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Barbara E. Ainsworth and Cheryl Der Ananian

There is a growing recognition of the need for the primary prevention of chronic illnesses across the lifespan. In recent years, diseases that were formerly associated with adulthood such as diabetes are being diagnosed in adolescents and young adults. While there have been many prevention efforts focusing on health in children and adolescents, there is a limited body of research examining prevention in young adults. This article examines the concept of wellness in the Millennial generation and describes how their life course experiences impact seven domains of wellness. Specifically, this article describes the period and cohort effects that influence the domains of wellness and how the Millennial generation differs from other generations in these aspects of wellness. Finally, this paper provides an overview of the technological and cultural influences on wellness in the Millennial generation.

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Meghan Baruth, Sara Wilcox, Cheryl Der Ananian and Sue Heiney

Background:

Adjuvant treatment for breast cancer may result in long-lasting, adverse emotional and physical side effects, and reduce quality of life (QOL). This pilot study examined the effects of a home-based walking program on QOL and fatigue in early stage breast cancer survivors and whether changes in walking behavior were associated with changes in outcomes.

Methods:

Participants (n = 32) were randomized to a 12-week home-based walking intervention plus brief telephone counseling (n = 20) or a wait-list control group (n = 12). Self-reported fatigue, QOL, and walking were assessed at baseline and 12-weeks. Results are presented as effect sizes.

Results:

Participants in the intervention had improvements in a majority of fatigue and QOL outcomes, whereas the control group had no change or worsened in many; effect sizes were generally in the small to medium range. Changes in fatigue/QOL outcomes were associated with changes in walking behavior, with effects generally in the small to medium range.

Conclusion:

Home-based physical activity (walking) programs may be an appropriate avenue for alleviating the adverse side effects that often accompany adjuvant treatment for breast cancer. These programs have potential for widespread dissemination, which may have considerable impact on the quality of life of women recently completing breast cancer treatment.

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Melissa Bopp, Cheryl Der Ananian and Matthew E. Campbell

The demonstrated health benefits of active commuting (AC) and low participation rates among older adults indicate a need to examine the socioecological correlates of AC by age category. An online survey of employed U.S. adults examined AC participation and individual, employment-related, community, and environmental variables. Participants were dichotomized by age (younger: 18–49 yr; n = 638, 64% and older: ≥50 yr; n = 359, 36%). Logistic-regression analyses examined differences in AC correlates by age. Older adults were less likely to be active commuters (13.4%) than younger adults (27.9%; p < .001) For older adults, analyses yielded a Nagelkerke R2 = .76, with perceived behavioral control, behavioral beliefs, household cars, and walking distance as predictors. Analyses for younger adults resulted in a Nagelkerke R2 = .79, with perceived behavioral control, coworker normative beliefs, parking problems at work, greater employer and community support for AC, and bad weather as predictors. Findings suggest age should be considered when examining and targeting AC behaviors.

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Sarah J. Wherry, Cheryl Der Ananian and Pamela D. Swan

Background: This study evaluated the feasibility and effectiveness of a home-based exercise intervention using the Wii Fit Plus®. Methods: A randomized, controlled trial of 24 women (age 53.6 [5.4] y) was used to assess compliance and changes in balance over 12 weeks. Balance was measured via the Berg Balance Scale and Frailty and Injuries: Cooperative Studies of Intervention Techniques-4 Scale at baseline and week 6 and week 12. Participant compliance to the intervention was captured via paper logs and the electronic record collected by the Wii Fit Plus®. Results: Participants in the intervention group were 95% compliant based on electronic records. There were no significant differences between groups for total score on either balance scale. There was a significant group × time interaction in favor of the intervention for maximum velocity y (P < .05), average velocity (P < .05), and was trending for maximum velocity x (P = .05) in the tandem step, eyes closed position. Conclusions: The results suggest that the Wii Fit Plus® is appropriate for home-based interventions in middle-aged women. Modest improvements in balance indicate that this may be an effective means to improve or maintain balance in older women. More research is needed to determine compliance and benefits to reducing fall risk in durations exceeding 12 weeks.

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Sara Wilcox, Cheryl Der Ananian, Patricia A. Sharpe, Jennifer Robbins and Theresa Brady

Background:

Physical activity (PA) is important for arthritis self-management. A better understanding of the PA correlates in persons with arthritis will help inform interventions.

Methods:

Computer searches were conducted on PubMed, PsychInfo, Current Contents, and Cinahl databases. Reference lists of extracted articles were also searched. Thirty-six studies published between 1976 and February 2004 met inclusion criteria.

Results:

PA correlates are presented for sociodemographic, psychological, health-related, social, and environmental categories. Self-efficacy, perceived benefits and barriers, mental well-being, prior PA, and pain received the most consistent support as PA correlates, whereas sociodemographic, social, and environmental variables were the least studied. Too few studies were conducted to allow comparisons across arthritis type or study design.

Conclusions:

We recommend that additional qualitative research be conducted to understand factors influencing PA in persons with arthritis. Prospective studies, particularly in the context of a PA program or intervention, would also be useful to better understand how barriers and enablers change over time.

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Cheryl Der Ananian, Renae Smith-Ray, Brad Meacham, Amy Shah and Susan Hughes

This study evaluated the feasibility and effectiveness of translating the evidence-based program, Fit & Strong!, into a Spanish program, ¡En Forma y Fuerte!. A single-group, quasi-experimental design (n = 34, mean age = 58.8 [8.1], 87.2% female, 87.2% reported speaking mostly Spanish) was used to assess implementation feasibility and the impact of ¡En Forma y Fuerte! on arthritis-related outcomes in Hispanics with arthritis. Significant improvements in lower-extremity strength, perceived physical function, and pain were observed from baseline to 8 weeks (p < .05); these improvements were maintained at 6 months. Significant improvements in aerobic endurance and stiffness were observed from baseline to 6 months (p < .05). No major program adaptations (other than language) were observed or reported. However, the instructors provided several suggestions for program improvements, including adjusting the literacy level and length of the program. Findings suggest ¡En Forma y Fuerte! is feasible and effective, potentially providing a much-needed program for older Hispanics with arthritis.

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Cheryl Der Ananian, Sara Wilcox, Ken Watkins, Ruth P. Saunders and Alexandra E. Evans

Most people with arthritis are not regularly active. Understanding what factors influence exercise is essential for designing programs to increase participation. The objective of this study was to examine the correlates of exercise in people with arthritis. Using a cross-sectional design, sociodemographic, health-related, and psychosocial variables were collected from community-dwelling individuals with arthritis (N = 141). Associations with exercise level were examined with bivariate statistics (ANOVAs, chi-squares) and logistic-regression analyses. Exercisers were less likely than nonexercisers and insufficiently active people to report that arthritis negatively affected their physical and social functioning, and they reported more positive affect and greater self-efficacy (p < .05). Exercisers also reported less pain than nonexercisers (p < .05). In multiple logistic-regression analyses, self-efficacy and physical limitations remained independent predictors of exercise. The results suggest the need to target exercise self-efficacy when designing exercise interventions. Results also suggest the need to tailor exercise programs to individuals’ physical limitations.