Digital Commons Network^™

Decreased Moderate To Vigorous Physical Activity Levels In Children With Asthma Are Associated With Increased Traffic-Related Air Pollutants, Juan Aguilera, Soyoung Jeon, Amit U. Raysoni, Wen-Whai Li, Leah D. Whigham

School of Earth, Environmental, & Marine Sciences Faculty Publications

People with asthma, particularly young children, are more adversely aected by trac emissions-and regular exercise reduces asthma symptoms and improves lung function. We studied the relationship between air pollution and objectively measured physical activity in children with asthma who were attending a school near a freeway. We continuously monitored air pollutants-PM2.5, PM10, nitrogen dioxide (NO2), and ozone (O3)-at the school for 10 weeks and measured physical activity levels via accelerometry in children (n = 12, ages 6-12 years). Concentrations of PM2.5, PM10, and NO2 were negatively associated with moderate to vigorous physical activity (PM2.5 and PM10: p < .001; NO2: p = …

Barriers And Facilitators Of Diet, Physical Activity Levels, And Sleep Among Nursing Undergraduates And Early-Career Nurses: A Qualitative Descriptive Study, Michael D. Wirth, Jaclyn Meyer Phd, Rn, Faan, Angela Jessup, Robin M. Dawson Phd, Rn, Cpnp-Pc

Publications

Purpose: Mechanisms leading to burnout, associated with high turnover in nursing, may start as early as in nursing school. Given health habits (e.g., diet, physical activity, and sleep) can exacerbate or lessen the impact of burnout, this study examined current barriers and facilitators to healthy diet, physical activity levels, and sleep among nursing undergraduates (UGs) and early-career nurses (ECNs). Research Design: Qualitative descriptive study. Sample: 25 nursing UGs and 25 ECNs (within 3 years of graduation) from a Southeastern college of nursing. Data Collection and Analysis: After development of theory-informed interview guides, participants conducted interviews either in-person or by phone, …

Leveraging Church Environments To Promote Rural Physical Activity And Healthy Eating, Kelsey Rothera Day

Theses and Dissertations

Rural residents experience a greater burden of chronic disease related to physical inactivity and poor diet than their urban counterparts. A promising strategy to improve these health behaviors in rural areas is to leverage existing structures that may support physical activity and healthy eating, such as churches, in public health interventions. Three studies were conducted as part of this dissertation. They were designed to: 1) examine whether the walkability and healthy food density of neighborhoods surrounding rural and urban churches are associated with race, socioeconomic status, and rural/urban status; 2) examine rural church leaders’ views on the role of faith-based …

Understanding Cultural Perceptions Of Health In Middle School Females For Obesity Prevention: A Case Study, Tien Vo, Egenia Dorsan, J. Mitchell Vaterlaus, Lori A. Spruance

Journal of Social, Behavioral, and Health Sciences

The purpose of this study was to understand acculturation and race/ethnicity influences in the home and school environment that affect physical activity and nutrition in female adolescents attending middle school. A convenience sample of eight female adolescents (n = 2 Asian American, n = 2 Black, n =2 Latinx/Hispanic, and n = 2 White) was interviewed individually via Zoom. Responses regarding acculturation, physical activity, and nutrition in the home and school environment were analyzed using qualitative case study analysis. Three themes were identified: 1) experiences related to home, health, and culture, 2) the intersection between school meals and personal …

Device Assessed Activity Behaviours In Patients With Indwelling Pleural Catheter: A Sub-Study Of The Australasian Malignant Pleural Effusion (Ample)-2 Randomized Trial, Carolyn J. Peddle-Mcintyre, Sanjeevan Muruganandan, Joanne Mcveigh, Deirdre B. Fitzgerald, Leon Straker, Robert U. Newton, Kevin Murray, Yun Chor Gary Lee

Research outputs 2022 to 2026

Background and Objective: Device-assessed activity behaviours are a novel measure for comparing intervention outcomes in patients with malignant pleural effusion (MPE). Australasian Malignant PLeural Effusion (AMPLE)-2 was a multi-centre clinical trial where participants with MPE treated with an indwelling pleural catheter were randomized to daily (DD) or symptom-guided (SGD) drainage for 60-days. Our aim was to describe activity behaviour patterns in MPE patients, explore the impact of drainage regimen on activity behaviours and examine associations between activity behaviours and quality of life (QoL). Methods: Following randomization to DD or SGD, participants enrolled at the lead site (Perth) completed accelerometry assessment. …

Exercise As A Prescription For Patients With Depressive Disorders: A Quality Improvement Project, Sydney Roscoe, Rachelle Pace

Doctor of Nursing Practice Final Manuscripts

Purpose: The aim of this Doctor of Nursing Practice project was to increase exercise counseling rates in the treatment of depression by (1) implementing a focused educational training program and (2) understanding factors that impacted utilization of the practice change.

Background: Approximately 280 million individuals suffer globally from depressive disorders. Depression remains the fourth leading cause of disabilities, significantly contributing toward the global burden of disease by increasing morbidity and mortality risk. Psychopharmacology and psychotherapy are current gold standards of treatment; however, providers often overlook the significant role exercise serves in reducing depressive symptoms and severity, as it remains underutilized. …

A Prescription For Exercise In Adolescents: A Pilot Project, Alexa Sikalis

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence based practice project was to increase physical activity (PA) times in pediatric patients who were not meeting the recommended guidelines of 60 minutes per day of activity. The goal was to educate adolescents on the benefits of exercise in order to increase their overall PA, even if it did not meet the recommended 60 minutes per day. The implemented education was also intended to motivate patients to establish healthy habits and minimize risks of poor health outcomes.

Background: Adolescence is characterized by development of neuronal plasticity and establishment of behavioral patterns. PA …

Comparative Analysis Between Physical Activity Affect And Discrete Emotions In College Students, Kelly L. Simonton, Timothy M. Dasinger, Alex C. Garn

International Journal of Physical Activity and Health

Objective: The purpose of this study was to investigate empirical distinctness and overlap between physical activity (PA) affect and emotions as well as potential unique relationships with PA beliefs and behaviors. Specifically, researchers wanted to explore the level of shared variance amongst discrete emotions and affect, which in effect tested the jingle-jangle fallacy that can be present in psychometric evaluation of related constructs.

Participants: College students (N=519; Mage= 20.47) enrolled in PA courses at two universities in the Southeastern United States completed questionnaires concerning their PA related emotions, affect, self-efficacy, and self-reported PA.

Methods: …

A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller

Evidence-Based Practice Project Reports

U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …

The Impact Of Sleep Quality Combined With Physical Activity On Autonomic Function (24-Hour Hrv) In College Students, Meghan Peterson

Masters Theses, 2020-current

Long-term poor sleep quality is associated with health outcomes that can lead to autonomic nervous system dysfunction. Both cardiorespiratory fitness and physical activity (PA) are associated with improvements in autonomic function and heart rate variability (HRV). Markers of fitness and sleep were explored to determine the degree of contribution to autonomic dysfunction. A total of 15 subjects, (age = 20.6±0.5; BMI = 23.9±1.0) completed 7 days of physical activity and sleep assessment via accelerometry. Participants then completed a graded exercise test to determine cardiorespiratory fitness (VO_2max), followed by a 24-H HRV measurement. HRV through LF:HF ratio was negatively …

Physical Activity In Managing Stress Among Managers During The Covid-19 Pandemic – A Systematic Review, Anna Hryniewicz, Anna Gmiąt, Magdalena Jaroch-Lidzbarska, Mariusz Lipowski

Baltic Journal of Health and Physical Activity

Introduction: During the COVID-19 pandemic managers experienced additional stress connected with taking responsibility for workers at the time of a worldwide crisis. Maintaining a high level of physical activity in this specific group possibly could have contributed to keeping both management skills and health condition at a high required standard. The purpose of this review is to verify the range of scientific interest on the subject of physical activity among managers as a stress coping strategy during the pandemic. Materials and Methods: For this systematic review six studies were chosen (two of them are qualitative descriptive, three are cross-sectional, one …

Effects Of Active Video Game Interventions On Physical Health And Development Among Healthy Preschool Children: A Systematic Review, Wanjiang Zhou, John Oginni, Juan Jose Palos Perez Sr., Kaitlyn Adams, Zan Gao

International Journal of Physical Activity and Health

Early physical activity (PA) interventions during preschool ages are necessary and critical to cultivate healthy movement behaviors for healthy growth and development. The increasing obesity rate among children is a major public health concern globally, which is largely due to poor adherence to participating in regular PA. Active video game (AVG) interventions have been increasingly used in promoting PA. The narrative review synthesized current literature regarding the effect of AVG interventions on physical health and development indicators among healthy preschoolers. A systematic review was performed in Academic Search Premier, CINAHL, ERIC, PubMed, SPORT Discus, and Web of Science, following the …

Physical Function Across The Lifespan In Adults With Multiple Sclerosis: An Application Of The Short Physical Performance Battery, Brenda Jeng, Petra Šilić, Rachel E. Bollaert, Brian M. Sandroff, Robert W. Motl

Exercise Science Faculty Research and Publications

Background

Multiple sclerosis (MS) typically has its onset in early and middle adulthood, but the population is steadily becoming more dominated by older adults. One of the primary consequences of both MS and aging involves declines of lower extremity physical function and mobility. This cross-sectional study compared physical function status based on Short Physical Performance Battery (SPPB) summary and component scores between persons with MS and healthy controls across 6 age groups. We further examined associations between SPPB summary scores and component scores as well as associations between summary scores and measures of physical and cognitive function for identifying the …

Analysis Of Energy Balance In Obese Healthcare Workers, Nani Cahyani Sudarsono, Ria Lestari, Tiffany Georgine T’Sidkenu Widjaja

Indonesian Journal of Public Health Nutrition (IJPHN)

Obesity is a global health challenge that seriously affects developing countries, including Indonesia. It is important to discover the energy balance calculated from energy intake and energy expenditure in obese individuals, especially in obese healthcare workers. This study aimed to analyze the balance of energy intake and expenditure, body composition, and physical activity level in obese healthcare workers at the Exercise Center of Indonesia Medical Education and Research Institute (IMERI FKUI). A cross-sectional study was held at Exercise Center IMERI FKUI. Total sampling was the sampling method utilized in the study. Study participants (aged above 18 years) were screened by …

Dnp Final Report: Promoting Physical Activity In Nurse Students, Rose Leal Guidry

DNP Final Reports

Undergraduate nursing students experience educational rigor and challenging clinical experiences that potentially affect stress levels and increase the risk for adverse mental and physical health outcomes. Prolonged stress is associated with emotional exhaustion, unhealthy coping mechanisms, unhealthy behaviors, and impaired functioning. This evidence-based practice project aimed to decrease undergraduate nursing students' perceived stress levels by promoting physical activity. The PICOT question that led this project was in undergraduate nursing students (P), how does the promotion of physical activity (I) compare to no promotion of physical activity (C) affect perceived stress (O) across one semester (T)? The evidence supports physical activity …

Resting Blood Pressure In Master Athletes: Immune From Hypertension?, Mike Climstein, Joe Walsh, Mark Debeliso, Tim Heazlewood, Trish Sevene, Luke Del Vecchio, Kent Adams

Kinesiology Faculty Publications and Presentations

Ageing is associated with decreased physical activity, obesity and increased risk of hypertension (HTN). Master athletes (MA) have either pursued a physically active lifestyle throughout their life or initiated exercise or sport later in life. We assessed resting blood pressure (BP) in male and female World Masters Games (WMG) athletes. This was a cross-sectional, observational study which utilized an online survey to assess the blood pressure (BP) and other physiological parameters. Results: a total of 2793 participants were involved in this study. Key findings included differences between genders with males reporting higher resting SBP (+9.4%, < 0.001), resting DBP (+5.9%, < 0.001) and mean arterial pressure (+6.2%, < 0.001). Significant differences ( < 0.001) were also identified when comparing WMG athletes' resting BP results (genders combined) to the general Australian population with WMG athletes having a lower SBP ( < 0.001, -8.4%) and DBP ( < 0.001, -3.6%). Additionally, 19.9% of males and 49.7% of female WMG participants were normotensive whereas 35.7% of the general Australian population were normotensive. Only 8.1% of the WMG athletes (genders combined) were found to be HTN compared to 17.2% in the general Australian population. These findings reflect a low prevalence of HTN in WMG participants and support our hypothesis of a low prevalence of HTN in an active, but aged cohort of MA.

Relationship Between Cognitive Performance, Physical Activity, And Socio-Demographic/Individual Characteristics Among Aging Americans, Imtiaz Masfique Dowllah, Juan Carlos Lopez-Alvarenga, Gladys Maestre, Ulku S. Karabulut, Michael Lehker, Murat Karabulut

School of Medicine Publications

Background: Physical activity (PA) has emerged as a promising approach to delay Alzheimer’s disease and related dementias, but the optimal intensity of PA to improve cognitive health remains unknown.

Objective: To evaluate the association between duration and intensity of PA and cognitive domains (executive function, processing speed, and memory) in aging Americans.

Methods: Linear regressions in hierarchical blocks for variable adjustment and the size of effect (η2) were analyzed by using the data of 2,377 adults (age = 69.3±6.7 years) from the NHANES 2011–2014.

Results: Participants with 3–6 h/week of vigorous- and > 1 h/week of moderate-intensity PA scored significantly higher …

Implementing A Health And Nutrition Program In Schools To Promote Healthy Lifestyle Choices, Justine Anderson

Occupational Therapy Doctoral Student Capstone Posters

y program aims to address obesity by educating faculty, children, and parents on proper nutrition and exercise to provide kids with the resources to maintain a healthy lifestyle. Students participated in groups incorporating fun ways to exercise, learning about food groups, creating food crafts with healthy foods, then trying those foods at their leisure. The idea is to expose them to new and/or healthier foods to expand their options for a healthier diet. Resources were also sent home for parents to give them fun activities to do at home that will continue developing their child’s knowledge and expand their palate.

Using Ot-Based Yoga Programs To Improve Sleep Health Across Populations, Hillary Williams

MOT Student Capstones

Sleep dysfunction affects all ages and inhibits successful engagement in everyday activities. Pain and psychological issues are common factors that contribute to sleep health. There is demand for holistic approaches to promote sleep health due to undesirable effects of medications. Yoga has been shown to improve health and wellness of those who practice and can be a tool to improve symptoms leading to poor sleep health. Sleep is an occupational domain that is underrecognized compared to the full scope of occupational therapy (OT). OTs can implement yoga programs to promote sleep health across the lifespan, because they are skilled in …

Use Of A Worksite Physical Activity To Improve Subjective Daytime Sleepiness Among Night Shift Healthcare Workers: A Quality Improvement Project, Marthe Sooh Nkongo

DNP Projects

Background and Significance: Shift work including work schedules beyond the typical "nine-to-five," causes the disruption of sleep-wake behaviors (Healy et al., 2021). The circadian misalignment is a potential pathway for the development of metabolic diseases, excessive daytime sleepiness, sleep deprivation, and declines in alertness and performance among night shift workers (James et al., 2017; McHugh et al., 2020; Parry et al., 2018). Emerging evidence suggests that physical activity synchronizes the sleep-wake cycles (Healy et al., 2021).

Purpose: This quality improvement project (QI) aimed to improve night-shift nurses ‘subjective daytime sleepiness by incorporating a 4-week worksite walking activity during working hours. …

A Process For Converting An In-Person Training To Increase Church Capacity To Implement Physical Activity And Healthy Eating Practices And Policies To An Online Format, Sara Wilcox Phd, Ruth P. Saunders Ph.D., Jessica Stucker, Andrew T. Kaczynski Ph.D., Kelsey R. Day, Deborah Kinnard, Lindsay Decker, John A. Bernhart Ph.D., Mph, Ches

Faculty Publications

The implementation of evidence-based public health programs into practice is critical for improving health, but trainings for organizational change agents are often not scalable. To describe the process of converting a training that targets faith-based organizational capacity development from an in-person to an online format. We engaged in an iterative process to convert the training delivery mode from in-person to online that included assessing stakeholder support, consulting the literature on best practices, seeking a design team, consolidating content, designing engaging lessons, and building an online site. Feedback from end-users and other audiences was incorporated throughout. Pilot participants with characteristics like …

Fit24, A Digital Health Intervention To Reduce Type 2 Diabetes Risk Among Hispanic Youth: Protocol For A Feasibility Pilot Study, Erica G Soltero, Callie Lopez, Salma M Musaad, Teresia M O'Connor, Debbe Thompson

Faculty, Staff and Students Publications

BACKGROUND: Poor physical activity (PA) and sleep behaviors in Hispanic adolescents contributes to increased risk for type 2 diabetes. Commonly owned digital devices and services like smartphones and text-messaging are highly used among adolescents and are promising intervention tools for reaching this age group. Personal activity trackers assess activity and sleep, making them ideal tools for addressing these behaviors. We propose to examine the feasibility of a 12-week intervention that uses theoretically grounded text messages and a Fitbit device to improve PA and sleep among Hispanic adolescents with obesity, as compared to a wait-list control group with a Fitbit device …

An 8-Week Peer Health Coaching Intervention Among College Students: A Pilot Randomized Study, Zi Yan, Jessica Cellucci, Juliana Cohen, Laura Kurdziel, Sarah Benes, Seungbin Oh, April Bowling

Health Sciences Faculty Publications

This study explored the effects of an 8-week peer coaching program on physical activity (PA), diet, sleep, social isolation, and mental health among college students in the United States. A total of 52 college students were recruited and randomized to the coaching (n = 28) or the control group (n = 24). The coaching group met with a trained peer health coach once a week for 8 weeks focusing on self-selected wellness domains. Coaching techniques included reflective listening, motivational interviews, and goal setting. The control group received a wellness handbook. PA, self-efficacy for eating healthy foods, quality of sleep, social …

Sibling Resemblance In Physical Activity Levels: The Peruvian Sibling Study On Growth And Health, Carla Santos, José Maia, Sara Pereira, Olga Vasconcelos, Rui Garganta, J. Timothy Lightfoot, Go Tani, Donald Hedeker, Peter T. Katzmarzyk, Alcibíades Bustamante

Population and Public Health Science Faculty Publications

Physical activity is associated with a host of positive health outcomes and is shaped by both genetic and environmental factors. We aim to: (1) estimate sibling resemblance in two physical activity phenotypes [total number of steps∙day⁻¹ and minutes for moderate steps per day (min∙day⁻¹)]; and (2) investigate the joint associations of individual characteristics and shared natural environment with intra-pair sibling similarities in each phenotype. We sampled 247 biological siblings from 110 nuclear families, aged 6–17 years, from three Peruvian regions. Physical activity was measured using pedometers and body mass index was calculated. In general, non-significant variations in …

Primary Results Of A Phase-Iii, Randomized Controlled Trial Of The Behavioral Intervention For Increasing Physical Activity In Multiple Sclerosis Project, Robert W. Motl, Ariel Kidwell, Brian M. Sandroff, Lara A. Pilutti, Gary R. Cutter, Roberto Aldunate, Rachel E. Bollaert

Exercise Science Faculty Research and Publications

Background

We undertook a phase-III, randomized controlled trial (RCT) that examined the effectiveness of a behavioral intervention based on social cognitive theory (SCT) and delivered through the Internet using e-learning approaches for immediate and sustained increases in physical activity among persons with multiple sclerosis (MS).

Method

The study followed a parallel group RCT design. Persons with MS (N = 318) were randomized into either behavioral intervention (n = 159) or attention/social contact control (n = 159) conditions. The conditions were administered over a 6-month period by persons who were uninvolved in screening, recruitment, random assignment, and outcome …

Assessing The Suitability Of A Virtual 'Pink Warrior' For Older Breast Cancer Survivors During Covid-19: A Pilot Study, Maria C Swartz, Michael C Robertson, Ursela Christopherson, Stephanie J Wells, Zakkoyya H Lewis, Jinbing Bai, Michael D Swartz, H Colleen Silva, Eloisa Martinez, Elizabeth J Lyons

Faculty, Staff and Student Publications

The COVID-19 pandemic impacted the conduct of in-person physical activity (PA) interventions among older survivors of BC, who need such interventions to stay active and prevent functional decline. We tested the feasibility of virtually delivering an exergame-based PA intervention to older BC survivors. We enrolled 20 female BC survivors ≥55 years and randomly assigned them to two groups. The intervention group (Pink Warrior 2) received 12 weekly virtual exergame sessions with behavioral coaching, survivorship navigation support, and a Fitbit for self-monitoring. The control group received 12 weekly phone-based survivorship discussion sessions and wore a Mi Band 3. Feasibility was evaluated …

Stand More, Sit Less, For Better Metabolic Health, Jehu N. Apaflo

International Journal of Exercise Science: Conference Proceedings

Sedentary behaviors are associated with metabolic risks such as weight gain, high adiposity, and abdominal/visceral fat deposition. The American College of Sports Medicine recommends a minimum of 150 mins per week of moderate to vigorous physical activity for health benefits. Adherence, however, is poor due to the prolonged sitting hours required for most modern jobs and the excessive television viewing habits. Emerging studies show that interrupting long sitting hours with intermitted breaks of light activities attenuates the pernicious effects of sedentariness. While most studies and policy guidelines focus on physical activity interventions, there is a lack of data on the …

Gamerfit-Asd Beta Test: Adapting An Evidence-Based Exergaming And Telehealth Coaching Intervention For Autistic Youth, Daniel P. Hatfield, Aviva Must, Winston Kennedy, Amanda E. Staiano, James Slavet, Rachael A. Sabelli, Carol Curtin, Linda G. Bandini, Phillip Nauta, Christopher Stuetzle, April B. Bowling

Population and Public Health Science Faculty Publications

Background: Health disparities faced by autistic youth are exacerbated by inadequate physical activity (PA) and sleep, whereas healthy PA and sleep may improve mood and function. Adaptive Game Squad (AGS) is an evidence-based telehealth coaching and exergaming intervention to improve PA and sleep for adolescents with diverse neurodevelopmental and psychiatric conditions. This study aimed to adapt AGS for autistic youth ages 10–15 years; beta-test the modified intervention for feasibility, accessibility, and engagement; and further refine the intervention for a larger planned demonstration pilot. Methods: Interdisciplinary experts adapted AGS to create GamerFit-ASD, a 12-week intervention that included a progressive exergame schedule, …

How Much Did It Cost To Develop And Implement An Ehealth Intervention For A Minority Children Population That Overlapped With The Covid-19 Pandemic?, Alexandra Monashefsky, Dar Alon, Tom Baranowski, Tiago V Barreira, Kelly A Chiu, Amy Fleischman, Melanie C Green, Shirley Huang, Ronald C Samuels, Caio Victor Sousa, Debbe Thompson, Amy S Lu

Children’s Nutrition Research Center Staff Publications

Background: eHealth interventions using active video games (AVGs) offer an alternative method to help children exercise, especially during a pandemic where options are limited. There is limited data on costs associated with developing and implementing such interventions.

Objectives: We quantified the costs of delivering an eHealth RCT intervention among minority children during COVID-19.

Methods: We categorized the total trial cost into five subcategories: intervention material development, advertising and recruitment, intervention delivery, personnel salaries, and COVID-19-related equipment costs.

Results: The total RCT cost was $1,927,807 (Direct: $1,227,903; Indirect: $699,904) with three visits required for each participant. The average cost per participant …

How Much Did It Cost To Develop And Implement An Ehealth Intervention For A Minority Children Population That Overlapped With The Covid-19 Pandemic?, Alexandra Monashefsky, Dar Alon, Tom Baranowski, Tiago V Barreira, Kelly A Chiu, Amy Fleischman, Melanie C Green, Shirley Huang, Ronald C Samuels, Caio Victor Sousa, Debbe Thompson, Amy S Lu

Children’s Nutrition Research Center Staff Publications

Background: eHealth interventions using active video games (AVGs) offer an alternative method to help children exercise, especially during a pandemic where options are limited. There is limited data on costs associated with developing and implementing such interventions.

Objectives: We quantified the costs of delivering an eHealth RCT intervention among minority children during COVID-19.

Methods: We categorized the total trial cost into five subcategories: intervention material development, advertising and recruitment, intervention delivery, personnel salaries, and COVID-19-related equipment costs.

Results: The total RCT cost was $1,927,807 (Direct: $1,227,903; Indirect: $699,904) with three visits required for each participant. The average cost per participant …