Browsing by Author "Keith, NiCole R."
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Item Community-Based Exercise Program Attendance and Exercise Self-Efficacy in African American Women(2014-01-29) Virgil, Kisha Marie; Mikesky, Alan E.; Keith, NiCole R.; De Groot, Mary K.; Hess, Lisa M.; Mushi-Brunt, Christina R.Rates of chronic disease and physical inactivity are disproportionately high among African American women. Despite the known benefits of physical activity and an increasing number of programs designed to increase activity, attendance rates to many exercise programs remain low. There is much to learn about program types, such as healthy lifestyle programs (HLP); individual factors, such as self-efficacy; and mediating variables that may influence exercise program attendance. An observational study design was used to compare exercise self-efficacy and attendance in a community-based exercise program in African American women who were enrolled in a HLP (N = 53) to women who were not (N = 27). Exercise program attendance was gathered across six months; demographics, self-efficacy and physical activity behaviors were assessed through surveys; and physiological variables (resting heart rate and blood pressure, height, and weight) and physical fitness (muscular strength and endurance and cardiovascular endurance) were measured at baseline. Descriptive statistics were used to describe participants and groups were compared using T-tests, chi-square and non-parametric statistics. Finally, mediation analyses were conducted using multiple regression models to assess self-efficacy as a potential mediator to exercise program attendance. Women who enrolled in this study were of low income (61% having an annual income less than $20,000), obese with a mean (standard deviation) body mass index (BMI) of 37.7 (7.6), pre-hypertensive with a mean (standard deviation) systolic blood pressure of 125.9 (14.4), and scored poorly and marginally on two fitness tests. On average, women reported being Moderately Confident in their ability to exercise regularly, yet had low attendance in the exercise program with a median number .5 days over six months and there were no significant differences in exercise self-efficacy (p = .23) or attendance in the exercise program between groups (p = .79). Additionally, exercise self-efficacy was not a mediating variable to program attendance. Women in this study had little discretionary income and several chronic disease risk factors, yet exercise program attendance was low even in those enrolled in a HLP. Identifying factors that increase exercise self-efficacy and factors that influence attendance beyond self-efficacy may help future program design and attendance.Item Comparison Between Dance-Based and Traditional Exercise on Health-Related Quality of Life: A Cross-Sectional Analysis(2022) Alamilla, Rafael A.; Dent, Shaquitta R.; Soliven Jr., Robert C.; Holt, Tharon; Kaushal, Navin; Keith, NiCole R.Health-related quality of life (HRQoL) includes physical health, cognitive well-being, and the presence of social support. Declines in HRQoL can result in physical impairment, social isolation, and impaired cognition. Regular exercise (EX) participation may lead to better HRQoL among older adults. Dance-oriented group fitness classes (DANCE) can provide participants with structured EX that involves high levels of coordination and social comradery. DANCE EX may be a viable alternative to traditional EX (TRAD) for the maintenance of HRQoL. PURPOSE: To determine whether participation in regular DANCE EX displays higher HRQoL in older adults when compared to those who participate in TRAD EX. METHODS: Twenty-nine older adults (age 69.8 ± 9.6 yrs; 28 females; 93.1% white) enrolled in a cross-sectional study examining those who either participated in DANCE EX or TRAD EX at the time of enrollment. All participants completed the following assessments: the Medical Outcomes Study Short Form 36 subscale for physical functioning (SF-36); the International Physical Activity Questionnaire (IPAQ); the Mini Mental State Examination (MMSE); the Duke Social Support Index (DSSI); and the Senior Fitness Test (SFT). RESULTS: A MANOVA test demonstrated a statistically significant difference in SFT scores between groups (F(2,29) = 3.11 p < 0.02; Wilk's λ = 0.29, partial η2 = 0.17). Univariate ANOVA tests detected a significant different between groups for chair stand (F(2,29) = 18.63, DANCE: 15.38 ± 4.05, TRAD: 9.07 ± 3.69; p < 0.001), 8 ft up-and-go (F(2,29) = 6.57, DANCE: 5.53 ± 1.02, TRAD: 7.87 ± 3.15; p = 0.02), 2 min step test (F(2,29) = 17.09, DANCE: 100.69 ± 19.58, TRAD: 66.47 ± 30.94; p < 0.001), and SF-36 (F(2,29) = 4.14, DANCE: 92.31 ± 5.25, TRAD: 79.31 ± 22.46; p = 0.05). Neither perceived social support nor cognitive function were significantly different between groups (p > 0.05). Weekly MET-mins of moderate (DANCE: 2,487.7 ± 2,226.3, TRAD: 1,752.0 ± 1,734.5) and vigorous (DANCE: 2,870.8 ± 2,829.8, TRAD: 1,920.0 ± 3,301.5) physical activity did not differ between groups (p > 0.05). CONCLUSIONS: DANCE EX supported higher levels of physical health—and no effect on cognitive well-being and social support—when compared to TRAD EX. DANCE EX may be a viable form of EX to support HRQoL in older adults.Item Depressive Symptom Severity as a Predictor of Attendance in the HOME Behavioral Weight Loss Trial(Elsevier, 2020-04) Shell, Aubrey L.; Hsueh, Loretta; Vrany, Elizabeth A.; Clark, Daniel O.; Keith, NiCole R.; Xu, Huiping; Stewart, Jesse C.; Psychology, School of ScienceObjective We examined whether total depressive symptoms and symptom clusters predicted behavioral weight loss attendance among economically disadvantaged adults in a randomized controlled trial. Methods 150 adults with obesity were randomized to 12 months of in-person, video conference, or enhanced usual care weight loss groups. We categorized percent session attendance in the intervention arms into three levels: no attendance, poorer attendance, and better attendance. Results Higher baseline Patient Health Questionnaire-8 (PHQ-8) score was associated with a greater odds of being in the poorer versus better attendance group (OR = 1.94, 95% CI: 1.02–3.69, p = .04). A similar relationship between PHQ-8 score and odds of being in the no attendance versus better attendance group was observed but was not statistically significant (OR = 1.63, 95% CI: 0.94–2.81, p = .08). Both cognitive/affective and somatic clusters contributed to the depressive symptoms-attendance relationships. Conclusion Greater depressive symptoms at the start of a behavioral weight loss program may predict poorer subsequent session attendance. Screening for and addressing depression may improve intervention uptake.Item Environments and situations as correlates of eating and drinking among women living with obesity and urban poverty(Wiley, 2021-09-01) Clark, Daniel O.; Keith, NiCole R.; Ofner, Susan; Hackett, Jason; Li, Ruohong; Agarwal, Neeta; Tu, Wanzhu; Medicine, School of MedicineObjective: One path to improving weight management may be to lessen the self-control burden of physical activity and healthier food choices. Opportunities to lessen the self-control burden might be uncovered by assessing the spatiotemporal experiences of individuals in daily context. This report aims to describe the time, place, and social context of eating and drinking and 6-month weight change among 209 midlife women (n = 113 African-American) with obesity receiving safety-net primary care. Methods: Participants completed baseline and 6-month weight measures, observations and interviews regarding obesogenic cues in the home environment, and up to 12 ecological momentary assessments (EMA) per day for 30 days inquiring about location, social context, and eating and drinking. Results: Home was the most common location (62%) at times of EMA notifications. Participants reported "yes" to eating or drinking at the time of nearly one in three (31.1% ± 13.2%) EMA notifications. Regarding social situations, being alone was significantly associated with less frequent eating and drinking (OR = 0.75) unless at work in which case being alone was significantly associated with a greater frequency of eating or drinking (OR = 1.43). At work, eating was most common late at night, whereas at home eating was most frequent in the afternoon and evening hours. However, eating and drinking frequency was not associated with 6-month weight change. Conclusions: Home and work locations, time of day, and whether alone may be important dimensions to consider in the pursuit of more effective weight loss interventions. Opportunities to personalize weight management interventions, whether digital or human, and lessen in-the-moment self-control burden might lie in identifying times and locations most associated with caloric consumption.Item Exploring Exercise Outcomes, Preferences, and Barriers in Adolescent and Young Adult Cancer Survivors(2024-08) Sherman, Melissa Marie; Keith, NiCole R.; Kaushal, Navin; Naugle, Kelly; Renbarger, JamiePhysical activity (PA) improves physiology and cognition including Quality of Life (QoL), fatigue, depression, anxiety, and emotional well-being. Despite the positive effects of PA, adolescent, and young adult (AYA) cancer survivors (15-39 yrs.) do not meet the American College of Sports Medicine (ACSM) recommended PA guidelines to elicit positive health outcomes. AYA survivors may have unique physical and psychological experiences that impact motivation, barriers, and preferences for participation in PA. The overarching purpose of this dissertation is to better understand the outcomes, motivation, preferences, and barriers to exercise adherence when completing exercise and PA interventions among AYA survivors of cancer. This dissertation addresses this purpose through three distinct studies: AYA Cancer Survivors and One-on-One Exercise in an In-person setting, AYA Cancer Survivors and One-on-One Exercise in a Virtual Setting, and subsequent focus groups that utilized the participants from both virtual and in-person studies. Results indicated that the nature of cancer and cancer treatment, type of cancer, age at diagnosis, and experience within treatment (i.e. surgery, radiation, chemotherapy, stem cell transplants) varied significantly across AYA survivors of cancer. Despite the differences in experience, cancer-related fear and anxiety were common among participants but were offset by a sense of control and accountability experienced during the larger study. Working one-on-one with a wellness coach or exercise trainer provided participants with a sense of accountability and a sense of control that otherwise was missing post-cancer treatment and remission. The extra support is needed to help alleviate fears and anxiety and to promote accountability, acceptability, and adherence to exercise. A multi-disciplinary approach with wellness coaching and individualized PA guidance is suggested for future programming in this population group. While AYA survivors of cancer are an often understudied population, future research must target more racially and ethnically diverse groups to understand this group as a whole better.Item Future Directions for Transforming Kinesiology Implementation Science Into Society(Human Kinetics Journals, 2023) Alamilla, Rafael A.; Keith, NiCole R.; Hasson, Rebecca E.; Welk, Gregory J.; Riebe, Deborah; Wilcox, Sara; Pate, Russell R.Physical activity policy can play a crucial role in ensuring that individuals, communities, and societies can obtain the wide range of health benefits associated with regular physical activity participation. Policies such as Title IX, the Americans With Disabilities Act, and state physical education laws have all increased opportunities for millions of Americans to participate in physical activity. With that said, how policies are developed and implemented vary considerably. The purpose of this manuscript is to contrast an academic conceptual framework with a pragmatic approach for policy implementation. In an ideal world, polices would be developed from foundational knowledge, scaled up to community-level interventions, and implemented in a sequential fashion. However, policy implementation is a disorderly process that requires a practical methodology. The National Physical Activity Plan encompasses strategies and tactics across 10 key societal sectors—and highlights the disorderly process of policy implementation across the various sectors.Item Identifying Contextual and Emotional Factors to Explore Weight Disparities between Obese Black and White Women(Libertas Academica, Ltd., 2016) Keith, NiCole R.; Xu, Huiping; de Groot, Mary; Hemmerlein, Kimberly; Clark, Daniel O.; Department of Kinesiology, School of Physical Education and Tourism ManagementBACKGROUND: Obese black women enrolled in weight loss interventions experience 50% less weight reduction than obese white women. This suggests that current weight loss strategies may increase health disparities. OBJECTIVE: We evaluated the feasibility of identifying daily contextual factors that may influence obesity. METHODS: In-home interviews with 16 obese (body mass index ≥ 30) black and white urban poor women were performed. For 14 days, ecological momentary assessment (EMA) was used to capture emotion and social interactions every other day, and day reconstruction method surveys were used the following day to reconstruct the context of the prior day's EMA. RESULTS: Factors included percentage of participants without weight scales (43.8%) or fitness equipment (68.8%) in the home and exposed to food at work (55.6%). The most frequently reported location, activity, and emotion were home (19.4 ± 8.53), working (7.1 ± 8.80), and happy (6.9 ± 10.03), respectively. CONCLUSION: Identifying individual contexts may lead to valuable insights about obesogenic behaviors and new interventions to improve weight management.Item Promoting ADL independence in vulnerable, community-dwelling older adults: a pilot RCT comparing 3-Step Workout for Life versus resistance exercise(Dove, 2017) Liu, Chiung-Ju; Xu, Huiping; Keith, NiCole R.; Clark, Daniel O.; Occupational Therapy, School of Health and Rehabilitation SciencesBACKGROUND: Resistance exercise is effective to increase muscle strength for older adults; however, its effect on the outcome of activities of daily living is often limited. The purpose of this study was to examine whether 3-Step Workout for Life (which combines resistance exercise, functional exercise, and activities of daily living exercise) would be more beneficial than resistance exercise alone. METHODS: A single-blind randomized controlled trial was conducted. Fifty-two inactive, community-dwelling older adults (mean age =73 years) with muscle weakness and difficulty in activities of daily living were randomized to receive 3-Step Workout for Life or resistance exercise only. Participants in the 3-Step Workout for Life Group performed functional movements and selected activities of daily living at home in addition to resistance exercise. Participants in the Resistance Exercise Only Group performed resistance exercise only. Both groups were comparable in exercise intensity (moderate), duration (50-60 minutes each time for 10 weeks), and frequency (three times a week). Assessment of Motor and Process Skills, a standard performance test on activities of daily living, was administered at baseline, postintervention, and 6 months after intervention completion. RESULTS: At postintervention, the 3-Step Workout for Life Group showed improvement on the outcome measure (mean change from baseline =0.29, P=0.02), but the improvement was not greater than the Resistance Exercise Only Group (group mean difference =0.24, P=0.13). However, the Resistance Exercise Only Group showed a significant decline (mean change from baseline =-0.25, P=0.01) 6 months after the intervention completion. Meanwhile, the superior effect of 3-Step Workout for Life was observed (group mean difference =0.37, P<0.01). CONCLUSION: Compared to resistance exercise alone, 3-Step Workout for Life improves the performance of activities of daily living and attenuates the disablement process in older adults.Item Reducing Physical Activity Disparities Among Vulnerable Minorities: Methods and Preliminary Outcomes(2022) Alamilla, Rafael A.; Georgiadis, Yanoula M.; Kaushal, Navin; Keith, NiCole R.INTRODUCTION: Vulnerable minorities experience high rates of chronic disease. Physical Activity (PA) is an effective preventive behavior to mitigate multiple diseases. Vulnerable minorities have low PA participation. Finding ways to engage PA in vulnerable minorities is imperative. PURPOSE: To describe the baseline data from a community-based wait-list pilot PA trial for vulnerable minorities. METHOD: Forty-five participants from a Midwest urban community were randomized to an experimental (EXP) or wait-list control (WLC) group. EXP participants were counseled to engage in regular PA (>4d/wk for >30 mins). EXP participants received a fitness center membership, trainer, and on-site monthly education to help them develop exercise identity and habit formation. The WLC group could engage in PA if desired but did not have the same research resources. Both groups completed monthly surveys assessing exercise identity, social support, and habit formation. Baseline data included one week of moderate-to-vigorous PA (MVPA) and health-related fitness assessments (measured by accelerometry and fitness tests, respectively). CONCLUSIONS: Data show baseline measures did not vary between groups. Moreover, our team experienced difficulties recruiting vulnerable minorities. Participant-stated barriers to participation in our study included: 1) Schedule (work, child’s school, etc.) and conflicting life demands; 2) Fear of getting ill or getting immediate family ill (COVID, flus, etc.); 3) Disruption of routine (e.g., children going on school break); 4) The limited hours of the fitness center; 5) Inflation & rising costs of goods (e.g., gasoline, food, etc.); and 6) Issues interacting with PARCS staff, lack of trust. Next steps include reporting final outcomes and developing refined recruitment methods.Item Reducing Physical Activity Disparities Among Vulnerable Minorities: Methods and Preliminary Outcomes(2023) Alamilla, Rafael A.; Georgiadis, Yanoula M.; Kaushal, Navin; Keith, NiCole R.INTRODUCTION: Vulnerable minorities experience high rates of chronic disease. Physical Activity (PA) is an effective preventive behavior to mitigate multiple diseases. Vulnerable minorities have low PA participation. Finding ways to engage vulnerable minorities in PA is imperative. PURPOSE: To describe preliminary data from a community-based wait-list pilot PA trial for vulnerable minorities. METHODS: Forty-five participants from a Midwest urban community were randomized to an experimental (EXP: N = 23; 15 F) or control (CON: N = 22; 15 F) group. Baseline measures are height = 168.5 ± 9.1cm (EXP), and 167.9 ± 7.0cm (CON); weight = 95.8 ± 26.4kg (EXP) and 85.0 ± 19.3kg (CON), age = 39.9 ± 9.7y (EXP) and 48.8 ± 13.2y (CON). EXP participants were counseled to engage in regular PA (>4d/wk for >30 mins). EXP participants received a fitness center membership, trainer, and on-site monthly education to help them develop exercise identity and habit formation. The CON group could engage in PA if desired but did not have the same research resources. Both groups completed monthly surveys assessing exercise identity, social support, and habit formation. Baseline data included one week of moderate-to-vigorous PA (MVPA) and health-related fitness (measured by accelerometry and fitness tests, respectively). RESULTS: Paired-samples T-test were used to make baseline comparisons. Study participants were 73.2% White, 67.4% employed full-time, 56.1% obtained a bachelor’s degree or higher, and 32.0% earned >300% of the federal poverty level. MVPA was 127.9 ± 69.8 min/wk (EXP) and 174.7 ± 103.1 min/wk (CON). Other non-significant outcomes included body fat % (EXP: 37.1 ± 10.9%; CON: 32.9 ± 12.0%), 8ft-up-and-go time (EXP: 5.01 ± 0.8s; CON: 5.05 ± 1.10s), and 30s chair stand (EXP: 15.3 ± 6.5; CON: 17.5 ± 5.2), 30s seated arm curl (EXP: R =18.9 ± 5.1, L = 19.2 ± 5.1; CON: R = 21.2 ± 5.7, L = 20.1 ± 5.4). Chair sit-and-reach scores for right (EXP: -0.1 ± 8.3cm; CON: 1.0 ± 12.2cm, p = 0.003 ) and left (EXP: -0.3 ± 8.2cm; CON: 0.1 ± 11.4cm, p = 0.01) legs were different. CONCLUSION: Data show baseline measures did not vary between groups and difficulty recruiting vulnerable minorities. Next steps include reporting final outcomes and developing refined recruitment methods.