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2019

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The Impact Of Maternal Nutrition During Pregnancy On Inflammation And Birth Outcomes, Lori Ogden Jan 2019

The Impact Of Maternal Nutrition During Pregnancy On Inflammation And Birth Outcomes, Lori Ogden

Theses and Dissertations--Nursing

More than 85% of American adults do not consume recommended amounts of fruits or vegetables. Preterm birth and hypertensive disorders of pregnancy are common adverse conditions affecting pregnancy and are leading causes of maternal and fetal morbidity and mortality. Preterm birth affects nearly 10% of all births in the United States and is on the rise, as are hypertensive disorders, which have increased by 25% over the last two decades. Pregnancy is a state of controlled inflammation, and dysregulation has been linked to preterm birth and other adverse gestational outcomes. A healthy diet is recommended in pregnancy, but little is …


Developing A Workflow To Evaluate Medications For Repurposing Using Health Claims Data: Application To Substance Use Disorders, Emily Ruth Hankosky Jan 2019

Developing A Workflow To Evaluate Medications For Repurposing Using Health Claims Data: Application To Substance Use Disorders, Emily Ruth Hankosky

Theses and Dissertations--Pharmacy

Healthcare big data are a growing source of real-world data with which to identify and validate medications with repurposing potential. Previously, we developed a claims-based workflow to evaluate medications with potential to treat stimulant use disorders. In order to test the workflow, the framework was applied in the context of opioid use disorders (OUDs), for which there are medications with known efficacy. Using the Truven Marketscan Commercial Claims Database, a nested case-control analysis was conducted to determine the association between OUD medications (buprenorphine, naltrexone) and remission. Cases were defined as enrollees with a remission diagnosis and matched (1:4) to controls …


Therapeutic Video Games And The Simulation Of Executive Function Deficits In Adhd, Markus Tiitto Jan 2019

Therapeutic Video Games And The Simulation Of Executive Function Deficits In Adhd, Markus Tiitto

Theses and Dissertations--Pharmacy

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by difficulty paying attention, impulsivity, and hyperactivity. Diagnosis of ADHD rose 42% from 2003–2004 to 2011–2012. In 2011, 3.5 million children were treated with drugs. Optimizing therapy can take a year, and may not be completely effective.

A clinical trial is currently being conducted of a device/drug combination using the computer game Minecraft, to determine how certain activities affect executive function, working memory, and restraint in patients diagnosed with ADHD. The human subjects’ responses are being modeled using artificial neural networks (ANNs), an artificial intelligence method that can be utilized …


Toward An Enzyme-Coupled, Bioorthogonal Platform For Methyltransferases: Probing The Specificity Of Methionine Adenosyltransferases, Tyler D. Huber Jan 2019

Toward An Enzyme-Coupled, Bioorthogonal Platform For Methyltransferases: Probing The Specificity Of Methionine Adenosyltransferases, Tyler D. Huber

Theses and Dissertations--Pharmacy

Methyl group transfer from S-adenosyl-l-methionine (AdoMet) to various substrates including DNA, proteins, and natural products (NPs), is accomplished by methyltransferases (MTs). Analogs of AdoMet, bearing an alternative S-alkyl group can be exploited, in the context of an array of wild-type MT-catalyzed reactions, to differentially alkylate DNA, proteins, and NPs. This technology provides a means to elucidate MT targets by the MT-mediated installation of chemoselective handles from AdoMet analogs to biologically relevant molecules and affords researchers a fresh route to diversify NP scaffolds by permitting the differential alkylation of chemical sites vulnerable to NP MTs that are unreactive to …


A Pilot Study Of A Multiple Health Behavior Change Intervention For Smokers, Srihari Seshadri Jan 2019

A Pilot Study Of A Multiple Health Behavior Change Intervention For Smokers, Srihari Seshadri

Theses and Dissertations--Clinical and Translational Science

Background: Being both obese and a smoker increases the probability of developing type 2 diabetes, cardiovascular disease, and cancer, diseases that impact Kentucky residents disproportionately. Kentucky (KY) has a high incidence of obesity (34.2%) and smoking (24.5 %). Weight gain associated with smoking cessation also can undermine health benefits of quitting, and may lead to smoking relapse.

Aim: The aim of the pilot study was to implement and evaluate a Multiple Health Behavioral Change (MHBC) program that combines Cooper Clayton Method to Stop Smoking (CCMSS) and the Diabetes Prevention Program (DPP) for weight control.

Method: A 15-week intervention was administered …


The Impact Of Dysphagia And Gastrostomy On Quality Of Life In Caregivers Of Patients With Amyotrophic Lateral Sclerosis, Emily Clare Sither Goggin Jan 2019

The Impact Of Dysphagia And Gastrostomy On Quality Of Life In Caregivers Of Patients With Amyotrophic Lateral Sclerosis, Emily Clare Sither Goggin

Theses and Dissertations--Communication Sciences and Disorders

There is little research studying the relationship between caregiver quality of life and gastrostomy, a palliative intervention recommended to manage dysphagia and malnutrition in patients diagnosed with Amyotrophic Lateral Sclerosis (ALS). To facilitate a more comprehensive assessment of treatment effectiveness and to better guide patients and their families, this study investigated the relationship between gastrostomy, caregiver strain, and patient disease-related factors. Patients with bulbar-onset ALS and their caregivers were recruited regardless of their decision to accept or decline future gastrostomy. Caregivers completed the Modified Caregiver Strain Index (MCSI) to assess levels of caregiver strain as an index of quality of …


Changes In Muscle Size, Quality And Power Are Related To Physical Function In Patients With Critical Illness, Kirby Mayer Jan 2019

Changes In Muscle Size, Quality And Power Are Related To Physical Function In Patients With Critical Illness, Kirby Mayer

Theses and Dissertations--Rehabilitation Sciences

Patients admitted to intensive care unit (ICU) are known to develop significant impairments in physical function. Patients with critical illness suffer up to 30% reductions in muscle size within the first ten days of admission to the ICU. Muscle strength testing, Medical Research Council-sum score, is current gold-standard to diagnosis ICU-acquired weakness and predicts risk of mortality and long-term physical function. Muscle power different from muscle strength in that it accounts for velocity of movement, is potentially a better independent predictor of function that has not been studied in this population. In addition, we hypothesize that muscle size and quality …


Pyocyanin, A Virulence Factor Produced By Sepsis-Causing Pseudomonas Aeruginosa, Promotes Adipose Wasting And Cachexia, Nika Larian Jan 2019

Pyocyanin, A Virulence Factor Produced By Sepsis-Causing Pseudomonas Aeruginosa, Promotes Adipose Wasting And Cachexia, Nika Larian

Theses and Dissertations--Pharmacology and Nutritional Sciences

Sepsis is a leading cause of death among critically ill patients that results in metabolic alterations including hypercatabolism, lipoatrophy, and muscle wasting, contributing to the development of cachexia. Septic cachexia is associated with loss of body weight, fat mass, and lean mass and dysregulated immune function. There are currently no efficacious treatment strategies for septic cachexia, and nutritional interventions have limited success in preventing hypercatabolic wasting. Pyocyanin is a virulence factor produced by sepsis-causing Pseudomonas aeruginosa that has been shown to activate the aryl hydrocarbon receptor (AhR), increase inflammation, and produce reactive oxygen species. Thus, pyocyanin represents a novel mechanistic …


The Role Of Endoplasmic Reticulum Stress In Ethanol-Induced Neurodegeneration, Yongchao Wang Jan 2019

The Role Of Endoplasmic Reticulum Stress In Ethanol-Induced Neurodegeneration, Yongchao Wang

Theses and Dissertations--Pharmacology and Nutritional Sciences

Heavy ethanol use causes neurodegeneration manifested by neuronal loss and dysfunction. It is becoming imperative to delineate the underlying mechanism to promote the treatment of ethanol-induced neurodegeneration. Endoplasmic reticulum (ER) stress is a hallmark and an underlying mechanism of many neurodegenerative diseases. This study aims to investigate the role of ER stress in ethanol-induced neurodegeneration. In experimental design, adult mice were exposed to binge ethanol drinking by daily gavage for 1, 5, or 10 days and the response of ER stress was examined. We found the induction of ER stress appeared at 5 days and remained at 10 days. Moreover, …


Azithromycin Therapy Reduces Cardiac Inflammation And Mitigates Adverse Cardiac Remodeling After Myocardial Infarction, Ahmed Hamish Neamah Al-Darraji Jan 2019

Azithromycin Therapy Reduces Cardiac Inflammation And Mitigates Adverse Cardiac Remodeling After Myocardial Infarction, Ahmed Hamish Neamah Al-Darraji

Theses and Dissertations--Pharmacology and Nutritional Sciences

Introduction: Myocardial infarction (MI) remains the leading cause of morbidity and mortality worldwide. Induced by cardiomyocyte death, MI initiates a prolonged and uncontrolled inflammatory response which impairs the healing process. Immune cells, such as macrophages, play a central role in organizing the early post-MI inflammatory response and the subsequent repair phase. Two activation states of macrophages have been identified with distinct and complementary functions (inflammatory vs. reparatory). This bimodal pattern of macrophage activation is an attractive therapeutic target to favorably resolve post-MI inflammation and enhance recovery. It has been demonstrated that azithromycin (AZM), a commonly used antibiotic with immunomodulatory effects, …


Exploring The Role Of Insulin Receptor Signaling In Hippocampal Learning And Memory, Neuronal Calcium Dysregulation, And Glucose Metabolism, Hilaree N. Frazier Jan 2019

Exploring The Role Of Insulin Receptor Signaling In Hippocampal Learning And Memory, Neuronal Calcium Dysregulation, And Glucose Metabolism, Hilaree N. Frazier

Theses and Dissertations--Pharmacology and Nutritional Sciences

In the late 90’s, emerging evidence revealed that the brain is insulin-sensitive, highlighted by broad expression of brain-specific insulin receptors and reports of circulating brain insulin. Contemporary literature robustly supports the role of insulin signaling in normal brain function and suggests that insulin-related processes diminish with aging, evidenced by decreased signaling markers, reduced insulin receptor density, and lower levels of insulin transport across the blood-brain barrier. In the context of pathological cognitive decline, clinical trials using intranasal insulin delivery have reported positive outcomes on memory and learning in patients with mild cognitive decline or early-stage Alzheimer’s disease. However, while the …


Effects Of A Systemic High Urea Concentration On The Endometrial And Embryonic Transcriptomes Of The Mare, Yatta Linhares Boakari Jan 2019

Effects Of A Systemic High Urea Concentration On The Endometrial And Embryonic Transcriptomes Of The Mare, Yatta Linhares Boakari

Theses and Dissertations--Veterinary Science

Pregnancy loss remains a major source of economic cost to the equine industry. Frequently, the exact causes of pregnancy loss remain unknown. It has been shown, in other species, that increased dietary protein leading to elevated blood urea nitrogen concentrations (BUN) can be a factor in decreased survival of the early embryo. Our studies provided novel information regarding the effects of elevated BUN on endometrium and embryos from mares as well as insights on changes in their gene expression. Our first objective was to develop an experimental model to elevate BUN during diestrus using intravenous urea infusion. We analyzed the …


Biology And Management Of The Soybean Stem Borer, Dectes Texanus Leconte, In Kentucky, Izabela Gomes Jan 2019

Biology And Management Of The Soybean Stem Borer, Dectes Texanus Leconte, In Kentucky, Izabela Gomes

Theses and Dissertations--Entomology

Dectes texanus LeConte (Coleoptera: Cerambycidae) is a longhorn beetle species endemic to eastern United States. Originally described as a pest of weeds from the family Asteraceae, D. texanus has expanded its host range and is found infesting the stems of soybeans, Glycine max (L.) through the southwestern and middle United States. Female D. texanus chews a hole in the epidermis of a petiole and oviposits on it. Then, the D. texanus larva depletes all the pith of the stem making a tunnel down to the base of the plant and girdle the stem about 5 cm above the …


The Impact Of A Fruit And Vegetable Farmers' Market Voucher Prescription Program On A Low-Income Rural Population, Kevin Anthony Richie Jan 2019

The Impact Of A Fruit And Vegetable Farmers' Market Voucher Prescription Program On A Low-Income Rural Population, Kevin Anthony Richie

Theses and Dissertations--Nutrition and Food Systems

Objective: Measures the impact of the Farmers’ Market Voucher program on weight, body mass index, waist circumference, during the 2016 summer on a rural, low-income population residing in Appalachian Kentucky.

Background: Rural communities often have limited access to fresh fruits and vegetables (FV) which contributes to low levels of consumption. FV are calorie poor, nutrient dense and are inversely associated with inflammation markers, obesity, hypertension, and high blood glucose levels. Appalachian rural communities have a higher prevalence of obesity, diabetes, strokes, and death by heart attack when compared to the U.S. Farmers’ markets

Methods: Pre-experimental intervention design examining FV consumption …


A Comparison Of Body Composition Estimates Between The Norland Dxa, The Idxa, And The Bodpod® In Overweight To Obese Adults, Jalyn Mason Jan 2019

A Comparison Of Body Composition Estimates Between The Norland Dxa, The Idxa, And The Bodpod® In Overweight To Obese Adults, Jalyn Mason

Theses and Dissertations--Nutrition and Food Systems

Background: Body composition measures include fat mass (FM), fat free mass (FFM), and percent body fat (%BF), which are markers of health status and disease risk. Accurate body composition assessment is needed to evaluate an individual’s health and the efficacy of treatment strategies. Objective: Compare body composition estimates obtained from the Norland DXA, BodPod®, and iDXA before and after a 12-week exercise intervention. Subjects/setting: Overweight to obese (BMI 25–35 kg/m2) sedentary men and women (n=30) aged 18 to 40 years were recruited from central KY. Main outcome measure: Agreement in FM, FFM, and %BF between Norland DXA, iDXA, …


Dive Into The Hunger Pool: Exploring Students’ Experiences, Coping Strategies, And Suggestions Related To Elements Of Food Security At The University Of Kentucky, The Nu Sandar Oo Jan 2019

Dive Into The Hunger Pool: Exploring Students’ Experiences, Coping Strategies, And Suggestions Related To Elements Of Food Security At The University Of Kentucky, The Nu Sandar Oo

Theses and Dissertations--Nutrition and Food Systems

Background: College food insecurity (CFI) is a prevalent social justice and public health issue in the U.S. with the prevalence ranging between 15-59%. Though numerous quantitative studies were first conducted in the past decade, little qualitative research was conducted to assess CFI.

Objective: To explore and deeply understand the contexts of CFI at a land-grant university in Kentucky.

Methods: This qualitative study used a validated food insecurity survey tool and hour-long focus groups that were audio recorded and transcribed. Three theoretical models were combined into an adapted model and utilized for the thematic analysis.

Results: Thirty-three students participated in one …


Comparison Of The Kentucky Nutrition Education Program Healthy Eating Index Pre- And Post- Test Data For 2012-2013, Corey Joe Shepherd Jan 2019

Comparison Of The Kentucky Nutrition Education Program Healthy Eating Index Pre- And Post- Test Data For 2012-2013, Corey Joe Shepherd

Theses and Dissertations--Nutrition and Food Systems

Nutrition education has become a topic of significant concern in today’s society. An area prominent in the interest of nutrition is the battle against food security. Programs like the Supplemental Nutrition Assistance Program – Education (SNAP-Ed) is helping to improve its participants’ food security by providing nutrition education. Kentucky SNAP-Ed participants were asked to complete a survey and a 24-hour food recall to evaluate their knowledge in the following areas: Healthy Eating Index (HEI) scores, food resource management and nutrition practices. Each participant completed an average of 7-12 nutrition education lessons throughout the year. To graduate from the program participants …


Evaluating The Experiences Of Fcs Cooperative Extension Agents Use Of Policy, Systems And Environmental Strategies To Reduce Obesity In Rural Counties, Jordan Lynn Bressler Jan 2019

Evaluating The Experiences Of Fcs Cooperative Extension Agents Use Of Policy, Systems And Environmental Strategies To Reduce Obesity In Rural Counties, Jordan Lynn Bressler

Theses and Dissertations--Nutrition and Food Systems

High rates of obesity are seen across the country with rural areas disproportionately affected. Based on the socio-ecological model, policy, system, and environmental approaches targeted at the population level have the potential to create more sustainable health behavior change than individual level approaches. Historically, the Cooperative Extension Service (CES) has provided direct education related to healthy eating and active living in response to high obesity rates. Utilizing the resources and infrastructure of the CES, the Centers for Disease Control challenged CESs across the country to implement PSE strategies in counties with obesity rates greater than 40% through the CDC 1416 …


Promotion Of Fruit And Vegetable Intake Through Recipe Card Distribution And Sampling At Farmers’ Markets Throughout Kentucky, Umaima Sidra Afsheen Syeda Jan 2019

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 …


The Interactive Effect Of A Text Message Intervention And Connectivity Among Rural Adolescents, Kara Coldiron Jan 2019

The Interactive Effect Of A Text Message Intervention And Connectivity Among Rural Adolescents, Kara Coldiron

Theses and Dissertations--Nutrition and Food Systems

Social cohesion among peers profoundly influences decision making during adolescence. Despite this, the current research is very limited concerning the association of social cohesion and intimacy among rural adolescent peers with dietary intake and weight outcomes. This is problematic because social cohesion could be an unknown contributing factor in obesity among rural adolescents. The purpose of this study was to investigate how social cohesion and intimacy among rural adolescents in Kentucky and North Carolina affects the outcomes of a text message intervention aimed at improving fruit, vegetable, fast food and sugar sweetened beverage intake. Additionally, to determine if social cohesion …


Pilot Study Of Text Message Nudges As A Way To Improve Weight Loss Outcomes, Madison Copher Jan 2019

Pilot Study Of Text Message Nudges As A Way To Improve Weight Loss Outcomes, Madison Copher

Theses and Dissertations--Nutrition and Food Systems

Weight loss programs for women are on the rise, including both face to face and online programs. However, current research is limited on the process measures and content which produce adherence and the largest outcomes. With obesity on the rise in the United States, it is important to understand out health coaches can strengthen their programs to better support the obese population in their weight loss journey. The purpose of this pilot study was to develop and test the acceptability of text message nudges among women participating in an online weight loss program; determine how dose may be associated with …


The Utilization Of Technology As An Approach To Improve Meal Planning And Dietary Intake, Alexa Lauren Kuziel Jan 2019

The Utilization Of Technology As An Approach To Improve Meal Planning And Dietary Intake, Alexa Lauren Kuziel

Theses and Dissertations--Nutrition and Food Systems

The prevalence of obesity is rising in the United States and one factor that contributes to it is the lack of cooking at home and planning out meals. Since text messaging is now a main avenue of communication, it could be used to motivate people to plan out their meals and cook at home instead of consuming fast food. Current research on how weekly nudges might relate to peoples’ goals about meal preparation and dietary intake is very limited. The purpose of this study was to examine if sending weekly nudges, focusing on specific dietary goals, improves meal planning and …


Poverty In The Center Of The Conversation About Child Labor In Bangladesh, Zannatul Mustafa Jan 2019

Poverty In The Center Of The Conversation About Child Labor In Bangladesh, Zannatul Mustafa

Student Works

No abstract provided.


What Makes You Happy? Predicting Wellbeing In Nicaraguan Adolescents And Young Adults, Daniel A. Rodriguez Jan 2019

What Makes You Happy? Predicting Wellbeing In Nicaraguan Adolescents And Young Adults, Daniel A. Rodriguez

Doctor of Psychology (PsyD)

The present study sought to identify significant predictors of wellbeing within a sample of 2,764 high school and university students in Nicaragua, a country where significant stressful events and suicide are common. Ages ranged from 11-22 years (M = 16.63, SD = 2.85), and 60.3% identified as female. Measures used include the Personal Wellbeing Index, the Child and Youth Resilience Measure, the Patient Health Questionnaire-4, and demographic questions. Parent occupations were coded using the International Standard Classification of Occupations (ISCO-08). A multiple regression was conducted to identify five core variables that combined to predict approximately 30% of the variance of …


Comparative Nutrient Removal With Innovative Green Soprtion Media For Groundwater And Stormwater Co-Treatment, Dan Wen Jan 2019

Comparative Nutrient Removal With Innovative Green Soprtion Media For Groundwater And Stormwater Co-Treatment, Dan Wen

Electronic Theses and Dissertations

As indicated by the National Academy of Engineering, the understanding of nitrogen cycle has been deemed as one of 14 grand challenges in engineering of the 21st century. Due to rapid population growth and urbanization, the stormwater runoff increased in quantity as well as its nutrient concentrations, which may trigger serious environmental issues such as eutrophication in aquatic systems and ecosystem degradation. This study focuses on stormwater and groundwater quality control via Biosorption Activated Media (BAM) which can be applied to enhance the nutrient removal potential as an emerging Best Management Practices (BMPs). BAM was tested in this study with …


University Of North Florida Environmental Center Annual Report 2019, James W. Taylor, Erin Largo-Wight, John Carlisle, Maria Mark, Jennifer Grissom, Justin M. Lemmons Jan 2019

University Of North Florida Environmental Center Annual Report 2019, James W. Taylor, Erin Largo-Wight, John Carlisle, Maria Mark, Jennifer Grissom, Justin M. Lemmons

Annual Reports

2019 Annual Report of the Environmental Center at the University of North Florida


'I Think I'M Gonna Hurl': A Narrative Review Of The Causes Of Nausea And Vomiting In Sport, Patrick B. Wilson Jan 2019

'I Think I'M Gonna Hurl': A Narrative Review Of The Causes Of Nausea And Vomiting In Sport, Patrick B. Wilson

Counseling & Human Services Faculty Publications

Exercise-associated gastrointestinal (GI) distress can negatively impact athletic performance and interfere with exercise training. Although there are a few universal underlying causes of GI distress, each symptom often has its own unique triggers and, therefore, its own prevention and management strategies. One of the most troubling GI symptoms an athlete can experience during training and competition is nausea/vomiting. The prevalence of nausea varies with several factors, two of the most important being exercise intensity and duration. Relatively brief, high-intensity exercise (e.g., sprinting, tempo runs) and ultra-endurance exercise are both associated with more frequent and severe nausea. The potential causes of …


Life Skills Program For Youth Who Have Experienced Homelessness, Michael Black, Ariel Campbell Jan 2019

Life Skills Program For Youth Who Have Experienced Homelessness, Michael Black, Ariel Campbell

Occupational Therapy Capstones

Background: According to the United States Department of Education (2017), for the 2016-2017 school year, there was an estimated 1,924 students enrolled in public schools in Wyoming experiencing homelessness, with an estimated 295 of these students unaccompanied by a family member or guardian. Homeless youth comprise one of the most vulnerable and medically underserved populations in the United States (Ammerman et al., 2004) and are also substantially more likely to have mental health concerns as a result of their past traumatic experiences (Davies & Allen, 2017). Homeless youth typically develop identities and habits that enable them to negotiate and survive …


Occupational Therapy In Primary Care: Progressive Neurological Disorder, Amanda Callahan, Danielle Chartier Jan 2019

Occupational Therapy In Primary Care: Progressive Neurological Disorder, Amanda Callahan, Danielle Chartier

Occupational Therapy Capstones

The purpose of this scholarly project is to provide occupational therapists with a quick reference guide describing the unique role of occupational therapy to provide treatment for patients with multiple sclerosis within a primary care setting.

A substantial literature review was completed to gather knowledge on multiple sclerosis, occupational therapy, primary care, and the intertwining of these three concepts. The findings from the literature review assisted to guide the development of the product.

A collaborative client and therapist guide was developed to guide treatment for individuals with multiple sclerosis within a primary care setting. Occupational therapists bring a holistic perspective …


A Group Protocol For Promoting Wellness In Rural Community-Dwelling Older Adults, Emily Bachmeier, Laurel Busch Jan 2019

A Group Protocol For Promoting Wellness In Rural Community-Dwelling Older Adults, Emily Bachmeier, Laurel Busch

Occupational Therapy Capstones

Purpose: In the United States, there are currently 46 million citizens aged 65 and older. This number is projected to more than double by the year 2060 (Mather, 2016). As the elderly population continues to grow, the need for evidence-based, client centered prevention programs for community-dwelling older adults becomes more crucial to promote independence and preserve well-being in the community. Older adults living in rural areas are at an even higher risk of losing independence secondary to decline in activity tolerance, which further elevates their need for targeted interventions (Park, Kim, & Lee, 2015). Creating a preventative program to maintain …