e-cigarettes, and such preference varied with age groups and smoking status. We also found that several flavors were …

Examination Of Resistance Settings Based On Body Weight For The 3-Minute All-Out Critical Power Test, Marlene J. Schulte, Jody L. Clasey, Bradley S. Fleenor, Haley C. Bergstrom

Kinesiology and Health Promotion Faculty Publications

There are conflicting suggestions regarding the most valid resistance (3-5% of body weight) to use for the critical power (CP) 3-min all-out (CP_3min) test to estimate CP and anaerobic work capacity (AWC). The purpose of this study was to determine if the CP and AWC estimates from the CP_3min test were affected by the percentage of body weight used to set the resistance on a Monark cycle ergometer. Ten recreationally trained participants (mean ± SD: Age: 22.2 ± 2.2 yrs.) completed the CP_3min test at resistances of 4.5% (CP_4.5%) and 3% (CP_3%) …

Effects Of Very Short-Term Dynamic Constant External Resistance Exercise On Strength And Barbell Velocity In Untrained Individuals, M. Travis Byrd, Haley C. Bergstrom

Kinesiology and Health Promotion Faculty Publications

This study examined the effect of an upper body dynamic constant external resistance (DCER) exercise (barbell bench press [BP]), using the very short-term training (VST) model on strength and barbell velocity. Ten (5 females, 5 males) subjects (mean ± SD age: 21.4 ± 2.8 yrs; height: 1.75 ± 0.12 m; body mass: 83 ± 8.8 kg) completed two pre-test visits (pre-test 1 and pre-test 2) to serve as the within subjects control, three training visits, and one post-test visit. The subject’s 1 repetition maximum (1RM) for the BP as well as the mean (BP_MV) and peak (BP_{PV …}

The Effects Of A Worksite Wellness Program On Prescription Claims, Carrie Deann Davidson

Theses and Dissertations--Kinesiology and Health Promotion

The purpose of this study was to determine the effectiveness of the worksite wellness weight loss program called Weight Loss Matters (WLM) for employees at the University of Kentucky. The three main objectives were to measure the effect of Weight Loss Matters for employees from June 2006 to December 2011 in the following areas (1) prescription claims for hypertension, diabetes, and dyslipidemia, (2) weight loss, and (3) food diary compliance. Participants included 591 employees who participated in WLM for at least one session from 2006 to 2011 for whom there were data. This study employed a Quasi-experiment, longitudinal design. Data …

Riding Through Life: A Lifespan Study Of The Attitudes, Behaviors, And Areas Of Educational Opportunity For Female Equestrians Toward Bra Use And Health Outcomes When Engaged In Equestrian Sports, Karin Pekarchik

Theses and Dissertations--Community & Leadership Development

Equestrian sport is a popular exercise choice for females of all ages, although the links between this exercise choice, health outcomes, and risk to health have not been thoroughly examined. These issues are of particular interest because the female equestrian has the opportunity to ride and/or compete for decades, from early to very late in life, covering almost the full sequence of the female lifespan. Equestrian sports provide physical activity through riding and caring for the horse, and promote positive mental outcomes through tangible practices, such as engaging in physical activity and hard work, goal-setting, acquisition of skills, and participation …

Promoting Healthy Eating And Physical Activity: A Qualitative Examination Of Community-Based Obesity Interventions In Rural Kentucky, Brooke F. Butterworth

Theses and Dissertations--Nutrition and Food Systems

Rural Americans are medically underserved groups and are at greater risk of becoming obese than urban Americans. The purpose of this qualitative study was to determine the perceived causes of obesity in six counties of rural Kentucky and to determine how to customize strategies to reduce obesity in these areas. University of Kentucky Cooperative Extension Service Agents formed coalitions in each of the six counties to assess their communities’ needs and assets to inform plans for implementing evidence-based obesity interventions. Between February and August of 2015, the coalitions were convened for a total of 11 meetings. Each of the coalition …

How Feedback And Goal-Setting Impact Children's Recess Physical Activity, Ryann Koufoudakis, Heather Erwin, Aaron Beighle, Michelle L. Thornton

Kinesiology and Health Promotion Faculty Publications

In recent years, schools desire to promote physical activity (PA) for their students but are restricted due to resources being expended in other areas of their curriculum, including standardized testing preparation. Recess/lunch periods have potential to contribute important amounts of PA to youth’s overall levels. Interventions to maximize PA during recess are warranted. The purpose of this study was to demonstrate the impact of feedback and goal-setting on students’ PA during recess. A sample of 136 (67 females, 69 males) 4^th and 5^th grade students in the Southeast United States wore unsealed Walk4Life pedometers during recess for one …

Comprehensive Sexuality Education In Kentucky, Luciana D. Hockersmith

Theses and Dissertations--Community & Leadership Development

Discussions of sex education of any kind can be controversial in a given setting. Traditional approaches to sex education prompt debate regarding effectiveness. Key indicators central to the effectiveness of sex education continue to be rates of teen pregnancy and transmission of sexually transmitted diseases (STDs). With discontentment surrounding the effectiveness of “traditional approaches,” a more wide-ranging method is worthy of being explored. The curriculum approach of Comprehensive Sexuality Education (CSE) includes six key concepts, and subsequent sub-concepts, intended to provide a broad and even all-inclusive range of topics for a similarly broad and even all-inclusive range of ages of …

Promoting Healthy Home-Cooked Family Meals: Evaluation Of A Social Marketing Program Targeting Low-Income Mothers, Mollie Y. Dawahare

Theses and Dissertations--Nutrition and Food Systems

Objective: Evaluate how a social marketing approach compares to traditional nutrition education curriculum for promoting behavioral changes related to eating and food.

Design: Nonequivalent comparison group, entry-exit design. Participants from 12 Kentucky counties assigned either comparison or pilot group. Comparison group received traditional nutrition education curriculum and pilot group received the social marketing program, Cook Together, Eat Together (CTET) curriculum. EFNEP’s Behavior Checklist and 24-Hour Dietary Recall were administered at entry and exit of the 8-week programs.

Participants: Females (18-72 years of age) from families eligible to receive SNAP benefits (n=64 comparison group participants, n=60 pilot group participants).

Intervention: …

Testing Multi-Theory Model (Mtm) In Predicting Initiation And Sustenance Of Physical Activity Behavior Among College Students, Vinayak K. Nahar, Manoj Sharma, Hannah Priest Catalano, Melinda J. Ickes, Paul Johnson, M. Allison Ford

Kinesiology and Health Promotion Faculty Publications

Background: Most college students do not adequately participate in enough physical activity (PA) to attain health benefits. A theory-based approach is critical in developing effective interventions to promote PA. The purpose of this study was to examine the utility of the newly proposed multi-theory model (MTM) of health behavior change in predicting initiation and sustenance of PA among college students.

Methods: Using a cross-sectional design, a valid and reliable survey was administered in October 2015 electronically to students enrolled at a large Southern US University. The internal consistency Cronbach alphas of the subscales were acceptable (0.65-0.92). Only those who did …

Individual Responses For Muscle Activation, Repetitions, And Volume During Three Sets To Failure Of High- (80% 1rm) Versus Low-Load (30% 1rm) Forearm Flexion Resistance Exercise, Nathaniel D. M. Jenkins, Terry J. Housh, Samuel L. Buckner, Haley C. Bergstrom, Kristen C. Cochrane, Cory M. Smith, Ethan C. Hill, Richard J. Schmidt, Joel T. Cramer

Kinesiology and Health Promotion Faculty Publications

This study compared electromyographic (EMG) amplitude, the number of repetitions completed, and exercise volume during three sets to failure of high- (80% 1RM) versus low-load (30% 1RM) forearm flexion resistance exercise on a subject-by-subject basis. Fifteen men were familiarized, completed forearm flexion 1RM testing. Forty-eight to 72 h later, the subjects completed three sets to failure of dumbbell forearm flexion resistance exercise with 80% (n = 8) or 30% (n = 7) 1RM. EMG amplitude was calculated for every repetition, and the number of repetitions performed and exercise volume were recorded. During sets 1, 2, and 3, one …

Short-Term, High-Fat Diet Accelerates Disuse Atrophy And Protein Degradation In A Muscle-Specific Manner In Mice, Steven L. Roseno, Patrick R. Davis, Lance M. Bollinger, Jonathan J. S. Powell, Carol A. Witczak, Jeffrey J. Brault

Kinesiology and Health Promotion Faculty Publications

BACKGROUND: A short-term high-fat diet impairs mitochondrial function and the ability of skeletal muscle to respond to growth stimuli, but it is unknown whether such a diet alters the ability to respond to atrophy signals. The purpose of this study was to determine whether rapid weigh gain induced by a high-fat (HF) diet accelerates denervation-induced muscle atrophy.

METHODS: Adult, male mice (C57BL/6) were fed a control or HF (60 % calories as fat) diet for 3 weeks (3wHF). Sciatic nerve was sectioned unilaterally for the final 5 or 14 days of the diet. Soleus and extensor digitorum longus …

Global School-Based Childhood Obesity Interventions: A Review, Melinda J. Ickes, Jennifer Mcmullen, Taj Haider, Manoj Sharma

Kinesiology and Health Promotion Faculty Publications

Background: The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this growing concern. The purpose of this review is to compare and contrast U.S. and international school-based obesity prevention interventions and highlight efficacious strategies.

Methods: A systematic literature review was conducted utilizing five relevant databases. Inclusion criteria were: (1) primary research; (2) overweight or obesity prevention interventions; (3) school-based; (4) studies published between 1 January 2002 through 31 December 2013; (5) published in the English language; (6) child-based interventions, which could include parents; and …

School Day Segmented Physical Activity Patterns Of High And Low Active Children, Stuart J. Fairclough, Aaron Beighle, Heather Erwin, Nicola D. Ridgers

Kinesiology and Health Promotion Faculty Publications

BACKGROUND: Variability exists in children's activity patterns due to the association with environmental, social, demographic, and inter-individual factors. This study described accelerometer assessed physical activity patterns of high and low active children during segmented school week days whilst controlling for potential correlates.

METHODS: Two hundred and twenty-three children (mean age: 10.7 ± 0.3 yrs, 55.6% girls, 18.9% overweight/obese) from 8 north-west England primary schools wore ActiGraph GT1M accelerometers for 7 consecutive days during autumn of 2009. ActiGraph counts were converted to minutes of moderate (MPA), vigorous (VPA) and moderate-to-vigorous (MVPA) physical activity. Children were classified as high active (HIGH) or …

Physical Activity, Sleep Patterns, And Health Outcomes In University Law Enforcement Officers, Nicole C. Koebke

Theses and Dissertations--Kinesiology and Health Promotion

Research indicates that law enforcement officers (LEOs) have a higher prevalence of developing coronary artery disease (CAD) compared to the general population. Sleep deprivation and physical inactivity have been found to be related to many risk factors for CAD. This cross-sectional study examined the health status and the relationship between sleep and physical activity outcomes versus CAD risk factors among 27 University LEOs. The subjects’ health behaviors, and CAD and metabolic syndrome risk factors were described using basic statistics. Accelerometer derived sleep and physical activity outcomes were correlated to measures of health to identify potential relationships. 33% of LEOs were …

A Systematic Review Of Physical Activity Interventions In Hispanic Adults, Melinda J. Ickes, Manoj Sharma

Kinesiology and Health Promotion Faculty Publications

Healthy People 2020 aims to achieve health equity, eliminate disparities, and improve the health of all groups. Regular physical activity (PA) improves overall health and fitness and has the capability to reduce risk for chronic diseases. Identifying barriers which relate to the Hispanic population is important when designing PA interventions. Therefore, the purpose was to review existing PA interventions targeting Hispanic adults published between 1988 and 2011. This paper was limited to interventions which included more than 35% Hispanic adults (n = 20). Most of the interventions were community based (n = 16), although clinical, family-based, and faith-based …

Relationships Of Access And Affordability To Household Food Security Status Among Rural, Low Income Caregivers, Jodi Elaine Marani

Theses and Dissertations--Kinesiology and Health Promotion

Household food security status in rural areas is a significant issue facing caregivers as positive health outcomes depend on appropriate access to healthy foods necessary to lead an active life. Access and affordability of healthy foods are two mediating factors of household food security that may be improved to ultimately increase rates of food security and overall health status among rural, low income populations.

The purpose of the study was to examine the factors of access and affordability of nutritionally adequate food sources in one rural community in relation to food security status through the perspective of its caregivers. In …

Differential Neuromuscular Training Effects On Acl Injury Risk Factors In"High-Risk" Versus "Low-Risk" Athletes, Gregory D. Myer, Kevin R. Ford, Jensen L. Brent, Timothy E. Hewett

Kinesiology and Health Promotion Faculty Publications

BACKGROUND: Neuromuscular training may reduce risk factors that contribute to ACL injury incidence in female athletes. Multi-component, ACL injury prevention training programs can be time and labor intensive, which may ultimately limit training program utilization or compliance. The purpose of this study was to determine the effect of neuromuscular training on those classified as "high-risk" compared to those classified as "low-risk." The hypothesis was that high-risk athletes would decrease knee abduction moments while low-risk and control athletes would not show measurable changes.

METHODS: Eighteen high school female athletes participated in neuromuscular training 3x/week over a 7-week period. Knee kinematics and …