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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

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
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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

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
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As part of the recently passed Patient Protection and Affordable Care Act, chain restaurants with 20 or more locations nationwide are required to post calorie information on menus and menu boards in order to help consumers make healthier decisions when dining out. Previous studies that have evaluated menu-labeling policies show

As part of the recently passed Patient Protection and Affordable Care Act, chain restaurants with 20 or more locations nationwide are required to post calorie information on menus and menu boards in order to help consumers make healthier decisions when dining out. Previous studies that have evaluated menu-labeling policies show mixed results and the majority have been conducted in urban cities along the east coast. This study was the first to look at the effectiveness of menu labeling in a southwest population. The primary objective of this cross-sectional study was to determine if noticing or using calorie menu labels in a fast food restaurant was associated with purchasing fewer calories. A second aim of this study was to evaluate the relationship between socio-demographic characteristics and the likelihood of noticing and using menu labeling. Customer receipts and survey data were collected from 329 participants using street-intercept survey methodology at 29 McDonald's locations in low- and high-income neighborhoods throughout the Phoenix metropolitan area. The study population was 63.5% male, 53.8% non-Hispanic white, and 50.8% low-income. Results showed that almost 60% of the study sample noticed calorie menu labeling and only 16% of participants reported using the information for food or beverage purchases. Income was the only socio-demographic characteristic that was associated with noticing menu labeling, with higher-income individuals being more likely to notice the information (p=0.029). Income was also found to be associated with using menu labels, with higher income individuals being more likely to use the information (p=0.04). Additionally, individuals with a bachelors degree or higher were more likely to use the information (p=0.023) and individuals aged 36 to 49 were least likely to use the information (p=0.046). There were no significant differences in average calories purchased among those who noticed menu labeling; however, those who reported using calorie information purchased 146 fewer calories than those who did not use the information (p=0.001). Based on these findings it is concluded that calorie menu labeling is an effective public policy and that nutrition education campaigns should accompany national menu labeling implementation in order to make the policy more effective across all socio-demographic groups.
ContributorsGreen, Jessie (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Bruening, Meg (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Arizona State University (Publisher)
Created2014
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Description
Although many studies have looked into the benefits and consequences of consuming breakfast, most have not looked into the unintended consequences of breakfast being served at school; specifically the consumption of an additional breakfast. This cross-sectional study investigated the prevalence and health related outcomes of the consumption of an additional

Although many studies have looked into the benefits and consequences of consuming breakfast, most have not looked into the unintended consequences of breakfast being served at school; specifically the consumption of an additional breakfast. This cross-sectional study investigated the prevalence and health related outcomes of the consumption of an additional breakfast at school amongst youth using a survey assessing possible predictors (i.e. parental education, morning activities, race), the ASA-kids 24-hr dietary recall, and height and weight measurements. A total of fifty-eight participants (aged 13.5±1.6 years; 55.2% male) were recruited at after school library programs and Boys and Girls Clubs in the Phoenix, Arizona Metro Area during 2014. The main outcomes measured were BMI percentile, total calories, iron, sodium, carbohydrates, added sugar, and fiber. In the study, the prevalence of consumption of an additional breakfast at school at least once a week or more was 32.7%. There were no significant differences between the consumption of an additional breakfast and not an additional breakfast amongst the main outcomes measures. The directionality of the relationship between the consumption of an additional breakfast and overweight/obesity amongst youth was inverse (OR = 0.309; p-value = 0.121), but this was not significant. This study found that the consumption of an additional breakfast at school is not contributing to overweight/obesity in youth, nor does it alter overall caloric and nutrient intake. School breakfast programs are important for providing breakfast and key nutrients to youth.
ContributorsSimpson, Julie (Author) / Bruening, Meg (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Rider, Linda (Committee member) / Arizona State University (Publisher)
Created2015
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Description
Salad bars are promoted as a means to increase fruit and vegetable consumption among school-age children; however, no study has assessed barriers to having salad bars. Further, it is not known if barriers differ across school level. This cross-sectional study investigated the barriers to having salad bars across school level

Salad bars are promoted as a means to increase fruit and vegetable consumption among school-age children; however, no study has assessed barriers to having salad bars. Further, it is not known if barriers differ across school level. This cross-sectional study investigated the barriers to having salad bars across school level among schools without salad bars in Arizona (n=177). Multivariate binominal regression models were used to determine differences between the barriers and school level, adjusting for years at current job, enrollment of school, free-reduced eligibility rate and district level clustering. The top five barriers were not enough staff (51.4%), lack of space for salad bars (49.7%), food waste concerns (37.9%), sanitation/food safety concerns (31.3%), and time to get through the lines (28.3%) Adjusted analyses indicated two significant differences between barriers across school level: time to get through lines (p=0.040) and outside caterer/vendor (p=0.018) with time to get through lines reported more often by elementary and middle school nutrition managers and outside caterer/vendor reported most often by high school nutrition managers. There were several key barriers reported and results indicate that having an outside vendor/caterer for their meal programs and time to get through the service lines varied across school level. High schools report a higher percent of the barrier outside caterer/vendors and elementary and middle schools report a higher percent of the barrier time to get through the lines. Results indicate that research determining the approximate time it takes students to get through salad bar lines will need to be considered. More research is needed to determine if the barrier time to get through the service lines is due to selection of food items or if it is due to the enrollment size of the lunch period. Future research interventions may consider investigating food safety and sanitation concerns of middle school nutrition managers. Findings may be used to guide ways to decrease barriers in schools without salad bars.
ContributorsKebric, Kelsey (Author) / Bruening, Meg (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Adams, Marc (Committee member) / Arizona State University (Publisher)
Created2016
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Description
Objectives

This cross-sectional study sought to assess the eating and physical activity behaviors among in-state and out-of-state college freshmen attending Arizona State University and to determine if social connectedness mediated the relationship between residency status and eating and physical activity behaviors.

Methods

College freshmen from two dormitories were recruited for participation from Arizona

Objectives

This cross-sectional study sought to assess the eating and physical activity behaviors among in-state and out-of-state college freshmen attending Arizona State University and to determine if social connectedness mediated the relationship between residency status and eating and physical activity behaviors.

Methods

College freshmen from two dormitories were recruited for participation from Arizona State University’s Tempe campus. A 128-item survey assessing demographics, college life, eating and physical activity behaviors, and social connectedness was administered. In addition, participants completed up to three days of dietary recall. Multivariate linear regression models, adjusting for age, gender, race, ethnicity, highest parental education, dormitory, Pell grant status, number of dietary recalls, and availability of a weekend day of dietary recall were used to assess the relationships between residency status, social connectedness, and eating and physical activity behaviors.

Results

No associations were observed between residency status and calories, grams and percentage of calories from fat, and added sugar. There was a statistically significant association between residency status and moderate-to-vigorous physical activity (MVPA). In-state students reported 21 minutes less per day of MVPA than out-of-state students did (β=-20.85; 95% CI=-30.68, -11.02; p<0.001). There was no relationship between residency status and social connectedness. Social connectedness and eating and physical activity behaviors were not associated. Social connectedness did not mediate the relationship between residency status and eating and physical activity behaviors.

Conclusions

In-state and out-of-state students differed in their MVPA; however, this relationship was not mediated by social connectedness. Further studies are needed to confirm the relationship between MVPA and residency status. In addition, more studies are needed to assess the relationship between social connectedness and MVPA.
ContributorsNelson, Stephanie A. (Stephanie Anne), 1958- (Author) / Bruening, Meg (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Whisner, Corrie (Committee member) / Arizona State University (Publisher)
Created2016
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Description
Background: Latinos have disproportionately high rates of obesity and type 2 diabetes. Family-based interventions may reduce chronic disease risk among Latinos across generations.

Purpose: To assess the efficacy of Athletes for Life (AFL), a 12-week community-and-family-based behavioral intervention, for improving diet, physical activity (PA), anthropometrics, fitness, and biochemical outcomes among

Background: Latinos have disproportionately high rates of obesity and type 2 diabetes. Family-based interventions may reduce chronic disease risk among Latinos across generations.

Purpose: To assess the efficacy of Athletes for Life (AFL), a 12-week community-and-family-based behavioral intervention, for improving diet, physical activity (PA), anthropometrics, fitness, and biochemical outcomes among mostly Latino parents.

Methods: Parents with at least one child 6-11 years of age were randomized to active AFL participation (n=14) or a wait-list control (n=14) group. AFL consisted of twice weekly 90 minute sessions (45 minutes of nutrition-focused lessons and 45 minutes of PA participation) designed to promote fruit and vegetable consumption, reduction of sugar intake, and increasing habitual PA. Data were collected prior to and immediately after the 12 week intervention.

Results: Participants (37.9±7.2y) were mostly Latino (93%), Spanish speaking (68%), and women (93%). Relative to participants in the control group, AFL participants had a significant reduction in body fat (-1.1±1.2% vs. 0.2±1.2%; p=0.014), resting (-7.6±10.2 bpm vs. +2.1±6.8 bpm; p<0.01), exercise (-8.4±8.7 bpm vs. +0.4±7.3 bpm; p<0.01), and recovery heart rate (-11.9±12.8 bpm vs. -0.3±11.4 bpm; p=0.01), and one mile run time (-1.5±1.0 min vs. -0.1±0.9 min; p<0.01), and a significant increase in estimated VO2 peak (+1.9±1.9 ml/kg/min vs. 0.0±1.8 ml/kg/min; p=0.01). AFL participants also reported an increase in the number of days/week accumulating 30 minutes of MVPA (+0.8±3.2 vs. -1.5±2.3; p=0.004) and daily servings of fruits (+1.3±1.4 vs. +0.3±1.4; p<0.05) and vegetables (+1.8±1.7 vs. +0.1±1.2; p<0.05), relative to control participants. There were no significant differences between groups in changes in diet assessed by 3-day food record, accelerometer-measured PA, weight, blood pressure, visceral fat, biomarkers for cardiovascular disease or nutritional biomarkers.

Conclusions: Despite the lack of effects on diet and PA behaviors, AFL shows promising preliminary efficacy for reducing body fat and improving fitness among adult participants. Future research aimed at improving fitness among Latino parents with family-based intervention is warranted.
ContributorsChavez, Adrian (Author) / Vega-Lopez, Sonia (Thesis advisor) / Crespo, Noe (Committee member) / Hekler, Eric (Committee member) / Shaibi, Gabriel (Committee member) / Bruening, Meg (Committee member) / Arizona State University (Publisher)
Created2015
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Description
Although past literature has examined the prevalence of campus food pantries, most have not examined student satisfaction of campus food pantries the acceptability and feasibility of the campus food pantries in the U.S. This descriptive and quasi-experimental study assessed the acceptability and feasibility of campus food pantry intervention on two

Although past literature has examined the prevalence of campus food pantries, most have not examined student satisfaction of campus food pantries the acceptability and feasibility of the campus food pantries in the U.S. This descriptive and quasi-experimental study assessed the acceptability and feasibility of campus food pantry intervention on two campuses (Downtown Phoenix and Tempe) at Arizona State University (ASU). The acceptability measures were composed of 30 survey questions including demographics, satisfaction survey, and food insecurity questionnaires, which were abstracted from the U.S. Adult 10-Item Food Security Survey Module. The food pantry was open once a week at each site. Any ASU students who enrolled in Spring 2017 and visited a food pantry were eligible to participate in the study. A total of 39 ASU students participated in the study during January 2017 and February 2017 (48.1 % female, 42.3 % White). The number of surveys collected at each site was 52. The majority of students were first-year undergraduate students (57.9% Downtown Phoenix, 45.5% Tempe). Based on their answers to the U.S. Adult 10-Item Food Security Survey Module, 21.2% of students (n=11) indicated low food security, while 48.1% of students (n=25) indicated very low food security. Almost 70% of pantry users reported that they have experienced food insecurity. In this study, the majority (90%) of students were satisfied with the service, hours of operation, and location for both the Downtown and Tempe food pantries. Additionally, 85.7% of students reported that they need additional resources such as financial aid (49%), a career center (18.4%), health services (10.2%), and other services (8.2%). The Pitchfork Pantry operated by student, university, and community support. Total donations received between Fall 2016 and Spring 2017 were 4,600 food items. The study found that most students were highly satisfied with the campus food pantries and it was feasible to operate two pantries on the ASU campus. These findings can be used to contribute to future research into campus food pantries, which may be the solution for food insecurity intervention among college populations.
ContributorsKim, Ellie (Author) / Bruening, Meg (Thesis advisor) / Ransdell, Lynda (Committee member) / Vega-Lopez, Sonia (Committee member) / Arizona State University (Publisher)
Created2018
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Fruit and vegetable consumption among school children falls short of current recommendations. The development of Public-Private Partnerships (PPP), which combine the resources of government entities with the resources of private entities, such as businesses or not-for-profit agencies, has been suggested as an effective approach to address a number of public

Fruit and vegetable consumption among school children falls short of current recommendations. The development of Public-Private Partnerships (PPP), which combine the resources of government entities with the resources of private entities, such as businesses or not-for-profit agencies, has been suggested as an effective approach to address a number of public health concerns, including inadequate fruit and vegetable consumption. The United States Department of Agriculture's (USDA) Fresh Fruit and Vegetable Program (FFVP) provides fruits and vegetables as snacks at least twice per week in low-income elementary schools. In addition to increasing fruit and vegetable consumption behaviors at school, children participating in the FFVP have been found to make more requests for fruits and vegetables in grocery stores and at home, suggesting the impact of the program extends beyond school settings. The purpose of this multicase study was to describe key stakeholders' perceptions about creating PPPs between schools and nearby retailers to cross-promote fruits and vegetables in low-income communities, using the FFVP. Semi-structured interviews were conducted with participants from three cases groups: grocery store/produce managers (n=10), district FFVP personnel (n=5) and school FFVP personnel (n=12). Data were analyzed using a directed content analysis approach using constructs from the Health Belief Model, including benefits, barriers, strategies, and motivation. While findings varied by case group, key benefits of creating a PPP included the potential to increase store sales, to enhance public relations with the community, and to extend the impact of the FFVP to settings outside of schools. Barriers included offering expensive produce through the FFVP, time/labor-associated costs, and needing approval from authorities and supervisors. Strategies for developing a PPP included using seasonal produce and having clear instructions for teachers and staff. Stakeholders reported being motivated to create a PPP by the potential to improve health outcomes in children and by wanting to help the community. Both objective and subjective measures were suggested to measure the success of such a partnership. Finally, the educational component of the USDA's Supplemental Nutrition Assistance Program (SNAP-Ed) has the potential to serve as a catalyst for organizing a PPP between FFVP-participating schools and nearby grocery stores.
ContributorsGruner, Jessie (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Evans, Browynne (Committee member) / Bruening, Meg (Committee member) / Tasevska, Natasha (Committee member) / Hekler, Eric (Committee member) / Arizona State University (Publisher)
Created2017
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Background: Hispanic women are at high risk for Type 2 Diabetes (T2D), in part due to their high prevalence of obesity, which may influence the development of insulin resistance and disease onset. Unhealthy eating contributes to T2D risk. Dietary patterns are the combination of total foods and beverages among individual’s

Background: Hispanic women are at high risk for Type 2 Diabetes (T2D), in part due to their high prevalence of obesity, which may influence the development of insulin resistance and disease onset. Unhealthy eating contributes to T2D risk. Dietary patterns are the combination of total foods and beverages among individual’s over time, but there is limited information regarding its role on T2D risk factors among Hispanic women. Objective: To identify a posteriori dietary patterns and their associations with diabetes risk factors (age, BMI, abdominal obesity, elevated fasting blood glucose, and hemoglobin A1c) among overweight/obese Hispanic women. Design: Cross-sectional dietary data were collected among 191 women with or at risk for T2D using the Southwestern Food Frequency Questionnaire capturing the prior three months of intake. Dietary patterns were derived using exploratory factor analysis. Regression scores were used to explore associations between dietary patterns and diabetes risk factors. Results: The patterns derived were: 1) “sugar and fat-laden”, with high loads of sweets, drinks, pastries, and fats; 2) “plant foods and fish”, with high loads of vegetables, fruits, fish, and beans; 3) “soups and starchy dishes”, with high loads of soups, starchy foods, and mixed dishes; 4) “meats and snacks”, with high loads of red meat, salty snacks, and condiments; 5) “beans and grains”, with high loads of beans and seeds, whole-wheat and refined grain foods, fish, and alcohol; and 6) “eggs and dairy”, with high loads of eggs, dairy, and fats. The “sugar and fat-laden” and “meats and snacks” patterns were negatively associated with age (r= -0.230, p= 0.001 and r= -0.298, p<0.001, respectively). Scores for “plant foods and fish” were associated with fasting blood glucose (r= 0.152, p= 0.037). There were no other statistically significant relationships between the dietary patterns and risk factors for T2D. Conclusions: A variety of patterns with healthy and unhealthy traits among Hispanic women were observed. Being younger may play an important role in adhering to a dietary pattern rich in sugary and high-fat foods and highlights the importance of assessing dietary patterns among young women to early identify dietary traits detrimental for their health.
ContributorsArias-Gastelum, Mayra (Author) / Vega-Lopez, Sonia (Thesis advisor) / Der Ananian, Cheryl (Committee member) / Whisner, Corrie (Committee member) / Bruening, Meg (Committee member) / Hooker, Steven (Committee member) / Arizona State University (Publisher)
Created2018