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Mailey EL, Besenyi GM, Montney J, Durtschi J. Mental health clients' receptiveness to and recommendations for integrating physical activity discussions into therapy: a mixed methods study. Psychother Res 2024:1-12. [PMID: 38451844 DOI: 10.1080/10503307.2024.2325512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/24/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVE The mental health benefits of physical activity are well-established. Integrating physical activity counseling into therapy would expand the reach of this evidence-based treatment for mental illness. This mixed methods study examined mental health clients' receptiveness and recommendations for effectively discussing physical activity in therapy. METHODS A diverse sample of U.S. adults in therapy (N = 478) completed a survey that included the open-ended question: What specific recommendations would you have for your therapist to effectively discuss physical activity with you? We conducted a qualitative content analysis to identify their most common recommendations. RESULTS Most participants indicated they would be comfortable discussing physical activity with their therapist. The content analysis resulted in 26 unique categories; most common recommendations included: provide information about what to do (n = 81), discuss physical activity benefits (n = 63), be understanding and nonjudgmental (n = 49), provide accountability (n = 41), and consider physical/mental health conditions (n = 35). Overarching themes emphasized making mental health central to discussions, tailoring discussions to each client, and reframing physical activity as a feasible, enjoyable activity. CONCLUSIONS Mental health clients are open to discussing physical activity during therapy if it is approached in a supportive, understanding, and personalized way. Clients' recommendations can inform future professional development for therapists.
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Affiliation(s)
- Emily L Mailey
- Department of Kinesiology, Kansas State University, Manhattan, KS, USA
| | - Gina M Besenyi
- Department of Kinesiology, Kansas State University, Manhattan, KS, USA
| | - Justin Montney
- Department of Kinesiology, Kansas State University, Manhattan, KS, USA
| | - Jared Durtschi
- Department of Applied Human Sciences, Kansas State University, Manhattan, KS, USA
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Goodman BD, Streetman AE, Mailey EL, Rosenkranz RR, Heinrich KM. Differences in physical activity behaviors between university women from metropolitan, micropolitan, and rural areas. Journal of American College Health 2023:1-6. [PMID: 37399528 DOI: 10.1080/07448481.2023.2227714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 05/11/2023] [Accepted: 06/11/2023] [Indexed: 07/05/2023]
Abstract
Objective: Rural and emerging adult women report low physical activity (PA) levels. This study identified differences in current self-reported PA levels and perceived resources among US university women from metropolitan, micropolitan, and rural areas. Participants: Women were ages 18-24 y, full-time students who attended in-person university classes before COVID-19. Methods: They completed an online cross-sectional survey between July-September 2020 collecting demographic, university PA (via IPAQ), and perceived PA resource data. Results: Most participants reported metropolitan area high school (70.4%) and university (92.3%) attendance. Metropolitan participants did less job-related moderate PA during university (0.0 (0.0-360.0) MET-min) than rural (160.0 (0.0-1320.0) MET-min) participants. Metropolitan and micropolitan participants identified more high school community and natural resources than rural participants. Rural participants identified more university campus and community resources than metropolitan participants. Conclusions: University women reported similar levels of PA regardless of the rurality of their high school community.
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Affiliation(s)
- Blake D Goodman
- Department of Kinesiology, Kansas State University, Manhattan, Kansas, USA
| | - Aspen E Streetman
- Department of Kinesiology, Kansas State University, Manhattan, Kansas, USA
| | - Emily L Mailey
- Department of Kinesiology, Kansas State University, Manhattan, Kansas, USA
| | - Richard R Rosenkranz
- Department of Kinesiology, Kansas State University, Manhattan, Kansas, USA
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, Nevada, USA
| | - Katie M Heinrich
- Department of Kinesiology, Kansas State University, Manhattan, Kansas, USA
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Heinrich KM, DeBlauw J, Beattie CM, Mailey EL, Besenyi G. What Happened When Fitness Facilities Closed? How Fitness Facility Users Adapted During Covid-19 Shutdowns. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000878280.97184.cb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Mailey EL, Rosenkranz R, Rosenkranz SK, Ablah E, Talley M, Biggins A, Towsley A, Honn A. Reducing Occupational Sitting While Working From Home: Individual and Combined Effects of a Height-Adjustable Desk and an Online Behavioral Intervention. J Occup Environ Med 2022; 64:91-98. [PMID: 34654038 DOI: 10.1097/jom.0000000000002410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study examined the individual and combined effects of a height-adjustable desk and an online behavioral intervention on sedentary behavior and health among university employees working from home. METHODS Participants (N = 95) were randomly assigned to one of four conditions: Desk Only, Program Only, Desk + Program, or Control. Desk participants received a height-adjustable desk; program participants received a 12-week web-based intervention. Outcomes measured at baseline and post-intervention included workday sitting and cardiometabolic health outcomes. RESULTS Reductions in sitting were largest in the Desk + Program condition (-206 min/workday; d = 1.84), followed by the Desk Only condition (-122 min/workday; d = 0.98), and the Program Only condition (-96 min/workday; d = 1.13). There were no significant changes in the health outcomes assessed. CONCLUSIONS Both a height-adjustable desk and an online behavioral intervention effectively reduced occupational sitting, and a combined approach was most effective.
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Affiliation(s)
- Emily L Mailey
- Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Mailey and Ms Talley); Department of Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan, Kansas (Dr Rosenkranz, Dr Rosenkranz, Ms Biggins, and Ms Towsley); Department of Population Health, University of Kansas School of Medicine - Wichita, Wichita, Kansas (Dr Ablah and Ms Honn)
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Besenyi GM, Pruneda O, Mailey EL, DeBlauw JA, Beattie CM, Gustat J, Heinrich KM. Effects of the COVID-19 Pandemic on Physical Activity Behavior across Domains and Settings. J Healthy Eat Act Living 2021; 1:181-197. [PMID: 37771563 PMCID: PMC10522009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
COVID-19 restrictions and alterations to daily living (e.g. working from home, caregiving responsibilities) necessitated changes in physical activity (PA) behavior. The purpose of this study was to understand how PA within specific domains and behavior settings changed during the COVID-19 pandemic, as well as the extent to which PA increased or decreased as a function of participants' gender, work location (i.e., home vs. jobsite) and caregiving responsibilities. An e-survey, conducted April-June 2020, examined changes in PA across domains and settings in a national sample of 805 adults. Respondents reported domain-specific increases in household and recreational PA, but decreases in active transportation, occupational PA, and public transportation use. Weekly minutes of PA changed significantly across all behavior settings, with reported increases in home-based, neighborhood, parks/trails, and total PA, and decreases in PA through recreational sports and fitness facilities. Total weekly PA minutes increased by 10.6%. Those with caregiving responsibilities reported increases in household PA and PA frequency, whereas those without caregiving responsibilities were more likely to report increases in sitting. Those working from home reported a larger increase in neighborhood PA. Those working at a jobsite with caregiving responsibilities reported less weekly PA, while those working from home with caregiving responsibilities reported greater weekly PA. The overall increase in weekly PA minutes and ability to adapt to different domains/settings was encouraging. Future interventions should capitalize on domain- and setting-specific changes, while considering work location and caregiving responsibilities to develop innovative PA promotion strategies.
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Affiliation(s)
- Gina M. Besenyi
- Department of Kinesiology, College of Health and Human Sciences, Kansas State University,
U.S.A
| | - Oziel Pruneda
- Department of Kinesiology, College of Health and Human Sciences, Kansas State University,
U.S.A
| | - Emily L. Mailey
- Department of Kinesiology, College of Health and Human Sciences, Kansas State University,
U.S.A
| | - Justin A. DeBlauw
- Department of Kinesiology, College of Health and Human Sciences, Kansas State University,
U.S.A
| | - Cassandra M. Beattie
- Department of Kinesiology, College of Health and Human Sciences, Kansas State University,
U.S.A
| | - Jeanette Gustat
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University,
U.S.A
| | - Katie M. Heinrich
- Department of Kinesiology, College of Health and Human Sciences, Kansas State University,
U.S.A
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Jackson SK, Sharp RL, Mailey EL, Ahlers AA. Exercise and stress levels associated with a visit to Tallgrass Prairie National Preserve. Parks Stewardship Forum 2021. [DOI: 10.5070/p537151754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Mailey EL, Gasper R, Dlugonski D, Besenyi GM. Promoting Strength Training Among Baby Boomers: Message Framing Effects on Motivation and Behavior. Int J Behav Med 2020; 28:499-510. [PMID: 33200382 DOI: 10.1007/s12529-020-09939-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Regular participation in strength training significantly enhances older adults' physical and functional health, yet only 14% of adults over age 50 report engaging in strength training at least twice per week. Exercise messages about why and how older adults should engage in strength training could influence their perceptions of and participation in the behavior. This study was designed to promote strength training among adults aged 50-70 and to determine whether the message frame accompanying a brief workout would have an impact on participants' motivation, self-efficacy, and/or physical activity behavior. METHODS Participants (N = 308) were randomly assigned to one of four message conditions: Easy Intrinsic, Hard Intrinsic, Easy Extrinsic, or Hard Extrinsic. Immediately after completing baseline measures of motivation and physical activity, participants received the recommended strength training workout and corresponding motivational message. They completed follow-up measures of motivation and physical activity 2 weeks later. RESULTS Controlled regulation was higher at follow-up among participants exposed to an extrinsic message relative to an intrinsic message (F(3,208) = 3.08, p = .03). Strength training (Z = - 5.95, p < .001) and moderate physical activity (Z = - 3.23, p = .001) increased among participants not engaging in regular strength training at baseline. CONCLUSIONS These results suggest message framing may have a short-term impact on Baby Boomers' physical activity motivation, such that emphasizing extrinsic goals (i.e., weight loss and appearance) may contribute to controlled motivation. However, repeated measurements are needed to determine the longer-term maintenance and influence of these effects.
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Affiliation(s)
- Emily L Mailey
- Department of Kinesiology, Kansas State University, KS, Manhattan, USA.
| | - Rebecca Gasper
- Department of Kinesiology, Kansas State University, KS, Manhattan, USA
| | - Deirdre Dlugonski
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, KY, Lexington, USA
| | - Gina M Besenyi
- Department of Kinesiology, Kansas State University, KS, Manhattan, USA
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Rosenkranz SK, Mailey EL, Umansky E, Rosenkranz RR, Ablah E. Workplace Sedentary Behavior and Productivity: A Cross-Sectional Study. Int J Environ Res Public Health 2020; 17:ijerph17186535. [PMID: 32911740 PMCID: PMC7558581 DOI: 10.3390/ijerph17186535] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 12/13/2022]
Abstract
Reducing sedentary behavior in the workplace has become an important public health priority; however, some employers have expressed concerns regarding the potential for reduced productivity if employees are not seated while at work. Therefore, the aim of this study was to determine the relationship between workplace sedentary behavior (sitting time) and work productivity among full-time office-based employees, and further to investigate other potential factors associated with productivity. A 19-item online self-report survey was completed by 2068 government employees in Kansas. The survey assessed workplace sedentary behavior, work productivity, job satisfaction, and fatigue. Overall, office workers reported high levels of sedentary time (mean > 78%). The primary results indicated that sitting time was not significantly associated with productivity (β = 0.013, p = 0.519), but job satisfaction and fatigue were positively (β = 0.473, p < 0.001) and negatively (β = −0.047, p = 0.023) associated with productivity, respectively. Furthermore, participants with the highest level of sitting time (>91% of the time) reported lower job satisfaction and greater fatigue as compared with the lowest level of sitting time (<75% of the time). Taken together, these results offer promising support that less sitting time is associated with positive outcomes that do not seem to come at the expense of productivity.
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Affiliation(s)
- Sara K. Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, 1105 Sunset Ave, Rm 322, Manhattan, KS 66502, USA;
- Correspondence: ; Tel.: +1-785-341-6690
| | - Emily L. Mailey
- Department of Kinesiology, Kansas State University, 8 Natatorium, Manhattan, KS 66506, USA;
| | - Emily Umansky
- Department of Population Health, University of Kansas School of Medicine–Wichita, 1010 N Kansas, Wichita, KS 67214, USA; (E.U.); (E.A.)
| | - Richard R. Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, 1105 Sunset Ave, Rm 322, Manhattan, KS 66502, USA;
| | - Elizabeth Ablah
- Department of Population Health, University of Kansas School of Medicine–Wichita, 1010 N Kansas, Wichita, KS 67214, USA; (E.U.); (E.A.)
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Mailey EL, Irwin BC, Joyce JM, Hsu W. InDependent but not Alone: A Web‐Based Intervention to Promote Physical and Mental Health among Military Spouses. Appl Psychol Health Well Being 2019; 11:562-583. [DOI: 10.1111/aphw.12168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
Objectives: In this study, we investigated how exercise is portrayed in popular, non-fitness focused magazines targeting various audiences. Methods: Ten popular magazines were selected based on target audience (Teens, Young Adults, Family, Middle-Aged Adults, Older Adults). Ten digital articles from each magazine's health/fitness section were coded for the primary reason to exercise, the frequency, intensity, time, and type of exercise recommended, and whether their recommendations were evidence-based. Frequencies were calculated by target audience. Results: The primary reason for exercise differed by audience, with appearance and fitness empha- sized by magazines targeting younger audiences, and mental health/quality of life emphasized in magazines targeting older adults. Over half of the articles described exercises that should be completed 2x-3x/week for <10 minutes. Articles frequently recommended circuit workouts that could be completed at moderate or self-selected intensity. Only 10% of articles cited peer- reviewed evidence. Conclusions: Results showed popular magazines often represent exercise as something that can be completed in a short time frame with meaningful benefits. However, an overemphasis on appearance in young adults is apparent, which could undermine intrinsic mo- tivation and behavior. Improved communication between researchers and popular magazines is needed to promote sharing of credible, evidence-based exercise content with the public.
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Affiliation(s)
- Emily L. Mailey
- Associate Professor, Department of Kinesiology, Kansas State University, Manhattan, KS;,
| | - Rebecca Gasper
- Graduate Research As- sistant, Department of Kinesiology, Kansas State University, Manhattan, KS
| | - Deirdre Dlugonski
- Assistant Professor, Department of Kinesiology, East Carolina University, Greenville, NC
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Mailey EL, Mershon C, Joyce J, Irwin BC. "Everything else comes first": a mixed-methods analysis of barriers to health behaviors among military spouses. BMC Public Health 2018; 18:1013. [PMID: 30111307 PMCID: PMC6094922 DOI: 10.1186/s12889-018-5938-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 08/07/2018] [Indexed: 11/10/2022] Open
Abstract
Background Military spouses are integral to the health of their families, but have demonstrated elevated levels of stress, depression, and anxiety. Participating in health behaviors such as physical activity and healthy eating may have a positive impact on spouses’ physical and mental health, but emerging evidence suggests spouses’ participation in these behaviors is scarce. Thus, the purpose of this study was to examine the most frequently reported barriers to health behaviors among military spouses. Methods Military spouses were recruited to complete surveys (N = 230) or participate in focus group sessions (N = 22). On the surveys, participants indicated up to 3 of their most frequent barriers to physical activity, diet, social connection, and stress management. Responses were coded and summed to identify the most commonly reported barriers to each health behavior. Subsequently, focus group sessions were conducted to gain a more in-depth understanding of the challenges military spouses face when trying to maintain a healthy lifestyle. Focus group transcripts were coded using thematic data analysis to identify the most frequently discussed barriers for each behavior. Results On the surveys, lack of time was the most prevalent barrier for physical activity, social connection, and stress management, and the second most prevalent barrier for diet. Financial concerns were the most prevalent barrier to maintaining a healthy diet. Barriers related to parent/family responsibilities were commonly reported across all health behaviors. During the focus group sessions, the transient military lifestyle was reported to have a significant impact on all of the health behaviors. Other military-related stressors including deployments and the necessity to “do it all” alone were frequently discussed. Many participants exhibited rigid definitions of what “counts” as exercise or health eating. Overall, participants reported sacrificing participation in health behaviors to attend to other priorities. Conclusions Military spouses reported numerous barriers to health behaviors that made it difficult for them to prioritize their own health and well-being. Although some of the barriers reported were similar to barriers reported by civilians, unique stressors associated with military life further impeded participation in health behaviors. These findings can be used to inform future health promotion interventions for military spouses.
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Affiliation(s)
- Emily L Mailey
- Department of Kinesiology, Kansas State University, 8 Natatorium, Manhattan, KS, 66506, USA.
| | - Carrie Mershon
- Department of Kinesiology, Kansas State University, 8 Natatorium, Manhattan, KS, 66506, USA
| | - Jillian Joyce
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, 213 Justin Hall, Manhattan, KS, 66506, USA
| | - Brandon C Irwin
- Department of Kinesiology, Kansas State University, 8 Natatorium, Manhattan, KS, 66506, USA
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Ablah E, Grilliot E, Okut H, Mailey EL, Rosenkranz SK, Rosenkranz RR. Many Kansas Worksites Offer Few Interventions to Reduce Occupational Sedentary Behavior. Int J Environ Res Public Health 2018; 15:ijerph15081745. [PMID: 30110954 PMCID: PMC6121883 DOI: 10.3390/ijerph15081745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/03/2018] [Accepted: 08/09/2018] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to identify the extent to which sedentary behavior interventions are being implemented in Kansas worksites. The WorkWell KS Physical Activity Assessment was administered online to 111 worksites across Kansas from October 2016 through April 2018. Each worksite identified a point of contact to complete the worksite-level assessment. Four of the WorkWell KS Physical Activity Assessment's items assessed interventions that may reduce employees' sedentary behavior: offering point-of-decision prompts to reduce employees' sedentary behavior, offering a program for employees to reduce their sedentary time at work, having an organizational norm that allows employees to stand, stretch, and/or move during meetings at least every 30 minutes, and offering standing desks. All 111 worksites that participated in the WorkWell KS Physical Activity Workshop completed the WorkWell KS Physical Activity Assessment, resulting in a 100% response rate. Most worksites (59%, n = 65) reported offering no information, program, policy, or environmental change interventions aimed to reduce sedentary behavior. The most commonly reported intervention offered by worksites to reduce employees' sedentary behavior was standing desks (32%, n = 35). Overall, participating worksites reported implementing a few interventions that are designed to reduce sedentary behavior.
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Affiliation(s)
- Elizabeth Ablah
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita; 1010 North Kansas, Wichita, KS 67214, USA.
| | - Elizabeth Grilliot
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita; 1010 North Kansas, Wichita, KS 67214, USA.
| | - Hayrettin Okut
- Office of Research, University of Kansas School of Medicine-Wichita; 1010 North Kansas, Wichita, KS 67214, USA.
| | - Emily L Mailey
- Department of Kinesiology, Kansas State University; Natatorium 8920 Denison Avenue, Manhattan, KS 66506, USA.
| | - Sara K Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, Kansas State University; 212 Justin Hall, 1324 Lovers Lane, Manhattan, KS 66506, USA.
| | - Richard R Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, Kansas State University; 212 Justin Hall, 1324 Lovers Lane, Manhattan, KS 66506, USA.
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Casey K, Mailey EL, Rosenkranz RR, Swank A, Ablah E, Rosenkranz SK. Does dietary intake change during an intervention to reduce sedentary behavior and cardiovascular disease risk? A randomized comparative effectiveness trial. BMC Nutr 2018; 4:16. [PMID: 32153880 PMCID: PMC7050876 DOI: 10.1186/s40795-018-0223-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 03/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence from physical activity interventions suggests that women, in particular, may overcompensate for exercise energy expenditure by increasing caloric intake. Sedentary behavior and poor dietary quality are independent risk factors for many major chronic diseases, including cardiovascular disease (CVD). The primary purpose of this study was to determine whether insufficiently active women, accumulating less than 60 min per week of moderate-to-vigorous physical activity, alter caloric intake or dietary quality when participating in an 8-week intervention to reduce sedentary behavior and CVD risk. A secondary aim was to determine whether the two treatment groups differed from one another in dietary intake while participating in the intervention. METHODS Insufficiently active women (n = 49) working full-time sedentary jobs were randomized to one of two treatment groups to reduce sedentary behavior during the workweek: short-break (1-2 min breaks from sitting every half hour, SB), or long-break (15 min breaks from sitting twice daily, LB). Three-day food records were collected at baseline, week 4 and week 8. Dietary quality was assessed using the Alternative Healthy Eating Index 2010 (AHEI-2010). Risk factors for CVD were assessed at baseline and week 8. RESULTS For all participants, average caloric intake decreased significantly from baseline to week 8 by approximately 12% (∆ = - 216.0 kcals, p = 0.003). Average caloric intake decreased significantly over time for the SB group (∆ = - 369.6 kcals, p = 0.004), but not the LB group (∆ = - 179.5 kcals, p = 0.17). There was no significant difference between SB and LB groups with regard to calories from baseline to week 8 (F = 0.51, p = 0.48). Total AHEI-2010 scores did not decrease significantly for all participants (∆ = - 4.0, p = 0.14), SB (∆ = - 5.2, p = 0.16), or LB groups (∆ = - 4.5, p = 0.67). CONCLUSIONS Following an 8-week intervention to reduce sedentary time, insufficiently active women decreased caloric intake over time, however there were no differences between SB and LB groups. In all participants, dietary quality was not altered over time. Future studies should explore sedentary reduction interventions compared to physical activity interventions as a means to create negative energy balance, as frequent sedentary breaks may be effective for improving health outcomes in women. TRIAL REGISTRATION ClinicalTrials.gov registration number NCT02609438, retrospectively registered November 20, 2015.
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Affiliation(s)
- Kelsey Casey
- Department of Human Nutrition, Kansas State University, 1105 Sunset Ave, 3rd Floor, Manhattan, KS 66502 USA
| | - Emily L. Mailey
- Department of Kinesiology, Kansas State University, 8D Natatorium, Manhattan, KS 66502 USA
| | - Richard R. Rosenkranz
- Department of Human Nutrition, Kansas State University, 1105 Sunset Ave, 3rd Floor, Manhattan, KS 66502 USA
| | - Aaron Swank
- Department of Kinesiology, Kansas State University, 8D Natatorium, Manhattan, KS 66502 USA
| | - Elizabeth Ablah
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, 1010 North Kansas, Wichita, KS 672114 USA
| | - Sara K. Rosenkranz
- Department of Human Nutrition, Kansas State University, 1105 Sunset Ave, 3rd Floor, Manhattan, KS 66502 USA
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Mailey EL, Hsu WW. Is a general or specific exercise recommendation more effective for promoting physical activity among postpartum mothers? J Health Psychol 2017; 24:964-978. [PMID: 28810385 DOI: 10.1177/1359105316687627] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This comparative effectiveness trial examined the effects of a behavior change intervention supplemented by a general or specific exercise recommendation on physical activity among postpartum mothers. Participants ( N = 49) attended three workshop sessions that provided the exercise recommendation and taught self-regulatory skills. Physical activity, self-efficacy, planning, and barriers were assessed at baseline, post-intervention, and 6-month follow-up. Self-reported physical activity increased significantly in both groups ( p < .001), but the increase was larger in the general condition ( p = .03). Both groups reported increased planning and decreased barriers. Postpartum mothers may benefit from interventions that teach strategies for overcoming barriers while allowing them to choose preferred activities.
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Mailey EL, Phillips SM, Dlugonski D, Conroy DE. Overcoming barriers to exercise among parents: a social cognitive theory perspective. J Behav Med 2016; 39:599-609. [PMID: 27108160 DOI: 10.1007/s10865-016-9744-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 04/18/2016] [Indexed: 11/28/2022]
Abstract
Parents face numerous barriers to exercise and exhibit high levels of inactivity. Examining theory-based determinants of exercise among parents may inform interventions for this population. The purpose of this study was to test a social-cognitive model of parental exercise participation over a 12-month period. Mothers (n = 226) and fathers (n = 70) of children <16 completed measures of exercise, barriers self-efficacy, perceived barriers, and exercise planning at baseline and 1 year later. Panel analyses were used to test the hypothesized relationships. Barriers self-efficacy was related to exercise directly and indirectly through perceived barriers and prioritization/planning. Prioritization and planning also mediated the relationship between perceived barriers and exercise. These paths remained significant at 12 months. These results suggest efforts to increase exercise in parents should focus on improving confidence to overcome exercise barriers, reducing perceptions of barriers, and helping parents make specific plans for prioritizing and engaging in exercise.
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Affiliation(s)
- Emily L Mailey
- Department of Kinesiology, Kansas State University, 1A Natatorium, Manhattan, KS, 66506, USA.
| | - Siobhan M Phillips
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Deirdre Dlugonski
- Department of Kinesiology, East Carolina University, Greenville, NC, USA
| | - David E Conroy
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
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Phillips SM, Awick EA, Conroy DE, Pellegrini CA, Mailey EL, McAuley E. Objectively measured physical activity and sedentary behavior and quality of life indicators in survivors of breast cancer. Cancer 2015; 121:4044-52. [PMID: 26308157 DOI: 10.1002/cncr.29620] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 06/20/2015] [Accepted: 07/10/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND The primary purpose of the current study was to determine prospective associations of accelerometer-assessed physical activity intensity and sedentary time with health-related quality of life (HRQOL) indicators among survivors of breast cancer. METHODS A total of 358 survivors of breast cancer wore an accelerometer for 7 days at baseline to assess different activity intensities (light, lifestyle, and moderate to vigorous) and sedentary behavior. Six months later, survivors completed online questionnaires that assessed HRQOL indicators (disease-specific HRQOL, fatigue, depression, and anxiety) and relevant covariates. Relationships between activity and sedentary behavior quartiles and HRQOL indicator scores were examined using generalized liner models with Bonferroni multiple comparison adjustment. RESULTS After adjustment for covariates and sedentary time, each increasing lifestyle activity quartile was associated with reduced fatigue duration (P for trend, .03). Each increasing baseline moderate-to-vigorous physical activity (MVPA) quartile was found to be significantly associated with higher Physical Well-Being, Functional Assessment of Cancer Therapy-Breast (FACT-B) total, and trial outcome index scores; fewer breast cancer-specific concerns; and lower fatigue interference, and these differences were statistically and clinically significant between survivors in quartile 1 and quartile 4. After controlling for covariates and MVPA, relationships between sedentary time and HRQOL were mostly null with the exception of lower fatigue duration. CONCLUSIONS Objectively measured MVPA was found to be positively associated with many HRQOL indicators. Lifestyle activity was found to be only inversely associated with fatigue duration whereas sedentary time was found to be positively associated with fatigue duration. Future research is warranted to explore these relationships further.
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Affiliation(s)
- Siobhan M Phillips
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Elizabeth A Awick
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois
| | - David E Conroy
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Christine A Pellegrini
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Emily L Mailey
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois
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Wong CN, Chaddock-Heyman L, Voss MW, Burzynska AZ, Basak C, Erickson KI, Prakash RS, Szabo-Reed AN, Phillips SM, Wojcicki T, Mailey EL, McAuley E, Kramer AF. Brain activation during dual-task processing is associated with cardiorespiratory fitness and performance in older adults. Front Aging Neurosci 2015; 7:154. [PMID: 26321949 PMCID: PMC4532928 DOI: 10.3389/fnagi.2015.00154] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 07/28/2015] [Indexed: 11/13/2022] Open
Abstract
Higher cardiorespiratory fitness is associated with better cognitive performance and enhanced brain activation. Yet, the extent to which cardiorespiratory fitness-related brain activation is associated with better cognitive performance is not well understood. In this cross-sectional study, we examined whether the association between cardiorespiratory fitness and executive function was mediated by greater prefrontal cortex activation in healthy older adults. Brain activation was measured during dual-task performance with functional magnetic resonance imaging in a sample of 128 healthy older adults (59–80 years). Higher cardiorespiratory fitness was associated with greater activation during dual-task processing in several brain areas including the anterior cingulate and supplementary motor cortex (ACC/SMA), thalamus and basal ganglia, right motor/somatosensory cortex and middle frontal gyrus, and left somatosensory cortex, controlling for age, sex, education, and gray matter volume. Of these regions, greater ACC/SMA activation mediated the association between cardiorespiratory fitness and dual-task performance. We provide novel evidence that cardiorespiratory fitness may support cognitive performance by facilitating brain activation in a core region critical for executive function.
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Affiliation(s)
- Chelsea N Wong
- Neuroscience Program, University of Illinois at Urbana-Champaign Urbana, IL, USA ; The Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign Urbana, IL, USA
| | - Laura Chaddock-Heyman
- The Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign Urbana, IL, USA
| | - Michelle W Voss
- Department of Psychology, University of Iowa Iowa City, IA, USA
| | - Agnieszka Z Burzynska
- The Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign Urbana, IL, USA
| | - Chandramallika Basak
- The Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas Dallas, TX, USA
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh Pittsburgh, PA, USA
| | - Ruchika S Prakash
- Department of Psychology, The Ohio State University Columbus, OH, USA
| | - Amanda N Szabo-Reed
- Cardiovascular Research Institute, University of Kansas Medical Center Kansas City, KS, USA
| | - Siobhan M Phillips
- Department of Preventative Medicine, Northwestern University Medical School Chicago, IL, USA
| | - Thomas Wojcicki
- Exercise Science, Lansing School of Nursing and Health Sciences, Bellarmine University Louisville, KY, USA
| | - Emily L Mailey
- Department of Kinesiology, Kansas State University Manhattan, KS, USA
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign Urbana, IL, USA
| | - Arthur F Kramer
- The Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign Urbana, IL, USA
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Mailey EL, McAuley E. Physical Activity Intervention Effects on Perceived Stress in Working Mothers: The Role of Self-Efficacy. Women Health 2014; 54:552-68. [DOI: 10.1080/03630242.2014.899542] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mailey EL, Huberty J, Dinkel D, McAuley E. Physical activity barriers and facilitators among working mothers and fathers. BMC Public Health 2014; 14:657. [PMID: 24974148 PMCID: PMC4227023 DOI: 10.1186/1471-2458-14-657] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 06/19/2014] [Indexed: 11/10/2022] Open
Abstract
Background The transition to parenthood is consistently associated with declines in physical activity. In particular, working parents are at risk for inactivity, but research exploring physical activity barriers and facilitators in this population has been scarce. The purpose of this study was to qualitatively examine perceptions of physical activity among working parents. Methods Working mothers (n = 13) and fathers (n = 12) were recruited to participate in one of four focus group sessions and discuss physical activity barriers and facilitators. Data were analyzed using immersion/crystallization in NVivo 10. Results Major themes for barriers included family responsibilities, guilt, lack of support, scheduling constraints, and work. Major themes for facilitators included being active with children or during children’s activities, being a role model for children, making time/prioritizing, benefits to health and family, and having support available. Several gender differences emerged within each theme, but overall both mothers and fathers reported their priorities had shifted to focus on family after becoming parents, and those who were fitting in physical activity had developed strategies that allowed them to balance their household and occupational responsibilities. Conclusions The results of this study suggest working mothers and fathers report similar physical activity barriers and facilitators and would benefit from interventions that teach strategies for overcoming barriers and prioritizing physical activity amidst the demands of parenthood. Future interventions might consider targeting mothers and fathers in tandem to create an optimally supportive environment in the home.
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Affiliation(s)
- Emily L Mailey
- Department of Kinesiology, Kansas State University, 1A Natatorium, Manhattan, KS 66502, USA.
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21
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Mullen SP, Wójcicki TR, Mailey EL, Szabo AN, Gothe NP, Olson EA, Fanning J, Kramer A, McAuley E. A profile for predicting attrition from exercise in older adults. Prev Sci 2013; 14:489-96. [PMID: 23412942 DOI: 10.1007/s11121-012-0325-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The purpose of this study was to determine a profile for predicting attrition among older adults involved in a 12-month exercise program. The parent study was a single-blinded randomized controlled trial. The study took place between 2006 and 2009 within a university setting. Older adults (N = 179) completed baseline assessments of functional performance and psychosocial measures. Participants who were randomized, elected to receive treatment, and did not complete the exercise program were considered "dropouts" (n = 35). Those who completed the program (n = 144) were classified as "completers." A latent profile analysis revealed two distinct patterns of memory complaints, self-efficacy to overcome barriers to exercise, balance performance, and stair performance. Dropouts were nearly twice as likely to be members of the profile that exhibited a higher degree of memory complaints, lower self-efficacy for overcoming exercise barriers, poorer single leg balance, and longer times to walk down stairs. The results provide an initial validation of a profile for discriminating between "dropouts" and "completers," one that may have considerable utility for screening older adults prior to study entry.
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Affiliation(s)
- Sean P Mullen
- Department of Kinesiology and Community Health, University of Illinois, Freer Hall 227, 906 S. Goodwin Ave, Urbana, IL 61801, USA.
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McAuley E, Wójcicki TR, Gothe NP, Mailey EL, Szabo AN, Fanning J, Olson EA, Phillips SM, Motl RW, Mullen SP. Effects of a DVD-delivered exercise intervention on physical function in older adults. J Gerontol A Biol Sci Med Sci 2013; 68:1076-82. [PMID: 23401566 DOI: 10.1093/gerona/glt014] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Given the rapidly increasing demographic of older adults, it is vital to implement effective behavioral strategies to improve physical function to maintain activities of daily living. However, changing physical activity in older adults remains extremely difficult. The current trial tested the efficacy of a novel, 6-month, home-based, DVD-delivered exercise program focusing on flexibility, balance, and toning on the physical function of older adults. METHODS Older adults (N = 307) were recruited from 83 towns and cities throughout central Illinois. The trial consisted of 4 waves of recruitment and randomization from May 2010 through January 2012. Inclusion criteria included being inactive, at least 65 years of age, English speaking, providing physician's consent, and willingness to be randomized. Eligible participants were randomly assigned to 1 of 2 treatment conditions: the exercise intervention or a healthy aging, attentional control. Functional assessments were completed at baseline and following the 6-month DVD intervention. Measures included the Short Physical Performance Battery, assessments of flexibility and strength, and self-reported functional limitations. RESULTS Participants in the DVD intervention condition demonstrated significant improvements in the Short Physical Performance Battery (p = .005), lower extremity flexibility (p = .04), and upper body strength (p = .003). There were no effects of the intervention on self-reported functional limitations. CONCLUSIONS The exercise intervention produced a clinically significant improvement in the Short Physical Performance Battery and improvements in flexibility and strength, demonstrating the effectiveness of a low-cost DVD exercise program in improving physical function in older adults.
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Affiliation(s)
- Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA.
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23
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Voss MW, Heo S, Prakash RS, Erickson KI, Alves H, Chaddock L, Szabo AN, Mailey EL, Wójcicki TR, White SM, Gothe N, McAuley E, Sutton BP, Kramer AF. The influence of aerobic fitness on cerebral white matter integrity and cognitive function in older adults: results of a one-year exercise intervention. Hum Brain Mapp 2012; 34:2972-85. [PMID: 22674729 DOI: 10.1002/hbm.22119] [Citation(s) in RCA: 359] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Revised: 02/13/2012] [Accepted: 04/05/2012] [Indexed: 11/07/2022] Open
Abstract
Cerebral white matter (WM) degeneration occurs with increasing age and is associated with declining cognitive function. Research has shown that cardiorespiratory fitness and exercise are effective as protective, even restorative, agents against cognitive and neurobiological impairments in older adults. In this study, we investigated whether the beneficial impact of aerobic fitness would extend to WM integrity in the context of a one-year exercise intervention. Further, we examined the pattern of diffusivity changes to better understand the underlying biological mechanisms. Finally, we assessed whether training-induced changes in WM integrity would be associated with improvements in cognitive performance independent of aerobic fitness gains. Results showed that aerobic fitness training did not affect group-level change in WM integrity, executive function, or short-term memory, but that greater aerobic fitness derived from the walking program was associated with greater change in WM integrity in the frontal and temporal lobes, and greater improvement in short-term memory. Increases in WM integrity, however, were not associated with short-term memory improvement, independent of fitness improvements. Therefore, while not all findings are consistent with previous research, we provide novel evidence for correlated change in training-induced aerobic fitness, WM integrity, and cognition among healthy older adults.
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Evans EM, Schmidt MD, Mojtahedi MC, Guest DD, Das BM, Mailey EL. Peer led behavioral intervention and changes in weight status in female college freshman. FASEB J 2012. [DOI: 10.1096/fasebj.26.1_supplement.257.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Szabo AN, McAuley E, Erickson KI, Voss M, Prakash RS, Mailey EL, Wójcicki TR, White SM, Gothe N, Olson EA, Kramer AF. Cardiorespiratory fitness, hippocampal volume, and frequency of forgetting in older adults. Neuropsychology 2012; 25:545-53. [PMID: 21500917 DOI: 10.1037/a0022733] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE The purpose of this study was to extend our earlier work to determine the extent to which cardiorespiratory fitness is associated with the frequency of memory problems via its effects on the hippocampus and spatial working memory. We hypothesized that age, sex, education, body composition, and physical activity were direct determinants of fitness, which, in turn, influenced frequency of forgetting indirectly through hippocampal volume and spatial working memory. METHOD We conducted assessments of demographic characteristics, Body Mass Index (BMI), physical activity, cardiorespiratory fitness, hippocampal volume, spatial working memory, and frequency of forgetting in 158 older adults (M age = 66.49). Path analyses within a covariance modeling framework were used to examine relationships among these constructs. RESULTS Sex, age, BMI, and education were all significant determinants of cardiorespiratory fitness. The hypothesized path models for testing the effects of fitness on frequency of forgetting through hippocampal volume and accuracy and speed of spatial working memory all fit the data well. CONCLUSIONS Our findings suggest that older adults with higher levels of fitness show greater preservation of hippocampal volume, which, in turn, is associated with more accurate and faster spatial memory and fewer episodes of forgetting. Given the proportion of older adults reporting memory problems, it is necessary to determine whether improvements in fitness brought about by physical activity interventions can result in subsequent attenuation of memory problems or potentially in improvements in memory.
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Affiliation(s)
- Amanda N Szabo
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
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26
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Erickson KI, Weinstein AM, Sutton BP, Prakash RS, Voss MW, Chaddock L, Szabo AN, Mailey EL, White SM, Wojcicki TR, McAuley E, Kramer AF. Beyond vascularization: aerobic fitness is associated with N-acetylaspartate and working memory. Brain Behav 2012; 2:32-41. [PMID: 22574272 PMCID: PMC3343297 DOI: 10.1002/brb3.30] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 11/21/2011] [Accepted: 11/27/2011] [Indexed: 11/21/2022] Open
Abstract
Aerobic exercise is a promising form of prevention for cognitive decline; however, little is known about the molecular mechanisms by which exercise and fitness impacts the human brain. Several studies have postulated that increased regional brain volume and function are associated with aerobic fitness because of increased vascularization rather than increased neural tissue per se. We tested this position by examining the relationship between cardiorespiratory fitness and N-acetylaspartate (NAA) levels in the right frontal cortex using magnetic resonance spectroscopy. NAA is a nervous system specific metabolite found predominantly in cell bodies of neurons. We reasoned that if aerobic fitness was predominantly influencing the vasculature of the brain, then NAA levels should not vary as a function of aerobic fitness. However, if aerobic fitness influences the number or viability of neurons, then higher aerobic fitness levels might be associated with greater concentrations of NAA. We examined NAA levels, aerobic fitness, and cognitive performance in 137 older adults without cognitive impairment. Consistent with the latter hypothesis, we found that higher aerobic fitness levels offset an age-related decline in NAA. Furthermore, NAA mediated an association between fitness and backward digit span performance, suggesting that neuronal viability as measured by NAA is important in understanding fitness-related cognitive enhancement. Since NAA is found exclusively in neural tissue, our results indicate that the effect of fitness on the human brain extends beyond vascularization; aerobic fitness is associated with neuronal viability in the frontal cortex of older adults.
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Affiliation(s)
- Kirk I. Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA
| | - Andrea M. Weinstein
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA
| | - Bradley P. Sutton
- Department of Bioengineering, University of Illinois, Champaign, IL
- Beckman Institute for Advanced Science and Technology, University of Illinois, Champaign, IL
| | | | - Michelle W. Voss
- Beckman Institute for Advanced Science and Technology, University of Illinois, Champaign, IL
- Department of Psychology, University of Illinois, Champaign, IL
| | - Laura Chaddock
- Beckman Institute for Advanced Science and Technology, University of Illinois, Champaign, IL
- Department of Psychology, University of Illinois, Champaign, IL
| | - Amanda N. Szabo
- Department of Kinesiology and Community Health, University of Illinois, Champaign, IL
| | - Emily L. Mailey
- Department of Kinesiology and Community Health, University of Illinois, Champaign, IL
| | - Siobhan M. White
- Department of Kinesiology and Community Health, University of Illinois, Champaign, IL
| | - Thomas R. Wojcicki
- Department of Kinesiology and Community Health, University of Illinois, Champaign, IL
| | - Edward McAuley
- Beckman Institute for Advanced Science and Technology, University of Illinois, Champaign, IL
- Department of Kinesiology and Community Health, University of Illinois, Champaign, IL
| | - Arthur F. Kramer
- Beckman Institute for Advanced Science and Technology, University of Illinois, Champaign, IL
- Department of Psychology, University of Illinois, Champaign, IL
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McAuley E, Wójcicki TR, White SM, Mailey EL, Szabo AN, Gothe N, Olson EA, Mullen SP, Fanning J, Motl RW, Rosengren K, Estabrooks P. Physical activity, function, and quality of life: design and methods of the FlexToBa trial. Contemp Clin Trials 2011; 33:228-36. [PMID: 22024470 DOI: 10.1016/j.cct.2011.10.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Revised: 08/26/2011] [Accepted: 10/04/2011] [Indexed: 01/18/2023]
Abstract
The Flexibility, Toning, and Balance (FlexToBa) Trial is a two-armed randomized controlled trial which will contrast the effects of a DVD-delivered, home-based, physical activity intervention and a Healthy Aging attention control condition on physical activity, functional performance, functional limitations, and quality of life in low active, older adults. This innovative trial will recruit 300 participants across central Illinois who will be randomized into the intervention arm or control arm of the study. The intervention will last 6 months with a 6 month follow-up. Assessments at baseline, post intervention and follow-up will include physical activity (self-report and accelerometry), a battery of functional performance measures, functional limitations, quality of life, and an array of psychological health measures. In addition, measures of external validity will be included to determine public health significance of a successful outcome. Participants will engage in a progressive series of activities focusing on flexibility, strengthening, and balance exercises which are demonstrated by a trained exercise leader and age-appropriate models on a series of DVDs. Delivery of the intervention has its basis in social cognitive theory. The specific aims of the trial are (a) to determine the effects of the DVD-delivered FlexToBa program on physical activity, functional performance, functional limitations, and quality of life, (b) to examine the mediators of the relationships between physical activity and functional limitations and quality of life, (c) to assess external validity indicators relative to the intervention, and (d) to determine differential effects of the intervention on psychosocial health measures.
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Affiliation(s)
- Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL 61801, USA.
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Mullen SP, Olson EA, Phillips SM, Szabo AN, Wójcicki TR, Mailey EL, Gothe NP, Fanning JT, Kramer AF, McAuley E. Measuring enjoyment of physical activity in older adults: invariance of the physical activity enjoyment scale (paces) across groups and time. Int J Behav Nutr Phys Act 2011; 8:103. [PMID: 21951520 PMCID: PMC3206413 DOI: 10.1186/1479-5868-8-103] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Accepted: 09/27/2011] [Indexed: 01/19/2023] Open
Abstract
The purpose of this study was to validate the Physical Activity Enjoyment Scale (PACES) in a sample of older adults. Participants within two different exercise groups were assessed at two time points, 6 months apart. Group and longitudinal invariance was established for a novel, 8-item version of the PACES. The shortened, psychometrically sound measure provides researchers and practitioners an expedited and reliable instrument for assessing the enjoyment of physical activity.
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Affiliation(s)
- Sean P Mullen
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Erin A Olson
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Siobhan M Phillips
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Amanda N Szabo
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Thomas R Wójcicki
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Emily L Mailey
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Neha P Gothe
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Jason T Fanning
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Arthur F Kramer
- Beckman Institute, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, Illinois 61801, USA
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
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McAuley E, Mullen SP, Szabo AN, White SM, Wójcicki TR, Mailey EL, Gothe NP, Olson EA, Voss M, Erickson K, Prakash R, Kramer AF. Self-regulatory processes and exercise adherence in older adults: executive function and self-efficacy effects. Am J Prev Med 2011; 41:284-90. [PMID: 21855742 PMCID: PMC3160622 DOI: 10.1016/j.amepre.2011.04.014] [Citation(s) in RCA: 142] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 03/15/2011] [Accepted: 04/26/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND Self-efficacy and the use of self-regulatory strategies are consistently associated with physical activity behavior. Similarly, behavioral inhibition and cognitive resource allocation-indices of executive control function-have also been associated with this health behavior. PURPOSE The purpose of this study was to examine the hypothesis that self-efficacy mediates the relationship between self-regulatory processes, such as executive function, and sustained exercise behavior. METHODS Older adults (N=177, mean age=66.44 years) completed measures of executive function, self-reported use of self-regulatory strategies, and self-efficacy prior to and during the first month of a 12-month exercise intervention. Percentage of exercise classes attended over the following 11 months was used to represent adherence. Data were collected from 2007 to 2010 and analyzed in 2010-2011. Structural equation models were tested examining the effect of executive function and strategy use on adherence via efficacy. RESULTS As hypothesized, results showed significant direct effects of two elements of executive function and of strategy use on self-efficacy and of efficacy on adherence. In addition, there were significant indirect effects of strategy use and executive function on adherence via self-efficacy. CONCLUSIONS Higher levels of executive function and use of self-regulatory strategies at the start of an exercise program enhance beliefs in exercise capabilities, which in turn leads to greater adherence.
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Affiliation(s)
- Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois, 906 S. Goodwin Avenue, Urbana IL 61801, USA.
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Gothe NP, Mullen SP, Wójcicki TR, Mailey EL, White SM, Olson EA, Szabo AN, Kramer AF, McAuley E. Trajectories of change in self-esteem in older adults: exercise intervention effects. J Behav Med 2011; 34:298-306. [PMID: 21222223 PMCID: PMC3118401 DOI: 10.1007/s10865-010-9312-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Accepted: 12/20/2010] [Indexed: 11/28/2022]
Abstract
This 12-month, 2 arm, single blind randomized controlled exercise trial examined relationships among changes in multidimensional self-esteem as a function of intervention mode (i.e., walking vs. flexibility-toning-balance). Data were collected on three equidistant occasions (baseline, 6 and 12 months). One-hundred seventy-nine older adults (M(age) = 66.38) began the study and 145 completed assessments at all time points. Participants completed measures of physical and global self-esteem as well as demographic information. There were no significant group differences at baseline on these demographic indicators or esteem variables. Data were analyzed using linear and parallel process growth modeling procedures. Results supported the position that across both groups, domain-level (i.e., physical self-worth) was dependent upon sub-domain-level (i.e., perceived attractiveness, strength, and condition) esteem change. Furthermore, greater improvements were observed in the flexibility-toning-balance group, in terms of perceived strength and attractiveness esteem, compared to the walking group. Our findings support theoretically-based predictions and extend the literature showing unique psychological responses conditional on specific types of physical activities.
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Affiliation(s)
- Neha P. Gothe
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Sean P. Mullen
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Thomas R. Wójcicki
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Emily L. Mailey
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Siobhan M. White
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Erin A. Olson
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Amanda N. Szabo
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Arthur F. Kramer
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL 61801, USA
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
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McAuley E, Mailey EL, Mullen SP, Szabo AN, Wójcicki TR, White SM, Gothe N, Olson EA, Kramer AF. Growth trajectories of exercise self-efficacy in older adults: influence of measures and initial status. Health Psychol 2011; 30:75-83. [PMID: 21038962 DOI: 10.1037/a0021567] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study examined differential trajectories of exercise-related self-efficacy beliefs across a 12-month randomized controlled exercise trial. METHOD Previously inactive older adults (N = 144; M age = 66.5) were randomly assigned to one of two exercise conditions (walking, flexibility-toning-balance) and completed measures of barriers self-efficacy (BARSE), exercise self-efficacy (EXSE), and self-efficacy for walking (SEW) across a 12-month period. Changes in efficacy were examined according to efficacy type and interindividual differences. Latent growth curve modeling was employed to (a) examine average levels and change in each type of efficacy for the collapsed sample and by intervention condition and (b) explore subpopulations (i.e., latent classes) within the sample that differ in their baseline efficacy and trajectory. RESULTS Analyses revealed two negative trends in BARSE and EXSE at predicted transition points, in addition to a positive linear trend in SEW. Two subgroups with unique baseline efficacy and trajectory profiles were also identified. CONCLUSION These results shed new light on the relationship between exercise and self-efficacy in older adults. They also highlight the need for strategies for increasing and maintaining efficacy within interventions, namely targeting participants who start with a disadvantage (lower efficacy) and integrating efficacy-boosting strategies for all participants prior to program end.
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Affiliation(s)
- Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA.
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McAuley E, Szabo AN, Mailey EL, Erickson KI, Voss M, White SM, Wójcicki TR, Gothe N, Olson EA, Mullen SP, Kramer AF. Non-Exercise Estimated Cardiorespiratory Fitness: Associations with Brain Structure, Cognition, and Memory Complaints in Older Adults. Ment Health Phys Act 2011; 4:5-11. [PMID: 21808657 PMCID: PMC3146052 DOI: 10.1016/j.mhpa.2011.01.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
There is increasing evidence that cardiorespiratory fitness (CRF) is associated with brain structure and function, and improvements in CRF through exercise training have been associated with neural and cognitive functioning in older adults. The objectives of this study were to validate the use of a non-exercise estimate of CRF, and to examine its association with cognitive function, brain structure and subjective memory complaints. Low active, older adults (N = 86; M age= 65.14) completed a physician-supervised maximal exercise test, a 1-mile timed walk, several measures of cognitive function, and a 3 Tesla structural MRI. Fitness was also calculated from an equation derived by (Jurca et al., 2005) based on age, sex, body mass index, resting heart rate, and self-reported physical activity level. Analyses indicated that all three measures of CRF were significantly correlated with one another. In addition, measures of cognitive function, hippocampus volume, and memory complaints were significantly correlated with each measure of fitness. These findings have implications for using a low-risk, low-cost, non-exercise estimate of CRF in determining fitness associations with brain structure and cognitive function in older adults. As such, this measure may have utility for larger population based studies. Further validation is required, as is determination of whether such relationships hold over the course of exercise interventions.
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Affiliation(s)
| | | | | | | | | | | | | | - Neha Gothe
- University of Illinois at Urbana-Champaign
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Szabo AN, Mullen SP, White SM, Wojcicki TR, Mailey EL, Gothe N, Olson EA, Fanning J, Kramer AF, McAuley E. Longitudinal invariance and construct validity of the abbreviated late-life function and disability instrument in healthy older adults. Arch Phys Med Rehabil 2011; 92:785-91. [PMID: 21458777 PMCID: PMC3772086 DOI: 10.1016/j.apmr.2010.12.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Revised: 12/15/2010] [Accepted: 12/16/2010] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To cross-validate the psychometric properties of the abbreviated Late-Life Function and Disability Instrument (LL-FDI), a measure of perceived functional limitations and disability. DESIGN Baseline and 12-month follow-up assessments conducted across the course of a 12-month exercise program. SETTING University research community. PARTICIPANTS Older healthy adults (N=179; mean ± SD age, 66.43±5.67y) at baseline; 145 were retained at follow-up. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES LL-FDI and functional performance measures. RESULTS Factor analyses confirmed the factor structure of the abbreviated LL-FDI, and all subscales met minimal criteria for temporal invariance. Significant correlations also were found between functional limitations subscales and an array of physical function performance measures, supporting the scale's construct validity. CONCLUSIONS The abbreviated LL-FDI with some modifications appears to be temporally invariant in community-dwelling older adults. Additionally, moderate relationships between functional limitations and functional performance provide further support for these being conceptually distinct constructs.
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Affiliation(s)
- Amanda N Szabo
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
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Mailey EL, Wójcicki TR, Motl RW, Hu L, Strauser DR, Collins KD, McAuley E. Internet-delivered physical activity intervention for college students with mental health disorders: a randomized pilot trial. PSYCHOL HEALTH MED 2011; 15:646-59. [PMID: 21154018 DOI: 10.1080/13548506.2010.498894] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The prevalence of mental health disorders among college students is rising and the increasing rates of anxiety and depression have important societal implications. Physical activity has been proposed as an adjuvant to traditional treatment approaches (i.e. psychotherapy or pharmacotherapy), and the internet is a potentially useful means of delivering physical activity information to the college-aged population. This randomized pilot trial examined the effects of an internet-based physical activity intervention on physical activity, self-efficacy, depression, and anxiety in college students (n = 47) receiving mental health counseling. Physical activity, depression, anxiety, exercise self-efficacy, and barriers self-efficacy were assessed at baseline and post-intervention. There was a significant time effect for physical activity, with both groups increasing their physical activity levels across the 10-week intervention but with a larger increase in the intervention condition (d = 0.68) than the control condition (d = 0.05). Exercise and barriers self-efficacy declined across the intervention, but more so in the control than intervention condition. Effects on depression and anxiety were nonsignificant. Finally, correlation analyses showed increases in physical activity were associated with increases in exercise self-efficacy (r = 0.62) and barriers self-efficacy (r = 0.63) and decreases in depression (r = -0.44) in the intervention condition, but not in the control condition. These results suggest that an internet-delivered physical activity intervention may be a promising approach to promoting physical activity among college students undergoing mental health counseling.
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Affiliation(s)
- Emily L Mailey
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Voss MW, Prakash RS, Erickson KI, Basak C, Chaddock L, Kim JS, Alves H, Heo S, Szabo AN, White SM, Wójcicki TR, Mailey EL, Gothe N, Olson EA, McAuley E, Kramer AF. Plasticity of brain networks in a randomized intervention trial of exercise training in older adults. Front Aging Neurosci 2010; 2. [PMID: 20890449 PMCID: PMC2947936 DOI: 10.3389/fnagi.2010.00032] [Citation(s) in RCA: 353] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 07/02/2010] [Indexed: 01/06/2023] Open
Abstract
Research has shown the human brain is organized into separable functional networks during rest and varied states of cognition, and that aging is associated with specific network dysfunctions. The present study used functional magnetic resonance imaging (fMRI) to examine low-frequency (0.008 < f < 0.08 Hz) coherence of cognitively relevant and sensory brain networks in older adults who participated in a 1-year intervention trial, comparing the effects of aerobic and non-aerobic fitness training on brain function and cognition. Results showed that aerobic training improved the aging brain's resting functional efficiency in higher-level cognitive networks. One year of walking increased functional connectivity between aspects of the frontal, posterior, and temporal cortices within the Default Mode Network and a Frontal Executive Network, two brain networks central to brain dysfunction in aging. Length of training was also an important factor. Effects in favor of the walking group were observed only after 12 months of training, compared to non-significant trends after 6 months. A non-aerobic stretching and toning group also showed increased functional connectivity in the DMN after 6 months and in a Frontal Parietal Network after 12 months, possibly reflecting experience-dependent plasticity. Finally, we found that changes in functional connectivity were behaviorally relevant. Increased functional connectivity was associated with greater improvement in executive function. Therefore the study provides the first evidence for exercise-induced functional plasticity in large-scale brain systems in the aging brain, using functional connectivity techniques, and offers new insight into the role of aerobic fitness in attenuating age-related brain dysfunction.
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Affiliation(s)
- Michelle W Voss
- Department of Psychology, Beckman Institute, University of Illinois at Urbana-Champaign IL, USA
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Mailey EL, White SM, Wójcicki TR, Szabo AN, Kramer AF, McAuley E. Construct validation of a non-exercise measure of cardiorespiratory fitness in older adults. BMC Public Health 2010; 10:59. [PMID: 20144197 PMCID: PMC2831835 DOI: 10.1186/1471-2458-10-59] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Accepted: 02/08/2010] [Indexed: 11/25/2022] Open
Abstract
Background Cardiorespiratory fitness (CRF) is associated with a decreased risk of all-cause mortality but is rarely assessed in medical settings due to burdens of time, cost, risk, and resources. The purpose of this study was to test the construct validity of a regression equation developed by Jurca and colleagues (2005) to estimate CRF without exercise testing in community dwelling older adults. Methods Participants (n = 172) aged 60 to 80 years with no contraindications to submaximal or maximal exercise testing completed a maximal graded exercise test (GXT) and the submaximal Rockport 1-mile walk test on separate occasions. Data included in the regression equation (age, sex, body mass index, resting heart rate, and physical activity) were obtained via measurement or self-report. Participants also reported presence of cardiovascular conditions. Results The multiple R for the regression equation was .72, p < .001 and CRF estimated from this equation was significantly correlated with the MET value from the GXT (r = 0.66) and with CRF estimated from submaximal field testing (r = 0.67). All three CRF indices were significantly and inversely associated with reporting more cardiovascular conditions. Conclusions This research provides preliminary evidence that a non-exercise estimate of CRF is at least as valid as field test estimates of CRF and represents a low-risk, low-cost, and expedient method for estimating fitness in older adults.
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Affiliation(s)
- Emily L Mailey
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, 906 S Goodwin Ave, Urbana, IL 61801, USA
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