Community Health and Preventive Medicine Commons^™

Identifying Barriers And Place-Based Solutions To Physical Activity For Older Adults In East Tennessee, Lydia Hoskins, Jodi Southerland

Journal of Appalachian Health

Introduction: Older adults in East Tennessee (TN), the fastest growing demographic, face significant health challenges, with 44% reporting four or more chronic conditions. The state ranks 45th in physical inactivity among older adults, exacerbating chronic disease risks, fall-related injuries, and mental health issues. Urban-rural disparities in East TN further complicate efforts to promote active living, particularly for rural residents.

Purpose: This qualitative study explored socioecological barriers and solutions to increase physical activity (PA).

Methods: In April 2024, two focus group were conducted in East TN, with a total of 11 participants composed of six community partners and five older adults. …

Profiling Of Physical Activity Usage In Selected Urban Green Spaces In Marikina City, Trizsa Jasmin C. Ty, Alberto L. Dimarucut, Camille B. Castro, Danielle Naomi L. Uy

CSID Journal of Infrastructure Development

Urban Green Spaces (UGS) play an important role in providing opportunities for physical activity in urbanized cities. This observational cross-sectional study aims to profile two selected UGS, namely Marikina River Park and Marikina Heights Park Complex, in Marikina City, in the context of their use for physical activity and recreation. Interviews with two government officials were conducted to collect data on the historical background of the selected parks. Systematic observation, using the System for Observation of Play and Recreation in Communities tool, was conducted to observe park visitors and their physical activity for four days in each park. Each park’s …

Sports And Physical Activity Of Poles In The Context Of Good Health And Well-Being As A Sustainable Development Goal, Elżbieta Biernat, Monika Piątkowska, Robert Podstawski

Baltic Journal of Health and Physical Activity

Investing in physical activity (PA) is vital for achieving sustainable development goals. We examine PA trends in Poland using data from Eurobarometer surveys conducted in 2013, 2017, and 2022. In 2022, 64.6% of Poles did not participate in sports, and 41.8% did not engage in non-sport PA. There is a concerning trend of increasing inactivity in sports (Chi²_2022/2017 = 34.64; p < 0.001; Chi²_2017/2013 = 56.98; p < 0.001) and non-sports PA (Chi²_2022/2017 = 18.3, p < 0.01 and Chi²_2017/2013 = 16.95, p < 0.01). Participation in sport and PA is influenced by individual, inter-personal, environmental, political, and global factors. Notably, there is an upward trend in interpersonal (e.g., club membership, volunteering), environmental (e.g., PA in parks/nature, at home), and political (e.g., dissatisfaction with local government actions) factors. Government intervention is crucial and requires: (1) establishment of an institution for leadership and advocacy of PA, (2) adoption of a cross-sectoral approach for a coordinated change, and (3) increased in-vestment in monitoring systems to track the impact of interventions. These actions are essential for fostering a more active and healthier population in Poland.

A Program Evaluation Case Study, Madelyne G. Culbertson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This case study presents a program evaluation of a physical activity intervention implemented in Bourbon County, Kentucky, guided by the Centers for Disease Control and Prevention’s Framework for Program Evaluation in Public Health.

Practical Strategies For Establishing A Physical Activity Program For Older Aboriginal People - Reflections About Decolonising Practice, Margaret Gidgup, Josephine Umbella, Anne-Marie Hill

Journal of the Australian Indigenous HealthInfoNet

Background
Physical activity (PA) is a vital component of healthy ageing. However, there are few culturally appropriate PA programs available for older Aboriginal and Torres Strait Islander people. The objectives of this review were to i) assist health professionals to gain understanding about working with older Aboriginal people, ii) provide practical strategies that guide a decolonising approach when delivering PA programs.

Methods
A review of PA program delivery was undertaken by two researchers, one of whom was a Noongar Wadjak woman. The researchers conducted a weekly PA program for older Aboriginal people on Noongar Boodja (Country). The researchers took a …

Adolescent Obesogenic Behaviors: The Influence Of Race/Ethnicity, Generation Status, Acculturation, And Tme Lived Outside The United States, Tien D. Vo, Alisha H. Redelfs, Mackay Graper, Lori A. Spruance

Journal of Social, Behavioral, and Health Sciences

Children living with obesity are at higher risk for chronic disease. Dietary behaviors, sedentary time, and physical activity contribute to the risk of developing obesity. The purpose of this research was to identify associations between acculturation and race/ethnicity influences on obesogenic behaviors in middle school students. A national convenience sample of diverse U.S. children (11–14) was recruited to participate in an online survey (N = 615). Dietary behaviors, including fruit and vegetable consumption (F/V) and sugar-sweetened beverage consumption (SSB), as well as screen time and physical activity, were quantified. Multivariable regression models (linear and logistic) were built. We analyzed …

Feasibility Of Fit24, A Digital Diabetes Prevention Program For Hispanic Adolescents: Qualitative Evaluation Study, Erica G Soltero, Salma M Musaad, Teresia M O'Connor, Debbe Thompson, Keith Norris, Bettina M Beech

Faculty, Staff and Students Publications

BACKGROUND: Digital health interventions are promising for reaching and engaging high-risk youth in disease prevention opportunities; however, few digital prevention interventions have been developed for Hispanic youth, limiting our knowledge of these strategies among this population.

OBJECTIVE: This study qualitatively assessed the feasibility and acceptability of Fit24, a 12-week goal-setting intervention that uses a Fitbit watch (Fitbit Inc) and theoretically grounded SMS text messages to promote physical activity and sleep among Hispanic adolescents (aged between 14 and 16 years) with obesity.

METHODS: After completing the intervention, a subsample of youth (N=15) participated in an in-depth interview. We categorized the themes …

From Survivors To Care Providers: A Multi-Dimensional Study On Physical Activity In Cancer Care, Gaurav Kumar

Theses & Dissertations

As the population of cancer survivors grows, understanding the dynamics of physical activity (PA) engagement is critical due to its potential benefits in reducing adverse health outcomes and mortality associated with cancer. Despite known benefits, both adherence to and promotion of PA among cancer survivors face significant challenges. This comprehensive study examines PA levels, barriers, facilitators, and perceptions among cancer survivors and oncology care providers over a ten-year period. The objectives are to assess adherence levels to PA among cancer survivors, explore the perceived barriers and facilitators to PA engagement from the survivors' perspectives, and understand the barriers, facilitators, and …

Inequality In Opportunities And Outcomes: Indicators To Inform Data-Driven Community Systems For Youth Physical Activity, Ann Essay

Theses & Dissertations

Indicators illuminating whole-of-community and setting system physical activity (PA) outcomes and drivers are needed to inform population health improvement efforts. This multi-study dissertation examines inequalities in PA resources, opportunities, and outcomes and the factors influencing inequalities across multiple temporal and geospatial scales (e.g., community, setting). First, a scoping review examined community-level variability in PA resource and opportunity availability by community sociodemographic characteristics (e.g., race). Across 46 included studies, 41 unique indicators characterizing community PA systems were identified, and 29.8% of relationships assessed indicated greater resource/opportunity availability in communities of higher socioeconomic status or lower minority population prevalence. The indicators synthesized …

See Me, Hear Me, Know Me: Perspectives On Diet And Physical Activity Influences Among Teens Living In Rural Texas Communities, Debbe Thompson, Julie Miranda, Chishinga Callender, Jayna M Dave, Godlove Appiah, Salma M A Musaad

Faculty, Staff and Students Publications

Teens in rural communities are at greater risk of obesity than teens in urban areas. Diet and physical activity influence obesity risk. Understanding their perspectives is an important step in intervention design. This qualitative investigation explored teen perspectives on how living in a rural community influenced their diet and physical activity choices. Forty parent-teen pairs were recruited. Data collection included surveys and telephone interviews. This paper reports teen perspectives identified in the first interview. Thematic analysis was used to code and analyze the data. Findings revealed that the primary factor driving teens' diet and physical activity behaviors was the teens …

Association Of Parkinson’S Disease Status With Accelerometer-Derived Physical Activity And Sedentary Behavior In Older Women: The Women’S Health Study (Whs)), Jennifer L Hale, Gregory Knell, Michael D Swartz, Eric J Shiroma, Terry Ellis, I-Min Lee, Kelley Pettee Gabriel

Faculty, Staff and Student Publications

Evidence suggests that individuals diagnosed with Parkinson's Disease (PD) spend less time in moderate-to-vigorous intensity physical activity (MVPA) compared to those without PD. However, prior studies primarily included men and did not consider movement across the entire intensity spectrum. To address these gaps, the association of PD status with total volume physical activity and time spent in sedentary, low light-intensity physical activity (LLPA), high light-intensity physical activity (HLPA), and MVPA among older women was examined. This is a cross-sectional analysis of 17,466 ambulatory women enrolled in the Women's Health Study (WHS) with a median (IQR) age of 70 (67-75) years …

The Effect Of Long Covid Syndrome On Physical Activity, Patrisha Hanna Villarmea

Master of Science in Kinesiology

Long covid syndrome is a condition where individuals experience persistent symptoms and functional limitations that can last about three months to two years after the initial Covid-19 infection. While long-term health consequences of Covid-19 have garnered significant attention,the impact of long covid syndrome symptoms is poorly understood. The purpose of the study is to explore the effect of long covid syndrome symptoms to an individual’s physical activity. Furthermore, this research aims to provide an overview of the existing literature on the effect of long covid syndrome symptoms on physical activity. The research would invite participants to answer two surveys that …

An Sms Text Message-Based Type 2 Diabetes Prevention Program For Hispanic Adolescents With Obesity: Qualitative Co-Design Process, Erica Soltero, Callie Lopez, Sandra Mihail, Ayleen Hernandez, Salma M Musaad, Teresia M O'Connor, Debbe Thompson

Faculty, Staff and Students Publications

BACKGROUND: SMS text message-based interventions are a promising approach for reaching and engaging high-risk youths, such as Hispanic adolescents with obesity, in health promotion and disease prevention opportunities. This is particularly relevant, given that SMS text messaging is widely accessible and available and that adolescents are frequent texters. Including youths in the development of SMS text message content can lead to more acceptable and relevant messaging; however, few studies include this group as cocollaborators.

OBJECTIVE: This study aimed to use a co-design process to inform the development of SMS text messages that promote healthy physical activity (PA) and sleep behaviors …

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 …

Factors Associated With Physical Activity Increases And Decreases Among A Sample Of Appalachian Residents During The Covid-19 Pandemic: A Cross-Sectional Study, Christiaan G. Abildso, Angela M. Dyer, Shay M. Daily, Christa Lilly, Emily A. Sarkees, Samantha I. Moyers, Thomas K. Bias

Journal of Appalachian Health

Introduction: Physical activity (PA) can prevent and reduce the deleterious physical and mental health effects of COVID-19 and associated lockdowns. Research conducted early in the pandemic demonstrates that a greater proportion of adults in the U.S. have decreased than increased PA, and the effects vary by sociodemographic factors. Ongoing evidence is important to identify patterns in PA changes during the pandemic.

Purpose: This study aims to identify factors associated with increases and decreases in PA during the COVID-19 pandemic in a convenience sample of adults residing in Appalachia.

Methods: Surveys were collected from a convenience sample of adults from eight …

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 …

The Role Of Vigorous And High Intensity Interval Training Physical Activity Counseling In Prenatal Care, Emily Lau, Brendan T. Lynch, Sonia Hassan

Medical Student Research Symposium

Background: Physical activity is becoming a more common component of preventative medicine and patient counseling; however, the prevalence of physical activity counseling and specific social determinants of health have prevented women, namely prenatal patients, from receiving this counseling from their providers¹. Physical activity, including high intensity interval training (HIIT), has been shown to be feasible for implementation in patient counseling³ and shown to be safe for pregnant women, even into the third trimester². We hypothesize that the current percentage of patients, including prenatal patients, being counseled on physical activity is lacking. In addition, we hypothesize …

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 …

Sit Less, Move More: A National Study Of Physical-Activity Behavior And Cancer, Stella O. Nwogugu

Dissertations, Theses, and Capstone Projects

Background: Physical activity is associated with lower risks of cancer, the second leading cause of death among Americans. Yet, sedentary behavior is the prevailing lifestyle for about 80% of American adults. Additionally, cancer survivors remain significantly inactive, even though physical activity has been shown to decrease risk of cancer and cancer recurrence, improve tolerance of cancer therapy, and reduce mortality. This research explores the relative impact of personal agency, social support, and key demographic variables on physical-activity behavior for a national sample of adults as well as how these relationships differ for cancer survivors and their counterparts.

Methods: Using the …

Association Of Lifestyle Behaviors With Non-Alcoholic Fatty Liver Disease And Advanced Fibrosis Detected By Transient Elastography Among Hispanic/Latinos Adults In The Us, Natalia I Heredia, Xiaotao Zhang, Maya Balakrishnan, Jessica P Hwang, Aaron P Thrift

Faculty, Staff and Students Publications

OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent liver disease, with the highest prevalence observed in the U.S. among Hispanic/Latino adults. While physical activity and dietary behaviors have established protective associations with NAFLD and its severity, these associations have not been well-characterized in Hispanic/Latino adults. The purpose of this study was to assess the association of lifestyle behaviors with NAFLD and advanced fibrosis in US Hispanic/Latino adults.

DESIGN: We selected all Hispanic/Latino adults from the 2017-2018 National Health and Nutrition Examination Survey (NHANES). NAFLD was defined as CAP ≥285 dB/m, and advanced fibrosis as liver stiffness measurements ≥8.6 …

Comparing The Impact Of Food Insecurity, Access To Exercise Opportunities, And County Classification On Obesity Rates In Ohio, Ankur Parekh, Deborah Lee

Scholarship in Medicine - All Papers

Objective: We completed a study to determine how food insecurity, access to exercise opportunities, and county classification (rural or urban) impacted obesity rates in Ohio. We hypothesized that the county classification impacted obesity the most followed by food insecurity and access to exercise opportunities.

Methods: We obtained data on food insecurity, access to exercise opportunities, and obesity from County Health Rankings and county classification data from the United States Department of Agriculture Census. We analyzed correlations between obesity and food insecurity and obesity and access to exercise opportunities in both county types. We also analyzed changes in obesity rates in …

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

DNP Research Projects

Abstract

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

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

Factors Associated With Physical Activity Intent Among Adults With Multiple Sclerosis, Biebele Okpeahior

College of Graduate Studies: Theses & Dissertations

Introduction. Although research has highlighted the benefits of physical activity in people with Multiple Sclerosis (MS), they are still more likely to live an inactive lifestyle. There are limited studies that examine the relationship between physical activity and the Theory of Planned Behavior (TPB) among the MS population. This study aimed to explore the factors that associate with physical activity intent of adults with MS utilizing the constructs of the TPB. Methods. This study utilized a cross-sectional online survey done via a social media platform. There were 326 respondents to the survey and ultimately 249 surveys that met the criteria …

Physical Activity And Exercise With Blood Flow Restriction As Medicine During The Covid-19 Pandemic And Beyond, Isaac J. Wedig

Dissertations, Master's Theses and Master's Reports

During the COVID-19 pandemic, physical activity levels have decreased and sitting time has increased. This is a major concern as physical inactivity increases the risk for severe COVID-19 outcomes. Evidence also indicates that COVID-19 survivors can experience reduced physical function (i.e., ability to complete daily living activities) long after acute illness. Currently, there are no evidence-based guidelines for recovering physical function following COVID-19 infection. Exercise with blood flow restriction (BFR) presents a promising rehabilitation strategy as the benefits of traditional exercise can be achieved using lower intensities. However, several barriers such as cost, access to equipment, and lack of standardized …

Lifestyle Tools For Men’S Health And Disease Prevention: Well-Being Through Nutrition, Physical Activity, Stress Management, And Connection, Leigh A. Frame

Clinical Research and Leadership Faculty Publications

Mental health is an often-overlooked aspect of overall health and wellness (well-being). Mental illness is increasingly common with 1 in 5 American adults experiencing it annually, and 1 in 20 suffering from a serious mental illness each year [1]. Treatment rates for mental illness are lower in men (37.4%) compared to women (51.2%) [1]. Globally, treatment rates are similar with an estimated cost to the global economy of $1 trillion annually, yet less than 2% of government health expenditure is for mental health worldwide [2]. Despite this, only nine studies have been published specifically targeting men’s mental health through lifestyle …

Mental Health Benefits Of Physical Activity In Older Adults, Adrian Kurt Zitzmann

Master of Science in Nursing Family Nurse Practitioner

Physical activity is the fountain of youth, strengthening both the physical body as well as the mind, leading to better emotional stability and a general sense of well-being. The population over age 65 is nearing retirement age and are transitioning from a high paced work and family life to a slower and less active “empty nest” lifestyle. Among adults over age 65, will implementing an exercise program for 30 minutes per day increase mental well-being? The benefits of physical activity will be supported by gathering a group of older adults ages 65 and up from a local retirement community to …

Factors Associated With Meeting Physical Activity Guidelines During The Covid-19 Pandemic, Natalia I Heredia, Michael Machiorlatti, Belinda M Reininger, Candace Robledo

Faculty, Staff and Student Publications

INTRODUCTION: The COVID-19 pandemic impacted individual physical activity levels. Less is known regarding how factors such as sociodemographic and built environment were associated with physical activity engagement during the pandemic. Understanding these factors is critical to informing future infectious disease mitigation policies that promote, rather than hinder physical activity. The purpose of this study was to assess predictors of physical activity levels during the beginning of the pandemic (April-June 2020), including Stay-at-Home length and orders, neighborhood safety, and sociodemographic characteristics.

METHODS: Data included 517 participants who responded to an anonymous online survey. Physical activity was assessed with a modified Godin …

Visual Factors Associated With Physical Activity In Schoolchildren, Síofra Harrington, John Kearney Prof, Veronica O'Dwyer Dr

Articles

Clinical relevance Physical activity is an essential part of childhood physical and mental development. Recent research identified visual problems associated with a sedentary lifestyle in children in Ireland.

Background This study explored the association between visual function in children and their engagement with physical activities outside school.

Methods Participants were 1,626 schoolchildren (728 aged 6–7 years, 898 old 12–13 years) in randomly selected schools in Ireland. Before data collection, parents/legal guardians of participants completed a standardised questionnaire reporting physical activity as no activity (mostly on screens), light activity (occasional walking/cycling), moderate activity (/week engaged in sports), or regular activity ( …

Physical Activity As A Predictor Of Obesity In Autistic Children, Cody A. Mullins

Graduate Theses/Dissertations

Research has found autistic children to be 40% more likely to be obese compared to their non-autistic peers. Reduced physical activity (PA) is thought to be a contributing factor to the increased prevalence of obesity in autistic children. This was one of the first studies to investigate the PA behaviors of autistic children during an adapted physical education (APE) class using accelerometry. The purpose of this study was to examine the PA of autistic children and determine the relationship between PA and obesity. Participants were recruited from a school for students with disabilities who participate in a once-weekly APE class …

Obesity Prevention Toolkit To Combat Weight Gain Related To Sedentary Behavior And Dietary Habits In College Students: An Evidence-Based Project, Maria Amos, Martha Fuller

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Forty percent of the US population ages 20-39 are categorized as obese,

their BMI is over 30, and 35% of college age students are obese or overweight. Issues related to obesity cost the US $147 billion annually. Between 40%-50% of college students are reported to be inactive. Inactivity can lead to increased morbidity and mortality related to increased risks of cardiovascular disease, diabetes, hypertension, musculoskeletal issues, and depression. Providing dietary and physical activity education and access to nutritional information promotes behavior change in young adults.

Aims of Service Change: This evidence-based project proposal aims to provide a toolkit …