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Advisor(s)

Dorothy Pekmezi

Committee Member(s)

Robert Motl

Daniel Chu

Gregory Pavela

Thomas Buford

Document Type

Dissertation

Date of Award

1-1-2025

Degree Name by School

Doctor of Philosophy (PhD) School of Public Health

Abstract

Crohn’s disease is a chronic inflammatory disorder of the gastrointestinal tract, affecting approximately 1 million individuals in the United States. In addition to gastrointestinal symptoms, complications such as arthralgia, sacroiliitis, and osteopenia may diminish physical fitness and exacerbate disease burden. Physical activity is a promising complementary, non-invasive strategy for managing Crohn’s disease, yet few studies have examined outcomes across the entire activity continuum from sedentary behavior to vigorous exercise. This study sought to provide a nuanced understanding of activity patterns in adults with Crohn’s disease (n=47) by comparing them with age-, socioeconomic status-, and sex-matched healthy controls (n=45), exploring Social Cognitive Theory correlates, and assessing associations with disease-specific outcomes. Results indicated that, compared to healthy controls, the Crohn’s cohort exhibited lower total time in sedentary bouts (mean difference = +55.6 minutes per bout, p=.03), fewer daily sedentary periods (mean difference = -1.2 bouts per day, p=.01), and fewer breaks in sedentary time (mean difference = -1.0 breaks per day, p=.02). Self-reported and device-measured physical activity levels were similar between groups. Fisher’s z-test indicated that social support was more strongly correlated with device-measured light physical activity (z=1.8, p=.04) in the Crohn’s group, whereas in controls, exercise goal setting was more strongly associated with moderate-to-vigorous physical activity (z =-1.9, p=.03) and the number of active bouts per day (z=-1.6, p=.05). Bivariate correlation coefficients provided evidence of significant associations between activity patterns and disease outcomes (e.g., plasma C-reactive protein, clinical disease activity), with daily step count emerging as the only significant independent predictor of clinical disease activity (=-.52, p<.001). Findings from this study have implications for future intervention development aimed at promoting healthier activity patterns among adults with Crohn’s disease. Data obtained from a larger, more diverse sample of individuals with Crohn’s disease should be used to further examine associations between Social Cognitive Theory constructs and activity patterns, identify barriers and facilitators to physical activity, and evaluate intervention needs and preferences.

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