Annmarie A. Lyles

A Mobile, Avatar-Based App for Improving Body Perceptions Among Adolescents: A Pilot Test

Background One barrier to effectively treating weight issues among adolescents is that they tend to use social comparison instead of objective measures to evaluate their own health status. When adolescents correctly perceive themselves as overweight, they are more likely to adopt healthy lifestyle behaviors. Objective The purpose of this pilot test was to develop and assess acceptability and usability of an avatar-based, theoretically derived mobile app entitled Monitor Your Avatar (MYA). Methods The MYA app was engineered for high school adolescents to identify, using avatars, what they thought they looked like, what they wanted to look like, and what they actually looked like based on body measurements. Results The MYA app was pilot-tested with male and female adolescents aged 15-18 years to assess for acceptability and usability. A total of 42 students created and viewed their avatars. The majority of the adolescents were female (28/42, 67%), age 16 years (16/42, 38%), white (35/42, 83%), non-Hispanic (36/42, 86%), in grade 10 (20/42, 48%), healthy weight for females (23/28, 82%), and obese for males (7/14, 50%). The adolescents had positive reactions to the avatar app and being able to view avatars that represented them. All but one student (41/42, 98%) indicated some level of comfort viewing the avatars and would use the app in the future to see how their bodies change over time. Conclusions Avatar-based mobile apps, such as the MYA app, provide immediate feedback and allow users to engage with images that are personalized to represent their perceptions and actual body images. This pilot study adds to the increasing but limited research of using games to improve health outcomes among high school adolescents. There is a need to further adapt the MYA app and gather feedback from a larger number of high school adolescents, including those from diverse backgrounds.

Stakeholders' Perceptions of Care Coordination: A Participatory Process

OBJECTIVE Children with special health care needs or chronic conditions are more likely to have unmet health needs than other children. The purpose of this study was to use a community engagement research strategy to assess the essential elements of care coordination that can serve as the foundation for a system-wide care coordination model for children with special health care needs. STUDY DESIGN As part of a summit designed to review the status of pediatric care coordination within the state of Arizona and a call to action, a qualitative descriptive study was conducted to solicit anonymous feedback from 104 stakeholders (family, health care provider, or community entity) on the strengths and areas of improvement in the current system that provides care to Arizona children with special health care needs. Data were analyzed using inductive content analysis. RESULTS Five essential categories crucial to building an effective and seamless care coordination model were extracted from the data: Communication, Insurance, Health Care Capacity, Provider Knowledge, and Family Education. CONCLUSIONS The results from this study can serve as the working foundation to build a system-wide model for pediatric care coordination throughout the state. Providing care coordination services involves many activities across a wide range of organizations and locations. Research that is inclusive of community stakeholders can determine essential components for building a foundation for care coordination.

The Value of Preparing PhD Students as Research Mentors: Application of Kram's Temporal Mentoring Model

The ability to successfully mentor others is an essential skill necessary for building and strengthening an infrastructure of well-prepared nurse faculty to accelerate advancements in nursing science. Mentoring is a fundamental part of the nurse faculty role, but new faculty are often unprepared to take on mentoring roles early in their academic career. Applied training in research mentoring initiated during doctor of philosophy (PhD) programs may better prepare future faculty to manage teaching and mentoring responsibilities earlier and with greater confidence. The unique opportunity exists for PhD students to engage in research mentoring with undergraduate nursing students, with probable benefits for both the mentor and the mentee. This manuscript uses Krams temporal mentoring model as a guide to examine the training experiences of 3 PhD students mentoring undergraduate nursing students and discusses the benefits and challenges associated with these mentoring relationships. Collectively, these experiences provide preliminary support and guidance for the development and adoption of formal PhD mentor training programs to better prepare future PhD nursing faculty for their mentoring responsibilities.

Adolescent Boys’ Reactions to Using Avatars to Represent Their Bodies

UNLABELLED The purpose of this study was to provide a detailed description of completing the Attitudes and Avatars Instrument in the classroom and explore the feasibility and acceptability of the instrument. METHODS The descriptive study included three written open-ended questions for data collection to which young adolescent boys responded after completing the Attitudes and Avatars Instrument. RESULTS Fifty-nine boys between 11 and 14 years of age completed the instrument in the time allotted and had an overall positive reaction. CONCLUSION As the Attitudes and Avatars Instrument continues to develop as a screening instrument, it is imperative to obtain feedback from boys of diverse races and ethnicities.

Modifiable Family Factors Among Treatment-Seeking Families of Children With High Body Mass Index: Report of a Pilot Study

PURPOSE The purpose of this pilot study was to explore parenting style and other potential family and social indicators of an obesogenic or weight-promoting family environment. Modifiable factors were sought on which to base a nursing behavioral intervention that could be combined with diet and exercise to reduce youth weight. METHODS Twenty-eight parents and their 9- to 18-year-old children who were seeking care for overweight responded to in-home surveys to characterize parenting style (warmth/responsiveness and control). We also examined the extent to which parent modeling of health behavior, child feeding practices, parent knowledge of nutrition, and family social characteristics differed by the control aspect of parenting style. RESULTS Nearly all youth and parents reported substantial parental love (responsiveness), suggesting little variability in the warmth aspect of parenting style. In contrast, considerable variability was found in the control (moderate versus high) aspect of parenting style. Large effect sizes indicated that mothers with moderate control perceived their lifetime weight to be higher, had more concern about their youths weight (p = .03), had better knowledge of nutrition, and had a lower body mass index (p = .02) than did mothers with high (firm or restrictive) control. Moderate effect sizes indicated that mothers with moderate control demonstrated better modeling behavior, higher perception of youth weight, practiced less pressure to eat, and had youth with lower body mass index and percent body fat than did mothers with high (firm or restrictive) control. Families who volunteered for the study kept their data gathering appointments, but we recommend a recruitment period of more than 4 months and the inclusion of several referral sites. DISCUSSION Further study of how parent control is related to youth overweight and how appropriate control can be achieved among families with teens who are overweight is recommended.

Longitudinal analysis of virtual community perceptions of cohesion: The role of cooperation, communication, and competition.

Online, virtual group interactions may help adherence to health promotion programs. The purpose of this study was to explore longitudinal relationships among dimensions of group cohesion and group-interaction variables to inform and improve group-based strategies within programs aimed at promoting physical activity in virtual communities. In all, 56 online virtual users completed a group dynamics–based physical activity promotion intervention and assessments of group cohesion and group interaction at baseline and 4 weeks. Friendly competition and cooperation were consistently strong predictors of cohesion. Facilitating a sense of friendly competition and cooperation may increase engagement in physical activity programs by bolstering group cohesion.