Theses and Dissertations

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Browsing Theses and Dissertations by Department "Health & Human Performance"
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    A GOAL-ORIENTED EVALUATION OF THE FAMILY MEDICINE RESIDENCY PROGRAM AT THE SAINT LOUISE CLINIC
    (Middle Tennessee State University, 2016-06-28) Murfree, Sarah Tomlinson ; Weatherby, Norman ; Wrye, Bethany ; Health & Human Performance
    Medical residency programs have challenges including cost, quality, and physician shortages. Family medicine residency programs provide training in many specialty areas to ensure physicians have the knowledge needed to treat the whole family. Program evaluations can identify challenges, areas for improvement, and successes in residency programs.
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    A PROSPECTIVE ANALYSIS OF THE RELATIONSHIP BETWEEN FISH INTAKE AND CENTRAL ADIPOSITY
    (Middle Tennessee State University, 2016-03-25) Morris, Tracy Garrison ; Weatherby, Norman ; Colson, Janet ; Owusu, Andrew ; Ragan, Brian ; Health & Human Performance
    Accumulation of visceral adipose tissue, or central adiposity, increases prevalence of many chronic diseases and mortality, this relationship is independent of total of body fat. Central adiposity is commonly defined as having a waist circumference of > 102 cm in men and > 88 cm in women. Increased fish intake may have a beneficial effect on central adiposity. This prospective study examined the longitudinal relationship between fish intake at baseline and central adiposity over time.
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    A ZERO-HOUR PHYSICAL ACTIVITY PROGRAM'S BENEFIT ON ACADEMIC ACHIEVEMENT IN ELEMENTARY AGED SCHOOL CHILDREN
    (Middle Tennessee State University, 2017-11-09) Phillips, Kristin Lynn ; Dunlap, John ; Palmer, Thomas ; Belcher, Donald ; Health & Human Performance
    With childhood obesity on the rise and the need for American children to be academically successful compared to peer nations, it is imperative that physical activity become part of the typical school day for all elementary aged school children. There is an understanding that physical activity not only benefits physical fitness and health, but that it positively affects children’s academic achievement. With only one-half of American children meeting the CDC’s recommendation of 60 minutes daily, the physical and cognitive effects of inactivity have been widespread and undeniable.
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    Addressing Food Insecurity: Nutrient and Social Network Analysis of Urban Church Food Pantries
    (Middle Tennessee State University, 2018) Noerper, Tracy ; Health & Human Performance
    Food insecurity, defined as having limited or uncertain access to adequate and safe food, is a chronic problem for many Americans. Individuals who are food insecure can have poorer nutrient intakes which could lead to or exacerbate chronic disease. Food pantries are part of a multi-pronged approach to help food insecure households access emergency foods and maintain normal and healthy eating patterns. Existing studies suggest that food pantry items are typically deficient in vitamins A and C, calcium and possibly other nutrients such as fiber, vitamin D and potassium. The majority of food pantries in existence today are administered by churches. The purpose of this research is to explore the social networks of urban church food pantries, evaluate church pantry demographics and analyze the nutrient content of pantry food packages. Results of the social network analysis found that medium-sized churches with membership between 100 and 299 had the greatest number of social network ties between church pantries and the zip codes they serve. Demographic results showed that the average church had approximately 400 members with an average age of 48 years old. Of the 96 churches in the sample, 17 (20.24%) were affiliated with the Methodist denomination. Caucasian (white) was the primary race in 62% of church memberships. Forty-six churches indicated they currently had an on-site food pantry. Nutritional analysis of 18 churches providing pre-made food bags revealed that the dairy and fruit food groups were lacking, and met minimum dietary recommendations for less than 2 and 3 days, respectively. Calcium, vitamins A and C were also found in low levels. Protein and total grain food group servings were found to each meet minimum dietary recommendations for at least 10 days. The amounts of sodium and added sugars found in pantry bag foods were considerable and would meet maximum daily limits for 10 and 15 days, respectively. Future research of church food pantries should focus on reducing barriers that limit the distribution of fruit and dairy food groups. Research should further investigate the social networks of church pantries to ensure that the most vulnerable urban populations are not being underserved.
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    AN EXAMINATION OF MENTAL HEALTH LITERACY AND STIGMA AGAINST MENTAL ILLNESS USING AN ITEM RESPONSE THEORY APPROACH
    (Middle Tennessee State University, 2018) Bowman, Angela S. ; Health & Human Performance
    Mental illness is a leading cause of disease burden for college age individuals and impacts an estimated 43 million Americans annually. The individual burden of mental illness causes high physical morbidity and mortality that leads to a dramatically shortened lifespan. Mental illness is highly treatable, and early intervention leads to an improved long-term outcome. Regardless of level of disability, people displaying symptoms of mental illness are more harshly stigmatized than those with other non-mental health ailments. The latter stigmatization results in years long delay in mental health help-seeking. Existing evidence indicates that health literacy is vital to maintaining good physical health. However, the knowledge and skills that facilitate one’s ability to prevent, recognize, and manage mental health related issues has not been incorporated into traditional definitions of health literacy. Mental health literacy programming has been hypothesized to improve delays in mental health help-seeking through improved knowledge and awareness that results in reduced stigma against mental illness. The evidence base supporting this hypothesis is lacking mainly due to the need for theory-based psychometrically sound instruments that allow for reliable and valid measurement of mental health literacy. The appropriate assessment of mental health literacy is critical to reducing the burden of mental illness stigma. Thus, this study uses advanced statistical and psychometric analyses, including item response theory, to examine items of a recently developed scale purporting to measure mental health literacy. Major scale revisions are elucidated, and using theory-based test construction practices, a new mental health literacy scale is proposed. The psychometric properties of the new scale are discussed, as is the extent to which mental health literacy is related to enacted mental illness stigma. The use of the new mental health literacy scale as part of evidenced-based interventions to improve mental health literacy should help lessen the burden of stigma against people with mental health problems.
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    AN EXAMINATION OF PREDIABETES, TYPE 2 DIABETES, AND ASSOCIATED FACTORS AMONG ADULTS IN THE UNITED STATES
    (Middle Tennessee State University, 2018) Rajvong, Willie Phanthakone ; Health & Human Performance
    This study aimed to examine the association between type-2 diabetes, prediabetes, and associated factors. The 2015-2016 NHANES datasets were analyzed using complex sample tables and logistic regression. Individuals with BMI classification of overweight, and obesity classes 1 through 3 were more likely to have type 2 diabetes or prediabetes than normal weight; smoking 11 – 20 cigarettes were more likely to have type 2 diabetes than those who smoked 1 – 10 cigarettes; consuming alcohol were less likely to have type 2 diabetes than those not consuming alcohol; meeting recommendations for moderate work-related or vigorous leisure-time physical activity were less likely to have prediabetes than those who did not; consuming ≥ 51g of sugar daily were less likely to have type 2 diabetes than those who consumed ≤ 50g sugar daily. Future research should examine possible cause and effect relationships between factors.
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    AN EXAMINATION OF THE EFFECT OF RECENT SUBSTANCE ABUSE TREATMENT ON CURRENT OPIOID USE
    (Middle Tennessee State University, 2019) Bass-Thomas, Cynthia Michelle ; Health & Human Performance
    ABSTRACT The opioid epidemic in the United States has become a public health crisis affecting many American communities. Effective treatment is vital in fighting the opioid epidemic. Existing evidence suggests that providing opioid users with opioid treatment programs (OTPs) is an effective method of treatment that will also provide these users with the best health and social outcomes. A significant barrier to treatment for opioid abusers is access to treatment. The focus of this study was to examine if substance abuse and mental health treatment in the past 12 months have an effect on the amount of days of current opioid use when controlling for age, gender, race/ethnicity, health insurance, and employment. Current opioid use is defined as one to thirty days (1- 30 days) in this study. The data source consisted of the 2016 National Survey on Drug Use and Health (NSDUH). Prevalence estimates were calculated using a Factorial Analysis of Variance to assess the effect of substance abuse and mental health treatment as directed by this study. The study results for examining if substance abuse and mental health treatment in the past 12 months had an effect on the amount of days of current opioid use indicated a statistically significant difference (F(1, 86) = 4.332, p =.040), accounting for (8.9%) of the variance.
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    Assessment of 4 weeks of P90x(r) training on muscular strength and endurance, anaerobic power, and body composition.
    (Middle Tennessee State University, 2014-06-23) Clark, Casey ; Caputo, Jennifer ; Farley, Richard ; Health & Human Performance
    The purpose of this study was to investigate the effect of a 4 week P90x training intervention on markers of physical fitness: upper body strength (US), lower body strength (LS), upper body endurance (UE), lower body endurance (LE), mean anaerobic power (MP), and body composition (%BF). College-aged adults (N = 13) were tested before and after the 4 week training intervention with a bench press and half squat exercises, Wingate anaerobic cycling test, and 7-site skinfolds. A one-way repeated measures multivariate analysis of variance (MANOVA) documented a relationship between the training intervention and changes in the dependent variables F (1, 5) = 7.37, p = .022, η2 = .898. There were significant improvements observed in US, p = .036; UE p = .003; LS, p = <.001; LE, p = .005; and %BF, p = .004. No significant change was observed in MP, F (1, 10) = 2.35, p = .16, η2 = .19. These findings demonstrate that the P90x training program can be an effective tool for improving measures of physical fitness. Due to its effectiveness, one-time purchase cost, convenience of home-use, and video-led training, P90x could be a viable method for addressing perceived barriers of exercise such as lack of time, cost, lack of an exercise partner.
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    ATHLETES FROM FOOTBALL BOWL SUBDIVISION SCHOOLS PERCEPTIONS OF SPORT SPECIALIZATION AND ITS RELATIONSHIP WITH PERFECTIONISM
    (Middle Tennessee State University, 2017-12-12) Hughes, Jason Neal ; Jubenville, Colby ; Gray, Joey ; Rost, James ; McAlister, James ; Health & Human Performance
    Sport specialization is an emerging trend amongst athletes today who are looking to gain an advantage over the competition. However, little research has been conducted to evaluate the psychological consequences of sport specialization. The purpose of study was to investigate the effect that sport specialization has on perfectionism. Additionally, this study examined if specializing in sport had any long-term consequences by investigating the time in which someone specializes in sport and its relationship with perfectionism.
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    Athletic Trainers' Knowledge of Performance Enhancing Drugs
    (Middle Tennessee State University, 2016-07-17) Faircloth, Clayton David ; Ragan, Brian ; Gray, Helen ; Health & Human Performance
    Performance enhancing drugs (PEDs) have been around for years and have recently become an issue in sports. They have effected all levels of sports from high school to professional. There has been 2.9-4.0 million Americans to use some sort of anabolic-androgenic steroid (AAS) (Pop et al., 2014). It’s not only steroids that are used as PEDs there is a long list that will be reviewed in this study. These PEDs have evolved over the years and new drugs are continuously changing. In organized sport Athletic Trainers (ATs) are the primary resource for athletes when it comes to injuries, knowledge on nutrition, and supplements (Burns et al., 2004). It is important for ATs to be able to provide relevant information on PEDs. This study has developed a test to determine an ATs knowledge of PEDs. It will hopefully benefit the patients that ATs treat by encouraging better knowledge of PEDs.
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    BALANCE: RELATIONSHIP TO FUNCTIONAL MOVEMENT AND TRAINING TO MINIMIZE ASYMMETRY
    (Middle Tennessee State University, 2018) Harrison, Layci ; Health & Human Performance
    Functional movement assessments are used to predict injury in multiple populations, but the components that most contribute to functional movement are unknown. Identifying the influence of static balance via the Balance Error Scoring System (BESS) and dynamic balance via the Y-Balance Test (YBT), can provide valuable information to clinicians. This information can be used to help individuals improve functional movement screening (FMS) scores which, in turn, can reduce injury risk. After injury, some individuals experience anterior balance asymmetry, which further increases injury risk. However, early balance training on a limb during rehabilitation is often contraindicated. The cross-over effect, which occurs when training benefits are observed in an untrained limb following training of the contralateral limb, may be helpful in minimizing the development of balance asymmetries following injury. In study one of the dissertation, the contributions of static and dynamic balance on functional movement were evaluated and the contributions of BESS and YBT scores to FMS scores were determined. The effects of unilateral balance training on bilateral anterior reach in those with a bilateral asymmetry in anterior reach was tested in the second study. In the first study, participants from the general population (N = 71) completed the FMS, the YBT, and the BESS. Together (p < .001, R2 = .54) and individually, both YBT (p < .001, R2 = .498) and BESS (p < .001, R2 = .321) were significant predictors of FMS scores. When controlling for age (p < .001, R2 Change = .364) and history of lower body surgery (p < .001, R2 Change = .532), the YBT and the BESS were still significant predictors of the FMS. Risk of injury according to YBT risk and FMS risk were not associated, χ^2 (1,N=77)=1.20, p = .273, Cramer’s V = .125. There was a significant association between BESS risk and FMS risk, χ^2 (1,N=77)=9.27, p = .01, Cramer’s V = .347. In the second study, a subgroup from the first study (N = 16) with an anterior reach asymmetry completed 5 weeks of balance training on the leg with the better balance according to the YBT. After 5 weeks of balance training, there was not a significant interaction between group and time for the trained leg (G-G p = .594, n2p = .035) indicating the training was not effective at improving anterior reach of the trained leg. There was also not a significant interaction between group and time for the untrained leg (G-G p = .403, n2p = .028), showing no cross-over of balance ability to the untrained leg. Overall, static and dynamic balance both contribute to functional movement. This information can be used when developing training and rehabilitation protocols to reduce injury risk as measured by FMS. However, the training outlined in this study did not significantly improve anterior reach of the trained or untrained leg in individuals with an anterior reach asymmetry. As a result, more research in needed to identify a training protocol to improve anterior reach and, therefore, reduce injury risk in this population.
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    BARRIERS TO PHYSICAL ACTIVITY AMONG KUWAITI UNIVERSITY STUDENTS
    (Middle Tennessee State University, 2015-01-29) Alsahli, Sultan Mohammed ; Belcher, Dr. Don ; Lee, Dr. Yun Soo ; Mincey, Dr. Rosemarie ; Health & Human Performance
    ABSTRACT
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    Becoming an Outdoors-Woman: relationships among frequency of participation in BOW programs, enduring involvement, and leisure satisfaction /
    (Middle Tennessee State University, 2011) Hargrove, Karen ; Health & Human Performance
    The purpose of the study was to define the relationships among the frequency of participation in the Becoming an Outdoors-Woman (BOW) program, overall participation in outdoor recreation following BOW participation, the dimensions of enduring involvement, and overall leisure satisfaction. In addition, possible relationships among the five dimensions of enduring involvement and the six subcomponents of leisure satisfaction were examined. The sample consisted of 1,283 women who had participated in at least one BOW program or event within the past 12 months. Demographic data were collected from the sample. Multiple regression analysis showed that only the number of activities not related to the BOW program and the enduring involvement dimension of identity expression were significant predictors of overall leisure satisfaction. Correlation analysis showed that participants' BOW program participation was significantly related to all five dimensions of enduring involvement. Correlation analysis showed an overall significant relationship (p less than .001) between BOW and non-BOW participation. The number of BOW activities and BOW frequency of participation over the past 12 months were significantly related, the number of outdoor recreation activities not related to BOW (non-BOW) and non-BOW frequency of participation were significantly related, and that there was a significant negative relationship between BOW participation and non-BOW participation. All five dimensions of enduring involvement were significantly related to all six subscales of leisure satisfaction (p less than .001). Independent t-tests showed statistically significant differences between those who purchased gear or equipment, licenses, and memberships in conservation, environmental, or other outdoor-related organizations and those who did not purchase gear or equipment, licenses, or memberships in their mean scores for all five dimensions of enduring involvement. The highest mean scores for purchasers were in the attracition and the identity affirmation dimensions of enduring involvement; the highest mean scores for those who did not purchase were in identity affirmation. Results of this study suggest that women's outdoor recreation activity outside the BOW program is an important predictor of their leisure satisfaction, and that BOW participation and the five dimensions of enduring involvement are correlated. Leisure satisfaction subscales and enduring involvement dimensions are positively correlated, and that purchase behavior is linked to the dimensions of enduring involvement. This study represents the first known use of the Modified Involvement Scale (MIS) (Kyle, Absher, et al., 2007) with a program of activities, rather than with a single outdoor activity.
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    BENEFITS AND BARRIERS TO PHYSICAL ACTIVITY AMONG SAUDI FEMALE UNIVERSITY STUDENTS IN THE KINGDOM OF SAUDI ARABIA AND THE UNITED STATES
    (Middle Tennessee State University, 2016-08-25) Alsahli, Maali ; Belcher, Dr. Donald ; Colclough, Dr. Scott ; Health & Human Performance
    Regular physical activity is known to have vital benefits for individuals. Consequently, it is important to know if people understand the benefits of physical activity and barriers that prevent them from being physically active. Previous research indicates that Saudi female university students do not engage in regular physical activity. However, there is little research on this demographic. Therefore, the objectives of this study were to assess the perceived benefits of physical activity and determine the most common barriers to physical activity among Saudi female university students in the Kingdom of Saudi Arabia (KSA) and the United States. The Health Belief Model was utilized to guide this research. Data was collected from 211 female students from Hafr Al batin University (UHA) in KSA and Middle Tennessee State University (MTSU) in the USA using the Exercise Benefits / Barriers Scale (EBBS).
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    BHUTANESE REFUGEES' HEALTH BEHAVIORS AND PERCEPTIONS: A QUALITATIVE APPROACH TO UNDERSTANDING BHUTANESE REFUGEES' POST-RESETTLEMENT EXPERIENCES WITH HEALTH CARE SERVICES IN MIDDLE TENNESSEE
    (Middle Tennessee State University, 2014-06-26) Oliver, Brittney Dunnae-Najie ; Owusu, Andrew ; Bates, Denise ; Hamilton, Gloria ; Health & Human Performance
    Extant research investigating the health perceptions and behaviors of Bhutanese refugees is limited, especially in resettled populations. The purpose of the current research was to explore Bhutanese refugees' perceived experiences with health services received post-resettlement as well as their post-resettlement health care practices and continued use of pre-resettlement health behaviors. A qualitative approach was utilized in the current study. Three audio-recorded focus groups were conducted with Nepali-speaking women in the Bhutanese refugee community. Participants were also asked to complete a demographic questionnaire. English transcripts were coded and analyzed using a grounded theory, constant comparison approach.
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    Body Mass Index and the Influence of Caloric Labeling
    (Middle Tennessee State University, 2014-11-14) Commons, Kandace ; Winborn, Doug ; Bates, Denise ; Health & Human Performance
    The purpose of this study was to identify a relationship between BMI (body mass index) and using calorie labels on menu boards. This study is a quantitative study in which the researcher analyzed data from an annual, cross-sectional study known as the Behavioral Risk Factor Surveillance System. A total of 475,865 random participants were included. Data from the Behavioral Risk Factor Surveillance System were initially analyzed with cross tabulations and descriptive statistics. Hypothesis testing was completed by logistic regression with SPSS. This was used to determine a positive relationship between BMI and using calorie labels. Participants who are obese were more likely to use calorie labels to make a decision on food than non-obese participants. With new legislation being enacted, more extensive research is necessary to facilitate public health efforts.
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    Caffeine supplementation and reactive agility in elite youth soccer players /
    (Middle Tennessee State University, 2012) Jordan, James ; Health & Human Performance
    Caffeine has been shown to provide ergogenic benefits to sports performance. However, limited research is available on the effects of caffeine on agility performance. This study examined the effects of 6 mg kg -1 body mass of caffeine on performance of a reactive agility test (RAT) in 17 elite, male, youth soccer players. Using a double-blind, repeated-measures design, players completed 4 days of testing on the RAT after a standardized warm-up. Height and body mass were measured and players were accommodated to the RAT on Day 1. Day 2 was used to establish the participants' baseline performance on the RAT. Players were randomly assigned to caffeine or placebo on Day 3 and the condition was reversed on Day 4. Caffeine or placebo was ingested in a gelatin capsule 1 hour prior to performing the RAT. During days 2, 3, and 4, players completed 3 randomized run-throughs of the RAT with at least one run-through to the right and left sides to assess players' performance to their dominant and non-dominant sides. There were no significant differences in players' reaction times among the experimental conditions for reaction time to the dominant side, however, there were significantly faster reaction times to their non-dominant side with caffeine F (2, 15) = 4.185, p = .036, eta = .358. There were no significant differences among experimental conditions on players' sprint times to their dominant and non-dominant sides. There were no significant differences among conditions on players' total times to complete the RAT to their dominant side, however, total times to their non-dominant side was approaching significance F (2, 15) = 3.643, p = .051, eta = .327. There were no significant differences among conditions on players' heart rates at any point of measurement. There were no significant differences among conditions on player's RPE after the completion on the warm-up however, players' RPE at the conclusion of the RAT was significantly higher with caffeine F
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    Cardiovascular Disease Risk in Grenadian Women
    (Middle Tennessee State University, 2017-02-23) Todd, Angela Fachini ; Bates-Fredi, Denise ; Weatherby, Norman ; Miller, Hilary ; Health & Human Performance
    Abstract
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    CERTIFIED ATHLETIC TRAINERS' KNOWLEDGE OF THE NATA POSITION STATEMENT OF PREVENTING SUDDEN DEATH IN SPORTS ASSOCIATED WITH SUDDEN CARDIAC ARREST
    (Middle Tennessee State University, 2016-10-28) Hunt, Robin ; Gray, Joey ; Estes, Steven ; Health & Human Performance
    Sudden cardiac death (SCD) in athletes has become an increased concern for sports medicine and health care professionals covering athletic events. Death due to sudden cardiac arrest (SCA) has effected all levels of athletes from middle school to professional. Three out of one-thousand athletes have a cardiac condition that puts them at risk for SCD (Geier, 2016). Unfortunately, only 5% of patients survive after going into cardiac arrest (Geier, 2016). The need for certified athletic trainers (AT) and health care professionals being able to recognize signs and symptoms, and having emergency action plans (EAP) set in place, will only increase the athletes’ odds of survival. Certified athletic trainers must be aware of the position statement presented by the National Athletic Trainers’ Association (NATA) in regards to preventing sudden cardiac death, specifically sudden cardiac death. This study has developed a test to determine an ATs knowledge of sudden cardiac death in athletes. It will benefit the athletes playing the game they love, as well as test the knowledge of the ATs.
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    Certified Athletic Trainers' Knowledge of the NATA Position Statement: Exertional Heat Illnesses
    (Middle Tennessee State University, 2016-10-28) Jones, Kirstie ; Gray, Joey ; Estes, Steve ; Health & Human Performance
    Every year there are an abundant amount of exertional heat illnesses (EHIs) cases among athletes and those numbers are currently on the rise. The occurrence of EHIs has increased over time. From the years 1931-1959 there was only 5 players’ deaths reported in relation to EHIs compared to the 103 players reported to have died from 1960-2000 (Health Research Funding, 2015). The occurrence of EHIs are on the rise and we need medical professionals provided care that have the knowledge to recognize and treat these conditions. Certified athletic trainers (ATs) should be aware of the position statements provided for them concerning these illnesses. The National Athletic Trainers’ Association (NATA) develops position statements to provide ATs with the most current research concerning illnesses like EHIs. This study was used to develop a psychometrically sound test to assess the knowledge of ATs on the NATA position statement: Exertional Heat Illnesses. It will be used to show ATs what knowledge they need to have compared to what they already know.