Master of Public Health / Department of Kinesiology / Emily Mailey / INTRODUCTION: Research has focused on the relationship between socioeconomic status and physical activity, yet there are limited examinations which directly address social groups dealing with major issues associated with insufficient income. Studies have neglected the role of psychosocial stressors, such as financial stress, food insecurity, availability of government assistance programs, as well as psychological distress relative to the relationship between physical activity and low-income status. The purposes of this study were threefold: 1) to describe the multidimensional characteristics of life among low-income populations; 2) to examine how psychosocial stressors and health conditions vary across subsets of low-income groups; and 3) to examine the relationship among income, psychological distress and physical activity within low-income populations. METHODS: Data from the 2015 National Health Interview Survey (NHIS) were analyzed for the purposes of this investigation. Descriptive statistics were calculated for the low-income status individuals who provide complete data for all variables of interest to this study. A series of chi-square analyses were conducted to determine whether key psychosocial stressors, health behaviors, and health conditions differed by low-income (FIPR) groups. Two stepwise logistic regression analyses were conducted to examine these factors and their relationships with moderate-intensity (MPA) and vigorous (VPA)-intensity physical activity. RESULTS: Overall, women made up 58.5% of the sample size. Blacks/African Americans accounted for 20.6% of the sample, yet 28.0% of FIPR Group 1 identified as Black/African American. FIPR Group 1 was disproportionately unemployed, with 63.5% unemployed compared to 46.9% for the sample. One-quarter (25.9%) of the entire sample reported severe psychological distress, yet 33.9% of FIPR Group 1 and 30.8% of FIPR Group 2 reported severe distress. Nearly three-quarters (70%) of the sample was overweight or obese and 44.2% lived with at least one chronic disease at the time the survey was taken. Overall, 67.9% of the sample reported zero minutes of VPA and 51.3% reported zero minutes of MPA. Both psychological distress and income showed significant relationships with VPA. Psychological distress remained significantly associated with VPA after controlling for all covariates; however, income was no longer related to VPA after demographic and health-related variables were added to the model. Income was not related to MPA. Psychological distress demonstrated a weak relationship with MPA before the other covariates were added to the model, at which point the relationship became non-significant. Only the relationship between psychological distress and VPA was significant in the final models. Although some of the psychosocial stressor, demographic, and health-related variables contributed to the relationships between income, physical activity, and psychological distress, these variables explained only a small portion of the variance in both MPA and VPA. CONCLUSION: Low-income individuals are faced with difficult decisions and are limited in the choices they can make to improve health. It is important to understand the multidimensional characteristics of life under limited income to better serve and improve the health of low-income populations. Further study of the relationships among income, physical activity and psychological distress is needed to further this understanding.

abstract: With many students of all ages attending after school programs (APSs) where there are a variety of program specific goals, this study examined the physical activity (PA) patterns of youth and teens attending afterschool programs as well as their physical activity during the school week. The first phase of the study used a validated observational instrument System for Observing Play and Leisure in Youth (SOPLAY) to record PA data and contextual aspects. Data was analyzed using cross-tabulations, chi-square test, and a table created to understand moderate to vigorous physical activity (MVPA) levels and contextual variables of the ASP. Findings suggest both girls and boys engaged in MVPA in environments built for play, while the mean percentage of girls engaged in MVPA was less than boys regardless of activity area. The second phase of the study used a survey comprised of two self-administered instruments. The first section used the Middle School Health Behavior Survey (MSHBS), which has been previously validated to record youth and teens PA behaviors during the past school week inside and outside of school. The second portion of the survey asked youth and teens about PA participation, leisure time, perceptions of the after school program, and choices within the after school program using the validated Kaiser Physical Activity Survey (KPAS). Data was analyzed using descriptive statistics to calculate and summarize data within and across both groups. Results showed more than half of youth and teens surveyed were active in some form during the past week regardless of being in school or outside of school, approximately less than a third are in front of a television or computer for less than an hour, and the favorite part of the ASP to youth and teens was the Gym and Friends respectively. / Dissertation/Thesis / Doctoral Dissertation Physical Education 2015

abstract: ABSTRACT The purpose of this study was to investigate physical activity (PA) program characteristics preferred by low-income childbearing age Latinas and the relationship with the participants’ personal characteristics, cultural values, and acculturation. This was an exploratory study guided by the Preferences and Health Behavior Model (PaHBM), developed by this investigator. Recruitment occurred at three sites; two sites were located in Phoenix, AZ and one site was located in Houston, TX. Non pregnant Latinas between 18 to 35 years old were included (N=275). Latinas were excluded if they were pregnant, incarcerated, physically or mentally disabled, or had chronic diseases (e.g. cardiovascular disease). Quantitative data were collected using the Predictors and Preferences of Physical Activity Research Intervention Participation in an Underserved Latina Community Questionnaire, developed by this author, along with the Brief Acculturation Rating Scale for Mexican Americans, and the Mexican American Cultural Values Scale. The hypotheses were tested utilizing Chi-square, Pearson correlation and logistic regression. Annual family income, parity, country of origin, BMI and acculturation were the personal characteristics significantly associated with preferred PA program by this group of Latinas. Latino women were heterogeneous in their preferences. In general, sixty percent endorsed dancing as the type of activity preferred, 20% preferred PA education and 20% preferred walking. Major differences were found between the types of activity the Latino women were currently participating in compared to their preferred type of activity. Of the 124 who reported to be walking/jogging, almost half (49) preferred dancing, 22 preferred PA education and only 12 preferred walking. The study findings add to the existing knowledge by looking at factors that should be considered when developing PA interventions as well as when prescribing or recommending PA to this population. These results demonstrate the need to identify the preferred PA program characteristics of Latinas prior to developing interventions. Failure to know the patient’s preferred PA program characteristics may result in prescribing or recommending an undesired activity and decrease participation in PA interventions. RESUMEN El propósito de este estudio fue identificar las características preferidas en un programa de actividad física por una comunidad de mujeres Latinas de bajos recursos económicos y en edad fértil, así como la relación de esas características con sus propias características personales, sus valores culturales y su adaptación a la comunidad Anglosajona. Este fue un estudio exploratorio guiado por el “Modelo Preferencias y Comportamiento Saludables” (PaHBM), por sus siglas en Ingles, desarrollado por esta investigadora. El reclutamiento de las Latinas ocurrió en tres sedes: Una en Houston, TX y dos en Phoenix, AZ. Las mujeres Latinas fueron incluidas si tenían entre 18 y 35 años de edad. Se excluyeron mujeres que estaban embarazadas, estuvieran encarceladas, físicamente o mentalmente incapacitadas o que sufrieran alguna enfermedad crónica. Los datos cuantitativos fueron recolectados a través de una encuesta llamada “Predictores y preferencias de participación en un programa investigativo de actividad física”, desarrollada por la autora de este estudio, además utilizando la escala breve de aculturación para Mejicanos Americanos y la escala de valores culturales en Mejicanos Americanos. Las hipótesis fueron probadas utilizando el Chi-cuadrado, la correlación de Pearson, y la regresión lógica. Las características personales más asociadas con las características del programa preferido fueron el salario anual de la familia, el número de hijos, el país de origen, y el índice de masa corporal. En general, 60% prefirieron bailar, 20% clases de actividad física y 20% caminar. Mayores diferencias se encontraron en el tipo de actividad en las que las mujeres Latinas estaban participando, comparado con lo que ellas preferían. De 124 participantes que estaban caminando o trotando, 49 Latinas (39%) preferían bailar, 22 Latinas (17%) preferían clases de actividad física y solo 12 Latinas (10%) prefirieron caminar. Estos resultados demuestran la necesidad de identificar las características del programa de actividad física antes de crear dicho programa. Estos resultados son una adición a los conocimientos existentes, en los que se identificaron factores que deben ser considerados cuando se planea un programa así como cuando se prescribe o se recomienda actividad física a esta población. Sera un fracaso no conocer las preferencias de una paciente para mantenerse físicamente activa porque puede resultar en la prescripción o recomendación de actividades que la paciente no desea y esto se traducirá en reducción de la participación en programas de actividad física. / Dissertation/Thesis / Doctoral Dissertation Nursing and Healthcare Innovation 2016

abstract: This body of research sought to explore relationships between parenting practices, physical activity resources, and Hispanic children’s physical activity. Guided by the Family Ecological Model (FEM) and the Ecological Model of Physical Activity (EMPA) this study examined the influence of parents on children’s physical activity through an integrative review. A cross sectional study was conducted to investigate potential relationships between parental perception safety at school, gender, and children’s physical activity. A cross sectional study was also utilized to examine potential correlations between parenting practices, physical activity resources, and children’s physical activity. Parental role modeling of physical activity and parental support for physical activity emerged as parenting practices that have considerable potential to impact children’s physical activity. Gender differences among children’s physical activity were also a key finding of this study with boys participating in more physical activity than boys. While quality of physical activity resources did not have significant associations with parenting practices or children’s physical activity, more research is needed to determine how resources for physical activity may impact parenting practices, and children’s physical activity. / Dissertation/Thesis / Doctoral Dissertation Nursing and Healthcare Innovation 2017

This aim of this thesis evolved following a review of the literature investigating the factors which influence children’s participation in outdoor play. The review was conducted in light of theory recommending that when seeking to promote physical activity, considering context-specific behaviours and behaviour-specific determinants can enhance the effectiveness of interventions. An initial focus on outdoor play was warranted given the capacity for promotion of physical activity during leisure-time, concerns that children’s independent time outdoors is becoming increasingly restricted, and limited research focus on this domain of physical activity. The synthesised quantitative and qualitative evidence indicated that independent mobility, parental perceptions of safety and the availability of other children to play with were important factors related to outdoor play. However, the review also demonstrated that current understanding of how, where and with whom children spend their leisure-time is limited, and that traditional notions of children’s outdoor time may need to be re-evaluated. These deficiencies were in part due to the complexity of defining and measuring children’s outdoor play. The contributions of different indoor and outdoor leisure-time contexts towards total daily moderate to vigorous physical activity (MVPA) was identified as a particular knowledge gap. The aim of this thesis was therefore to develop greater understanding of the indoor and outdoor contexts of children’s leisure-time physical activity. A novel approach to context-specific physical activity research was devised. This method incorporated use of accelerometry to record physical activity intensity with high resolution, Global Positions System (GPS) receivers to automatically record indoor or outdoor location, and diary data to provide complementary contextual detail. Rather than utilise a domain label such as outdoor play, this method sought to combine measurement tools to not only objectively record physical activity intensity, but also build a picture of the context of this activity using combinations of contextual attributes. Children at the transition between primary and secondary school were the focus of the research due to the changes in independence which occur at approximately this age (10-13 years). The research consisted of three studies presented across three chapters. Chapter Five used data collected between 2006 and 2008 from children aged 10–11 years from Bristol involved in the Personal and Environmental Associations with Children's Health (PEACH) project. Given the association of outdoor play with independent mobility and the availability of other children, the chapter quantified who children spent their time with when indoors or outdoors after school, and measured associations with MVPA. Using a newer GPS receiver, Chapter Six aimed to assess the feasibility of using GPS data to differentiate indoor and outdoor location, and establish a cut-point for use in free-living individuals. Chapter Seven then used this GPS method in combination with accelerometry and diary data provided by children aged 11-13 years from Edinburgh. Owing to concerns that children’s unstructured outdoor time is restricted by parents in favour of adult organised sport and clubs, the chapter aimed to record the profile of children’s physical activity. This was achieved by recording whether indoor and outdoor leisure-time physical activity was structured or unstructured, and exploring relationships between periods spent in these contexts and total daily MVPA. Chapter Six demonstrated that using the signal-to-noise ratio from GPS data is an accurate tool for differentiating indoor and outdoor location, with 96.8% of all ten-second epochs correctly classified. Together the findings of Chapters Five and Seven suggest that children obtain their physical activity in multiple contexts and that no single context appears to fulfil the recommendation of 60 minutes of MVPA per day. Chapter Five showed that children spent most of the after school period with parents or alone, especially when indoors. However when participants were outdoors with other children, multivariate regression analyses indicated that these periods were most strongly associated with MVPA. Complementing these findings, Chapter Seven revealed that in a relatively active and affluent sample, participants accumulated most of their MVPA in school-time or unstructured leisure-time contexts (both indoors and outdoors). The results revealed that these active children spent more than one hour in unstructured outdoor leisure-time contexts each day. However, associations with MVPA were weaker than expected, and whilst being outdoors was favourable compared to being indoors, it was apparent that there is scope to maximise MVPA further when children are outdoors. The median contributions of structured leisure-time contexts to daily MVPA were minimal regardless of indoor or outdoor location. Deconstructing leisure-time according to contextual attributes recorded by a combination of measurement tools proved to be an informative approach for understanding variation in children’s MVPA. Taken together the findings of the thesis indicate potential for leisure-time to contribute greater volumes of MVPA. The results emphasise the importance of children being outdoors, the value of unstructured forms of physical activity and the necessity for children to spend time with their peers. It is clear from these studies that indoor time is also a vital source of MVPA. The work presented in this thesis makes a valuable contribution to our understanding of how children spend their leisure-time and how this relates to physical activity. Further research is required to explore the many other contextual attributes of children’s leisure-time, so that indoor and outdoor environments can be manipulated as part of multi-component interventions that promote physical activity as effectively as possible.

The worldwide prevalence of obesity is reaching epidemic proportions in both adults and children and leading to increased risk of non-communicable diseases (WHO, 2004), including coronary heart disease, circulatory disease, cancer and type 2 diabetes. In the UK, increasing levels of obesity may relate to a decrease in sport and physical activity participation as only 39% of males and 32% of females are sufficiently active to meet stated targets for physical activity (Townsend et al., 2012). In Britain, approximately 8% of the population originate from ethnic minorities that includes a high proportion of individuals from Arabic countries, with a significantly greater odds ratio for a sedentary leisure-time physical activity pattern than people from other countries. The thesis contains three studies which identify the patterns of physical activity in Arabic males (men and boys) in Liverpool, and explores the barriers and motivations to adopting physically active lifestyles, before addressing the feasibility of an intervention to enhance levels of physical activity. Study 1 examined the patterns of physical activity in 62 Arabic men and 65 boys during 7 consecutive days of continuous accelerometry recording. Men and boys were more active during weekdays than weekend days. Although boys were more active than men, they did not perform sufficient minutes of moderate to vigorous activity (60 min per day) to reach recommendations of MVPA. The men, however completed 190 mins per week of activity in the moderate intensity category and therefore satisfied Government guidelines. Study 2 investigated the barriers and motivators in becoming physically active by using focus group semi-structured interview techniques, followed by transcription and content analysis. The findings of the study indicated that physical activity plays a significant role in the individual’s health and that Arabic males perceive several benefits of physical activity for the individual, such as self-confidence, mental health and improved physical condition. There was a mixed interpretation and understanding of physical activity in these groups, with barriers to becoming more active cited as lack of time and socio-cultural barriers of not being accustomed to being physically activity. Facilitators, that encouraged participants to become physically active, included religion and enjoyment. Study 3 used a mixed methods approach to investigate the feasibility of an awareness raising intervention to increasing the levels of physical activity in Arabic males who owned exergames at home. An intervention group of men and boys were provided with physical activity guidelines. Changes in their physical activity levels were measured (using accelerometry) 4 weeks after receiving the guidelines and compared with a control group. The intervention provoked more light activity, moderate and MVPA activity in the men but no reduction in their sedentary behaviour. In boys, light and moderate activity increased, sedentary behavior decreased, but there was no significant difference in MVPA levels. Semi-structured interviews showed that the men found physical activity guidelines alone were not sufficient to motivate them to change their physical activity levels, but the boys found the provision of these useful. Conclusion. This study demonstrated that Arabic men met recommendations for physical activity, whereas boys did not. Barriers to the adoption of physical activity revolved mainly around a lack of understanding of physical activity and guidelines. The intervention strategy was regarded as family-focused and entertaining but not useful in promoting sustainable change in physical activity levels.

Made available in DSpace on 2014-06-11T19:28:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-05-14Bitstream added on 2014-06-13T20:36:46Z : No. of bitstreams: 1 zanetti_mc_me_rcla.pdf: 772213 bytes, checksum: 7896b5d7cf2e3d207bcbbc502ba1f503 (MD5) / Atualmente, nossa sociedade vem sofrendo uma transformação sem precedentes, no qual, a população, de uma maneira geral, tem se deparado com inúmeros distúrbios, sejam eles, de ordem: social, psicológica e biológica. Esses distúrbios têm refletido em uma menor qualidade de vida e saúde de nossa população, bem como, aumento nos níveis de estresse, diminuição na qualidade de sono, entre outros. Por outro lado, o exercício físico, e a Educação Física escolar vem sendo apontados como importantes agentes promotores de saúde. Pensando nisso, procuramos investigar a influência destas atividades, sobre a estrutura do sono de 58 alunas do sexo feminino, com idades entre 11 e 12 anos (l11.47), da cidade de Limeira SP. Para a coleta dos dados foram aplicados três questionários, no qual, o questionário 1, foi composto por perguntas relativas: à estrutura de sono; problemas de saúde; uso de medicamentos; relacionamento familiar e com amigos; hábitos pessoais; entre outros; o questionário 2 (PAQ-C), foi utilizado para medir o nível de atividade física regular e classificar as adolescentes em ativas e sedentárias; o questionário 3, foi estruturado e utilizado para verificar a percepção subjetiva de qualidade de sono. Posteriormente, aplicamos o teste Qui-quadrado para verificar se havia diferença entre as respostas apresentadas pelas alunas ativas e sedentárias para as questões referentes ao questionário 1, e a questão relativa à percepção subjetiva de qualidade de sono (questionário 3). Adicionalmente, empregamos a análise residual nas questões, onde foi encontrada diferença significativa. Este teste foi utilizado para verificar o comportamento das variáveis e categorias, bem como, determinar as variáveis que mais contribuíram para a diferença encontrada. O teste t para amostras independentes foi aplicado para verificar se havia diferença... / Currently, our society has been suffering a transformation without precedents, in which, the population, in a general way, if has come across with innumerable disorders, is they, social, psychological and biological order. These disorders have reflected in a lesser life quality and health of our population, increase in the levels of stress, reduction in the sleep quality, among others. On the other hand, the physical exercise, and the Physical Education in school have been pointed as important promotional agents of health. Thinking about this, we decided to investigate the influence of these activities, on the structure of the sleep of 58 girls, with ages between 11 and 12 years (l11.47), of the city of Limeira - SP. For the collection of the data three questionnaires had been applied, in which, questionnaire 1, were composed for questions about: sleep structure; health problems; medicine use; relationship in the family and with friends; personal habits; among others; questionnaire 2 (PAQ-C), was used to measure the level of regular physical activity and to classify the adolescents in sedentary or active; questionnaire 3, was structuralized and used to verify the subjective perception of the sleep quality. After, we apply the Qui-square test to verify if it had difference between the answers presented for the active and sedentary girls for the referring questions to questionnaire 1, and the relative question to the subjective perception of the sleep quality (questionnaire 3). Additionally, we use the residual analysis in the questions, where difference was found significant. This test was used to verify the behavior of the variable and categories, and to determine the variable that had more contributed for the joined difference. Test t for independent samples was applied to verify if it had difference between the schedule to sleep and to wake up, and the daily averages... (Complete abstract click electronic access below)

abstract: The health enhancing effects of physical activity are well documented in the literature. However, women continue to report lower participation in exercise and physical activity (PA) compared to men. As women age an overall trend in decreased activity is observed. The primary place of activity reported in women is the home and one of the most commonly reported reasons for lack of physical activity is the lack of time. Few instruments have been developed that focus on the activity patterns of women. The Cross Cultural Physical Activity Study that this study was based on targeted women of color to assess the types of activity and constraints to activity experienced by African American and Native American women over 40 years old. This secondary data analysis focused on the psychometric properties of two scales used in the above study, The Physical Recreation Questionnaire (PRQ) and The Typical Week Physical Activity Survey (TWPAS). An exploratory factor analysis (EFA) was conducted on the 18 items from the Physical Recreation Questionnaire (PRQ) which focused on constraints to PA. The results of the EFA were a poor fit of a two factor model. The three factor model had a favorable fit in the EFA. Confirmatory factor analysis (CFA) was then conducted on the 18 items in the PRQ. Results of the CFA supported the presence of three latent variables: enjoyment of PA, constraints to PA, and negotiation of constraints to PA. The Typical Week Physical Activity Survey (TWPAS) is a 35 item measure of moderate PA that includes the activities most often reported by women. The purpose of the TWPAS was to capture habitual PA that might not be recorded in other PA questionnaires. The TWPAS was correlated with criterion measures of PA records, treadmill, accelerometer, and BMI. Although correlations were small, they were in the expected direction with the criterion measures. The evaluation of the instruments supported the presence of the construct of constraints to PA in the PRQ and the measurement of moderate intensity PA in the TWPAS. / Dissertation/Thesis / Ph.D. Nursing and Healthcare Innovation 2012

Whilst it is realised that children's attitudes are established in the early years there has been a dearth of studies into the socio-cultural factors affecting young children's perceptions of physical activity. It has been recognised that there is an urgent need for investigators to try and develop insights into how these children interpret the messages they receive from significant others. Grounded theory has become accepted as a valuable approach to gathering and interpreting qualitative data. It encourages the researcher to make sense of the social world by providing a framework which allows theories to emerge from data collected in contrast to traditional research methodologies where the emphasis is on testing set hypotheses. This study reviews the status of the grounded theory literature and assesses the potential use of this approach in developing substantive and formal theories accounting for behavioural phenomena amongst young children. There exist two almost contrasting approaches to using grounded theory, the Glaserian and Straussian, both of which are complex and difficult to understand; if however the researcher is to make an informed choice about which approach is most suitable it is necessary to evaluate and consequently choose one of these two approaches. Fifty four children, seven to nine years of age, were studied over a four year period, using interview and observational data collection techniques to establish their activity choices and attitudes towards physical activity. Peers were found to have a strong influence, particularly in the later years spent in primary school. The grounded theory analysis produced a core category subsequently labelled, 'Interpreting Myself - The Identity Profile Continuum' and composed of three axes. There were also three mediating categories which, together with the core category serve to account for behavioural phenomena amongst the sample. Children were found to create an identity for themselves based around the way that they interpret messages from parents and peers. Identities can change in different social contexts and over time. As they become older. however, children begin to accept their identity which contours their behaviour and attitudes towards both organised sport, physical education and playground activities.

This essay reviews scientific literature regarding the possible effect of exercise on sleep physiology in non-clinical individuals. Exercise and sleep as research phenomena in the literature is examined, documented experimental evidence and theories on the possible mechanisms of a sleep-exercise relationship is reviewed, and suggestions for future research is made. Exercise and sleep are wide-ranging phenomena with a multitude of variables and aspects, making them difficult to research. Although exercise having historically and popularly being favorably associated with sleep, the objective scientific evidence for such a relationship is conflicting.This possibly due to studies using differing methods of various quality and focusing on different aspects of the object of research. There are several theories regarding how an exercise-sleep connection could function, none has yet to be substantiated by existing evidence.