Digital Commons Network^™

A Social Media Game To Increase Physical Activity Among Older Adult Women: Protocol Of A Randomized Controlled Trial To Evaluate Challenge, Michael C Robertson, Maria Chang Swartz, Karen M Basen-Engquist, Yisheng Li, Kristofer Jennings, Debbe Thompson, Tom Baranowski, Elena Volpi, Elizabeth J Lyons

Faculty, Staff and Student Publications

BACKGROUND: Older adult women often do not engage in sufficient physical activity (PA) and can encounter biological changes that exacerbate the negative effects of inadequate activity. Wearable activity monitors can facilitate PA initiation, but evidence of sustained behavior change is lacking. Supplementing wearable technologies with intervention content that evokes enjoyment, interest, meaning, and personal values associated with PA may support long term adherence. In this paper, we present the protocol of an NIA-funded study designed to evaluate the efficacy of CHALLENGE for increasing step count and motivation for PA in insufficiently active older women (Challenges for Healthy Aging: Leveraging Limits …

Integrated Delivery Of Health Care And Continuity Of Care For Older Mississippians With Mental And Behavioral Health Concerns, Tockie V. Hemphill

Journal of Public Health in the Deep South

The mental health of older adults is of national concern. There is some uncertainty regarding access to care and whether mental and behavioral health care will be readily available in primary care settings. This paper explores the concepts of integrated delivery of care and continuity of care for older adults. The definitions of the two concepts vary in detail, but are similar in purpose. There is an array of strategies presented that outline a continuity of care that involves an integrated delivery system. Relationship development is the core of this system, as well as older adults’ ability and willingness to …

Aging Redefined: Moving Past The Deficit Model, Aaron Guest

Journal of Public Health in the Deep South

The remarkable increase in longevity is the pivotal triumph of public health over the last two centuries. Yet, even as we experience the benefits of increased longevity, we continue to face rampant ageism – or the prejudice and discrimination directed at individuals perceived as 'old.' Worst of all, we know that ageism is associated with increased medical costs, poorer health outcomes, and increased mortality. Efforts to combat ageism have been insufficient. The triumvirate of ageism, gerontological illiteracy, and gerontophobia have resulted in a deficit model of aging. Far from being a liability, the rapid increase in the aging population presents …

Caregiver To Caregiver: An Exploratory Case Study In Adult Family Caregiving Experiences, Tamara Brocks, Kaye Bender

Journal of Public Health in the Deep South

Adult family caregiving is a national public health issue which is more prominently recognized since the COVID pandemic. The National Strategy to Support Family Caregivers (2022) highlights more than three hundred federal government actions in support of family caregivers and more than 150 actions that can be addressed at other levels of government with their partnerships to build a caregiver support system. A partnership between the Mississippi State Department of Health (MSDH), the Mississippi Public Health Association (MPHA) and AARP MS is working to address many of the issues related to the heathy aging ecosystem in Mississippi. This case study …

Personality Profile Of Rural-Dwelling Older Adults With Hoarding Disorder, Mary E. Dozier, Caitlyn A. Nix, Hilary L. Deshong

Journal of Public Health in the Deep South

Hoarding in late life represents a major barrier to aging in place, particularly for rural-dwelling older adults. One risk factor for hoarding disorder in late life may be underlying personality factors. However, there has not yet been an investigation of late life hoarding and possible maladaptive personality factors from the continuous five-factor model perspective in a sample of individuals diagnosed with hoarding disorder. Thus, we evaluated the five-factor personality profiles of older adults enrolled in treatment studies for hoarding disorder in rural Mississippi. Raw scores on the International Personality Item Pool-NEO-60 were converted into categories of Low (<1SD from …

Chronic Obstructive Pulmonary Disease Hot Spots In Mississippi, Taylor Jansen, Elizabeth Dugan

Journal of Public Health in the Deep South

Abstract

Introduction. Chronic obstructive pulmonary disease (COPD) is the sixth leading cause of death in the US and approximately 10% of people 65 years and older have COPD. This study examines the association of geographic-level risk factors with chronic obstructive pulmonary disease (COPD) prevalence using spatial-based analyses with the goal of identifying risk factors associated with county-level COPD and to identify communities at risk.

Methods. The study sample consisted of all N=82 counties in Mississippi and all data is reported at the county level. All measures were drawn from the 2023 Mississippi Healthy Aging Data Report. A hot spot …

The Mississippi Healthy Aging Data Report: Tools To Advance Health Equity, Elizabeth Dugan, Taylor Jansen, Chae Man Lee, Nina M. Silverstein, Yan-Jhu Su

Journal of Public Health in the Deep South

Introduction. This article describes the Mississippi Healthy Aging Data Report, which includes 125 indicators reported at the county and state level.

Methods. Data sources include the American Community Survey from the U.S. Census, the Behavioral Risk Factor Surveillance Survey, the Centers for Medicaid and Medicare Services, and other sources. Small-area estimation techniques are used to calculate age- and gender-adjusted county rates. Data visualizations illustrate health disparities.

Results. Mississippi is home to 663,581 people age 60 or older – 22% of the state’s total population. Approximately 12.9% of Medicare beneficiaries in Mississippi have Alzheimer’s disease or a related …

Association Of Self-Report Measures With Salivary Biomarkers In Post-Menopausal Women, Laree M. Hiser, Karen Arrant, Jung Hye S. Lee, Lei Zhang

Journal of Public Health in the Deep South

Background: Symptoms of menopause include inadequate sleep, depression, and anxiety. Studies of healthy aging frequently use self-report tools that are unverified by objective measures.

Purpose: To investigate the correlation between self-report measures of sleep or affect and salivary biomarkers in a small (n=32) sample of post-menopausal women.

Methods: Salivary cortisol and a-amylase were quantified by laboratory tests. Self-report data included hours of sleep and Patient-Reported Outcomes Measurement Information System (PROMIS^®) tools for sleep disturbance, anxiety, and depression. Correlation analyses were conducted between self-reported measures and biomarker concentrations.

Results: No statistically significant correlations were found between cortisol …

Optimizing Geriatric Care: A Niche-Driven Daily Implementation Of The 5ms Geriatric Assessment Tool To Minimize Length Of Stay, Lori Ann Aston-Dixon

Master's Projects and Capstones

Abstract

Background: This project's microsystem was a 32-bed medical-surgical telemetry unit at a small community hospital in Marin County. The unit needed a framework that focused on the unique needs of the geriatric population and daily activities that enhanced physical and cognitive activities to mitigate risks for any issues that created a prolonged Length of Stay (LOS).

Problem: The microsystem is a medical-surgical telemetry unit where the average length of stay (LOS) is five days, surpassing the organization's goal of four days. Reducing LOS can enhance patient satisfaction and meet organizational targets.

Context: This project aims to reduce the extended …

Rheumatoid Arthritis Disease Activity Is Associated With Frailty In Veterans, Courtney N. Loecker

Theses & Dissertations

Frailty, a physiologic vulnerability to everyday stressors, affects approximately 30% of the 1.3 million Americans with rheumatoid arthritis (RA) and is associated with increased risk for adverse health outcomes. Active RA manifests as inflammation, pain, and joint damage leading to functional impairments and morbidity which cumulatively influences frailty. However, the relationship between RA disease activity and frailty is incompletely understood.

This study evaluated the relationship of RA disease activity and frailty at baseline and over up to five years in Veterans. A cohort study was performed using data from the Veterans Affairs Rheumatoid Arthritis registry. RA disease activity was measured …

Decreasing Incivility Through Improved Communication And Teamwork, Marvin Ernest Tamayo

Master's Projects and Capstones

Problem: Workplace incivility (WI), lateral violence (LV), and bullying in healthcare settings are pervasive issues negatively impacting staff morale, turnover rates, and patient care outcomes. High turnover and low employee satisfaction scores from a September 2023 culture of safety survey signaled a toxic work environment characterized by ineffective communication and unprofessional behavior. Context: A 24-bed telemetry-stroke unit at a 172-bed acute care facility in the North Bay area of San Francisco.

Interventions: The Transtheoretical Model (TTM) of behavior change and the Crucial Conversation frameworks were used to improve staff communication and reduce incivility.

Measures: September 2023 and March …

Preventing Hospitalization-Associated Disability, Elizabeth M. White

Master's Projects and Capstones

Problem: Hospital-associated disability (HAD) affects one-third of hospitalized adults, diminishing post-discharge independence and contributing to high mortality rates. Identifying at-risk patients through early assessment of nutritional and functional status upon admission is critical to personalizing care and improving discharge outcomes.

Context: A 24-bed adult medical-surgical unit in a 173-bed suburban hospital in Northern California is part of a large not-for-profit healthcare organization. Interventions: Nursing staff received education on the Enhanced Recovery Medicine (ERM) pathway designed to prevent HAD. A visual display board, maintained and updated by unit champions, gave staff performance feedback. Nursing leadership reviewed admission assessments and addressed barriers …

Intermittent Clearance Of P21-Highly-Expressing Cells Extends Lifespan And Confers Sustained Benefits To Health And Physical Function, Binsheng Wang, Lichao Wang, Nathan S Gasek, Chia-Ling Kuo, Jia Nie, Taewan Kim, Pengyi Yan, Junyu Zhu, Blake L Torrance, Yueying Zhou, Lisa C Flores, Colton Allen, Allison M Andrade, Chun Guo, Rachel L Cohn, Evan R Jellison, Jenna M Bartley, George A Kuchel, Sheng Li, Tamar Pirtskhalava, Tamar Tchkonia, Sumit Yadav, Laura Haynes, James L Kirkland, Yuji Ikeno, Ming Xu

Faculty, Staff and Student Publications

A key challenge in aging research is to extend lifespan in tandem with slowing down functional decline so that the life with good health (healthspan) can be extended. Here, we show that monthly clearance of a small number of cells, which highly express p21Cip1 (p21high), starting from 20 months improves cardiac and metabolic function, and extends both median and maximum lifespan in mice. Importantly, by assessing health and physical function of these mice monthly until death, we show that clearance of p21high cells improves physical function at all remaining stages of life, suggesting healthspan extension. Mechanistically, …

Changes In Atherosclerotic Cardiovascular Disease Risk Scores In A Predominantly Black Cohort With Hiv And Associated Comorbidities: A Preliminary Study, Shana A B Burrowes, Erin Zisman, Lori E Fantry, Quoc Bui, Angela Wu, John Sorkin, Michael Miller, Shashwatee Bagchi

2020-Current year OA Pubs

INTRODUCTION: People with HIV (PWH) have an increased risk of atherosclerotic cardiovascular disease (ASCVD) compared to non-PWH, but the reasons for this increased risk remain elusive. We investigated the change in ASCVD risk scores over 4 years to identify clinical factors associated with change in risk scores or high-risk scores.

METHODS: We conducted a preliminary study using retrospective analysis of PWH, between 40 and 75 years old, seen at the Evelyn Jordan Center with at least two routine HIV visits. We collected clinical and demographic data and calculated the ASCVD risk scores using the Pooled Cohort Equation. Exploratory analyses examined …

Whole Genome Sequencing Based Analysis Of Inflammation Biomarkers In The Trans-Omics For Precision Medicine (Topmed) Consortium, Min-Zhi Jiang, Sheila M Gaynor, Xihao Li, Eric Van Buren, Adrienne Stilp, Erin Buth, Fei Fei Wang, Regina Manansala, Stephanie M Gogarten, Zilin Li, Linda M Polfus, Shabnam Salimi, Joshua C Bis, Nathan Pankratz, Lisa R Yanek, Peter Durda, Russell P Tracy, Stephen S Rich, Jerome I Rotter, Braxton D Mitchell, Joshua P Lewis, Bruce M Psaty, Katherine A Pratte, Edwin K Silverman, Robert C Kaplan, Christy Avery, Kari E North, Rasika A Mathias, Nauder Faraday, Honghuang Lin, Biqi Wang, April P Carson, Arnita F Norwood, Richard A Gibbs, Charles Kooperberg, Jessica Lundin, Ulrike Peters, Josée Dupuis, Lifang Hou, Myriam Fornage, Emelia J Benjamin, Alexander P Reiner, Russell P Bowler, Xihong Lin, Paul L Auer, Laura M Raffield, Nhlbi Trans-Omics For Precision Medicine (Topmed) Consortium, Topmed Inflammation Working Group

Faculty, Staff and Student Publications

Inflammation biomarkers can provide valuable insight into the role of inflammatory processes in many diseases and conditions. Sequencing based analyses of such biomarkers can also serve as an exemplar of the genetic architecture of quantitative traits. To evaluate the biological insight, which can be provided by a multi-ancestry, whole-genome based association study, we performed a comprehensive analysis of 21 inflammation biomarkers from up to 38 465 individuals with whole-genome sequencing from the Trans-Omics for Precision Medicine (TOPMed) program (with varying sample size by trait, where the minimum sample size was n = 737 for MMP-1). We identified 22 distinct single-variant …

Navigating Change: Cultivating Faculty Support For Curriculum Revision Through The 4ms Framework, Sarah Dearing

Doctor of Nursing Practice Projects

Public campaigns have increased awareness of Alzheimer’s disease and other dementias, however, education for healthcare providers concerning brain health and appropriate screenings to identify elderly patients at risk is not present. This curricular policy change project outlines the need for faculty buy-in to complete a curriculum change that addresses the lack of geriatric-evidence based education within an Associate of Applied Science in Nursing (AASN) program. Qualitative data identifies the amount of geriatric-evidence based education present in the current AASN curriculum map. Using Lewin’s change management theory (CMT) and the Cognitive-Affective-Social Theory of Learning Environments (CASTLE), an educational module teaching the …

Enhancing Family Nurse Practitioner Education Through End-Of-Life Simulation: A Quality Improvement Project, Deborah Jamison

Doctor of Nursing Practice Projects

Providing compassionate and effective end-of-life care is a crucial skill for Family Nurse Practitioners (FNP) students (Collins & Small, 2019). However, many students experience significant anxiety and lack confidence in such challenging situations. The problem identified for the Doctor of Nursing Practice (DNP) Quality Improvement (QI) project is the lack of training focused on end-of-life care in the FNP program at a College of Nursing (CON) within an academic clinical center. The project’s purpose was to improve confidence and anxiety levels among FNP students in providing end-of-life care. The project aimed to create an inventive and immersive end-of-life simulation with …

It Was Difficult To Understand The System: Developing A Coordinator Role To Support International Nursing Students- A Qualitative Study, Nick Gibson, Amanda Graf, Tania Beament, Neil Ferguson, Esther Adama, Deborah Kirk, Joyce Muge-Sugutt, Kylie Mccullough

Research outputs 2022 to 2026

International students are an important component of the host country and universities bringing economic, social, and community contributions. International students are the most vulnerable students with challenges related to academic expectations, language proficiency, and socio-cultural integration. This study explores the challenges of international students in a Western Australian School of Nursing and Midwifery. An exploratory questionnaire (n=10), three focus groups (n=15) and a quality improvement survey (n=80) informed this study. Four themes emerged: stress in the first weeks, incorrect and/or late enrolments, lack of guidance and support, and system navigation nightmares. Other issues included: accommodation, culture shock, financial concerns, information …

Development Of A Thwarted Belonging Measure In Older Adults: An Application To Neighborhood Context And The Moderating Role Of Neuroticism, Jaclyn Elisa Keenoy

Theses, Dissertations and Culminating Projects

This research focuses on thwarted belonging (TB), its associations with the neighborhood contextual factors of social cohesion and physical disorder in older adults, and the moderating role of neuroticism. TB is a key component of the Interpersonal Psychological Theory of Suicide (IPTS) that has serious implications for health and well-being (Van Orden et al., 2012). Despite these implications, TB is less frequently investigated outside of the suicide literature. Thus, the first aim of this research was to create a valid measure of TB in a sample of 5,001 older adults using data from the Health and Retirement Study using a …

The Impact Of Sense Of Loneliness On Geriatric Depression: The Mediating Role Of Sense Of Mattering And Psychological Adjustment Download Pdf, Haya K. Aman Ms.

psychology

Background

Depression is a highly prevalent mental disorder in older adults, and among its highest risk factors is loneliness. Although this relationship is commonly evident, the mechanisms underlying it, such as sense of mattering and psychological adjustment, lack exploration. The current research aims to examine the relationship between loneliness and geriatric depression and explore the mediating roles of sense of mattering and psychological adjustment.

Methods

A sample of 200 older adults (63.5% females; mean age = 75.6; SD = 8.806) were recruited from 24 geriatric homes in Cairo, Egypt. Participants responded to the Arabic versions of the Mini-Mental State Examination …

Apolipoprotein Ε4 Is Associated With Increased Risk Of Fall- And Fracture-Related Hospitalization: The Perth Longitudinal Study Of Ageing Women, Jedd Pratt, Jack Dalla Via, Craig Sale, Abadi K. Gebre, Blossom C.M. Stephan, Simon Laws, Kun Zhu, Wai H. Lim, Richard L. Prince, Joshua R. Lewis, Marc Sim

Research outputs 2022 to 2026

Apolipoprotein ε4 (APOE ε4) may be a genetic risk factor for reduced bone mineral density (BMD) and muscle function, which could have implications for fall and fracture risk. We examined the association between APOE ε4 status and long-term fall- and fracture-related hospitalization risk in older women. A total of 1 276 community-dwelling women from the Perth Longitudinal Study of Aging Women (mean age ± SD = 75.2 ± 2.7 years) were included. At baseline, women underwent APOE genotyping and detailed phenotyping for covariates including prevalent falls and fractures, as well as health and lifestyle factors. The association between APOE ε4 …

Assessing Sarcopenia In Advanced-Stage Ovarian Cancer Patients Undergoing Neoadjuvant Chemotherapy: A Case Series, Christelle Schofield, Dennis R. Taaffe, Robert U. Newton, Daniel A. Galvão, Paul A. Cohen, Jin Soo Kim, Tarek Meniawy, Carolyn Peddle-Mcintyre

Research outputs 2022 to 2026

Objectives: In ovarian and other cancers, low muscle mass and density are associated with poorer clinical outcomes. However, screening for cancer-related sarcopenia (typically defined as low muscle mass) is not routinely conducted. The European Working Group on Sarcopenia in Older People (EWGSOP) recommends an algorithm for sarcopenia screening and diagnosis in clinical settings, with sarcopenia based on muscle strength and mass, and severity on physical performance. We explored the application of the EWGSOP2 algorithm to assess sarcopenia in six ovarian cancer patients receiving neoadjuvant chemotherapy. Methods: We assessed sarcopenia risk with the SARC-F screening questionnaire (at risk ≥4 points), muscle …

Acute Effects Of Multi-Joint Eccentric Exercise On Lower Extremity Muscle Activation Measured During Land And Water Walking, Brayden Worley

All Graduate Reports and Creative Projects, Fall 2023 to Present

Although prior literature has established the preliminary clinical benefits of aquatic exercise across various clinical populations, there is a need to explore the potential for including aquatic-based movement as a key component of a multi-modal approach toward improving mobility and reducing fall risk. Eccentric exercise may complement aquatic exercise given that movements performed in water immersion tend to be low impact. Eccentric exercise may also improve the passive stiffness of lower extremity extensors, which gives an additional rationale for the potential of eccentric exercise to reduce fall risk when combined with aquatic exercise. There may also be an acute response …

Age-Related Dysregulation Of The Retinal Transcriptome In African Turquoise Killifish, Steven Bergmans, Nicole C L Noel, Luca Masin, Ellen G Harding, Aleksandra M Krzywańska, Julie D De Schutter, Rajagopal Ayana, Chi-Kuo Hu, Lut Arckens, Philip A Ruzycki, Ryan B Macdonald, Brian S Clark, Lieve Moons

2020-Current year OA Pubs

Age-related vision loss caused by retinal neurodegenerative pathologies is becoming more prevalent in our ageing society. To understand the physiological and molecular impact of ageing on retinal homeostasis, we used the short-lived African turquoise killifish, a model known to naturally develop central nervous system (CNS) ageing hallmarks and vision loss. Bulk and single-cell RNA-sequencing (scRNAseq) of three age groups (6-, 12-, and 18-week-old) identified transcriptional ageing fingerprints in the killifish retina, unveiling pathways also identified in the aged brain, including oxidative stress, gliosis, and inflammageing. These findings were comparable to observations in the ageing mouse retina. Additionally, transcriptional changes in …

A Protocol For The Inclusion Of Minoritized Persons In Alzheimer Disease Research From The Adni3 Diversity Taskforce, Ozioma C Okonkwo, Beau M Ances, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Black or African American (hereinafter, Black) and Hispanic or Latino/a/x (hereinafter, Latinx) adults are disproportionally affected by Alzheimer disease, but most research studies do not enroll adequate numbers of both of these populations. The Alzheimer's Disease Neuroimaging Initiative-3 (ADNI3) launched a diversity taskforce to pilot a multipronged effort to increase the study inclusion of Black and Latinx older adults.

OBJECTIVE: To describe and evaluate the culturally informed and community-engaged inclusion efforts to increase the screening and enrollment of Black and Latinx older adults in ADNI3.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used baseline data from a longitudinal, multisite, …

Associations Of Mid-To-Late-Life Inflammation With Late-Life Mobility And The Influences Of Chronic Comorbidities, Race, And Social Determinants Of Health: The Atherosclerosis Risk In Communities Study, Kirby G Parker, B Gwen Windham, Chad Blackshear, Keenan A Walker, Sara B Parker, Ron C Hoogeveen, Christie M Ballantyne, Anna Kucharska-Newton, Priya Palta, Elizabeth Selvin, Maria Vassilaki, Thomas H Mosley, Michael E Griswold

Faculty, Staff and Students Publications

Background: Relationships of midlife inflammation with late-life mobility and influences of chronic health conditions, race, and social determinants of health (SDoH) on these relationships are poorly understood.

Methods: Among 4758 community-dwelling participants (41% men, 20% Black), high-sensitivity C-reactive protein (hsCRP) was measured over 20+ years: in midlife at study visit 2 (V2: 1990-1992, 47-68 years); at V4 (1996-1998, 53-74 years); and with concurrent late-life 4-m gait speed at V5 (2011-2013, 67-88 years, mean 75 years). SDoH measures included race, the national-rank area deprivation index, education, and income. We examined associations of late-life gait speed with midlife hsCRP (V2 continuous and …

Covering The Care: Most Prevalent Health Conditions And Their Associated Costs Among Nh’S Insured Population – Behavioral Health And Cardiovascular Disease Top The List, Bethany Swanson, Erica Plante, Deborah Fournier

Faculty Publications

This data brief presents an analysis of available claims data from New Hampshire’s commercial, Medicaid, and Medicare insured populations. Specifically, the study identifies the top ten most prevalent health conditions, the cost of treatment for those conditions, and the overall medical cost for those with one of the identified conditions. The analysis is based on the most recent calendar year of available claims data (January – December 2022).

Frailty Explains Variation In Emergency Department Use For Older Veterans During The Covid-19 Pandemic, Justine Seidenfeld, Karen M. Stechuchak, Valerie A. Smith, Catherine Stanwyck, Chelsea Perfect, Courtney Van Houtven, Susan Nicole Hastings

Journal of Geriatric Emergency Medicine

Background: Older adults were critically vulnerable to disruptions in health care during the COVID-19 pandemic, but it is not known if changes in ED utilization varied based on patient characteristics. Using a cohort of older Veterans, we examined changes in ED visit rates based on four characteristics of interest: age, race, area deprivation index, and frailty

Methods: Participants were aged ≥65, with ≥2 visits in primary or geriatric clinics between 02/02/2018-05/07/2019. An adjusted negative binomial regression model was constructed for each characteristic. We report mean counts of all ED visits by quarter for subgroups separately, and report rate …

Impacts Of Social Media Use On The Wellbeing Of Older Adults : Evidence From China During The Covid-19 Pandemic, Xuying Dong

Lingnan Theses (Doctoral degree)

Given the trend of increasing use of information and communication technologies among Chinese elder population, more attention should be drawn on the relationship between social media use and wellbeing of older adults. This research explores the social media use situation among older adults in mainland China as well as its influences on their wellbeing, and employs a mixed approach including quantitative questionnaire distributed via WeChat social media platform and qualitative interview among Chinese older adults who are over 60 years of age in Jingzhou, Hubei Province. Generally speaking, social media use can improve the wellbeing of Chinese older adults, more …

Factors Related To Physical Activity Of Patients With Permanent Cardiac Pacemaker, Priyaporn Phruksahiran, Noraluk Ua-Kit

Chulalongkorn Medical Journal

Background: Over 1.3 million patients worldwide have permanent cardiac pacemakers (PPM). Patients with PPM, in the first to third months after implantation, still report problems with physical activity (PA), such as limitations in their lives, jobs, and exercise, inability to perform activities as before, and decreased PA.

Objectives: This study aimed to investigate the PA of patients with PPM and identify factors (age, perceived self-efficacy, perceived benefits, perceived barriers, social support, and health literacy) related to the PA of patients with PPM.

Methods: This descriptive-correlational study included 110 male and female patients with PPM from three tertiary hospitals in …