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- All Subjects: Nutrition
- All Subjects: Rural
- Genre: Masters Thesis
- Creators: Bruening, Meg
- Member of: Theses and Dissertations
Description
Fruit and vegetable (FV) consumption continues to lag far behind US Department of Agriculture (USDA) recommendations. Interventions targeting individuals' dietary behaviors address only a small fraction of dietary influences. Changing the food environment by increasing availability of and excitement for FV through local food production has shown promise as a method for enhancing intake. However, the extent to which local production is sufficient to meet recommended FV intakes, or actual intakes, of specific populations remains largely unconsidered. This study was the first of its kind to evaluate the capacity to support FV intake of Arizona's population with statewide production of FV. We created a model to evaluate what percentage of Dietary Guidelines for Americans (DGA) recommendations, as well as actual consumption, state-level FV production could meet in a given year. Intake and production figures were amended to include estimates of only fresh, non-tropical FV. Production was then estimated by month and season to illustrate fluctuations in availability of FV. Based on our algorithm, Arizona production met 184.5% of aggregate fresh vegetable recommendations, as well as 351.9% of estimated intakes of Arizonans, but met only 29.7% of recommended and 47.8% of estimated intake of fresh, non-tropical fruit. Much of the excess vegetable production can be attributed to the dark-green vegetable sub-group category, which could meet 3204.6% and 3160% of Arizonans' aggregated recommendations and estimated intakes, respectively. Only minimal seasonal variations in the total fruit and total vegetable categories were found, but production of the five vegetable sub-groups varied between the warm and cool seasons by 19-98%. For example, in the starchy vegetable group, cool season (October to March) production met only 3.6% of recommendations, but warm season (April to November) production supplied 196.5% of recommendations. Results indicate that Arizona agricultural production has the capacity to meet a large proportion of the population's FV needs throughout much of the year, while at the same time remaining a major producer of dark-green vegetables for out-of-state markets.
ContributorsVaudrin, Nicole (Author) / Wharton, Christopher (Christopher Mack), 1977- (Thesis advisor) / Bruening, Meg (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Villalobos, J. Rene (Committee member) / Arizona State University (Publisher)
Created2013
Description
Objectives Through a cross-sectional observational study, this thesis evaluates the relationship between food insecurity and weight status, eating behaviors, the home food environment, meal planning and preparation, and perceived stress as it relates to predominantly Hispanic/Latino parents in Phoenix, Arizona. The purpose of this study was to address gaps in the literature by examining differences in "healthy" and "unhealthy" eating behaviors, foods available in the home, how time and low energy impact meal preparation, and the level of stress between food security groups. Methods Parents, 18 years or older, were recruited during two pre-scheduled health fairs, from English as a second language classes, or from the Women, Infants, and Children's clinic at a local community center, Golden Gate Community Center, in Phoenix, Arizona. An interview, electronic, or paper survey were offered in either Spanish or English to collect data on the variables described above. In addition to the survey, height and weight were collected for all participants to determine BMI and weight status. One hundred and sixty participants were recruited. Multivariate linear and logistic regression models, adjusting for weight status, education, race/ethnicity, income level, and years residing in the U.S., were used to assess the relationship between food security status and weight status, eating behaviors, the home food environment, meal planning and preparation, and perceived stress. Results Results concluded that food insecurity was more prevalent among parents reporting lower income levels compared to higher income levels (p=0.017). In adjusted models, higher perceived cost of fruits (p=0.004) and higher perceived level of stress (p=0.001) were associated with food insecurity. Given that the sample population was predominately women, a post-hoc analysis was completed on women only. In addition to the two significant results noted in the adjusted analyses, the women-only analysis revealed that food insecure mothers reported lower amounts of vegetables served with meals (p=0.019) and higher use of fast-food when tired or running late (p=0.043), compared to food secure mothers. Conclusion Additional studies are needed to further assess differences in stress levels between food insecure parents and food insecure parents, with special consideration for directionality and its relationship to weight status.
ContributorsVillanova, Christina (Author) / Bruening, Meg (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Vega-Lopez, Sonia (Committee member) / Arizona State University (Publisher)
Created2014
Description
Background: Adequate consumption of fruit and vegetables has been shown to prevent chronic diseases, such as cardiovascular disease, high blood pressure, and type two diabetes. The majority of Americans still consume inadequate daily servings of fruit and vegetables, which include women. Inadequate consumption of fruit and vegetables can be contributed to multiple barriers that hinder consumption in both urban and non-urban areas. The Special Supplemental Nutrition Program for Women, Infant, and Children (WIC) has been shown to positively influence fruit and vegetable consumption by providing healthy foods, such as fruit and vegetables. This study aims to compare the fruit and vegetable consumption of WIC and non-WIC participants between urban and non-urban Rural-Urban Commuting Area (RUCA) codes. Methods: This study was a cross-sectional, secondary analysis of a single time point from the Snuggle Bug/Acurrucadito Study, which had a sample size of (n=53) participants. The participants were separated into two groups, WIC participants, and non-WIC participants, and then further divided based on their respected RUCA code for comparison purposes. The assessment of fruit and vegetable consumption assessment derived from the participant’s 3-day food record. Results: The average consumption of fruit and vegetable consumption among participants was 3.8±2.5 servings There was an inverse relationship between WIC participation and fruit and vegetable consumption among all categories (fruit no juice -0.79, vegetables -0.32, vegetables no potato -0.32, fruit no juice and vegetables -1.1, and fruit no juice and vegetables no potato -1.1). However, none of the results were considered statistically significant. In addition, our study was unable to identify an association between fruit and vegetable consumption and locale due to the small sample size. Conclusions: There was no link observed between fruit and vegetable consumption and WIC participation. Further research of high quality is needed to confirm the relationship between fruit and vegetable consumption of WIC and non-WIC participants in urban and non-urban populations.
ContributorsOrtiz, Steven Michael (Author) / Bruening, Meg (Thesis advisor) / Whisner, Corrie (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2022
Description
Background:The second an individual is born, the gut microbiome starts acquiring unique characteristics, including microbial richness and evenness. In addition, it has been found that during infancy, the mode of delivery, antibiotic exposure, feeding patterns, and environment play a role in such development. However, infancy is still an understudied population related to the gut microbiota, specifically its’ connection to two modifiable factors-sleep-wake patterns and its’ interconnection with feeding practices in the first year of life.
Methods:
This secondary data analysis from a randomized longitudinal intervention study assessed the efficacy of a home-based education program in preventing the onset of childhood obesity. A convenience sample of 40 Hispanic mother and infant dyads were recruited to participate in an additional collection of fecal samples to evaluate associations between lifestyle/behavioral factors in infancy and gut microbiome composition in toddlerhood. Total sleep duration and feeding practices (breastmilk and formula) were assessed at one, six, and twelve months. In addition, alpha and beta diversity metrics were assessed from infant stool samples collected at 36 months.
Results:
This study found some significant and trending values for pairwise comparisons of alpha (Shannon Diversity Index) and beta (Bray Curtis and Jaccard Distance). Sleep-wake adequacy consisted of 14-17 total hours of sleep in 24 hours at one month and 12-16 hours for six and twelve months of age. No significant values were identified at one month of age. However, six and twelve months demonstrated significant observations for gut microbial richness and evenness. Trending differences (p=.06, Shannon Diversity Index) persisted in infants receiving adequate sleep at six months but for different feeding modalities. Faith’s PD, Pielou’s measure, and observed OTUs were three additional alpha-diversity metrics performed in all groups. Observed OTUs (p=.03) and Faith’s PD (p=.03) were significant at twelve months, demonstrating an increased microbial feature in infants receiving adequate sleep.
Conclusion:
The findings from this study may show how different timestamps in the first year of life may create gut microbial milestones. However, the interrelation between sleep-wake patterns, feeding modalities, and gut microbiome development is limited; further investigation is needed to monitor close changes and potentially create a criterion
ContributorsAlanis, Victoria (Author) / Whisner, Corrie M. (Thesis advisor) / Petrov, Megan E. (Committee member) / Bruening, Meg (Committee member) / Arizona State University (Publisher)
Created2022
Description
Purpose: Although numerous studies exist regarding the health impact of the Special, Supplemental Program for Women, Infants and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP) on their participants’, limited studies have examined how participation in one federal nutrition assistance program, may impact participation or perceived benefit of the other. This study aimed to examine how SNAP participation may impact weight-related pregnancy outcomes and participation of pregnant WIC participants. Methods: The present study is a cross-sectional, secondary data analysis of data available from the Arizona Department of Health Services. A total of 35,659 pregnant woman participated in the Arizona WIC program during 2018 and were included in the study. Pregnant participants were assigned to Group WIC or Group WIC+SNAP respectively. Data was aggregated to the clinic level and clinics with less than 10 pregnant participants were combined for a total of 101 clinics included in the analysis. Weight-related pregnancy outcomes measures included average pre-pregnancy weight, average gestational weight gain, BMI class, and delivery weight. Participation indicator outcomes included average number of visits during pregnancy, timing of first prenatal and postnatal WIC appointment, and entry into WIC within the first trimester. Race, ethnicity, language, and education were also analyzed.
Results: This study found average pre-pregnancy weight was statistically significant for women in group SNAP+WIC weighing 2.8 kg more than women in group WIC(p<0.001). Group WIC had a lower delivery weight average (p<0.001) and a higher amount of women beginning pregnancy with a normal BMI (p=0.004). Group WIC participants were statistically more likely to not enroll in WIC during the first trimester compared with Group WIC+SNAP (p=0.049). Group WIC was more likely to enroll in the 8th (p=0.045) and 9th month (p=0.009) of pregnancy and attend their first postpartum visit 6 months after delivery (p=0.007) as compared to Group WIC+SNAP.
Conclusions: This study found that pregnant WIC participants, not enrolled in SNAP have a lower pre-pregnancy weight and are more likely not to enroll within the first trimester. Future research should focus on individualized characteristics of WIC participants to further improve prenatal and postnatal support.
ContributorsStolworthy, Alexandra (Author) / Bruening, Meg (Thesis advisor) / Wadhera, Devina (Committee member) / Whisner, Corrie (Committee member) / Arizona State University (Publisher)
Created2022
Description
Objectives. To determine the association between parental level of acculturation using the Anglo Orientation Subscale (AOS) and the Mexican Orientation Subscale (MOS) derived from the Acculturating Rating Scale for Mexican Americans-II (ARSMA II) and their likelihood of serving green salad, vegetables, fruit, 100% fruit juice, and sugar-sweetened beverages during family meals. Methods. A sample of Hispanic parents of 6th, 7th, or 8th-grade adolescents (n=447; 39.8±6.8 years; 89.7% female) enrolled in a parenting intervention promoting healthy nutrition and substance use prevention. Parents completed baseline surveys to self-report whether they had family meals or not, acculturation-related questions, and the frequency with which they serve green salad, vegetables, fruit, 100% fruit juice, and sugar-sweetened beverages (SSB) during family meals. Associations between parental acculturation level and their likelihood of serving green salad, vegetables, fruit, 100% fruit juice and sugar-sweetened beverages during meal times were assessed with Spearman’s rank correlations. Results. There was a positive correlation between a higher level of acculturation on the Mexican Orientation Subscale (MOS) scale and the frequency of serving SSB during family meals (p=.006). There was a positive correlation between a higher level of acculturation on the Anglo Orientation Subscale (AOS) with the frequency of parents serving green salad (p=<.001), vegetables (p=<.001), and 100% fruit juice (p=.025) during family meals. Conclusion. Findings suggest that a higher Mexican orientation is associated with serving more sugar-sweetened beverages, and a higher Anglo orientation is associated with serving more green salad, vegetables, and 100% fruit juice to adolescents during family meals. Further research is needed to understand how the association of parental acculturation, home food environment, family meals, and socioeconomic status impact what they serve during family meals to their adolescents. A better understanding of what is served would help develop more evidence-based interventions that could help improve adolescents’ diet, which could help curb down obesity prevalence.
ContributorsOdell, Sandra P (Author) / Vega-Lopez, Sonia (Thesis advisor) / Ayers, Stephanie (Committee member) / Bruening, Meg (Committee member) / Arizona State University (Publisher)
Created2023
Description
OBJECTIVE: In 2020, the COVID-19 pandemic disrupted the health and wellbeing offamilies and communities alike. The purpose of this qualitative research study was to better understand the perspectives and experiences of Arizona mothers who gave birth and transitioned to parenthood during the COVID-19 pandemic. METHODS: This research study was a qualitative thematic analysis. Arizona residents aged 18 and older who gave birth after March 2020 and spoke English proficiently were eligible to participate in this research study. Participants completed a 90-minute virtual interview, answering questions about their overall perinatal experiences during the pandemic. Interviews were recorded, transcribed and reviewed for accuracy. A codebook of themes was created. The transcriptions were analyzed and coded using Delve software. RESULTS: In total, 18 interviews were coded for this study when saturation was reached. The average participant age was 31.78 ± 5.52 years and was predominantly White (89%). In total, 61% reported experiencing birth-related trauma and approximately 60% of participants were able to take parental leave, while 40% did not. Four principal themes emerged from data describing the transition to parenthood during the COVID-19 pandemic: 1) Maternal Experiences During COVID, 2) Navigating the Support System, 3) Perinatal Healthcare Insufficiencies, and 4) Retrospective Insights. Of these four primary themes, fourteen associated subthemes were also identified. CONCLUSION: The transition to parenthood is a multidimensional ecosystem centered around maternal and infant wellbeing with family, friends, community, and healthcare providers serving as primary influences. Inadequate healthcare, broken social networks, and diminished health promotion skills that bridge families to the care and support to thrive in parenthood have been reduced during the pandemic as women in this study exhibited poor mental health, faded self-efficacy, and reduced access to care.
ContributorsHoovler, Megan (Author) / Bruening, Meg (Thesis advisor) / Bever, Jennie (Committee member) / Reifsnider, Elizabeth (Committee member) / Arizona State University (Publisher)
Created2022
Description
Background: Studies have addressed food insecurity (FI) and fruit and vegetable (FV) consumption; however, not many have looked at the relationship between FI and FV consumption of caregivers with children. Researchers have not extensively evaluated if locale (urban and rural) plays a role in FV consumption. This cross-sectional study investigates the relationship between FI and consumption of FVs in caregivers and whether this relationship varies by locale. Methods: Caregivers with children completed baseline surveys as part of the Nutrition Incentive programs from the Gus Schumacher Nutrition Incentive Program (GusNIP) were included in analyses (n=3455; mean age= 33 ±0.12 years, 53.8% female). Caregivers reported their intake using the Dietary Screener Questionnaire (DSQ). The USDA 6-item food security screening module was used to assess food insecurity. Zip codes and Rural-Urban Continuum Codes (RUCC) were used to identify locale. Mixed linear models adjusted for sociodemographics (age, sex, race, and ethnicity), and clustered at the site level were used to assess the relationship between FV consumption and FI. Locale was examined as an interaction and was found to be not statistically significant, was included as a confounder in the models. Sensitivity analyses were conducted examining all FVs, FVs without potatoes included, FVs without juice included, and FVs without potatoes or juice. Results did not vary greatly, the aggregate FV variable is reported on below.
Results: The mean FV consumption was 4.83 +/- 0.060 servings. The prevalence of FI was 78.7%. FI was reported at 92.9% of urban households and 7.1% of rural households. The mixed linear model indicated that there was a significant relationship between FI and participant’s FV consumption (β=-0.51., 95% CI: -0.81, -0.22). This study found a relationship between FV consumption and locale only.
Conclusion: Caregivers’ FV consumption was significantly related to FI status; however, locale was not associated with their FV consumption. Research should further investigate the relationship between locale and FV consumption with consideration in the adolescent aged population, as these findings may be limited given the relatively small proportion of families living in rural settings.
ContributorsNieforth, Julia (Author) / Bruening, Meg (Thesis advisor) / Fricke, Hollyanne (Committee member) / Parks, Courtney (Committee member) / Ojinnaka, Chinedum (Committee member) / Arizona State University (Publisher)
Created2022
Description
Objectives. To determine how health-related conversations between parents and their adolescent children are associated with mealtime media device use by adolescents. Methods. A sample of Hispanic parents (n=344; 40.4 ± 6.6 years; 89.2% female) of 6th, 7th, or 8th-grade adolescents enrolled in a parenting intervention promoting healthy nutrition and substance use prevention. Parents completed baseline surveys to self-report the frequency with which they had health- or weight-related conversations with their adolescent child, and the frequency with which the adolescent used media devices during mealtimes (television/movie watching, cellphone use/texting, hand-held gaming devices, listening to music with headphones). Associations between health-related conversations and mealtime media devices were assessed with Spearman’s rank correlations. Chi-square tests and crosstabs were used to identify differences in parents setting limits on media use during mealtime depending on adolescent gender. Independent sample t-tests were used to compare the frequency of health- and weight-related conversations and media device use during mealtime based on adolescent gender. Results. Reported conversations about healthy eating, being physically active, and general weight of the adolescent were not associated with reported use of media devices by adolescents during mealtimes. Having conversations related to the adolescent weighing too much was positively and significantly correlated with television/movie watching (r=0.213; p<0.001), talking on a cellphone (r=0.119; p=0.034), using hand-held gaming devices (r=0.131; p=0.022), and listening to music with headphones (r=0.129; p=0.022). Having conversations about exercising to lose weight was also significantly correlated with television/movie watching during mealtimes (r=0.134; p=0.017). Parents reported having more frequent conversations about weighing too much with males when compared to adolescent females (2.45 ± 1.43 vs. 1.93 ± 1.28; t-stat= 3.58; p=0.005). Parents also reported more frequent weight-related conversations overall (weight-related scale) with males when compared to female adolescents (2.73 ± 1.39 vs 2.52 ± 1.26; t-stat=1.51; p=0.024). Conclusion. Findings suggest that higher frequency of weight-related conversation is associated with higher usage of media devices during mealtimes. Whether parenting practices, parental concerns about their children’s weight, and the home mealtime environment play a role on adolescent weight status in Hispanic households warrants further investigation.
ContributorsMartinez, Gabriela (Author) / Vega-Lopez, Sonia (Thesis advisor) / Bruening, Meg (Committee member) / Ayers, Stephanie (Committee member) / Arizona State University (Publisher)
Created2022
Description
Background: The Special Supplemental Nutrition Program for Women, Infant andChildren (WIC) provides participants with a supplemental food package that follows the
Dietary Guidelines for Americans (DGA’s). The WIC food package has been shown to
improve the diet quality and overall health status of WIC participants. Since the 2009
WIC food package revision, standard issuance of 1% or fat-free milk has been practiced
for participants 24 months or older. Improving the value that participants have on the
WIC foods can be an effective method to improve redemption of WIC foods and improve
overall participation. The aim of this study was to examine if allowing issuance of 2%
milk when clients refuse issuance of 1% or skim milk would affect benefit redemption of
milk and other WIC foods. The study also examined how providing clarification through
training on policy change for issuance of 2% milk would improve staff and director
knowledge of this change in policy.
Methods: This study was an observational, longitudinal study that used linear regression
analysis of aggregated data at the local agency-level from the Arizona WIC program.
Redemption data were analyzed using the Arizona WIC Health and Nutrition Delivery
System (HANDS) at three different intervals throughout the study. The three months
prior to the policy introduction (March-May 2020), redemption after policy introduction
(July-September 2020), and redemption after policy clarification with 2% milk policy
trainings (December 2020-February 2021). Redemption was measured as benefits issued
versus benefits redeemed. Two separate surveys were delivered (via Qualtrics) to the 18
local agency directors (n=18) and their staff members (n=287). These surveys were used
for descriptive purposes.
Results: The results of this study found that there was a decrease in redemption of 2%
milk and all foods at the post intervention stage of the study. WIC staff were found to
have a better understanding of policy to issue 2% milk. Conclusion: Although these
findings are consistent with other current research, further research is needed to examine
how changing policy on current food restrictions placed on WIC foods affects redemption
and how this may improve overall participation.
ContributorsZacarias, Ivan (Author) / Bruening, Meg (Thesis advisor) / Reifsnider, Elizabeth (Committee member) / Whisner, Corrie (Committee member) / Arizona State University (Publisher)
Created2022