Date Approved

6-16-2026

Embargo Period

6-16-2026

Document Type

Dissertation

Degree Name

Ph.D. Clinical Psychology

Department

Clinical Psychology

College

College of Science & Mathematics

Advisor

Danielle Arigo, Ph.D.

Committee Member 1

Tenelle Porter, Ph.D.

Committee Member 2

Leah M. Schumacher, Ph.D.

Committee Member 3

Philip Fizur, Psy, D.

Keywords

CVD;Digital;Engagement;Midlife;Physical activity;Women

Abstract

Women in midlife (ages 40-65) with risk factors for cardiovascular disease (CVD) need physical activity (PA) interventions that are informed by and address their daily challenges and life circumstances, to reduce their chances of premature mortality from CVD. Sustaining engagement with PA interventions remains a substantial challenge for women in midlife. The aims of the proposed study were to describe participants’ PA-relevant characteristics and intervention preferences and to identify their patterns of engagement with different PA support tools (tailored PA website, intervention involving pairing women as PA partners). With respect to engagement, there was limited between-person stability in engagement outcomes across days, with more variability attributed to within-person variation (and error; ICCs = 0.19-0.41). In the Website Studies, women’s satisfaction with their PA minutes the previous day was positively associated with their website use that day (d = 0.13), and this association was reversed between-person (d = -0.11). In the Partner Intervention, women’s PA motivation was positively associated with their likelihood of setting PA intentions, both between-person (OR = 7.41, 95% CI [3.67, 14.96], p < 0.001) and within-person (OR = 3.31, 95% CI [2.82, 3.90], p < 0.001). Researchers and clinicians may facilitate engagement in PA resources among women in midlife with CVD risk by focusing efforts on providing low-burden supports that address PA-relevant barriers (physical and mental health concerns, limited PA-specific support).

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