A mobility-impairing disability includes difficulty moving and maintaining body positions, handling, and moving objects, moving around in the environment, and difficulty with transportation. The negative impact of mobility impairments on daily life is profound and can lead to long-term negative health consequences. Mobility-impairing disabilities are associated with reduction in glucose tolerance, difficulty accessing healthy food, and physical inactivity. This dissertation investigated physical activity in people with mobility-impairing disabilities. First, Chapter 2 investigated the relationship between glucose disposal and physical activity in people with mobility-impairing disabilities. Chapter 3 explored collected survey data regarding physical access to food in a sample of 85 adults with mobility-impairing disabilities. The relationship between difficulty performing specific activities of daily living pertaining to food access and participation in muscle-strengthening activity was investigated. Chapter 4 consisted of an analysis of health-related outcomes to a 12-week self-guided Tai Chi and Qigong intervention compared to a video health information only control group. Results regarding the effects of physical activity on insulin sensitivity (Chapter 2) in people with mobility impairments were mixed. Self-reported muscle strengthening exercise frequency (Chapter 3) was negatively associated with difficulty loading or unloading groceries or other items from a car or transportation and difficulty with store check-out process. The results from Chapter 4 indicated no significant differences in handgrip strength following 12-weeks of self-guided Tai Chi and Qigong when compared to the control group. In sum, the overall results of this research indicated that physical activity is important for individuals with mobility impairments but that interventions to increase muscle strength in this group may need to be more specific or create more overload to elicit muscle-strengthening stimulus. Furthermore, the feasibility of conducting a remotely delivered exercise intervention in individuals with mobility impairments was confirmed; however, future research on a larger sample population is needed to determine the efficacy of this type of intervention on strength outcomes. Clinicians should continue to recommend regular exercise in people with mobility impairments due to the large body of research supporting its use across a variety of populations.

In the past decade, research has demonstrated the relationship between higher levels of self-compassion and lower levels of negative psychological outcomes. More recently, the concept of self-compassion has been explored within the context of various health behaviors. Very few studies have investigated the potential relationship between self-compassion and eating behaviors. Based on literature and the established relationship between negative self-evaluation and abnormal eating behaviors/eating disorders, the current study sought to examine correlations between self-compassion, eating behaviors, and stress in first time college freshmen. The study population consisted of 1478 participants; ages 18-22 years; females = 936 (63%), males = 541 (37%). Participants self-reported measures of the Perceived Stress Scale (PSS), the Three Factor Eating Questionnaire (TFEQ), and the Self Compassion Scale (SCS). PSS score, the overall score and individual subscale scores of SCS, and the three subscale scores of the TFEQ (restraint, disinhibiton, hunger) were examined with Pearson correlations. Results of this study indicate significant (p = < .05) differences between males and females in PSS and all three negative SCS subscales. There was a strong and consistent correlation between the eating behavior of disinhibition and all three negative constructs of self-compassion (self-judgment, r = .29; isolation, r = .23; over-identification, r = .28) in females. The eating behavior of restraint was similarly correlated with SCS self-judgment in females (r = .26). More research is needed to understand differences in stress, self-compassion, and eating behaviors between males and females and to better comprehend the weak associations between eating behaviors and the positive psychological constructs of self-compassion (self-kindness, common humanity, and mindfulness) for males and females. Additionally, future research should focus on the three subscales of disinhibition as they relate to the negative constructs of self-compassion. The preliminary results of this study suggest it would be beneficial, particularly to female college freshmen, to more fully understand the dynamics of the relationship between eating behaviors and self-compassion; this knowledge may help to better structure appropriate coping strategies for the prevention of disordered eating behaviors.

It is widely recognized that dietary protein induces greater satiety compared to carbohydrate and fat. Two separate trials were conducted to assess the use of protein as a dietary approach to manage energy intake (EI). The first, crossover trial, examined 24– hour EI after consuming a high protein bar (HP) vs. a high carbohydrate (HC) bar upon awakening on two separate days and a control, no bar day. Of the 54 participants who entered the trial, 37 subjects completed the study in its entirety. Results showed there was no significant difference in mean EI between the intervention days when the bars were consumed and the control day. The subjects consumed 1752±99 kcal on the control day, and 1846±75 and 1891±110 kcal on the days the HP and HC bars were consumed, respectively (P=0.591). However, compared to the control day, snack bar ingestion was significantly related to an increase in EI for the subjects who self-reported high weekly physical activity levels (n=11) (+22%; P=0.038 and +45%; P=0.030, HP and HC bars, respectively). These data suggest that individuals who have moderate to low physical activity levels compensate for the ingestion of energy bars (regardless of protein content) over a 24–hour period. The second parallel-arm, pilot trial examined the effect of 6 g daily gelatin ingestion vs. control on EI and weight change in healthy, overweight and obese women who initiated a walking program. Of the 37 women who entered the trial, 28 completed the six week trial. The results showed activity level (steps/d) increased in both groups (+ 22%, P=0.022). There was a significant group difference in mean EI at week 6 vs. baseline (–174±612 kcal/d and +197±320 kcal/d, P=0.001; gelatin and control groups, respectively). However, there was no significant between group difference for changes in weight, percent body fat and waist circumference. Those subjects having baseline Disinhibition scores of ≥12 gained significantly more weight throughout the study vs. those scoring <12 (P=0.004). These results indicate that daily gelatin ingestion may be a practical strategy for controlling EI among overweight and obese women initiating an exercise program.

Encouraging stair use may increase physical activity among college students. The overall goals of this study were to quantitatively and qualitatively evaluate a stair use initiative, which included a mural painting contest in a residential hall. The number of individuals exiting the stairs were counted and interview data were obtained regarding the visibility of the signs and murals and whether the signs or murals influenced stair use. Focus groups and interviews were conducted with the community assistants (CAs) and staff members involved with the project to obtain qualitative data on their perceptions and opinions of the mural painting event. It was hypothesized that the average number of individuals per half hour who used the stairs would significantly increase from baseline to post-test. To examine changes over time in individuals exiting the stairs, a quasi-experimental design was used with one baseline measurement and multiple posttests (n=5). Stair use was determined by counting individuals exiting the stairwells. Time differences in exiting stair use were examined with repeated measures analysis of variance (ANOVA). Descriptive statistics and t-tests were used to analyze interview data. Qualitative data were analyzed using a thematic analysis approach. There was a significant time effect on stair use (F=7.512, p =0.000) and a significant interaction between staircase and time (F=7.518, p=0.000). There was no significant interaction of gender over time (F=.037, p=0.997). A repeated measures ANOVA was conducted on each staircase individually and showed that significant time differences were only found in the Southwest staircase. Based on exit interviews (n=28), most students saw the directional signs (61%) and murals (89.3%). However, neither the signs (71.4%) nor the murals (82.1%) were perceived as influential on stair use. Data from the focus groups and interviews revealed that the mural painting contest did not occur as intended, because the contest piece did not take place. In conclusion, solely having residents of a residential hall paint murals in stairwells was insufficient for increasing stair use. A mural painting contest may be a viable approach if properly planned and implemented.