Background: First-generation college students (FGCS) often experience more stress compared to continuing-generation students (Holden et al., 2021). This stress can stem from familial and cultural obligations, financial challenges, and the experience of being part of a racial or ethnic minority group. Storytelling is a psychosocial process involving sharing personal experiences or fictional stories, usually reflecting the behavior patterns and orientation to events present in the culture of the teller. Limited research has explored storytelling interventions to address self-compassion and stress levels in first-generation college students Aims: This pilot study aimed to assess the feasibility and preliminary effects of a storytelling intervention for first-generation college students on perceived stress, resilience, and self-compassion, as determined by pre- and post-intervention. In addition, the incorporation of heart rate variability (HRV) measurements during storytelling quantified the physiological stress levels associated with the intervention and its potential correlation with stress reduction. Of additional interest was to obtain a qualitative characterization of the experiences, stresses, and supportive factors described in the stories told by participants. Methods: FGCS were recruited at Arizona State University. Participants (N=22, M age=21.18 years, SD=3.172) attended a storytelling session for one hour in person. Heart-rate variability assessment was used to measure participant emotions and psychological coherence during in-person storytelling. The outcome measures included the Brief Resilience Scale (BRS), Perceived Stress Scale-10 (PSS-10), Patient Health Questionnaire-4 (PHQ-4), Self-Compassion Scale Short Form (SCS-SF), and HRV coherence was assessed during the intervention. Quantitative analyses were conducted in SPSS Version 27. Using the content of the stories shared in the intervention, qualitative content analyses were conducted with 3 research project members. Results: A total of 36 participants agreed to be contacted and were emailed. Of these 36, 10 declined to participate and 4 were ineligible due to unwillingness to commit to 2 hours over 2 weeks to complete the study, (including an in-person visit to the lab) yielding 22 consented participants (61% recruitment of those screened). All consented individuals completed data collection, attended a storytelling intervention session, and completed the post-intervention data collection (100% retention). 5 major themes emerged from the data: (1) Barriers within Journey; (2) Immigrant and Immigrant Family Experiences; (3) Facilitators within Journey; (4) Reasoning for Attending University. The direction of change for HRV coherence with self-compassion and depression-anxiety was as expected. T-tests were generated for pre- and post- intervention self-reports: T1-T3 BRS SD= 0.79247, t= -0.673; T1-T3 PSS SD= 5.39540, t= -0.514; T1-T3 PHQ for anxiety SD= 1.91429, t= 0.111; T1-T3 PHQ for depression SD= 1.62302, t= 1.708; T1-T3 SCS SD= 0.46319, t= -1.956. Conclusions: Participants described telling and sharing their stories as therapeutic and regenerative. Statistical tests of emotional regulation with HRVB demonstrated minimal change in stress response, with an increase in self-compassion. A storytelling intervention demonstrates a promising coping tool as an avenue for retelling distressing events and increasing self-compassion and resilience.

Background: First-generation college students (FGCS) often experience more stress compared to continuing-generation students (Holden et al., 2021). This stress can stem from familial and cultural obligations, financial challenges, and the experience of being part of a racial or ethnic minority group. Storytelling is a psychosocial process involving sharing personal experiences or fictional stories, usually reflecting the behavior patterns and orientation to events present in the culture of the teller. Limited research has explored storytelling interventions to address self-compassion and stress levels in first-generation college students Aims: This pilot study aimed to assess the feasibility and preliminary effects of a storytelling intervention for first-generation college students on perceived stress, resilience, and self-compassion, as determined by pre- and post-intervention. In addition, the incorporation of heart rate variability (HRV) measurements during storytelling quantified the physiological stress levels associated with the intervention and its potential correlation with stress reduction. Of additional interest was to obtain a qualitative characterization of the experiences, stresses, and supportive factors described in the stories told by participants. Methods: FGCS were recruited at Arizona State University. Participants (N=22, M age=21.18 years, SD=3.172) attended a storytelling session for one hour in person. Heart-rate variability assessment was used to measure participant emotions and psychological coherence during in-person storytelling. The outcome measures included the Brief Resilience Scale (BRS), Perceived Stress Scale-10 (PSS-10), Patient Health Questionnaire-4 (PHQ-4), Self-Compassion Scale Short Form (SCS-SF), and HRV coherence was assessed during the intervention. Quantitative analyses were conducted in SPSS Version 27. Using the content of the stories shared in the intervention, qualitative content analyses were conducted with 3 research project members. Results: A total of 36 participants agreed to be contacted and were emailed. Of these 36, 10 declined to participate and 4 were ineligible due to unwillingness to commit to 2 hours over 2 weeks to complete the study, (including an in-person visit to the lab) yielding 22 consented participants (61% recruitment of those screened). All consented individuals completed data collection, attended a storytelling intervention session, and completed the post-intervention data collection (100% retention). 5 major themes emerged from the data: (1) Barriers within Journey; (2) Immigrant and Immigrant Family Experiences; (3) Facilitators within Journey; (4) Reasoning for Attending University. The direction of change for HRV coherence with self-compassion and depression-anxiety was as expected. T-tests were generated for pre- and post- intervention self-reports: T1-T3 BRS SD= 0.79247, t= -0.673; T1-T3 PSS SD= 5.39540, t= -0.514; T1-T3 PHQ for anxiety SD= 1.91429, t= 0.111; T1-T3 PHQ for depression SD= 1.62302, t= 1.708; T1-T3 SCS SD= 0.46319, t= -1.956. Conclusions: Participants described telling and sharing their stories as therapeutic and regenerative. Statistical tests of emotional regulation with HRVB demonstrated minimal change in stress response, with an increase in self-compassion. A storytelling intervention demonstrates a promising coping tool as an avenue for retelling distressing events and increasing self-compassion and resilience.

Objective: To examine the change in caregiver burden, stress, and heart rate variability (HRV) scores when family caregivers (FCG) of patients with Alzheimer’s disease (AD) used heart rate variability biofeedback (HRVB). Additional factors that could potentially moderate the effects of HRVB, such as education and income level, were separately examined. Methods: An 8-week HRVB intervention was compared to a music listening control (MLC) condition for 30 family caregivers (FCGs) of individuals with Alzheimer’s disease (AD) (and related dementias: ADRD). Analysis per education and income level were separately conducted. Results: The HRVB intervention with higher education and lower-income individuals showed more favorable HRV outcomes (noted to be slightly decreased in higher-income individuals). Perceived stress was reduced for both intervention groups, and caregiver burden levels decreased for all income groups, particularly in those with lower incomes. Discussion: Future researchers should increase the sample size, explore stratification based on income and education levels, and consider gender-based divisions, as these factors could yield valuable insights.

Meditation app usage is associated with decreases in stress, anxiety, and depression symptoms. Many meditation app subscribers, however, quickly abandon or reduce their app usage. This dissertation presents three manuscripts which 1) determined the behavioral, demographic, and socioeconomic factors associated with the abandonment of a meditation app, Calm, during the COVID-19 pandemic, 2) determined which participant characteristics predicted meditation app usage in the first eight weeks after subscribing, and 3) determined if changes in stress, anxiety, and depressive symptoms from baseline to Week 8 predicted meditation app usage from Weeks 8-16. In Manuscript 1, a survey was distributed to Calm subscribers in March 2020 that assessed meditation app behavior and meditation habit strength, and demographic information. Cox proportional hazards regression models were estimated to assess time to app abandonment. In Manuscript 2, new Calm subscribers completed a baseline survey on participants’ demographic and baseline mental health information and app usage data were collected over 8 weeks. In Manuscript 3, new Calm subscribers completed a baseline and Week 8 survey on demographic and mental health information. App usage data were collected over 16 weeks. Regression models were used to assess app usage for Manuscripts 2 and 3. Findings from Manuscript 1 suggest meditating after an existing routine decreased risk of app abandonment for pre-pandemic subscribers and for pandemic subscribers. Additionally, meditating “whenever I can” decreased risk of abandonment among pandemic subscribers. No behavioral factors were significant predictors of app abandonment among the long-term subscribers. Findings from Manuscript 2 suggest men had more days of meditation than women. Mental health diagnosis increased average daily meditation minutes. Intrinsic motivation for meditation increased the likelihood of completing any meditation session, more days with meditation sessions, and more average daily meditation minutes. Findings from Manuscript 3 suggest improvements in stress increased average daily meditation minutes. Improvements in depressive symptoms decreased daily meditation minutes. Evidence from this three-manuscript dissertation suggests meditation cue, time of day, motivation, symptom changes, and demographic and socioeconomic variables may be used to predict meditation app usage.

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.