School of Public Health
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The collections in this community comprise faculty research works, as well as graduate theses and dissertations.
Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.
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Item Associations between Classical Music, Physical Activity and Symptoms of Depression in Older Adults during the COVID-19 Pandemic(2023) Arnold-Nedimala, Naomi A; Smith, J Carson; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Background: The initial lockdown in March 2020 due to COVID-19 rattled the residents of North America as normalcy came to a standstill, freedom was stripped away, and people were forced to adapt to new restrictions and regulations, simply to survive. The elderly population was greatly affected by the lockdown as it prohibited those living in assisted living facilities to physically interact with family and friends highlighting the need to identify protective behaviors against mental health and depression. The neurological benefits of listening to classical music is an emerging area of research. A few studies suggest the positive outcomes of listening to classical music in reducing symptoms of depression. Additionally, while the cardiovascular benefits of exercise are well known, the impact of exercise on affect continues to be an emerging area of research. Purpose: The purpose of this study is to understand the efficacy of listening to classical music in attenuating symptoms of depression in older adults (50 – 90+) utilizing data collected from 3 separate time points during the COVID-19 pandemic, and to determine if physical activity is associated with providing additional benefit to lowering symptoms of depression Methods: A survey including the Geriatric Depression Scale (GDS), the Physical Activity Scale for the Elderly (PASE), and questions about listening to music (classical, Broadway, Christian music), and the frequency of listening to music was generated and distributed to people living in the United States and Canada immediately following the initial COVID-19 lockdown in April 2020. Informed consent was obtained prior to completing the survey, and participants who were interested in receiving a follow-up survey were asked to provide their email addresses. The follow-up surveys were generated 4-months (August 2020) and one year (April 2021) after the initial survey. Results: At the initial onset of the COVID-19 lockdown in April 2020, significant associations were observed between classical music listening (CML) and lower symptoms of depression, physical activity (PA) and lower symptoms of depression, music listening frequency, and lower symptoms of depression. In August 2020 and April 2021, significant associations were found between physical activity and lower symptoms of depression. However, no associations were observed between classical music listening and lower symptoms of depression, and music listening frequency and lower symptoms Additionally, significant associations were observed between age and lower symptoms of depression, sex, and lower symptoms of depression at all three time points. Conclusion: The results from our study suggest that there is an association between classical music listening and symptoms of depression, physical activity and symptoms of depression, music listening frequency and symptoms of depression in older adults (50+) during the early stages of the COVID-19 pandemic (April 2020). Additionally, the association between physical activity and symptoms of depression was maintained throughout the first year of the pandemic as supported by the data collected in August 2020 (4 months) and April 2021 (12-months).Item Influence of Latinx Fathers' Behaviors, Cognitions, Affect, and Family Congruence on Youth Energy Balance-Related Health Outcomes(2022) Rodriguez, Matthew Rene; Roy, Kevin; Hurtado Choque, Ghaffar Ali; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)For decades, researchers have studied and theorized about the ways fathers interact with children and other members of the family. While this research provides important evidence, few father involvement studies have included Latinx fathers. Numerous father involvement conceptual frameworks have helped us understand the ways fathers interact with their families. Much of this research has focused on fathers' behaviors, but research suggests other domains need more investigation, such as fathers' cognitions and affect. Understanding these additional domains of father involvement can provide important evidence for understanding the ways fathers influence the health of children. Fathers influence the health of their children within different cultural and socio-political contexts. When considering Latinx father involvement within a social determinants of health approach, research has encouraged focusing on upstream factors that can contribute to the health of Latinx families. Addressing these upstream factors can shape the health and wellbeing of children. Currently, Latinx youth suffer disproportionately from obesity compared to all other racial and ethnic groups in the U.S. Through investigating Latinx father involvement, I fill an important gap by researching the extent to which Latinx fathers' affect, behaviors, and cognitions shape youth health outcomes. I also investigate theorized moderators that may influence the relationship between fathers' involvement and youth health outcomes. Using a cross sectional study design with a community-based sample of Latinx fathers and youth (ages 10-14) (n=193), I use latent moderation structural analyses to test the theorized causal mechanisms.Item The relationship between unsupervised time after school and physical activity in adolescent girls(Springer Nature, 2006-07-31) Rushovich, Berenice R; Voorhees, Carolyn C; Davis, CE; Neumark-Sztainer, Dianne; Pfeiffer, Karin A; Elder, John P; Going, Scott; Marino, Vivian GRising obesity and declining physical activity levels are of great concern because of the associated health risks. Many children are left unsupervised after the school day ends, but little is known about the association between unsupervised time and physical activity levels. This paper seeks to determine whether adolescent girls who are without adult supervision after school are more or less active than their peers who have a caregiver at home. A random sample of girls from 36 middle schools at 6 field sites across the U.S. was selected during the fall of the 2002–2003 school year to participate in the baseline measurement activities of the Trial of Activity for Adolescent Girls (TAAG). Information was collected using six-day objectively measured physical activity, self-reported physical activity using a three-day recall, and socioeconomic and psychosocial measures. Complete information was available for 1422 out of a total of 1596 respondents. Categorical variables were analyzed using chi square and continuous variables were analyzed by t-tests. The four categories of time alone were compared using a mixed linear model controlling for clustering effects by study center. Girls who spent more time after school (≥2 hours per day, ≥2 days per week) without adult supervision were more active than those with adult supervision (p = 0.01). Girls alone for ≥2 hours after school, ≥2 days a week, on average accrue 7.55 minutes more moderate to vigorous physical activity (MVPA) per day than do girls who are supervised (95% confidence interval ([C.I]). These results adjusted for ethnicity, parent's education, participation in the free/reduced lunch program, neighborhood resources, or available transportation. Unsupervised girls (n = 279) did less homework (53.1% vs. 63.3%), spent less time riding in a car or bus (48.0% vs. 56.6%), talked on the phone more (35.5% vs. 21.1%), and watched more television (59.9% vs. 52.6%) than supervised girls (n = 569). However, unsupervised girls also were more likely to be dancing (14.0% vs. 9.3%) and listening to music (20.8% vs. 12.0%) (p < .05). Girls in an unsupervised environment engaged in fewer structured activities and did not immediately do their homework, but they were more likely to be physically active than supervised girls. These results may have implications for parents, school, and community agencies as to how to structure activities in order to encourage teenage girls to be more physically active.Item Girls' perception of physical environmental factors and transportation: reliability and association with physical activity and active transport to school(Springer Nature, 2006-09-14) Evenson, Kelly R; Birnbaum, Amanda S; Bedimo-Rung, Ariane L; Sallis, James F; Voorhees, Carolyn C; Ring, Kimberly; Elder, John PPreliminary evidence suggests that the physical environment and transportation are associated with youth physical activity levels. Only a few studies have examined the association of physical environmental factors on walking and bicycling to school. Therefore, the purpose of this study was (1) to examine the test-retest reliability of a survey designed for youth to assess perceptions of physical environmental factors (e.g. safety, aesthetics, facilities near the home) and transportation, and (2) to describe the associations of these perceptions with both physical activity and active transport to school. Test and retest surveys, administered a median of 12 days later, were conducted with 480 sixth- and eighth-grade girls in or near six U.S. communities. The instrument consisted of 24 questions on safety and aesthetics of the perceived environment and transportation and related facilities. Additionally, girls were asked if they were aware of 14 different recreational facilities offering structured and unstructured activities, and if so, whether they would visit these facilities and the ease with which they could access them. Test-retest reliability was determined using kappa coefficients, overall and separately by grade. Associations with physical activity and active transport to school were examined using mixed model logistic regression (n = 610), adjusting for grade, race/ethnicity, and site. Item-specific reliabilities for questions assessing perceived safety and aesthetics of the neighborhood ranged from 0.31 to 0.52. Reliabilities of items assessing awareness of and interest in going to the 14 recreational facilities ranged from 0.47 to 0.64. Reliabilities of items assessing transportation ranged from 0.34 to 0.58. Some items on girls' perceptions of perceived safety, aesthetics of the environment, facilities, and transportation were important correlates of physical activity and, in some cases, active transport to school. This study provides some psychometric support for the use of the questionnaire on physical environmental factors and transportation for studying physical activity and active transport to school among adolescent girls. Further work can continue to improve reliability of these self-report items and examine their association of these factors with objectively measured physical activity.Item Spatial clustering of physical activity and obesity in relation to built environment factors among older women in three U.S. states(Springer Nature, 2014-12-24) Tamura, Kosuke; Puett, Robin C; Hart, Jaime E; Starnes, Heather A; Laden, Francine; Troped, Philip JIdentifying spatial clusters of chronic diseases has been conducted over the past several decades. More recently these approaches have been applied to physical activity and obesity. However, few studies have investigated built environment characteristics in relation to these spatial clusters. This study’s aims were to detect spatial clusters of physical activity and obesity, examine whether the geographic distribution of covariates affects clusters, and compare built environment characteristics inside and outside clusters. In 2004, Nurses’ Health Study participants from California, Massachusetts, and Pennsylvania completed survey items on physical activity (N = 22,599) and weight-status (N = 19,448). The spatial scan statistic was utilized to detect spatial clustering of higher and lower likelihood of obesity and meeting physical activity recommendations via walking. Clustering analyses and tests that adjusted for socio-demographic and health-related variables were conducted. Neighborhood built environment characteristics for participants inside and outside spatial clusters were compared. Seven clusters of physical activity were identified in California and Massachusetts. Two clusters of obesity were identified in Pennsylvania. Overall, adjusting for socio-demographic and health-related covariates had little effect on the size or location of clusters in the three states with a few exceptions. For instance, adjusting for husband’s education fully accounted for physical activity clusters in California. In California and Massachusetts, population density, intersection density, and diversity and density of facilities in two higher physical activity clusters were significantly greater than in neighborhoods outside of clusters. In contrast, in two other higher physical activity clusters in California and Massachusetts, population density, diversity of facilities, and density of facilities were significantly lower than in areas outside of clusters. In Pennsylvania, population density, intersection density, diversity of facilities, and certain types of facility density inside obesity clusters were significantly lower compared to areas outside the clusters. Spatial clustering techniques can identify high and low risk areas for physical activity and obesity. Although covariates significantly differed inside and outside the clusters, patterns of differences were mostly inconsistent. The findings from these spatial analyses could eventually facilitate the design and implementation of more resource-efficient, geographically targeted interventions for both physical activity and obesity.Item Understanding and Retraining the Causal Attributions for Exercise Intenders(2019) Singpurwalla, Darius; Iso-Ahola, Seppo E; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Given that ~50% of all exercise intenders will fall into the intention-behavior gap (i.e., a situation where people fail to act on their intentions), it is necessary to identify the constructs and/or theories that can explain the discord between intention and behavior (i.e., the intention-behavior gap). For this purpose, the present research was conducted through two studies that were designed to test the efficacy of causal attributions as a means to reduce the intention-behavior discord. The first study collected information from 952 individuals on their exercise behavior and their associated causal attributions over a six-week period. The findings from this study included: (1) those individuals who fell into the intention-behavior gap made self-serving attributions for their exercise failure; (2) Weiner’s model accurately predicted several of the affective and cognitive responses to exercise behavior for the sample of exercise intenders; and (3) causal attributions were not found to be effective moderators of the intention-behavior relationship. The second study was an experiment that tested whether an attribution retraining intervention could improve exercise behavior for a sample of sedentary, exercise intenders (n=200). Results of this study were mixed as the intervention appeared to have been able to modify one of the targeted attributional dimensions (control), but the effect was not strong enough to change the exercise behavior of the participants in the experimental group. It is suggested that attributions may not be able to reduce the gap because they represent conscious deliberations of the behavior, while sustained exercise is based on nonconscious processing of relevant information to make exercise an automatic behavior.Item FUNCTIONAL CONNECTIVITY PATTERNS ASSOCIATED WITH AGING, PHYSICAL ACTIVITY, AND GENETIC RISK FOR ALZHEIMER’S DISEASE IN HEALTHY HUMAN BRAIN NETWORKS.(2017) Chirles, Theresa Jeanne; Smith, Carson J; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Leisure time physical activity (PA) and exercise training help to improve and maintain cognitive function in healthy older adults and in adults with the APOE-ε4 allele, a genetic risk for Alzheimer’s Disease (AD). Earlier work finding increased functional connectivity in the Default Mode Network (DMN) after a 12-week walking intervention in 16 older adults with mild cognitive impairment is presented in Chapter 3. The primary dissertation study investigating differences in brain function depending on PA level and genetic risk for AD prior to changes in cognition is presented in Chapters 4-6. Useable resting state and anatomical MRI scans were collected from 69 healthy adults (22-51 years) as well as saliva for APOE genotyping (carriers defined as homozygotes or heterozygotes of the ɛ4 allele) and responses to the Paffenbarger Physical Activity Questionnaire (High PA >1500 kcal, Low PA <1500 kcal per week). The following network measures of functional connectivity were calculated: global efficiency; node strength of Default Mode Network (DMN) and Fronto-Parietal Network (FPN) hubs and hippocampal subsections; and long-range connectivity of the medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC) in the DMN. Multiple linear regression analysis revealed statistically significant results for the long-range connectivity of the left PCC, a prominent hub of the DMN, and left mPFC. The differences in projected trajectories of the connectivity are potentially reflective of the compensatory time-course in our participants based on interactions of PA level and APOE status. The Low PA non-carriers had a positive slope indicating increased connectivity with age while carriers and non-carriers in the High PA category had horizontal aging trajectories. PA is associated with cognitive reserve (CR), a term describing the protection and adaptation of cognitive processes through neural efficiency and compensation mechanisms, and it is possible the Low PA non-carriers exhibited compensatory increases in connectivity of the left mPFC-PCC earlier than High PA study participants due to lower levels of CR. The promising findings that rs-fMRI can be used as an early detection of brain changes sensitive to PA levels and APOE-ɛ4 status are critical to the research and treatment of AD.Item Sleep Duration in Adolescent Girls: Correlates and Association with Obesity Risk(2013) Moshkovich, Olga; Saksvig, Brit I; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The present study aimed to identify demographic, behavioral, and school-related factors associated with week night sleep duration among an ethnically diverse sample of 582 adolescent girls from the Trial of Activity for Adolescent Girls (TAAG) 2. The distribution of sleep duration categories (<7 hours, 7-9 hours, and >9 hours) differed significantly among ethnic groups in bivariate analyses, but not in the final multivariate model. Additionally, sleep duration was negatively associated with distance to school from home, typical time spent on the computer, and school start time. In contrast to previous findings, shortened sleep duration was not associated with increased body mass index (BMI), body fat percentage, or quantity of moderate-to-vigorous physical activity (MVPA). Findings show support for delayed school start times. In addition, future research should examine whether interventions to reduce screen time activities among adolescents is effective in increasing their sleep duration.Item Change in Physical Activity and Associated Factors among Adolescent Girls(2012) Zook, Kathleen Renee; Rohm Young, Deborah; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Objective: Examine relationships between changes in physical activity (PA) and personal, psychosocial and environmental factors among adolescent girls. Methods: Longitudinal data were analyzed from two cohorts of adolescent girls. Participants were placed into four categories based on PA levels. Active Maintainer-AM, Inactive Maintainer-IM, Adopter-A, or Relapser-R. Anthropomorphic, personal, psychosocial and environmental data were collected. Multivariate logistic regression was used to estimate parameters. Results: In early adolescence, Free/reduced price lunch and PA Self-Efficacy were associated with AM; Race and Friend Support for PA with IM; and Friend Support for PA with R. In later adolescence, Distance to Nearest Park, PA Frequency with Friends, and Global Physical were associated with AM; BMI, Friend Support for PA, PA Frequency with Friends, and Age at Menses, with IM; BMI with A. Conclusion: PA predictors were different across the categories and the predictors were different for early adolescence and later adolescence.Item SOCIO-CULTURAL DETERMINANTS OF PHYSICAL ACTIVITY AMONG AFRICAN AMERICAN AND WHITE FEMALE ADOLESCENTS(2009) Scott, Wakina L.; Koblinsky, Sally A.; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Low physical activity is a problem for girls, and particularly African American female adolescents. Low physical activity has been associated with increased risks of cardiovascular disease, hypertension, diabetes, cigarette smoking, premature mortality, and overweight and obesity. Families and communities play an important role in influencing adolescent health; however, few studies have examined how these factors influence adolescent physical activity outcomes. Adopting an ecological theoretical framework, the purpose of this study was to examine the relationship between family factors (maternal control, maternal support, mother-child communication, and family cohesion), a community factor (religiosity, defined as attendance at religious services and religious youth activities) and physical activity among African American and White female adolescents. Wave I data from the National Longitudinal Study of Adolescent Health was analyzed. The sample includes 736 African American and 1,692 White female adolescents in grades seven through 12. Descriptive statistics were computed for all family and community measures. Logit models were used to evaluate family and community influences on female adolescents achieving five or more bouts of moderate to vigorous physical activity per week (MVPA); and whether the relationship between maternal control, maternal support, mother-child communication, family cohesion, religiosity, and MVPA was moderated by race. Maternal control was a significant predictor of MVPA for the total sample and the White female sample, with increased levels of maternal control associated with increased adolescent physical activity. Mother-child communication and religiosity were significantly positively associated with MVPA for African American females only. Maternal support and family cohesion were not found to be significant predictors of adolescent girls' physical activity in any of the models. Race significantly influenced the strength of the relationship between mother-child communication and adolescent MVPA, and between religiosity and adolescent MVPA, with findings revealing a stronger relationship for African American female adolescents than for White female adolescents. Strategies to engage female adolescents in physical activity, particularly African American female adolescents, should focus on increasing mother-child communication and girls' involvement with religious institutions.