VTechWorks Repository :: Browsing by Author "Harden, Samantha M."

Browsing by Author "Harden, Samantha M."

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Adjust your own oxygen mask before helping those around you: an autoethnography of participatory research
Steketee, Abby M.; Archibald, Thomas G.; Harden, Samantha M. (2020-09-03)
Background There is a need to unpack the empirical, practical, and personal challenges within participatory approaches advocated to optimize implementation. The unpredictable, chaotic nature of participatory approaches complicates application of implementation theories, methods, and strategies which do not address researchers’ situatedness within participatory processes. As an implementation scientist, addressing one’s own situatedness through critical reflection is important to unearth how conscious and unconscious approaches, including ontological and epistemological underpinnings, influence the participatory context, process, and outcomes. Therefore, the aim of this exploratory work is to investigate the heretofore blind spot toward the lived experience of implementation researchers within the participatory process. Methods We developed an integrated research-practice partnership (IRPP) to inform the implementation of a gestational weight gain (GWG) control program. Within this IRPP, one investigator conducted a 12-month autoethnography. Data collection and triangulation included field notes, cultural artifacts, and systematic timeline tracking. Data analysis included ethnographic-theoretical dialogue and restorying to synthesize key events and epiphanies into a narrative. Results Analysis revealed the unpredicted evolution of the GWG program into a maternal health fair and three themes within the researchers’ lived experience: (1) permeable work boundaries, (2) individual and collective blind spots toward the ontological and epistemological underpinnings of implementation paradigms, and (3) maladaptive behaviors seemingly reinforced by the research culture. These themes contributed to the chaos of implementation and to researchers’ experience of inadequate recovery from cognitive, emotional, and practical demands. These themes also demonstrated the importance of contextual factors, subjectivity, and value-based judgments within implementation research. Conclusion Building on extant qualitative research guidelines, we suggest that researchers anchor their approach to implementation in reflexivity, intentionally and iteratively reflecting on their own situatedness. Through this autoethnography, we have elucidated several strategies based on critical reflection including examining philosophical underpinnings of research, adopting restorative practices that align with one’s values, and embracing personal presence as a foundation of scientific productivity. Within the predominant (post-) positivism paradigms, autoethnography may be criticized as unscientifically subjective or self-indulgent. However, this work demonstrates that autoethnography is a vehicle for third-person observation and first-person critical reflection that is transformative in understanding and optimizing implementation contexts, processes, and outcomes.
Assessing Barriers and Motivators for Use of a Trail for Active Transportation in a College Town
FitzPatrick, Timothy Michael (Virginia Tech, 2017-05-30)
A high amount of the US population is not physically active, contributing to rates of heart disease and obesity. One strategy to increase physical activity is to use more active transportation, defined as walking or biking for transit. Besides increasing physical activity levels, active transportation can provide other benefits such as decreased air pollution from cars. College campuses provide opportunities for active transportation as most residences are close to campus. Therefore, we examined reasons for use and barriers to active transportation in students living in a community connected to a large university via a 1.9 mile, paved protected trail. Two pedestrian and bicycle counters were placed to find the number of walkers and bikers on the trail per day and students were recruited to take an online survey. We found that more people used the trail during the weekday compared to the weekend. Students did not receive much support from their friends and family to use the trail. Users of the trail were more likely to believe that using active transportation helps protect the environment while non-users were uncomfortable using a bike. Barriers included the time it took to use the trail and the need to carry items. Both users and non-users indicated that a financial incentive would motivate them to use the trail more. We conclude that non-users may be uncomfortable using a bike and worry about carrying their items for class. Changing university parking fees, providing bike lessons, and placing signs with directions and time to campus may increase active transportation to the university via this trail.
Beginning With the End in Mind: Contextual Considerations for Scaling-Out a Community-Based Intervention
Balis, Laura E.; Strayer, Thomas E., III; Ramalingam, NithyaPriya S.; Harden, Samantha M. (Frontiers, 2018-12-10)
Introduction: A number of effective physical activity programs for older adults exist, but are not widely delivered within community settings, such as the Cooperative Extension System. The purpose of this paper was to determine if an evidence-based intervention (EBI) developed in one state Extension system could be scaled-out to a new state system. Methods and results: The RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework was used to guide an iterative evaluation of three translational stages. Stage 1: Before program adoption, Extension health educators were surveyed and interviewed to assess physical activity programming perceptions and factors that may influence their decision to attend training or deliver the program in practice. Results indicated that a virtual, scalable training protocol would be necessary and that training needed to include hands-on instruction and be catered to those who were less confident in physical activity program delivery. Stage 2: Training attendees were surveyed pre- and post-training on factors related to the adoption-decision making process and contacted post-training to assess program delivery status. Training did not influence perceptions of the program, intent to deliver, or confidence in delivering the program. Stage 3: During program implementation, the program was evaluated through the RE-AIM framework by surveying across three key stakeholder groups: (1) program participants, (2) potential delivery personnel, and (3) Extension administrators. Findings indicate that the program has the potential to reach a large and representative proportion of the target audience, especially in rural areas. However, adoption and implementation rates among Extension health educators and community partners were low and data collection for effectiveness, implementation, and maintenance was a challenge. Conclusion: Overall, the results indicate initial struggles to translating and evaluating the program in a large, rural state. Implications for practice include making system-level changes to increase physical activity program adoption rates among Extension health educators and improve data collection and program evaluation through this community-based organization. More work is needed to identify infrastructure support and capacity to scale-out EBIs.
Determining Barriers and Facilitators to Implementing the Resist Diabetes Intervention in Salem Veterans Administration Medical Center Patients
VanDerBrink, Emily Marie (Virginia Tech, 2019-07-19)
With 47% of the veteran population aged 65 years or older, an age group with the highest prevalence of type 2 diabetes (T2D), prevention of T2D is critical within the Veterans Health Administration (VHA) system (1). Resist Diabetes (RD), a Social Cognitive Theory-based resistance training program, has been shown to reduce the prevalence of prediabetes by 34% in prediabetic older adults (2). The RD program could fill the gap within the VHA system for a structured diabetes prevention program not focused on weight, but instead focused on exercise. This thesis describes a mixed-methods investigation to determine what adaptations to the RD program are needed to implement the program within the Salem Veterans Affairs Medical Center (VAMC) patients. Salem VAMC care providers and veteran patients were recruited to gauge perceptions of the RD program, and identify barriers and facilitators to the referral process and program implementation. Semi-structured open-ended questionnaires and interview guides based upon the Consolidated Framework for Implementation Research (CFIR) (3) were utilized to determine major and minor themes within the provider and veteran responses. Quantitative data was also obtained to assess provider perceptions and participant characteristics. Major findings included: positive perceptions by providers for RD program acceptability, appropriateness and feasibility (4) within the Salem VAMC, positive perceptions of Intervention Characteristics of RD by veterans, major barriers to participation lied within the Outer Setting domain with travel, transportation, and time constraints. Major facilitators to program implementation lied within the Inner Setting domain with promotion by primary care. These findings could be used to inform a future version of the RD program adapted for the VHA system.
Development and Exploratory Findings of a Smartwatch Interface to Facilitate Group Cohesion in a Statewide Health Promotion Program
Esakia, Andrey (Virginia Tech, 2017-05-25)
Background: Physical inactivity of the general population is a major public health concern in the US and around the world. Community-based interventions that include evidence-based principles of group dynamics are effective at improving individual-level physical activity behaviors as well as changing social norms for health behaviors. The use of technologies such as smartwatches has a potential to channel and amplify underlying group dynamics principles in such interventions. In order to explore the use of smartwatches for group dynamics-based physical activity interventions, a smartwatch centered system was designed and deployed as part of an eight-week pilot study. Objectives: The primary goal of this study was to explore the degree to which smartwatches effectively channel group dynamics strategies in the context of an eight-week community based physical activity intervention. Methods: In this explanatory mixed-methods study, system usage data were analyzed (e.g., frequency of interaction with smartwatch and smartphone) and participant physical activity (e.g., participant steps tracked by the system). To provide a richer picture of the user experience, use of features, and impact of group dynamics, participants were invited to participate in one-on-one interviews after the pilot program. The group dynamics-based questions centered on the individual’s attraction to the group task and socially as well as the individual’s perception of group integration around the task and as a social unit (i.e., the four dimensions of cohesion). The interview recordings were transcribed verbatim and analyzed via an abbreviated grounded theory approach. The system usage data was visually and numerically summarized. Results: Five of the seven participants completed interviews. The interview analysis resulted in 365 meaning units representing 2 themes (related to user experience with devices and manifestations of group dynamic principles), 4 sub-themes and 23 categories. The participants completed 31.3 (SD=2.91) miles per week and engaged with the smartwatch and the Android app 2.6 and 1.5 times a day, respectively. Analysis of interviews and the system usage logs from five participants, reveal sustained engagement with the smartwatch and the smartphone app. The system facilitated self-reflection and awareness in terms of physical activity levels, encouraged interactions with the team members and helped them to stay aware of the daily goals. Additionally, the participants reported habit formation in terms of wearing and using the smartwatch on the daily basis. Implications: This study provides preliminary support that accessible information via the custom smartwatch watchface can be a viable solution for retaining higher participant engagement during group dynamics-based community interventions. Such devices can help expand group-dynamics interventions by making them less depended on in-person delivery methods.
Development and Feasibility of an Online Brief Emotion Regulation Training (BERT) Program for Emerging Adults
Gatto, Alyssa Jo; Elliott, Truitt J.; Briganti, Jonathan S.; Stamper, Michael J.; Porter, Nathaniel D.; Brown, Anne M.; Harden, Samantha M.; Cooper, Lee D.; Dunsmore, Julie C. (Frontiers, 2022-06-10)
Mental wellness is a critical component of healthy development in emerging adulthood and serves to protect against stress and promote resilience against psychopathology. Emotion regulation is a key mechanism for effective prevention because of its role in socio-emotional competence and its transdiagnostic significance for psychopathology. In this feasibility study, a brief, time and cost-effective emotion regulation training program for emerging adults (BERT) was developed and tested using the RE-AIM framework. Importantly, building interventions within the context of an implementation framework, such as the RE-AIM framework, enhances the chances that an intervention will be able to scale out and scale up. First, the brainwriting premortem method was utilized to refine program content, conducting focus groups a priori to identify potential program failures prior to program implementation. Undergraduate students (n = 12) attended four focus groups presenting initial program content. Four clinicians were also interviewed to determine program barriers. Qualitative analyses aggregated participant feedback to identify compliments, changes, and concerns about BERT and critical feedback was immediately implemented prior to initial testing. BERT was rooted in cognitive-behavioral practices and informed by the Gross model of emotion regulation. The 5-week program was then examined in a college sample (N = 42) to evaluate implementation (low attrition, high content engagement, favorable attitudes, low incidence of technical errors, costs), reach (enrollment and completion demographics comparable to the population in which recruitment took place), and efficacy (positive change in emotion regulation pre- to post-program). Of the recruited participants, 36 remained in the study where 27 completed at least 80% of program content. Repeated-measures ANOVAs exhibited significant improvements in emotion regulation, psychological distress, and negative affectivity, suggesting promising initial efficacy. Initial data provide support for feasibility and a future randomized control trial. BERT has potential significance for promoting healthy development as its brief electronic format reduced barriers and the program development process incorporated stakeholder feedback at multiple levels to inform better implementation and dissemination.
Development and Preliminary Testing of an Online Brief Emotion Regulation Training (BERT) Program for Emerging Adults
Gatto, Alyssa Jo (Virginia Tech, 2022-07-21)
Mental wellness is a critical component of healthy development and serves as a way to protect against stress and promote resilience against psychopathology. Emerging adulthood is an important time to foster mental wellness as individuals adjust to changing social roles, such as transitioning to college. Emotion regulation is a key mechanism for effective prevention because of its role in socio-emotional competence and its transdiagnostic significance for psychopathology. In this dissertation study, a brief, time and cost-effective emotion regulation training program for emerging adults (BERT) was developed and tested. Phase 1 focused on program development. Phase 2 utilized the brainwriting premortem method to refine program content. Undergraduate students (n = 12) attended four focus groups presenting initial program content. Four clinicians were also interviewed to determine program barriers. Qualitative analyses aggregated participant feedback to identify compliments, changes, and concerns about BERT in preparation for the pilot, and critical feedback was immediately implemented. In Phase 3, the 5-week program was pilot-tested in a college sample (N = 42) to evaluate Implementation (low attrition, high content engagement, favorable attitudes, low incidence of technical errors, costs), Reach (enrollment and completion demographics comparable to the population in which recruitment took place), and Efficacy (positive change in emotion regulation pre- to post-program). Twenty-seven participants completed at least 80% of program content. Chi-square analyses did not show any significant difference between participants who started the study and those who dropped out. Repeated measures ANOVAs exhibited significant improvements in emotion regulation, psychological distress, anxiety, stress, negative affectivity, and quality of life, suggesting promising initial efficacy. Development of BERT has high potential significance for promoting healthy development because the electronic delivery and brief nature of the program will reduce barriers to adoption and Implementation and the program development process that incorporates stakeholder feedback at multiple levels is expected to improve program Reach and Efficacy. The program development process, which incorporates stakeholder feedback at multiple levels, informs better implementation and dissemination.
Dissemination and Implementation Science Approaches for Occupational Safety and Health Research: Implications for Advancing Total Worker Health
Guerin, Rebecca J.; Harden, Samantha M.; Rabin, Borsika A.; Rohlman, Diane S.; Cunningham, Thomas R.; TePoel, Megan R.; Parish, Megan; Glasgow, Russell E. (MDPI, 2021-10-21)
Total Worker Health^® (TWH), an initiative of the U.S. National Institute for Occupational Safety and Health, is defined as policies, programs, and practices that integrate protection from work-related health and safety hazards by promoting efforts that advance worker well-being. Interventions that apply the TWH paradigm improve workplace health more rapidly than wellness programs alone. Evidence of the barriers and facilitators to the adoption, implementation, and long-term maintenance of TWH programs is limited. Dissemination and implementation (D&I) science, the study of methods and strategies for bridging the gap between public health research and practice, can help address these system-, setting-, and worker-level factors to increase the uptake, impact, and sustainment of TWH activities. The purpose of this paper is to draw upon a synthesis of existing D&I science literature to provide TWH researchers and practitioners with: (1) an overview of D&I science; (2) a plain language explanation of key concepts in D&I science; (3) a case study example of moving a TWH intervention down the research-to-practice pipeline; and (4) a discussion of future opportunities for conducting D&I science in complex and dynamic workplace settings to increase worker safety, health, and well-being.
Dissemination in Extension: Health Specialists' Information Sources and Channels for Health Promotion Programming
Strayer, Thomas E.; Balis, Laura E.; Ramalingam, NithyaPriya S.; Harden, Samantha M. (MDPI, 2022-12-12)
In the National Cooperative Extension System (herein: Extension), state-level specialists serve as key intermediaries between research, educators, and the community members they serve. There is a need to understand information seeking and sharing practices (i.e., dissemination) among specialists to increase the adoption of evidence-based health promotion programs. Specialists (N = 94) across 47 states were identified and invited to participate in this mixed methods study. A one-way ANOVA with Bonferroni corrections was used to analyze survey data. Data collected through semi-structured interviews were analyzed using an immersion crystallization approach. Forty-seven health specialists completed the survey representing 31 eligible states (65%) and were predominately female (89%), Caucasian (70%), had a doctorate (62%), and were employed within Extension for 10.2 + 9.7 years. The information sources used most frequently were academic journals and other specialists, and most used email and online meetings to communicate. Qualitative findings support the use of other specialists as a primary source of information and indicate specialists’ desire for an on-demand, bi-directional, online national repository of Extension programs. This repository would facilitate the dissemination of evidence-based programming across the system and reduce program duplication as well as information burden on county-based educators.
Dissemination of Health Promotion Information in Cooperative Extension: A multi-study exploration of channels, sources, and characteristics that influence intervention uptake
Strayer, Thomas Edward III (Virginia Tech, 2019-05-09)
A translational gap exists between the development of an evidence-based health promotion intervention and its eventual implementation in the intended setting. This lack of translation impacts the uptake of health promotion interventions within delivery systems such as the Cooperative Extension Service (Extension). Within this system, Extension educators serve as the intermediaries addressing needs in the communities in which they are employed with support from Extension health specialists. Previous research has shown that educators utilize other peer educators and specialists to learn and adopt health promotion programming, but these studies are over two decades old (e.g., missing technological advances such as Internet and social media) and often focused on a single state Extension system. The purpose of this research was to understand how evidence-based health promotion intervention information is shared within Cooperative Extension by 1) identifying information sources and channels of Extension specialists and educators while 2) identifying the characteristics of an intervention that aid in the adoption and uptake of these health promotion interventions. The first mixed-methods study aimed to identify information sources and channels used by Extension educators from a national sample and learn their preferences for information delivery. Results of this study (Manuscript 1), identified specialists as the key information source Therefore, the second study (Manuscript 2) focused on Extension health specialists' preferences for information sources and channels while also 1) determine how specialists communicate with educators 2) preliminary thoughts on a dissemination intervention. The final study (Manuscript 3) explored the intervention characteristics that are both educator and specialists deemed most important to their adoption decision-making process. The results of this dissertation inform the development of a dissemination intervention to bridge the translational gap across Extension. The information sources and channels used and trusted by both Extension educators and specialists are highlighted in this work. Additionally, specialists have given insight for consideration for an online repository that can be used on demand to both facilitate the adoption and uptake of health promotion interventions as needed by Extension Educators.
Effectiveness of a Worksite-Based Weight Loss Randomized Controlled Trial: The Worksite Study
Almeida, Fabio A.; You, Wen; Harden, Samantha M.; Blackman, Kacie C. A.; Davy, Brenda M.; Glasgow, Russell E.; Hill, Jennie L.; Linnan, Laura A.; Wall, Sarah S.; Yenerall, Jackie; Zoellner, Jamie M.; Estabrooks, Paul A. (Wiley-Blackwell, 2015-04-01)
Effects of Temperature and Tempo: Evaluating How Much Time in a Typical Community-Based Yoga Class Is Moderate-Intensity Aerobic Activity
Dysart, Anna; Harden, Samantha M. (MDPI, 2023-01-28)
The 2nd edition of the Physical Activity Guidelines for Americans (PAG) recommends, in part, 150 min of moderate-intensity aerobic physical activity. The PAG states that yoga may be able to help meet the guidelines for moderate-intensity aerobic exercise for adults and older adults. Our study aims to objectively measure the proportion of time participants’ activity that is categorized as moderate-intensity aerobic activity based on heart rate data and to subjectively measure rate of perceived exertion (RPE). Participants completed the Stanford Leisure-Time Activity Categorical item to establish baseline PAG aerobic activity compliance. Participants then completed four separate 1-h yoga sessions at different tempos (cadence) and temperatures while wearing heart rate monitors. During and directly after the session they also marked their RPE on a modified 10-point scale. All participants reached moderate-intensity aerobic activity for at least some portion of a yoga session based on heart rate monitor data and RPE. The average duration of moderate intensity was 32.75% of the class across all four class types, with no significant differences by condition. Age was a significant factor in time spent in moderate-to-vigorous physical activity for only the thermo-neutral Hatha classes (p = 0.010). Tempo, temperature, and baseline activity levels were not significant factors in time spent in moderate-to-vigorous intensity physical activity based on Pearson Correlation and the Kruskal–Wallis test. Hatha and Vinyasa yoga classes, at room or hot temperatures, can be used to meet a portion of the PAG moderate-intensity activity recommendations.
Effects of vibrotactile feedback on yoga practice
Islam, Md Shafiqul; Lee, Sang Won; Harden, Samantha M.; Lim, Sol (Frontiers, 2022-10-31)
Participating in physical exercise using remote platforms is challenging for people with vision impairment due to their lack of vision. Thus, there is a need to provide nonvisual feedback to this population to improve the performance and safety of remote exercise. In this study, the effects of different nonvisual types of feedback (verbal, vibrotactile, and combined verbal and vibrotactile) for movement correction were tested with 22 participants with normal vision to investigate the feasibility of the feedback system and pilot tested with four participants with impaired vision. The study with normal-vision participants found that nonvisual feedback successfully corrected an additional 11.2% of movements compared to the no-feedback condition. Vibrotactile feedback was the most time-efficient among other types of feedback in correcting poses. Participants with normal vision rated multimodal feedback as the most strongly preferred modality. In a pilot test, participants with impaired vision also showed a similar trend. Overall, the study found providing vibrotactile (or multimodal) feedback during physical exercise to be an effective way of improving exercise performance. Implications for future training platform development with vibrotactile or multimodal feedback for people with impaired vision are discussed.
Enhancing Online Yoga Instruction: Evaluating the Effectiveness of Visual Augmentations for Performance Assessment
Gopal, Ajit Ayyadurai (Virginia Tech, 2024-10-23)
Yoga is a mind-body practice known for its substantial psychological and physiological benefit, contributing to a healthy lifestyle. However, without professional guidance, individuals may experience reduced performance and increased risk of injury. While online yoga classes on platforms like Zoom have grown in popularity, tools to support instructors in accurately assessing and monitoring student performance remain insufficient. For certain populations, this lack of real-time professional guidance poses safety risks and limits the effectiveness of the practice. This study examined the effectiveness of using computer-vision-based visual augmentations in enhancing instructors' ability to assess student performance and ensure safety. Specifically, we investigated the effectiveness of various visual augmentations in aiding instructors' visual search for unstable or unsafe poses. Eleven certified yoga instructors (8 female, 3 male), each holding 200 to 500 RYT certifications, participated in the study. Instructors completed eight trials assessing 12 yoga poses using four different visual augmentations—Raw Video, Skeleton (joint locations overlay), Contour (participant outlines), and Contour + Skeleton—across two camera views (Single vs. Multiple Views). During each trial, eye-tracking data was collected as instructors identified potentially unstable (unsafe) poses, and they subsequently completed a usability questionnaire and NASA - TLX rating. Upon finishing all trials, instructors provided overall feedback on the usability of the visual augmentations and camera views Instructors showed no significant difference in their assessment performance across different visual augmentations and camera views. The Skeleton augmentation led to increased cognitive workload, as indicated by larger pupil diameters. The Contour alone augmentation was less effective for visual search based on the usability ratings, and combining Contour with Skeleton did not offer notable improvements. Simpler visualizations, such as Raw and Skeleton, received higher usability ratings, and instructors preferred Single View layouts over Multiple Views for their ease of use and lower cognitive demand. In conclusion, while Skeleton augmentation increased cognitive load, it did not significantly enhance visual search performance. Future research should explore alternative visual augmentation techniques and configurations to better assist instructors on performance assessment which increases overall performance while not substantially increasing cognitive workload.
An Examination of Celebrity Endorsement Used to Promote Branded Food and Beverage Products to American Children, Adolescents and Young Adults to Inform Policies to Promote Healthy Food Environments
Zhou, Mi (Virginia Tech, 2020-04-09)
Celebrity endorsement is a global billion-dollar business used by food, beverage and restaurant companies to influence dietary behaviors that may contribute to overweight and obesity. Evidence suggests that existing government policies and industry self-regulatory programs in the United States (US) do not adequately protect young Americans from celebrity endorsement that promotes energy-dense and nutrient-poor food and beverage products. This PhD dissertation describes four studies that examine the nature, extent, and perceived influence of celebrity endorsement used by business firms and non-profit organizations to promote branded food and beverage products or branded campaigns to American children, adolescents and millennial young adults to inform future research and policies to promote healthy food environments. Study one created a database of US celebrities (n=732) involved with food and beverage group, brand or product endorsements (1990-2017) to examine celebrity profiles and their endorsement relationships, company partnerships, the nutritional profile of products and brands. Evidence was analyzed using Python version 3.5.5 and SPSS version 24. Study two examined celebrities associated with the Partnership for a Healthier America's Fruits and Veggies (FNV) Campaign (2015-2016). Evidence was analyzed using data visualization tools supported by Python and SPSS, and results informed the FNV Campaign. Study three used Q methodology to explore the views of Millennials, born 1981-1994 (n=40) at Virginia Tech about celebrity endorsement of food and beverage products and brands. Participants sorted 48 celebrity images depicting brand and product endorsements on a normal distribution (+4 to -4) based on celebrity trustworthiness and complete a post Q-sort questionnaire. Data analysis used PQMethod 2.35 statistical software program, centroid factor analysis, and qualitative interpretation of unique factor arrays for sorters. Study four identified relevant evidence about US celebrity endorsement of food and beverage products (2000-2019), used an accountability framework to evaluate the adequacy of accountability structures, and suggested future policies and action needed for diverse stakeholders to use celebrity endorsement to promote healthy food environments. Future research should explore the trend of celebrity endorsement used in the US marketplace and examine the influence of this marketing strategy on young people's food preferences and choices based on more representative experimental research.
Expanding methods to address RE-AIM metrics in hybrid effectiveness-implementation studies
Harden, Samantha M.; Galaviz, Karla I.; Estabrooks, Paul A. (2024-11-04)
Background: Dissemination and implementation science is an evolving field that focuses on the strategies and mechanisms by which scientific evidence is adopted, used, and sustained in clinical and community practice. Main body: Implementation scientists are confronted by the challenge to balance rigor and generalizability in their work while also attempting to speed the translation of evidence into clinical and community practice. Hybrid Effectiveness-Implementation studies and the RE-AIM framework were conceptualized to address these challenges. Hybrid Effectiveness-Implementation (HEI) studies provide methods of examining the effectiveness of health promoting interventions while concurrently assessing the utility of dissemination and implementation strategies designed to enhance the application of evidence-based principles in practice. RE-AIM provides a set of planning and evaluation dimensions that can be assessed with a goal to balance internal and external validity. The purpose of this commentary is to provide clarity on definitions of each approach and how to effectively use them together to answer research questions that will advance dissemination and implementation science for health promotion. Conclusions: We provide examples of concerted use of RE-AIM within HEI studies from the literature and focus on language to provide a clarity and consistency across research questions, designs, and settings. We share how to operationalize RE-AIM dimensions in HEI studies for both dissemination and implementation strategies. Future directions include refining, defining, and evaluating each RE-AIM dimension within hybrid studies.
Exploration of Sports Nutrition Knowledge, Nutrition Practices and Physical Performance on Standardized U.S. Navy Physical Fitness Assessments in an ROTC Population
Brooks, Alexa Rose (Virginia Tech, 2018-06-28)
Although physical fitness is regarded as a determinant of combat readiness, more than two-thirds of American military personnel are considered overweight or obese. While the U.S. Army recognizes nutrition as a priority with the development of the Performance Triad, nutrition education in the U.S. Navy remains retroactive, targeting only weight management and neglecting the role of nutrition in performance enhancement. There is limited data regarding the nutrition knowledge of the U.S. Navy population, a key factor in designing nutrition-focused programs, partially due to the lack of an appropriate assessment tool. The purpose of this study was two-fold: 1) validate an 86-item modified Nutrition for Sport Knowledge Questionnaire (M- NSKQ) using 15 Registered Dietitian Nutritionists (RDN) from across the country, and 2) assess sports nutrition knowledge, nutrition practices, and performance on physical fitness assessments (PFA) from a sample of 102 midshipmen in the Naval Reserve Officer Training Corps (NROTC) at Virginia Tech. The M-NSKQ assesses nutritional knowledge regarding weight management, macronutrients, micronutrients, hydration, nutrient timing, supplementation, and alcohol. The mean M-NSKQ score for RDNs was 84%, and questions with less than 50% correct responses were modified. Although no significant associations were found between M-NSKQ scores and PFAs for midshipmen, the mean M-NSKQ score was only 51%, and less than 10% met the daily recommendations for fruit, vegetables, grains, and dairy. Specific areas for improvement are discussed. These results highlight the need for nutrition education that is designed to address the gaps in knowledge and poor nutrition practices identified within this naval population.
An Exploration of the Relationship between Campus Recreation Usage at Virginia Tech and the COVID-19 Pandemic
Mengle, Julie (Virginia Tech, 2024-05-06)
Throughout the pandemic, Virginia Tech Recreational Sports operations were adapted in compliance with federal, state, and local guideline to ensure the safety of the students it serves as a department. Operational adjustments that were made included closures, limited capacities, and virtual programming to name a few. Participation rates in all areas of Virginia Tech Recreational Sports naturally saw a significant decrease during the pandemic due to these restrictions. This project investigated the impact of the COVID-19 pandemic on student engagement in campus recreation, or recreational sports, programs at Virginia Tech with a focus on facility gym swipes, group exercise attendance, and intramural sports involvement spanning three distinct time periods: pre-COVID (T1), during COVID (T2), and post-COVID (T3). Virginia Tech Recreational Sports data uploaded to Virginia Tech’s University Data Commons was used to analyze engagement numbers for students at the undergraduate and graduate level across various demographics including academic college, race/ethnicity, and gender. Statistical tests for significance were not able to be completed with the data in this study alone, so the results were only interpreted qualitatively. This study indicates that there has been a gradual return to pre-COVID engagement and participation levels in all areas of Virginia Tech Recreational Sports, but the return has been varied across each area. Intramurals appears to have higher involvement post-COVID than pre-COVID, whereas gym swipes and group exercise participation numbers have not returned to pre-COVID levels for most demographics. Return to pre-COVID participation levels varies between academic colleges, race/ethnicity, and gender for all areas. Research plays an integral role in informing decisions and developing strategies that will shape the future of campus recreation. Understanding how student engagement has evolved as a result of the pandemic can guide programmers within Virginia Tech Recreational Sports, specifically Director of Rec Sports Ali Cross, to make data-informed decisions for their offerings.
An Exploration of the Structure, Issue Framing and Priorities of Virginia's Food Policy Groups to Collaborate on a Healthy, Resilient and Sustainable Food System
Walker, Ayron Elizabeth (Virginia Tech, 2019-06-18)
Food policy groups (FPG) have emerged in the United States (U.S.) to create healthy, resilient and sustainable food systems. There is a lack of research about FPG in the Commonwealth of Virginia. This M.S. thesis describes a mixed-methods study that investigated the structure, issue framing, activities and priorities of diverse FPG in Virginia to develop a healthy, resilient and sustainable food system framed around three research objectives. Objective one used a scoping review to inventory and visually map the location of Virginia's FPG. Objective two administered a validated, online questionnaire to document activities related to organizational capacity, social capital, context, effectiveness, and community outcomes. Objective three used a semi-structured interview guide to explore stakeholders' views about opportunities and challenges to align diverse FPG priorities and interests. Quantitative data were analyzed using descriptive statistics and qualitative data were transcribed, hand-coded, and analyzed for emergent themes. Results found that 58% of FPG (n=32/55) are located cities around universities (i.e., Richmond, Blacksburg and Charlottesville), and fewer located in rural counties with higher health outcomes. A majority (75%, n=12/16) operated on annual budget less than $50,000. A third (37.5%, n=6/16) reported food system resilience work and 50% (n=8/16) reported sustainability work. Stakeholders (n=11) reported collaboration as a mutual interest and necessary to address systemic challenges and all interviewed FPG (n=11) reported sustainable funding as a major challenge. The results of this study may inform future policies for Virginia's FPG to support a healthy, resilient and sustainable food system at local, state and national levels.
Exploration of training as an implementation strategy to promote physical activity within community settings: research, theory, and practice
Ramalingam, NithyaPriya Shivanthi (Virginia Tech, 2018-05-02)
The prevalence of inactivity remains high, with more than 80 percent of adults failing to meet physical activity guidelines. Numerous evidence-based interventions for physical activity promotion have been developed and tested to address this need, but are typically not scaled-up and sustained in the intended practice setting. Many of these physical activity promotion programs suggest community-based delivery, often requiring researchers to train delivery personnel on intervention components. However, there is a paucity of detail on for whom, under what conditions, and how training mechanism are effective in practice. The purpose of this research was to explore the questions related to the research, theory, and practice of training. For research, a mixed-methods exploration of delivery personnel characteristics and perceived barriers and facilitators before and after program delivery or non-delivery was conducted. For theory, a systematic review of physical activity trainings for community-based delivery personnel was conducted in the literature to determine the characteristics of those who were trained, the structural and mechanistic components of said trainings, and the effectiveness of these trainings. For practice, a case-study of existing training in a community based setting was conducted to determine training processes that are likely to be successful in the real world and to evaluate the feasibility of an observational tool for physical activity trainings. The results of this dissertation show that delivery personnel characteristics and skillset may impact the acceptability, appropriateness, and effectiveness of training. They also provide preliminary support for the inclusion and importance of peer support within physical activity trainings to increase the number and representativeness of people trained and increase comfort with the training material. Further, descriptions of training for in-person physical activity programs in community settings are vague and inadequate making them difficult to replicate. Taken together, these studies provide avenues for future research and practice to develop an evidence-base for training mechanisms.

Browsing by Author "Harden, Samantha M."

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