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Duck AA, Karimi M, Watkins LL, Tacy JW, Savell CL, Hall KC. Metabolic syndrome risk among adolescents in the Deep South and the relationships with behavioral health, food insecurity, and physical activity. J SPEC PEDIATR NURS 2024; 29:e12420. [PMID: 38095121 DOI: 10.1111/jspn.12420] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/11/2023] [Accepted: 12/04/2023] [Indexed: 01/30/2024]
Abstract
PURPOSE A combination of physical and psychosocial risk factors put adolescents at risk for poor cardiometabolic health and chronic disease burden, often recognized as metabolic syndrome. The purposes of this study were to (1) identify the prevalence of metabolic syndrome risk among adolescents, utilizing the metabolic syndrome severity index, and (2) determine the relationship between metabolic syndrome risk and behavioral health, food insecurity, and physical inactivity among adolescents. METHODS AND DESIGN A cross-sectional, descriptive, correlational design was deployed in an inner-city high school in the Deep South. An 8-month recruitment and enrollment period yielded a sample of 55 adolescents. A battery of measures included assessment of demographic data, anthropometric, cardiovascular, and psychosocial data. Utilizing these data elements, a progressive methodological approach was used to identify metabolic severity risk as a continuous variable for use in the adolescent population. RESULTS All participants identified as African American/Black. Among them, 71% (N = 39) were female and an average age of 16 (SD = 1.3) years old, with 67.3% (N = 37) of the sample at risk for metabolic syndrome. There was not a statistically significant relationship between metabolic syndrome severity score and behavioral health risk, food insecurity, and physical inactivity in this sample. PRACTICE IMPLICATIONS Future use of the continuous metabolic syndrome severity score may guide practice by utilizing longitudinal data to assess the trends of metabolic syndrome severity scores in relation to disease outcomes in adolescents. This may promote the identification of psychosocial and physical interrelationships with metabolic syndrome, thus improving overall health through the development of age-appropriate interventions.
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Affiliation(s)
- Angela A Duck
- University of Mississippi Medical Center School of Nursing, Jackson, Mississippi, USA
| | - Masoumeh Karimi
- University of Mississippi Medical Center School of Nursing, Jackson, Mississippi, USA
| | - LaDaryl L Watkins
- University of Mississippi Medical Center School of Nursing, Jackson, Mississippi, USA
| | - Joseph W Tacy
- University of Mississippi Medical Center School of Nursing, Jackson, Mississippi, USA
| | - Christy L Savell
- University of Mississippi Medical Center School of Nursing, Jackson, Mississippi, USA
| | - Katherine C Hall
- University of Mississippi Medical Center School of Nursing, Jackson, Mississippi, USA
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Duck AA, Carr K, Lim CS, Robinson JC. Integrating Behavioral Health and Primary Care in an Inner-City High School: Expanded Care in a School-Based Clinic in Mississippi, 2018-2020. Public Health Rep 2023; 138:16S-21S. [PMID: 37226942 PMCID: PMC10226072 DOI: 10.1177/00333549221128221] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Adolescence, a critical and rapid stage of human development, requires innovative approaches in the provision of health care. With considerable mental health issues occurring among adolescents, an urgent need exists to address their mental and behavioral health. School-based health centers can provide an important safety net, particularly for young people who lack access to comprehensive and behavioral health care. We describe the design and implementation of behavioral health assessment, screening, and treatment services in a primary care school-based health center. We reviewed primary care and behavioral health measures as well as the challenges and lessons learned of this process. Five hundred and thirteen adolescents and young adults aged 14-19 years from an inner-city high school in South Mississippi were screened for behavioral health issues from January 2018 through March 2020, and all 133 adolescents deemed at risk for behavioral health issues received comprehensive health care. Lessons learned included the importance of recruiting behavioral health providers to ensure sufficient staff, establishing academic-practice arrangements to ensure funding, increasing student enrollment by improving the return rate of consent for care, and enhancing data collection through process automation. This case study may help inform the design and implementation of integrated primary and behavioral health care in school-based health centers.
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Affiliation(s)
- Angela A Duck
- School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA
| | - Kayla Carr
- School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA
| | - Crystal S Lim
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - Jennifer C Robinson
- School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA
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Klamm MM, Duck AA, Welsch MA, Yan Y, Torres ER, Wade B, Stewart MW, Clayton J, Zhang L. Dispersion of daily physical activity behaviors in school-age children: A novel approach to measure patterns of physical activity. J SPEC PEDIATR NURS 2022; 27:e12364. [PMID: 34878735 PMCID: PMC9615512 DOI: 10.1111/jspn.12364] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The objectives of this paper are (1) to examine patterns of physical activity (PA) and sedentary behavior; (2) to describe development of a method to quantify movement dispersion; and (3) to determine the relationship between variables of movement (i.e., volume, intensity, and dispersion), volume of sedentary behavior, and estimated cardiorespiratory capacity in school-aged children. DESIGN AND METHODS A secondary analysis of an existing data set with raw accelerometer data identified PA patterns of movement dispersion in school-aged children. Bar graphs visually depicted each participant's daily vector magnitude counts. The research team developed a dispersion variable-movement dispersion-and formula to provide a new quantification of daily PA patterns. Total movement dispersion represents both intensity and distribution of movement, whereas pure movement dispersion refers to the distribution of movement during the wear time, independent of intensity. Kendall's tau examined the relationship between several variables: body mass index percentile, average minutes of sedentary behavior, average minutes of light PA, average minutes of moderate-vigorous PA (MVPA), derived VO2 max, total movement dispersion, and pure movement dispersion. RESULTS Three participants' activity graphs were presented as examples: (1) active, (2) inactive, and (3) mixed. The more active participant had the highest values for pure and total movement dispersion. The inactive participant had much lower pure and total movement dispersion values compared to the active participant. The mixed participant had high average minutes of MVPA yet lower pure and total movement dispersion values. Total movement dispersion had a significant correlation with average minutes of light PA (r = .406, p = .016) and average minutes of MVPA (r = .686, p < .001). Pure movement dispersion was significantly correlated with average minutes of light PA (r = .448, p = .008) and average minutes of MVPA (r = .599, p < .001). Average minutes of sedentary behavior (SB) were not significantly correlated with total (r = .041, p = .806) or pure movement dispersion (r = .165, p = .326). PRACTICE IMPLICATIONS Movement dispersion may provide another tool to advance knowledge of PA, potentially leading to improved health outcomes. Raw accelerometer data, such as that gathered at the elementary school in this study, offer opportunities to identify school-aged children at risk for obesity, SB, and lack of PA.
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Affiliation(s)
- Melissa M Klamm
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Angela A Duck
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Michael A Welsch
- Department of Population Health Science, the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Yonghua Yan
- Department of Mathematics and Statistical Sciences, Jackson State University, Jackson, Mississippi, USA
| | - Elisa R Torres
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Breanna Wade
- Department of Population Health Science, the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Mary W Stewart
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Jill Clayton
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Lei Zhang
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA
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Klamm M, Welsch MA, Duck AA, Torres ER, Wade B, Stewart MW. Using Accelerometer Data To Identify Physical Activity Patterns In An Older Adult: Innovative Approach For Individualized Physical Activity Promotion. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000761840.48197.db] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Welsch MA, Duck AA, Klamm M, Torres E, Wade B. Using Accelerometer Data to Identify Movement Patterns in an Older Adult: Innovative Strategy for Physical Activity Promotion. Open J Clin Med Case Rep 2021; 7:1745. [PMID: 34825061 PMCID: PMC8612217] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
UNLABELLED Evidence suggests a physically active lifestyle increases proportion of life lived free of disability. Unfortunately, physical activity participation in older adults is low, suggesting innovative strategies are needed. This case-report (1) examined daily activity routines from accelerometer data; and (2) utilized the movement patterns to "infuse" physical activity within the participant's normal routine. CASE-REPORT A 60 year old wore an Actigraph GT3X+ accelerometer, on 2 separate days and weeks. Movement patterns, from "raw" accelerometer data, were presented to the participant to identify areas of high and low activity, with suggestions how to increase overall activity. Results indicated activity patterns were reproducible. Physical activity infusions increased movement counts by 34%, and moderate-vigorous physical activity (MVPA) by ~82minutes. DISCUSSION Examination of "raw" accelerometer data identified distinct movement routines. Understanding these routines allowed for health provider/participant interaction that led to physical activity "infusions" which contributed to a large increase in MVPA, without major alterations to the individual's day.
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Affiliation(s)
- Michael A Welsch
- The John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
| | - Angela A Duck
- School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA
| | - Melissa Klamm
- School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA
| | - Elisa Torres
- School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA
| | - Breanna Wade
- The John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
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Duck AA, Hall KC, Klamm M, Temple M, Robinson JC. Physical activity and fitness: The feasibility and preliminary effectiveness of wearable activity tracker technology incorporating altruistic motivation in youth. J SPEC PEDIATR NURS 2021; 26:e12313. [PMID: 32970924 DOI: 10.1111/jspn.12313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/08/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to examine the feasibility and preliminary effectiveness of using wearable activity tracker technology, integrated with altruistic motivation in children to increase physical activity (PA), fitness, and prosocial behavior. DESIGN AND METHODS A quasiexperimental design was employed in two 4th grade classrooms in a rural southern state. The intervention was a wearable PA tracker and a web-based curriculum with activities to earn power points redeemable to provide life-saving food to undernourished kids internationally. Seventeen children in the intervention group participated in the 10-week PA program and 18 children were in the wait listed control group. Three measures were assessed in both groups at baseline and postintervention: (a) PA measured with accelerometers, (b) fitness levels measured with shuttle run, and (c) prosocial behavior measured with Strengths and Difficulties questionnaire. RESULTS Of the 35 children enrolled, the majority were nine years old (n = 28), black (n = 31) and female (n = 23). An overall enrollment rate of 88%, attrition rate of 9%, and an accelerometer noncompliance rate of 25% was determined to assess feasibility. There was no statistical significance between the control and intervention group outcome variables. The average minutes of PA in the control group decreased 8 min from baseline to postintervention (p = .05). In the intervention group, PA decreased by 10 min from baseline to postintervention (p = .12). In both the control and intervention groups, prosocial behavior scores decreased (p = .09 control; p = .62 intervention). The fitness scores, VO2 max, did not significantly change (intervention p = .21; control p = .35). PRACTICE IMPLICATIONS Developing effective interventions that foster PA and dissuade sedentary behaviors are essential to enhancing PA and fitness levels. The recruitment, retention, and accelerometer wear adherence suggest this setting, with this population is feasible. The intervention is deliverable, however, the potential of wearable activity trackers and the effect of prosocial behavior that benefits others in increasing PA and improving cardiorespiratory fitness, should be further researched by building on the successful elements of this study.
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Affiliation(s)
- Angela A Duck
- University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Katherine C Hall
- University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Melissa Klamm
- University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Melissa Temple
- Southwest Mississippi Community College, Summit, Mississippi, USA
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Duck AA, Stewart MW, Robinson JC. Physical activity and postural balance in rural community dwelling older adults. Appl Nurs Res 2019; 48:1-7. [PMID: 31266601 DOI: 10.1016/j.apnr.2019.05.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 05/07/2019] [Indexed: 11/29/2022]
Abstract
AIM The purpose of this study was two-fold: 1) identify the types of physical activity being done among rural community dwelling older adults; and 2) determine the relationship between amount of physical activity and postural balance in that population. BACKGROUND Balance impairment coupled with other fall risk factors pose a formidable challenge for aging adults. This study identified types of physical activity rural-community dwelling older adults do and explored the relationship between amount (in minutes) of physical activity and balance. METHODS A cross sectional, correlational design was used to recruit rural community-dwelling older adults. Data were collected using the Jackson Heart Study Physical Activity Survey, Berg Balance Scale, and Timed Up and Go Test; ActiGraph accelerometers were worn to objectively measure physical activity. RESULTS One hundred and one participants enrolled. Most were female (78%), White (74%), and between 65 and 91 years old. Berg Balance Scale scores positively correlated with average minutes of light (r = 0.262) and moderate (r = 0.276) physical activity; and the Jackson Heart Study Physical Activity Survey active living index (r = 0.320) and home and garden index (r = 0.324). In regression models, age and sex were the strongest predictors of Berg Balance Scale (adjusted r2 = 0.313, F(6, 89) = 8.203, P ≤ 0.001). Physical activity was not associated. CONCLUSIONS Minutes of light or moderate physical activity were not associated with balance. However, investigating factors such as physical activity that influence health functional status and balance deserve continuous attention.
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Affiliation(s)
- Angela A Duck
- University of Mississippi Medical Center, Jackson, MS, United States of America.
| | - Mary W Stewart
- University of Mississippi Medical Center, Jackson, MS, United States of America
| | - Jennifer C Robinson
- University of Mississippi Medical Center, Jackson, MS, United States of America
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