Intergenerational (IG) research has been a growing area of study, however, further study is recommended. The intergenerational physical activity leadership (IPAL+) program examined the feasibility of bringing together elementary school students (ESSs), high school students (HSSs), and older adults (OAs) on the playground to teach playground games to ESSs during lunch recess. A mixed methodology was used with concurrent triangulation collecting data through both means of qualitative (n = 26) and quantitative (n = 118) methods. Qualitative data gathering methods included one-on-one interviews, focus groups, and written responses interpreted through NVivo 11, hand-coding, and Colaizzi’s seven-step thematic analysis identified four emerging themes: Structure, IG Opportunities, Leadership Opportunities, and Enjoyment. Pre- and post-surveys were completed for quantitative data and analyzed through the statistical program IBM SPSS 24; a comparison of mean scores were examined to measure changes in leadership confidence, intergenerational attitudes, and social connectedness. Significance was set at p < .05 and discovered that ESSs experienced significant changes in levels of IG attitudes and social connectedness. / Graduate

Doctor of Philosophy / Department of Human Nutrition / Sara Rosenkranz / The aims of this dissertation were to provide innovative, applicable insights regarding the impact of single-meal consumption on metabolic and inflammatory responses in the acute post-meal (“postprandial”) period. In Chapter 2, the connection between large postprandial glucose and triglyceride (TG) fluxes and cardiovascular disease (CVD) risk were reviewed. A new marker of metabolic status, Metabolic Load Index (MLI), calculated by adding glucose and TG, was proposed based on several considerations: 1) independent associations between postprandial glucose and TG with CVD risk, although the substrates are considered to increase risk through similar mechanisms; 2) postprandial glucose and TG responses are interrelated; and 3) meals consumed in daily life typically contain both carbohydrate and fat. MLI may be useful in characterizing metabolic status/risk in both clinical and research settings. Chapter 3 was a systematic review with the purpose of objectively describing postprandial responses (i.e. magnitude and timing) to a high-fat meal (HFM) in five commonly assessed inflammatory markers: interleukin (IL)-6, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, IL-1β, and IL-8. IL-6 increased in >70% of studies, starting at ~1.4 pg/mL pre-meal and peaking at ~2.9 pg/mL ~6 hours post-HFM. Other markers (CRP, TNF-α, IL-1β, and IL-8) did not change after the HFM in the majority of studies. These findings suggest that IL-6 is an inflammatory marker that routinely increases following HFM consumption. Future postprandial studies should further investigate IL-6, as well as explore novel markers of inflammation. In Chapter 4, we compared the metabolic and inflammatory responses to a HFM (17 kcal/kg, 60% fat), representative of meals used in previous postprandial studies, to two meal trials that were more reflective of typical eating patterns: a moderate-fat meal (MFM; 8.5 kcal/kg, 30% fat), and a biphasic meal (BPM), in which the MFM was consumed twice, three hours apart. The HFM elicited a greater total area-under-the-curve (tAUC) TG response (1348.8 ± 783.7 mg/dL x 6 hrs) compared to the MFM (765.8 ± 486.8 mg/dL x 6 hrs; p = 0.0005) and the BPM (951.8 ± 787.7 mg/dL x 6 hrs; p = 0.03), but the MFM and BPM were not different (p = 0.72). It appears that the large postprandial TG response observed in previous studies may not be representative of the daily metabolic challenge for many individuals. Chapter 5 assessed the impact of both aging and chronic physical activity level on postprandial metabolic responses by comparing three groups: younger active (YA), older active (OA), and older inactive (OI) adults. The TG tAUC response was lower in YA (407.9 ± 115.1 mg/dL x 6 hr) compared to OA (625.6 ± 169.0 mg/dL x 6 hr; p = 0.02) and OI (961.2 ± 363.6 mg/dL x 6 hr; p = 0.0002), while the OA group TG tAUC was lower than OI (p = 0.02). Thus, it is likely that both aging and chronic physical activity level impact the postprandial metabolic response. This series of projects provides needed clarification regarding the postprandial metabolic and inflammatory responses to single-meal intake, particularly in the context of real-life application.

Doctor of Philosophy / Department of Human Nutrition / Sara Rosenkranz / This dissertation examined the impact of wellness-promotion interventions on health-related behaviors in youth, including dietary intake and physical activity (PA) levels. Additionally, the impact of wellness-promotion interventions on health-promoting opportunities for youth in an out-of-school setting was investigated. In study 1 (Chapter 2), the feasibility and preliminary impact of a 12-week, home-based wellness coaching intervention for changes in behavioral, psychosocial, and biomedical outcomes in normal-weight female children was evaluated. The two intervention conditions included a general health education condition, and one that implemented skills-building components in the areas of PA and healthy eating. Results showed that both intervention conditions were feasible and well-accepted by participants. There were no changes in the behavioral outcomes of PA levels or fruit and vegetable (FV) consumption, but girls who received the skills-building coaching condition showed an increase in emotional quality of life and a reduction in body fat percentage. Findings suggested that a home-based wellness coaching intervention was feasible and was potentially effective for impacting psychosocial and biomedical outcomes in normal-weight female children. Study 2 (Chapter 3) examined the impact of Girl Scout leader wellness training on implementation of wellness-promoting practices and opportunities for girls during troop meetings. This study compared the effectiveness of in-person versus online leader wellness training, specifically assessing opportunities for wellness-promoting behaviors, including FV consumption and PA during meetings. Study results indicated that leaders who received the wellness training in person increased their implementation of wellness-promoting practices significantly more than those who received the wellness training in an online format. Analyses regarding dissemination revealed that adoption of wellness-training principles occurred in approximately 43% of troop leaders, and that lower-income leaders were more interested in receiving the wellness training, as compared to higher-income leaders. Overall, results indicated that in-person wellness training was effective for improving wellness-promoting opportunities for girls, but a more cost-effective and further-reaching training method was needed for a larger public health impact. Therefore, study 3 (Chapter 4) evaluated the impact of online, video-based wellness training on Girl Scout leaders’ wellness-promotion self-efficacy, intention, and knowledge. These factors are established determinants of behavior change, including offering opportunities in the areas of PA and FV consumption. Results showed that leaders who received the video-based wellness training had a significant increase in self-efficacy for overcoming barriers related to PA and FV practices, as well as increased self-efficacy for offering vegetables during troop meetings. Both groups showed increased intention for offering both fruit and vegetable opportunities during upcoming meetings. These results showed that online, video-based wellness training was effective for impacting determinants of behavior change in Girl Scout troop leaders, which may improve the wellness opportunities for girls during troop meetings. Overall, the findings from this dissertation collectively contribute to the existing literature by providing evidence regarding effective interventions for improving wellness-promoting opportunities and experiences for youth. If disseminated and implemented widely, evidence-based interventions and practices similar to those discussed within this dissertation may lead to improvements in health-related behaviors among youth, increased wellness-promoting opportunities, and ultimately have a positive impact on population health.

Master of Landscape Architecture / Department of Landscape Architecture/Regional and Community Planning / Anne E. Beamish / Landscape architects have an opportunity to design outdoor environments that promote exploration and physical activity for elementary school students in an effort to combat childhood obesity and nature deficit disorder, while reinforcing the importance of reading. By layering themes from classic children’s literature into the landscape surrounding the Andover Public Library, a landscape was designed where children can explore physically and intellectually while being active in the outdoor environment. Research has identified the importance and benefits of outdoor exploration, activity and reading for elementary school students. Interviewing teachers and librarians about classic children’s literature and how they commonly use it helped inform my research efforts in choosing timeless and well-known pieces of children’s literature. Completing a site inventory and analysis of Andover Central Park, which surrounds the Andover Public Library, informed my site design process. The intent of my site design is to explore ways of incorporating children’s literature into a play landscape that provides opportunity for exploration and physical activity in nature.

The purpose of this research was to explore the influence of physical activity on depressive symptomatology and adolescent alcohol use during an underexplored transition from middle school to high school. The study initiative is supported by the fact that research has shown a unique and simultaneous decrease in physical activity (CDC, 2010), increase in depressive symptomatology (SAMHSA, 2010) and increase in alcohol use (USDHHS, 2011) during middle adolescence. A risk and resilience framework was used in efforts to conceptualize how these variables may be inter-related. Data from waves I and II of the National Longitudinal Study of Adolescent Health (Add Health, Bearman et al., 1997; Udry, 1997) was used (N = 2,054; aged 13-15 years). The sample was ethnically and racially diverse (58.2% White, 24% African American, 11.7% Hispanic, and 6.1% other). Structural equation models were developed to test the potential influence physical activity has on adolescent alcohol use (e.g., frequency of alcohol use and binge alcohol use) and whether any of the relationship was mediated by depressive symptomatology or varied as a function of gender. Results demonstrated that there was a significant influence of structured physical activity (e.g., sports) on adolescent alcohol use. However, contrary to the proposed hypothesis, engaging in structured physical activity appeared to contribute to greater binge drinking among adolescents. Instead of demonstrating a protective feature, the findings suggest that engaging in structured physical activity places adolescents at risk for binge drinking. Furthermore, no significant relationships, positive or negative, were found for the influence of physical activity (structured and unstructured) on frequency of alcohol use. The findings regarding mediation revealed binge drinking as a mediator between physical activity (structured) and depressive symptomatology. These findings provide support for research, practice, and policy initiatives focused on developing a more comprehensive understanding of alcohol use drinking behaviors, physical activity involvement, and depressive symptomatology among adolescents, which this study demonstrates are all associated with one another. Results represent an initial step toward evaluating these relationships at a much younger age.

In Canada, out of the total Aboriginal populations, the older Aboriginal adult populations continue to increase and suffer disproportionately poor health compared to non-Aboriginal seniors. Despite these facts, there is a dearth of research concerning Aboriginal older adults, especially regarding their engagement with physical activity. My thesis is written in the publishable paper format and is comprised of two papers. Using a scoping study methodology in paper one, I demonstrate that intersecting factors such as colonialism, social inequities, and physical activity practices that are rooted in Western ideals and do not address Indigenous older adults’ needs, all contribute to Indigenous older adults’ lack of participation in physical activity. Using a case study approach in paper two, I demonstrate how Elders In Motion, a program offered by the Northwest Territories Recreation and Parks Association (NWTRPA), shows a shift in physical activity programs becoming more respectful of older Aboriginal adults’ cultures and communities; however, while the staff at the NWTRPA has made a strong effort to adapt a southern-based program for northern communities in the NWT, there are several program features that reaffirm colonial practices and support Westernized ideas of physical activity. Taken together, the papers in this thesis make apparent that physical activity programs and research concerning physical activity for older Aboriginal adults continue to be embedded in colonial practices. As a result, there is a demonstrated need for program development and research in this area to work towards reducing health disparities and challenging colonial practices.

Although there is consistent evidence of an inverse association between physical activity and colorectal cancer (CRC), it is unclear whether physical activity has to be lifelong in order to protect against CRC, or whether there are critical time periods in which physical activity is most protective. This thesis investigated the association between recreational physical activities in specific age periods and across the lifetime and CRC risk in data from a population-based case control study (n=1395) in Newfoundland and Labrador. There were no significant associations between recreational physical activity at any age period or across the lifetime. Lack of association with activity in early adulthood is consistent with other studies in which this has been investigated. Lack of association in later life and across the lifetime may in part be explained by low levels of recreational physical activity, with only 30% of participants meeting World Cancer Research Fund cancer prevention recommendations.

Bakgrund: Stroke är en av de vanligaste orsakerna till dödsfall globalt. Man har sett att fysisk inaktivitet och stressrelaterad ohälsa var för sig är riskfaktorer för att drabbas av stroke, däremot saknas studier kring ifall där finns ett samband mellan dessa variabler.  Syfte: Undersöka sambandet mellan fysisk aktivitet under det senaste året och stressbeteende hos personer som drabbats av stroke eller TIA samt att studera om det föreligger könsskillnader vad gäller fysisk aktivitet och stress hos denna grupp.  Metod: Studien var en tvärsnittsstudie med korrelerande, komparativ och deskriptiv design. Data kommer från baslinjemätningar hos en randomiserad kontrollerad studie som inkluderade 79 personer som drabbats av stroke eller TIA. Fysisk aktivitet under det senaste året samlades in med Saltin Grimby Physical Activity Scale (SGPALS) och stressbeteende genom Hjärt-Lungfondens formulär kring stress.   Resultat: Ett lågt (r=-0.14) och icke signifikant samband (p=0.22) förelåg mellan den fysiska aktivitetsnivån och det självskattade stressbeteendet. Inga statistiskt signifikanta skillnader kunde urskiljas mellan män och kvinnor gällande fysisk aktivitet (p=0.81) respektive självskattat stressbeteende (p=0.72).  Slutsats: Det förelåg inget signifikant samband mellan fysisk aktivitet och stressbeteende hos personer som drabbats av stroke eller TIA. Nivå av fysisk aktivitet respektive stressbeteende skiljde sig inte åt mellan könen. Mer forskning inom ämnet behövs för att klargöra på vilket sätt fysioterapeuter ska kunna arbeta preventivt och identifiera personer som har en ökad risk att drabbas av stroke eller TIA. / Background: Globally stroke is one of the most common causes of death. Both physical inactivity and stress related illness are risk factors for suffering from a stroke, however there is a lack of studies regarding if there is a correlation between these variables. Aim: To examine the correlation between physical activity during the last year and stress behaviour among individuals affected by stroke or TIA and to study whether there were gender differences regarding levels of physical activity and stress within this group.  Method: The study was a cross sectional study with a correlative, comparative and descriptive design. Data collected comes from baseline measurements from a randomized controlled study that included 79 people affected by stroke or TIA. Physical activity during the last year was collected with Saltin Grimby Physical Activity Scale (SGPALS) and stress behaviour with the Swedish Heart-Lung Foundation form about stress.  Results: A low (r=-0.14) and not significant correlation (p=0.22) was present between the physical activity level and the self-estimated stress behaviour. No statistically significant differences could be discerned between women and men regarding physical activity (p=0.81) and self-estimated stress behaviour (p=0.72).  Conclusion: There was no significant correlation between physical activity and stress behaviour in people affected by stroke or TIA. Level of physical activity respective stress behaviour did not differ between the sexes. More research in the subject is needed to clarify in what way physiotherapists should be able to work preventively and identify people who have an increased risk to be affected by stroke or TIA.

Prediabetes, a condition in which glucose levels are higher than normal but not high enough to be diagnosed as type 2 diabetes, affects approximately 37% of adults in the United States and is a major public health concern. Extensive research has evaluated the association between physical activity (PA) and type 2 diabetes; however, few studies have examined the association between PA and prediabetes. Therefore, we evaluated the association between PA (including leisure time, occupational and total) and prediabetes status among adults, stratified by gender, using multinomial logistic regression models fit to serial cross-sectional 2007-2014 National Health and Nutrition Examination Survey data. After adjusting for age, race, body mass index, smoking status, family history of hypertension and education, results suggest that the association between leisure time [moderate PA: 0.98 (95% CI: 0.80–1.21); tertile 3: 1.05 (95% CI: 0.75–1.49)] and total PA [tertile 1: 1.15, (95% CI: 0.96–1.38); tertile 2: 1.00, (95% CI: 0.79–1.27); tertile 3: 0.96, (0.77–1.20)] and undiagnosed prediabetes and was not statistically significant among women. However, compared to women who engaged in no occupational PA, engaging in the highest tertile was statistically significantly associated with lower odds of undiagnosed prediabetes [tertile 3: 0.75, (95% CI: 0.58–0.97)]. Compared to men who engaged in no leisure time PA, men engaging in the highest tertile of leisure time PA had a statistically significant lower odds of undiagnosed prediabetes [Tertile 3: 0.79, ( 0.65–0.98)]. Compared to men who did not engage in any PA, men engaging in any PA did not have a statistically significant decrease in odds of undiagnosed prediabetes [tertile 1: 0.90, (0.71–1.16); Tertile 2: 0.93, (0.74–1.18); Tertile 3: 0.99, (0.80–1.21)]. Overall, our results show that for both men and women, there was a general lack of association between leisure-time, occupational, and total physical activity and prediabetes status in adjusted analyses.

Introduction: The cognitive benefits of physical activity and sport on executive function are of interest to researchers, especially considering the subsequent interventions that could be implemented. However, researchers frequently use different approaches to conceptualize and measure executive function, often using only a few computerized tasks. My Master’s thesis, therefore, aims to investigate the associations between executive function and physical activity and sport through two different studies to obtain a robust evaluation of executive function: 1) A quantitative study examining physical activity, sport and concussion history in university students and their effect on executive function, and 2) A qualitative study exploring the executive functions engaged during a game from elite university athletes’ experiences. Methods: Quantitative Study. Canadian university students (n=247) completed an online study with nine computerized executive function tasks and a behavioural self-report of executive function, as well as questions assessing weekly physical activity, athletic status, and concussion history. Structural equation modelling and linear regression were conducted to predict executive function based on age, sex, physical activity, athletic status and concussion history. Qualitative study. Canadian university athletes (n=19) participated in semi-structured interviews via Zoom to determine the executive functions engaged during a game. Thematic analysis was used to analyze the interview transcripts. Results: Quantitative Study. The three-factor model of executive function had an overall good fit: χ2 = 66.38, df = 51, p = 0.07, CFI = 0.95, TLI = 0.93, RMSEA = 0.04 [90% CI: 0.00–0.06], SRMR = 0.05. No direct relationship was found between the factors and age, physical activity, concussion history, or athletic status. Sex was significantly related to inhibition, b = 0.52, p = 0.02, such that males had greater inhibition. Physical activity (b = 0.09, p < .01), concussion history (b = 3.29, p < .05) and athletic status (b = -4.01, p < .05) were found to be significant predictors in the regression predicting self-reported executive functioning. Qualitative study. Three themes were generated: 1) Engaging in pre-play or pre-game planning, organization and decision making, 2) Engaging in mid-play problem solving and purposive action and 3) Engaging in post-play or post-game information processing, emotional control and effective performance. Conclusions: The quantitative study found that physical activity, athletic status and concussion history were predictive of subjective but not objective executive function. The qualitative study determined that athletes engage many executive functions that are dependent on the timing of both the play and the game (pre-, mid- or post-). Real-life behavioural manifestations of executive functioning are more challenging to assess and measure but may be better predicted by and relate to life factors such as physical activity and sport participation. The results of my thesis provide support for future research to utilize and develop more unique and ecologically valid methods of measuring EF in the field of physical activity and sport. / Graduate