A Comprehensive Evaluation of a Home Visitation Program Model\u27s Prenatal Physical Activity Curriculum Modules Delivered Primarily to Low-income Women

Background. Many low-income pregnant women receive prenatal physical activity (PA) curricula modules through home visitation programs. However, there is a lack of scientific evidence on the structural capacity, processes, and outcomes relating to these modules. Aims. The objective of this dissertation project was to examine the aforementioned in a single home visitation program model - the Maternal Infant Health Outreach Worker (MIHOW) program. More precisely, the aims of this study were to: (Aim 1) examine home visitors’ (i.e., Outreach Workers [OWs]) competencies in implementing the MIHOW program’s prenatal PA curriculum modules (i.e., structural capacity), (Aim 2) investigate the fidelity with which the MIHOW program’s prenatal PA curriculum modules were delivered to home visitation clients (i.e., processes), and (Aim 3) evaluate the impact of the MIHOW program’s curriculum on home visitation clients’ prenatal moderate-intensity physical activity (MPA) compared to a propensity score matched comparison group (i.e., outcomes). Methods. (Aim 1) A qualitative research design was used. Data from one interview and three focus groups conducted with OWs and five interviews conducted with their Site Leaders (i.e., supervisors) were used for analysis. (Aim 2) A mixed-methods research design was used. Data sources were the interviews and focus groups conducted in Aim 1 and the checklists of curriculum modules completed with 109 clients. These data sources were analyzed separately and then merged. (Aim 3) A nonrandomized quasi-experimental research design was utilized to evaluate how the MIHOW program’s pregnant clients’ (n = 98) absolute MPA metabolic equivalent of task (MET) minutes per week changed relative to a propensity score matched comparison group of pregnant women (n = 56). Physical activity measurements were taken at trimesters one, two and/or three. Generalized linear mixed modeling with a zero inflated negative binomial distribution was used as the statistical analysis strategy. Results. Key findings are shown by each aim. (Aim 1) OWs’ depth of knowledge on prenatal PA information and the modules varied; over half the OWs discussed implementing PA, rapport building, communication, adaptability, and/or problem-solving skills; over half the OWs felt comfortable delivering the modules. (Aim 2) Eight OWs discussed delivering the prenatal PA curriculum modules at multiple, most, or all of the home visits whereas the checklist data revealed that only 19.3% of clients received two or more “prenatal PA” and/or “other” curriculum modules. (Aim 3) The expected log absolute MPA MET minutes per week decreased 1.27 less for the comparison group than for the intervention group by trimester 3 [X2(1) = 4.77, p = .0289]. Conclusion. Taken together, these findings suggest that home visitors’ competencies relating to the prenatal PA curriculum modules and home visitors’ implementation of the prenatal PA curriculum modules have the potential to influence the recipients of these services. Thus, attention needs to be given to these factors when evaluating the effectiveness of home visitation program models’ prenatal PA curricula modules. Insight from this study can be used to enhance how home visitation program models’ prenatal PA curricula modules are implemented and evaluated

Evaluability Assessment of “Growing Healthy Communities,” a Mini-grant Program to Improve Access to Healthy Foods and Places for Physical Activity

Mini-grants have been used to stimulate multisector collaboration in support of public health initiatives by funding non-traditional partners, such as economic development organizations. Such mini-grants have the potential to increase access to healthy foods and places for physical activity through built environment change, especially in small and rural towns in the United States. Although a promising practice, few mini-grant evaluations have been done. Therefore, our purpose was to conduct an Evaluability Assessment (EA), which is a process that can help promising programs that lack evidence advance toward full-scale evaluation. Specifically, we conducted an Evaluability Assessment of a statewide mini-grant program, called “Growing Healthy Communities” (GHC), to determine if this program was ready for evaluation and identify any changes needed for future implementation and evaluation that could also inform similar programs

The Role of State and Trait Anxiety in the Processing of Facial Expressions of Emotion

State anxiety appears to influence facial emotion processing (Attwood et al. 2017 R. Soc. Open Sci. 4, 160855). We aimed to (i) replicate these findings and (ii) investigate the role of trait anxiety, in an experiment with healthy UK participants (N = 48, 50% male, 50% high trait anxiety). High and low state anxiety were induced via inhalations of 7.5% carbon dioxide enriched air and medical air, respectively. High state anxiety reduced global emotion recognition accuracy (p = 0.01, [Formula: see text]), but it did not affect interpretation bias towards perceiving anger in ambiguous angry–happy facial morphs (p = 0.18, [Formula: see text]). We found no clear evidence of a relationship between trait anxiety and global emotion recognition accuracy (p = 0.60, [Formula: see text]) or interpretation bias towards perceiving anger (p = 0.83, [Formula: see text]). However, there was greater interpretation bias towards perceiving anger (i.e. away from happiness) during heightened state anxiety, among individuals with high trait anxiety (p = 0.03, dz = 0.33). State anxiety appears to impair emotion recognition accuracy, and among individuals with high trait anxiety, it appears to increase biases towards perceiving anger (away from happiness). Trait anxiety alone does not appear to be associated with facial emotion processing

The First Intervention Study in Elder Self-Neglect: A Randomized Clinical Trial to Improve Vitamin D Levels

Despite high mortality rates, elder self-neglect is characterized by refusal of medical and social interventions. To date there have been no tested clinical interventions in elders who self-neglect. Previous research from the TEAM Institute has shown significantly low vitamin D levels in this population. This study aimed to determine the feasibility of a clinical intervention. Replacement of vitamin D was chosen because of its ease of administration and favorable safety profile. Methods: A randomized clinical trial using directly observed therapy of vitamin D was conducted using 50 elders, >65 years of age, with Adult Protective Services (APS) validated self-neglect. A staggered intervention with waiting controls was used to maximize statistical power. One-third (n=17) of the group was administered 50,000 IU vitamin D2 (ergocalciferol) monthly and the remainder (n=33) were administered 400 IU monthly. Serum 25-OH vitamin D was assessed at baseline and 5-months. Results: 69% agreed to participate in the study and of those n=40 (80%) remained at 5-months. At baseline, 12% (n=7) were deficient in vitamin D (<30nmol/L) and approximately 38% (n=22) had inadequate vitamin D levels (<50nmol/L). The baseline 25-OH vitamin D level was 59 nmol/L +25 (mean SD), and increased significantly to 72nmol/L +21 nmol/L at 5-months. Conclusion: These data are the first to provide evidence that clinical interventions are feasible in elders who self-neglect. The increase in vitamin D levels confirmed that the study personnel were able to successfully intervene community-dwelling elders with self-neglect. This study sets the precedent for future intervention and prevention studie

A role for human cytomegalovirus glycoprotein O (gO) in cell fusion and a new hypervariable locus.

A cell fusion assay using fusion-from-without (FFWO) recombinant adenoviruses (RAds) and specific antibody showed a role in fusion modulation for glycoprotein gO, the recently identified third component of the gH/gL gCIII complex of human cytomegalovirus (HCMV). As in HCMV, RAd gO expressed multiple glycosylated species with a mature product of 125 kDa. Coexpression with gH/gL RAds showed gCIII reconstitution in the absence of other HCMV products and stabilisation by intermolecular disulfide bonds. Properties of HCMV clinical isolate, Pt, also implicated gO in cell spread. Compared to laboratory strain AD169, Pt was resistant to gH antibody plaque inhibition, but mature gH was identical. However, the gO sequences were highly divergent (20%), with further variation in laboratory strain Towne gO (34%). Thus, gO forms gCIII with gH/gL, performs in cell fusion, and is a newly identified HCMV hypervariable locus which may influence gCIII's function in mediating infection

Factors Associated with Physical Activity Increases and Decreases Among a Sample of Appalachian Residents During the COVID-19 Pandemic: A Cross-Sectional Study

Introduction: Physical activity (PA) can prevent and reduce the deleterious physical and mental health effects of COVID-19 and associated lockdowns. Research conducted early in the pandemic demonstrates that a greater proportion of adults in the U.S. have decreased than increased PA, and the effects vary by sociodemographic factors. Ongoing evidence is important to identify patterns in PA changes during the pandemic. Purpose: This study aims to identify factors associated with increases and decreases in PA during the COVID-19 pandemic in a convenience sample of adults residing in Appalachia. Methods: Surveys were collected from a convenience sample of adults from eight counties in West Virginia from January to March 2021. Logistic regression analysis was used to identify sociodemographic, health, and rurality factors associated with (1) increased PA and (2) decreased PA during the pandemic, assessed retrospectively via self-report. Results: Analysis of 1,401 survey responses revealed that better self-rated health, lower body mass index, and higher income and education were associated with a greater likelihood of more time spent doing PA during the pandemic (p ≤ .05). Respondents with lower self-rated health, higher body mass index, lower income, and lower levels of education—plus females and those living in a more urban county—were more likely to spend less time doing PA during the pandemic (p ≤ .05). Implications: Analyses suggest that pre-pandemic disparities in PA by health, wealth, and education were exacerbated during the pandemic. These must be addressed before physical inactivity and ill health become endemic to the Appalachian Region

Effects of Electronic Cigarette E-Liquid Flavouring on Cigarette Craving

This experimental study, conducted remotely, investigated the effects of vaping nicotine-containing flavoured e-liquid, compared with unflavoured e-liquid, on (a) general cigarette craving, and (b) cue-elicited cigarette craving in response to smoking-related cues, among abstinent daily smokers. Participants (n = 84) were randomised to use an e-cigarette with nicotine-containing fruit/sweet-flavoured e-liquid (blackcurrant, strawberry, vanilla, caramel) or unflavoured e-liquid, for one week

An Evaluability Assessment of the West Virginia Physical Activity Plan, 2015: Lessons Learned for Other State Physical Activity Plans

Background The US National Physical Activity Plan (NPAP) was released in 2009 as a national strategic plan to increase physical activity (PA). The NPAP emphasized implementing state and local PA pro- grams. Dissemination of information about NPAP has been lim- ited, however. Community Context West Virginia is a predominantly rural state with high rates of chronic diseases associated with physical inactivity. In 2015 an evaluability assessment (EA) of the West Virginia Physical Activ- ity Plan (WVPAP) was conducted, and community stakeholders were invited to participate in updating the plan. Methods A good EA seeks stakeholder input, assists in identifying program areas that need improvement, and ensures that a full evaluation will produce useful information. Data for this EA were collected via national stakeholder interviews, document reviews, discussions among workgroups consisting of state and local stakehold- ers, and surveys to determine how well the WVPAP had been im- plemented. Outcome The EA highlighted the need for WVPAP leaders to 1) establish a specific entity to implement local PA plans, 2) create sector-spe- cific logic models to simplify the WVPAP for local stakeholders, 3) evaluate the PA plan’s implementation frequently from the out- set, 4) use quick and efficient engagement techniques with stake- holders when working with them to select strategies, tactics, and measurable outcomes, and 5) understand the elements necessary to implement, manage, and evaluate a good PA plan. Interpretation An EA process is recommended for other leaders of PA plans. Our project highlights the stakeholders’ desire to simplify the WVPAP so that it can be set up as a locally driven process that engages communities in implementation