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Ferguson CC, Clina JG, Young HJ, Gammon L, Jeter A, Abadie A, Rimmer JH. Improvements in nutrition knowledge among adults with physical disabilities: A program evaluation of the mindfulness, exercise, and nutrition to optimize resilience (MENTOR) program 2020-2021. Disabil Health J 2024; 17:101577. [PMID: 38184471 DOI: 10.1016/j.dhjo.2023.101577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND The Centers for Disease Control and Prevention (CDC) funds a quality improvement (QI) health promotion telewellness program for adults with physical disabilities. OBJECTIVE The nutrition component of the parent program, Mindfulness, Exercise, and Nutrition to Optimize Resilience (MENTOR) program, from 2020 to 2021, was evaluated to assess changes in nutrition knowledge of people with physical disabilities. METHODS This was a quasi-experimental program evaluation by pre-post survey of participating adults with physical disabilities. Participants attended weekly nutrition classes for eight weeks with optional one-on-one counseling with a Registered Dietitian. Participants completed pre-post General Nutrition Knowledge Questionnaire Revised (GNKQ-R) that were analyzed using paired t-tests. Participants were grouped into quartiles by pre-program GNKQ-R scores for additional comparisons. Program attendance and post-program feedback were also evaluated. RESULTS A total of 286 participants completed the MENTOR program, and 31% (n = 89) completed pre-post questionnaires for data analysis. Mean pre-program GNKQ-R scores were 58.4 ± 15.1 and post scores were 64.4 ± 11.3, which demonstrated a statistically significant improvement in nutrition knowledge (p < .001). Ancillary analysis revealed that participants with the lowest quartile of pre-program nutrition knowledge had the greatest improvements in their post-GNKQ-R scores (Mean change 16.4 ± 13.9). Questionnaire data revealed participants' subjective knowledge changes and their feedback on the nutrition component of the program. CONCLUSIONS The eight-week MENTOR program effectively improved nutrition knowledge among people with physical disabilities. This demonstrates the impact the program can have on individual knowledge levels. Additionally, these results support the implementation of the program to the broader population of people with disabilities.
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Affiliation(s)
- Christine C Ferguson
- National Center on Health, Physical Activity and Disability, 3810 Ridgeway Dr., Birmingham, AL, 35209, USA; Dean's Office, School of Health Professions, University of Alabama at Birmingham, 3810 Ridgeway Dr., Birmingham, AL, 35209, USA.
| | - Julianne G Clina
- National Center on Health, Physical Activity and Disability, 3810 Ridgeway Dr., Birmingham, AL, 35209, USA; Department of Nutrition Sciences, School of Health Professions, University of Alabama at Birmingham, 1675 University Blvd., Birmingham, AL, 35233, USA
| | - Hui-Ju Young
- National Center on Health, Physical Activity and Disability, 3810 Ridgeway Dr., Birmingham, AL, 35209, USA; Dean's Office, School of Health Professions, University of Alabama at Birmingham, 3810 Ridgeway Dr., Birmingham, AL, 35209, USA
| | - Lacey Gammon
- National Center on Health, Physical Activity and Disability, 3810 Ridgeway Dr., Birmingham, AL, 35209, USA; Lakeshore Foundation, 4000 Ridgeway Dr., Homewood, AL, 35209, USA
| | - Amanda Jeter
- National Center on Health, Physical Activity and Disability, 3810 Ridgeway Dr., Birmingham, AL, 35209, USA; Dean's Office, School of Health Professions, University of Alabama at Birmingham, 3810 Ridgeway Dr., Birmingham, AL, 35209, USA
| | - Allyn Abadie
- National Center on Health, Physical Activity and Disability, 3810 Ridgeway Dr., Birmingham, AL, 35209, USA; Department of Nutrition Sciences, School of Health Professions, University of Alabama at Birmingham, 1675 University Blvd., Birmingham, AL, 35233, USA
| | - James H Rimmer
- National Center on Health, Physical Activity and Disability, 3810 Ridgeway Dr., Birmingham, AL, 35209, USA; Dean's Office, School of Health Professions, University of Alabama at Birmingham, 3810 Ridgeway Dr., Birmingham, AL, 35209, USA
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Rimmer JH, Wilroy J, Galea P, Jeter A, Lai BW. Retrospective evaluation of a pilot eHealth/mHealth telewellness program for people with disabilities: Mindfulness, Exercise, and Nutrition To Optimize Resilience (MENTOR). Mhealth 2022; 8:15. [PMID: 35449508 PMCID: PMC9014229 DOI: 10.21037/mhealth-21-34] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/23/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND People with disabilities have few options to participate in wellness programs that are tailored to their health, functional level, specific interests/needs, and available in the comfort of their home. To address this need, we evaluated a mobile health wellness program for people with physical disabilities. METHODS Retrospective pilot evaluation of MENTOR (Mindfulness, Exercise, and Nutrition To Optimize Resilience), an 8-week, 40-hour online telewellness program adapted from the peer reviewed literature on wellness. The three core wellness domains-mindfulness, exercise, and nutrition-were delivered via Zoom to groups of participants with a disability. Each group met weekly with an assigned health coach who responded to Q&A about the program and presented new material on several additional wellness domains that could impact their health (e.g., relationships, contribution to society/community, spending outdoor time in nature). Pre/post measures included the Godin Leisure-Time Exercise Questionnaire (GLTEQ) and the UAB/Lakeshore Wellness Assessment (LWA). Participants were also interviewed and provided feedback after the program, which was thematically analyzed. RESULTS A total of 154 people from 15 states enrolled in the MENTOR program and 135 completed it (87.7% completers). Data were analyzed from a subset of participants (n=53) who were asked to complete a pre/post assessment and had complete data. Participants who were physically inactive at baseline improved their GLTEQ total activity (P=0.002; effect size =0.56) and moderate-to-vigorous activity scores (P=0.005; effect size =0.53). LWA results demonstrated that participants increased their exercise behavior (P=0.006; effect sizes =0.39) and contribution to society/community (P=0.013; effect size =0.37). Participants with low overall wellness (mental, physical & emotional health) at baseline had statistically significant improvements in exercise, nutrition, sleep, core values, self-care, hobbies, contribution to society/community, relationships, and overall wellness (all P<0.05 with effect sizes ranging from 0.43 to 1.07). Resultant qualitative themes were: (I) lifestyle transformation occurred through new positive experiences, physical and mental health benefits, and adoption of healthy behaviors; and (II) engagement through accessible online bonding through enjoyable and professional experiences. CONCLUSIONS A pilot telewellness program for people with disabilities is feasible and potentially effective in improving several domains of wellness. There is a need for precision-based mobile health (mHealth) programs that are tailored for people with disabilities and that can be accessed from various portable devices including their phone and/or tablet.
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Affiliation(s)
- James H. Rimmer
- Dean’s Office, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
- Lakeshore Foundation, Homewood, AL, USA
| | - Jereme Wilroy
- Lakeshore Foundation, Homewood, AL, USA
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Pierre Galea
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Byron W. Lai
- Lakeshore Foundation, Homewood, AL, USA
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA
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Lai BW, Rimmer JH, Yates A, Jeter A, Young HJ, Thirumalai M, Mehta T, Wilroy J. Critical factors influencing the decision to enroll in a physical activity intervention among a predominant group of adults with spinal cord injury: a grounded theory study. Spinal Cord 2020; 59:17-25. [PMID: 32747672 PMCID: PMC7397960 DOI: 10.1038/s41393-020-0530-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 07/17/2020] [Accepted: 07/20/2020] [Indexed: 11/09/2022]
Abstract
Study design Grounded theory qualitative approach. Objectives To examine critical factors associated with interest in enrolling in a physical activity (PA) research intervention among a predominant group of adults with spinal cord injury (SCI) and develop a theory that can enhance future recruitment success. Setting Participants were recruited through the network of a community exercise facility for people with physical disabilities. Methods Interviews were conducted with 22 wheelchair users (mean age 46 ± 13 years; SCI [n = 19], cerebral palsy [n = 1]; multiple sclerosis [n = 1]; and bilateral limb loss [n = 1]) in either a one-on-one format or focus group. Interview data were coded, and these codes were organized into conceptual categories using a constructivist grounded theory framework. Results Adults with SCI conceive three core concerns with enrolling into a PA trial: (1) capability to participate in the program due to scheduling, transportation, and secondary health conditions; (2) mental balancing of anticipated benefits versus the difficulty of starting the program; and (3) desirability of the program characteristics based on their preferences and needs. Concerns were organized into a theory that may enhance future recruitment success. Conclusions Recruitment is often overlooked in PA research for people with SCI despite it being a primary rate-limiting factor that severely limits the external validity of published studies. Study findings identified core recruitment concerns that are likely similar with general barriers to PA participation. This paper proposed a 3-step decision-making process that can serve as a starting point for overcoming recruitment issues in PA research with people with SCI.
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Affiliation(s)
- Byron W Lai
- Division of Pediatric Rehabilitation Medicine, University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, Birmingham, AL, USA. .,Lakeshore Foundation, University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, Homewood, AL, USA.
| | - James H Rimmer
- Lakeshore Foundation, University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, Homewood, AL, USA.,Dean's Office, University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, Birmingham, AL, USA
| | - Alex Yates
- Lakeshore Foundation, University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, Homewood, AL, USA
| | - Amanda Jeter
- Lakeshore Foundation, University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, Homewood, AL, USA
| | - Hui-Ju Young
- Department of Physical Therapy, University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, Birmingham, AL, USA
| | - Mohanraj Thirumalai
- Department of Health Services Administration, University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, Birmingham, AL, USA
| | - Tapan Mehta
- Department of Health Services Administration, University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, Birmingham, AL, USA
| | - Jereme Wilroy
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, Birmingham, AL, USA
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