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Biomedical subjects

Susan Noble Walker

Publications and source records attributed to Susan Noble Walker.

16 recordsLinked to original sources
PubMed2006

Differences in eating and activity behaviors, health history, and biomarkers among normal-weight, overweight, and obese rural midwestern hispanic women.

This project examined differences in health history, eating and activity behaviors, and biomarkers across three weight categories of rural, Midwestern, US-born Hispanic women as a way to identify critical factors for improving long-term health. Using a cross-sectional descriptive design, a convenience sample of 70 women, aged 19 to 69 years, completed general health, demographic, food frequency, and physical activity questionnaires. Height, weight, blood pressure, and waist circumferences were measured and recorded. One-way analyses of variance and chi(2) analyses were completed. Differences in the presence of diabetes and hypertension were demonstrated across the weight categories. In all three weight categories, fat intakes exceeded and fruit, vegetable, and dairy intakes were below current recommendations. Higher mean daily grain food intake was found for women of normal weight compared to overweight women (7.1+/-5.5 vs 3.6+/-2.3 servings, respectively, P=0.01). A greater proportion of normal-weight women (61.9%) met the targeted physical activity level compared to overweight (42.9%) and obese (21.4%) women (chi(2)=8.29, P=0.016). Because differences in physical activity rather than energy intakes might be a source of energy imbalances that affect weight, additional work to identify behavioral determinants that promote adoption of healthful activity behaviors will be a key component in designing effective educational strategies for these Hispanic women.

Adult↗
PubMed2006

Determinants of older rural women's activity and eating.

This research examined the relationship of cognitive-perceptual determinants from the Health Promotion Model to physical activity and healthy eating at baseline of a clinical trial among rural women aged 50 to 69. Two multivariate regression analyses with canonical correlation (N = 179) each yielded one interpretable canonical variate that explained similar amounts of variance (21.7% and 22.5%) in sets of activity and eating variables. In both analyses, the determinants set is a linear combination of all four cognitive-perceptual constructs from the model (perceived self-efficacy, benefits, barriers, interpersonal influences). The activity behavior set included caloric expenditure, VO2max, and stretching and strengthening activity, whereas the eating behavior set included daily percentage of calories from fat and servings of fruits and vegetables, meat, and whole grains. As predicted by theory, greater self-efficacy, benefits and interpersonal support, and fewer barriers are associated with desirable healthy lifestyle behaviors.

Aged↗
PubMed2006

Physical activity counseling for older women.

Physical inactivity is a major factor in increasing women's risk for chronic disease, disability, and premature mortality. This study compared the effectiveness of five behavioral counseling (BC) sessions with a comparison group receiving one BC session based on the five A's (ask, advise, assist, arrange, and agree) to increase moderate-intensity physical activity, muscle strengthening, and stretching activity. The health promotion model provided the framework for the intervention. A pretest/posttest comparison group design was used, with random assignment of 46 women recruited from an urban midwestern community. A significant group interaction was found only for cardiorespiratory fitness (p < .001). Significant time effects were found (p < .001) for both groups in increasing handgrip, leg strength, and flexibility. BC is a promising intervention to achieve physical activity behavior change with older women.

Aged↗
PubMed2005

Physical activity and fitness among midlife and older rural women.

This study investigated physical activity and fitness of midlife and older rural women. Random-digit dialing was used to recruit 225 women (57.9 +/- 5.6 years old). Self-reported activity (moderate activity, flexibility, and strength) and fitness (body composition, flexibility, strength, and estimated VO(2max)) were assessed. The women demonstrated low daily energy expenditure (30.74 +/- 10.63 kcal x kg(-1) x day(-1)) and estimated VO(2max) (20.12 +/- 7.81 ml x kg(-1) x min(-1)), with 51.5% reporting fair or poor health. Few women reported meeting Healthy People 2010 targets for moderate activity (43.1%), flexibility (28.9%), or strength )14.2%). When classified by estimated VO(2max) into three categories, differences were observed for body-mass index, percent body fat, sit and reach, and timed chair stands, with the poorest performance by those with low cardiorespiratory fitness. Adherence to Healthy People 2010 targets for moderate activity and strengthening was associated with higher cardiorespiratory fitness. These rural women are targets for physical activity interventions because of their sedentary behaviors and low cardiorespiratory fitness.

Aged↗
PubMed2005

Practice of health-promoting behaviors by nursing home residents.

The decade of the '90s witnessed the emergence of health promotion as a national priority for all age groups. Despite the fact that Healthy People 2010 identified objectives for the nursing home population, little is known about factors that promote the practice of health-promoting behaviors by nursing home residents. This study examined the separate and combined contributions of personal and contextual influences on the practice of health-promoting behaviors by nursing home residents. One hundred eighty-four residents and 90 staff members from six nursing homes participated in this study. Using a modified version of contextual regression analysis, 57.8% of the variance in health-promoting lifestyle (HPL) behaviors was explained when all variables were entered into the equation. Personal influences explained a significant amount of variation (53.5%) in current HPL behaviors. These findings underscore the importance of looking at ways to support the efforts of nursing home residents to engage in the practice of health-promoting behaviors.

Activities of Daily Living↗
PubMed2005

Tailored versus standard internet-delivered interventions to promote physical activity in older women.

PURPOSE: While substantial evidence demonstrates physical activity is effective at reducing risk for cardiovascular and other diseases, the percentage of older women participating in regular activity is low. The Internet offers an alternative method for delivery of a primary prevention intervention. This preliminary study examined the feasibility and effectiveness of using the Internet to deliver behavior change interventions for promoting physical activity in women ages 50-69 years. METHODS: Thirty-one healthy women (56.1 +/- 4.9 years) were randomly assigned to either tailored or standard newsletter groups. Both groups received 3 Internet-delivered newsletters at baseline, 1 month, and 2 months. Behavioral markers and biomarkers were measured at baseline and postintervention. Post-testing occurred at 3 months (1 month after delivery of the third newsletter). RESULTS: Repeated measures ANOVAs revealed improvement in measures of flexibility and perceived barriers to exercise for both groups. For the standard group, improvement occurred in % body fat while VO2max declined. Women indicated the newsletters were helpful in influencing behavior change. CONCLUSION: Internet-delivered newsletters appeared feasible and promising for favorably influencing perceptions about barriers to physical activity in these women. Selfreported physical activity did not increase although selected biomarkers did improve. Whether tailored or standard messaging was more effective was inconclusive.

Aged↗
PubMed2004

A randomized pilot test of "Moms on the Move": a physical activity intervention for WIC mothers.

BACKGROUND: Sedentary mothers are important to reach with physical activity promotion. PURPOSE: This study pilot tested "Moms on the Move," a Transtheoretical Model (TTM)-derived physical activity (PA) intervention for low-income mothers enrolled in the Women, Infants, and Children (WIC) program. METHOD: Sedentary mothers (N = 44) were randomized to (a). Moms on the Move (PA intervention) or (b). counseling on self-breast examination (control). Pre- and posttest measurement (baseline and 2 weeks after the 8-week interventions) included (a). stage of PA behavior change, (b). PA behavior, (c). selected TTM constructs, and (d). social support. Pre- and postdifference scores, chi-square, and one-way analyses of variance (ANOVAs) were used. RESULTS: The experimental group progressed in stage of change more than control, chi2(1, N = 44) = 20.50, p <.001. The experimental group had greater PA behavior: weekly minutes of PA, F(1, 42) = 46.85, p <.001; daily energy expenditure (EE), F(1, 42) = 23.01, p <.001; and weekly moderate PA EE, F(1, 42) = 32.63, p <.001. Experimental subgroup (n = 11) step counts increased pre-post, t(10) = 6.16, p <.001. An ANOVA showed that the experimental group had greater improvements in all TTM constructs and social support, ps <.001. CONCLUSIONS: WIC mothers are at risk for sedentary living and have not been targeted for PA behavior change using a provider-counseled approach. Although further testing is needed, Moms on the Move appears to be efficacious.

Adult↗
PubMed2003

Health-promoting lifestyle behaviors of Spanish-speaking Hispanic adults.

The study purpose was to determine (a) health-promoting lifestyle behaviors of Spanish-speaking Hispanics, (b) differences in these behaviors by demographics and acculturation, and (c) the extent to which perceived health status, demographics, and acculturation explain health-promoting lifestyles. The Spanish-language Health-Promoting Lifestyle Profile II (HPLPII) and other instruments were completed by a convenience sample of 545 Hispanic adults recruited in several midwestern communities. Of the six behavioral dimension scores of the HPLPII, scores were lowest for physical activity and highest for spiritual growth. They differed by age, gender, employment status, marital status, and acculturation. Perceived health status, demographics, and acculturation explained 12% of the variance in overall health-promoting lifestyle. These findings can help guide culturally appropriate interventions designed to improve this population's overall health.

Acculturation↗
PubMed1991

Confirming the theoretical structure of the McGill Pain Questionnaire in acute clinical pain.

Based upon a tripartite theoretical model of pain, the Pain Rating Index (PRI) of the McGill Pain Questionnaire (MPQ) continues to be one of the most frequently used instruments to measure clinical pain. Although a number of exploratory factor analytic studies have failed to consistently support the theoretical structure of the instrument, one previous confirmatory factor analytic study of chronic pain did statistically support the a priori model. Because it has been suggested that acute pain may not involve the same dimensions as chronic pain, this study provided a direct test of the theoretical structure of the MPQ through multi-sample confirmatory factor analysis (CFA) using data provided by women experiencing pain during labor (n = 185) and women experiencing acute postoperative pain (n = 192). Results of the LISREL CFA analysis indicated that the a priori, 3-factor, oblique model originally proposed by Melzack provided the most parsimonious representation of the data across the 2 samples of acute pain.

Acute Disease↗
PubMedDate not supplied

Differences in eating and activity markers among normal weight, overweight, and obese rural women.

PURPOSE: The purpose of this study was to examine differences in healthy eating and physical activity behaviors and associated biomarkers among normal weight (body mass index [BMI] < 25), overweight (BMI 25-29.9), and obese (BMI > or = 30) rural women. METHODS: Random digit dialing was used to recruit 225 rural women (57.9 +/- 5.6 years). Measures of healthy eating and physical activity were completed on the computer during individual sessions at the rural sites. Research nurses then assessed a battery of biomarkers of activity and eating, including blood lipids, blood pressure, cardiorespiratory fitness (VO(2max)), and resting heart rate. RESULTS: Major findings were differences across weight categories in daily calories consumed and expended, daily fruit servings, daily meat group servings, high-density lipoprotein cholesterol, vital signs, and cardiorespiratory fitness. The obese women both consumed and expended significantly more calories daily than those in the other two weight groups. Obese women consumed significantly fewer fruit group servings than both the normal weight and overweight women. Obese women consumed significantly more meat group servings than overweight women. There also were significant differences in systolic blood pressure, diastolic blood pressure, resting heart rate, high-density lipoprotein cholesterol, and cardiorespiratory fitness across the three weight groups. CONCLUSIONS: This study provides evidence of major differences in some eating and activity behaviors and biomarkers across BMI groups. Major differences exist between the normal weight and overweight group as compared to the obese group.

Activities of Daily Living↗
PubMedDate not supplied

Use and reliability of the World Wide Web version of the Block Health Habits and History Questionnaire with older rural women.

OBJECTIVE: To estimate the parallel forms reliability of the paper and pencil and World Wide Web versions of the 1998 Block Health Habits and History Questionnaire (HHHQ) and to examine the feasibility of older women using the Web version. DESIGN: Within a 2-week period, participants completed both the paper and pencil and Web versions of the HHHQ and pre- and postsurveys about their comfort level and experience in using the computer. SUBJECTS: A convenience sample of 31 white women, aged 58.2 6.3 years, from a rural location were recruited via direct mail, public service announcements, and public posters. VARIABLES MEASURED: The parallel forms reliability of the HHHQ administered in two different ways and the perceptions of the women on their computer use were measured. ANALYSIS: Dietary data were analyzed using Pearson correlations and paired t tests. Alpha significance level was set at P .70), with only vitamin C (r =.54) and iron (r =.65) falling below the acceptable standard. Eleven women indicated initial discomfort with the computer, but after the study, only three said they were uncomfortable completing the on-line survey. IMPLICATIONS: Internet dietary assessment tools could be a feasible assessment tool for older women to self-administer.

Aged↗
PubMedDate not supplied

Midlife and older rural women's adherence to U.S. Dietary Guidelines across stages of change in healthy eating.

Poor diet is one of the factors that influences morbidity and premature mortality among older women. The purpose of this descriptive correlational study was to assess (a) healthy eating behaviors of midlife and older rural women, as reflected by adherence to the Dietary Guidelines for Americans, and (b) differences in daily servings in each food group consumed by the women across stages of readiness for change in healthy eating. A sample of 371 midlife and older rural women attending a national meeting of a community education organization completed a questionnaire, including items to measure healthy eating and readiness for change in healthy eating. Only 5.9% of the women adhered to all levels of the Food Pyramid. Adherence to individual levels ranged from 3.5% for grain products to 65.4% for fruit. Analyses of variance revealed significant differences (p < 0.05) in servings consumed daily across stages of change for grain (F=4.80), fruits (F=19.02), vegetables (F=9.24), dairy (F=2.45), and meats (F=1.98). Findings suggest the need for community health nurses to design dietary interventions tailored for women's stage of readiness for change to reduce disability in this vulnerable population.

Adult↗
PubMedDate not supplied

Application of the Transtheoretical Model of behavior change to the physical activity behavior of WIC mothers.

This descriptive-correlational study examined the Transtheoretical Model (TTM) of behavior change in relationship to the physical activity behavior of mothers receiving assistance from the Women, Infants, and Children program. A purposive sample (N = 30) of six women at each of the five stages of readiness for behavior change was used. Relationships between stage of behavior change (measured using the Stage of Exercise Adoption tool) and other TTM constructs were examined. The constructs and corresponding instruments included physical activity behavior (Seven-Day Physical Activity Recall), pros, cons, decisional balance (Exercise Benefits/Barriers Scale and two open-ended questions), self-efficacy (Self-efficacy for Exercise scale), and processes of behavior change (Processes of Exercise Adoption tool and the Social Support for Exercise scale). Significant relationships were found between stage of behavior change and two physical activity energy expenditure indices (rs = 0.71-0.73, p < 0.01), daily minutes of moderate to very hard physical activity (rs = 0.81, p < 0.01), pros (rs = 0.56, p < 0.01), cons (rs = -0.52, p < 0.05), decisional balance (rs = 0.56, p < 0.01), and self-efficacy (rs = 0.56, p < 0.01). Use of the 10 processes of change differed by stage of change. Pros to physical activity included a sense of accomplishment, increased strength, stress relief, and getting in shape after pregnancy. Cons included fatigue, childcare, and cold weather. Results support the TTM as relevant to WIC mothers and suggest strategies to increase physical activity in this population.

Adaptation, Psychological↗
PubMedDate not supplied

Determinants of Medicare home healthcare service use among Medicare recipients.

BACKGROUND: Medicare reimbursement for home healthcare (HHC) services has changed dramatically in recent years. A clear understanding of the determinants of Medicare HHC services use is needed so that HHC agencies can meet the demand for services from an aging population while remaining financially sound. OBJECTIVES: The purpose of the study was to identify the determinants of Medicare HHC service within the framework of the Andersen Behavioral Model. METHODS: This cross-sectional secondary analysis used data from the 1996 Medical Expenditures Panel Survey to examine characteristics of 239 subjects who had received Medicare reimbursed HHC services. Predisposing characteristics, enabling resources, and need characteristics were examined to explain Medicare HHC service use. Two criterion measures, annual Medicare expenditures and days of care, were employed in hierarchical regression analyses. RESULTS: Variance in annual Medicare expenditures was explained by both the predisposing (R(2) =.16, <.001) and need characteristics (R(2) =.09, <.001). Variance in days of care was explained by predisposing characteristics (R(2) =.12, <.001) and need characteristics (R(2) =.15, <.001). The adjusted for the total model was.21 for annual Medicare expenditures and.25 for days of care. CONCLUSIONS: While Andersen's Behavioral Model is useful in explaining Medicare HHC service use, it may be important to use multiple measures as criterion variables since the amount and proportion of variance explained differs with the variable used.

Activities of Daily Living↗