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Objectives: Although childhood obesity has received growing attention, parents still fail to recognize overweight and obesity in their children. Accurate identification of overweight or obesity in their child is associated with the parent's responsiveness to interventions aimed at preventing weight-related health issues. Recent research shows that a child's age and

Objectives: Although childhood obesity has received growing attention, parents still fail to recognize overweight and obesity in their children. Accurate identification of overweight or obesity in their child is associated with the parent's responsiveness to interventions aimed at preventing weight-related health issues. Recent research shows that a child's age and gender are associated with parental misperception of their child's weight status, but little is known about the interaction of these factors across various age groups. This study examined the association between a wide range of parent, child, and household factors and the accuracy of parental perception of their child's body weight status compared to parent-measured body weight status. Methods: Data were collected from a random-digit-dial telephone survey of 1708 households located in five low-income New Jersey cities with large minority populations. A subset of 548 children whose parents completed the survey and returned a worksheet of parent-measured heights and weights were the focus of the analysis. Bivariate and multivariate analyses were performed to determine the factors significantly associated with parental perception of their child's body weight status. Results: Based on parent-measure heights and weights, 36% of the children were overweight or obese (OWOB). Only 21% of OWOB children were perceived by their parents as OWOB. Child gender, child body mass index (BMI) and parent BMI were significant independent predictors of parents' accuracy at perceiving their child's body weight status. Conclusion: Boys, OWOB children, and children of OWOB parents had significantly greater odds of parental underestimation of their body weight status. Parents had better recognition of OWOB in their daughters, especially older daughters, than in their sons, suggesting parental gender bias in identifying OWOB in children. Further research is needed regarding parental gender bias and its implications in OWOB identification in children.
ContributorsBader, Wendy (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Lloyd, Kristen (Committee member) / Crespo, Noe (Committee member) / Arizona State University (Publisher)
Created2013
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Availability and accessibility of foods in the home influence dietary behaviors. However, much of the literature involving measurement of the home food environment (HFE) has examined only self-reported data, and home food inventory tools have not been used to assess behavior change intervention efficacy. Thus, this quasi-experimental study was conducted

Availability and accessibility of foods in the home influence dietary behaviors. However, much of the literature involving measurement of the home food environment (HFE) has examined only self-reported data, and home food inventory tools have not been used to assess behavior change intervention efficacy. Thus, this quasi-experimental study was conducted to test the preliminary efficacy of a 10-week dietary behavioral intervention on the HFE, measured through the presence of fruits, vegetables, and sources of sugars in the household. Participants included 23 parents (21 females; age=36±5.5) of children 6-11 years old living in an ethnically diverse community within a Southwestern metropolitan area. Sociodemographic information was collected at baseline using a survey. A modified version of the Home Food Inventory was completed in the homes of participants by trained research assistants at baseline and following termination of the intervention. Relative to baseline, the intervention resulted in significant increases in availability of different types of fruits (7.7±3.2 vs. 9.4±3.1; p=0.004) and high fiber/low sugar cereal (2.3±1.4 vs. 2.7±1.4; p=0.033). There was a significant reduction in availability of sugar-sweetened beverages (3.2±1.9 vs. 1.7±1.3; p=0.004), and an increase in the number of households with accessible 100% fruit juice (3 vs. 17 households; p=0.001) and bottled/contained water (9 vs. 22 households; p<0.001). Moreover, there were meaningful changes in the number of households with accessible chocolate milk (7 vs. 0), strawberry milk (3 vs. 0), and diet soda pop (2 vs. 0). There was a significant increase in the number of households with accessible ready-to-eat vegetables (8 vs. 19 households; p=0.007), and ready-to-eat fruit (8 vs. 17; p=0.022), and a significant reduction in available prepared desserts (3.0±2.0 vs. 1.7±1.3; p=0.005), and candy (2.0±1.7 vs. 0.6±0.7; p<0.001). There were no significant changes in availability of vegetables and sugar-laden cereals, or accessibility of fresh fruit, fresh vegetables, dry cereal, candy, soda pop, desserts, and sports/fruit drinks. Overall, results suggest that the current dietary behavior change intervention resulted in positive changes in the HFE. Further research to confirm these results in a randomized controlled trial is warranted.
ContributorsCassinat, Rachel (Author) / Vega-Lopez, Sonia (Thesis advisor) / Bruening, Meredith (Committee member) / Crespo, Noe (Committee member) / Arizona State University (Publisher)
Created2015
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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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Background: Healthy eating plays critical roles in the prevention of many chronic diseases, but there are many barriers in life that prevent people from adopting and maintaining healthy diets. Thus, identifications of barriers that people perceive they have in trying to eat healthy can guide the strategies for dietary behavior

Background: Healthy eating plays critical roles in the prevention of many chronic diseases, but there are many barriers in life that prevent people from adopting and maintaining healthy diets. Thus, identifications of barriers that people perceive they have in trying to eat healthy can guide the strategies for dietary behavior change interventions by taking account of the barriers. Objective: The purpose of this study was to identify and quantify the perceived barriers to healthy eating (PBHE), to investigate the relationship between socioeconomic factors and PBHE, and to explore the associations between PBHE and dietary intake among parents of elementary-school aged children living in South Phoenix, AZ. Methods: Socioeconomic factors and PBHEs were obtained via survey and diet was assessed by two interviewer-assisted 24 h diet recalls. The associations between employment and PBHEs, education and PBHEs, and household monthly income and PBHEs were analyzed by Mann-Whitney Test, Kruskal Wallis Test, and Spearman’s correlation test, respectively. The relationship between PBHEs and dietary intake were analyzed by Spearman’s correlation test. Linear regression was used to assess the associations between total PBHE, and dietary intake (including added sugar, fruit and vegetable), adjusted by covariates (including socioeconomic status, birth country, age and gender). Results: Of 149 participants who completed the survey (mean age = 38.47±7.08 y), 136 completed the 24 h diet recalls. The mean reported total, social support, emotions and daily mechanics PBHE scores were 2.63±0.91, 2.52±1.16, 2.71±1.06, and 2.58±0.95, respectively, out of a 5-point scale. Daily fruit, vegetable, sugar-sweetened beverage, sweetened foods, and added sugar intake were reported as 1.66±1.56 servings, 2.45±1.43 servings, 1.19±1.30 servings, 2.02±2.12 servings and 49.93±31.17 g, respectively. Employment status was significantly associated with total PBHE (Z = -2.28, p=0.023), and support PBHE (Z = -2.623, p=0.009). Education was significantly related to total PBHE (χ2 = -7.987, p=0.046), and daily mechanics PBHE (χ2= 11.735, p=0.008). Household monthly income levels were significantly correlated to daily mechanics PBHE (r = -0.265, p=0.005). Added sugar was positively correlated with total PBHE (r=0.202, p=0.020), emotions PBHE (r=0.239, p=0.006), and daily mechanics PBHE (r=0.179, p=0.040). Sugar sweetened beverage intake was significantly related to emotions PBHE (r=0.183, p=0.035). When adjusting for socioeconomic factors in the regression analysis, there was no significant association between PBHE and diet intake. Conclusion: Overall, results suggest PBHEs listed in this study are mainly associated with socioeconomic factors, but they are not related to diet intake. Future studies will focus on the precise role of overcoming some identified barriers in improving healthy eating behaviors, and the causality between barriers and healthy eating.
ContributorsQiu, Chongying (Author) / Vega-Lopez, Sonia (Thesis advisor) / Crespo, Noe (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2018
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Description
Childhood obesity is a worsening epidemic in the U.S. with substantial racial/ethnic and socioeconomic disparities. Community-based approaches are necessary to target populations that are disproportionately affected by childhood obesity. The current randomized controlled trial assessed the effects of Athletes for Life (AFL), a 12-week community-based nutrition education and physical activity

Childhood obesity is a worsening epidemic in the U.S. with substantial racial/ethnic and socioeconomic disparities. Community-based approaches are necessary to target populations that are disproportionately affected by childhood obesity. The current randomized controlled trial assessed the effects of Athletes for Life (AFL), a 12-week community-based nutrition education and physical activity program that aims to improve cardiovascular fitness and promote healthy eating among families in the South Phoenix region, relative to a control condition. One of the goals of the intervention was to increase participating children's intake of fruits/vegetables and reduce their sugar intake, measured by a parent-reported food-frequency questionnaire. Data were collected on 110 child participants aged 6-11 years old. Relative to baseline values, participants in the intervention reportedly increased their fruit intake frequency by 0.12 + 2.0 times per day, whereas the control group decreased their intake by 0.32 + 1.28 times per day (p=0.026). Participants in the intervention group also increased their vegetable intake by 0.21 + 0.65 times per day, whereas control participants decreased their intake by 0.05 + 0.72 times per day (p=0.019). Participants in the intervention group decreased their intake of sugar-sweetened beverage (SSB) intake by 0.22 + 0.62 times per day, whereas control participants decreased their intake of SSBs by 0.04 + 0.40 times per day, however, the change observed in SSB intake was not significant between groups. Lastly, frequency of sugar-laden food intake decreased by 0.86 + 1.10 times per day among the intervention group, whereas control participants increased their intake by 0.02 + 1.10 times per day (p=0.033). The AFL study may serve as a framework for future community-based interventions to promote health in underserved areas.
ContributorsCirjan, Ioana Alina (Author) / Vega-Lopez, Sonia (Thesis director) / Crespo, Noe (Committee member) / School of Nutrition and Health Promotion (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
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Description
Although many studies have looked into the relationship between home food availability and dietary intake, few have assessed actual change in the home food environment as a result of an intervention program. This secondary data analysis of the Athletes for Life 3 (AFL3) program investigated the efficacy of a randomized

Although many studies have looked into the relationship between home food availability and dietary intake, few have assessed actual change in the home food environment as a result of an intervention program. This secondary data analysis of the Athletes for Life 3 (AFL3) program investigated the efficacy of a randomized controlled 12-week community-based, family-focused exercise and dietary behavior intervention program in improving the home food environment of families with children between the ages of 6 and 11 years old. A total of twenty-six adults from Phoenix, Arizona allowed research staff into their homes to assess variety of food availability, using a modified version of the Home Food Inventory and were randomized to either the AFL3 program or wait-list control group. The main outcomes of interest were change in availability of vegetables, fruits, sugar-sweetened beverages and desserts and WIC-approved breakfast cereal. There was a significant increase in the number of vegetable items (3.88 ± 0.85; p=0.006) and WIC-approved cereal items (1.16 ± 0.31; p=0.003) in the homes of the intervention participants, relative to the wait-list control group. Additionally, there was a significant decrease in the number of sugar-sweetened beverage items (1.18 ± 0.31; p=0.014) available in wait-list control participant homes. There were no other significant findings related to home food availability. Furthermore, dietary intake among adult participants did not significantly change as a result of change in home availability. In conclusion, the AFL3 intervention program was successful in eliciting small but significant changes at a household level related to vegetable and WIC-approved breakfast cereal availability.
ContributorsGhan, Emily (Author) / Vega-Lopez, Sonia (Thesis advisor) / Bruening, Meg (Committee member) / Crespo, Noe (Committee member) / Todd, Michael (Committee member) / Arizona State University (Publisher)
Created2016
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Description
Food shopping practices are important in promoting healthy eating habits. Whereas previous behavioral interventions have assessed the effects of such interventions on parent and child health behaviors and quality, few have examined their impact on food shopping practices. This study used a randomized controlled trial design to investigate the efficacy

Food shopping practices are important in promoting healthy eating habits. Whereas previous behavioral interventions have assessed the effects of such interventions on parent and child health behaviors and quality, few have examined their impact on food shopping practices. This study used a randomized controlled trial design to investigate the efficacy of Athletes for Life (AFL), a 12-week community-based, family-focused intervention program that targeted physical activity and dietary behavior, on food shopping practices among Latino parents with elementary school-aged children. A total of 140 Latino adults were randomized to the AFL intervention or a wait-list control group. AFL included weekly sessions that focused on nutrition education, meal planning, grocery shopping, and physical activity. Participants completed surveys at baseline and after the 12-week program to assess their frequency of use of healthy food shopping practices (i.e., nutrition facts panel use, ingredients list use, grocery list utilization), and whether they refer to specific nutrients within the nutrition facts panel. Intervention effects on the frequency of use of food shopping practices were analyzed using a logistic binomial regression. Effects on consulting specific nutrients within the nutrition facts panel were analyzed using a Quade’s analysis of covariance. Results showed that there was a significant increase in the utilization of grocery lists (2.45±1.42 vs. 1.64±1.57, p=.011, F=6.664), nutrition facts panels (2.76±1.30 vs. 1.40±1.24, p=<.0001, F=47.128), and ingredients lists (2.79±1.26 vs. 1.58±1.51, p=<.0001, F=20.055) among the intervention group participants. Additionally, participants in the intervention group increased their use of nutrition facts panels to look up individual nutrients, particularly calories (OR=4.162, 95% CI=1.762-9.833, p=.009), carbohydrates (OR=7.889, 95% CI=2.136-29.137, p=.018), protein (OR=12.013, 95% CI=2.479-58.222, p=.018), and sodium (OR=4.247, 95% CI=1.624-11.105, p=.027), compared to baseline use. These findings demonstrate that the AFL intervention program was successful in implementing a positive change among parents, which will presumably allow parents to make improvements in their food shopping behaviors that may in turn have an effect on their home food environment and dietary intake among adults and children within the home.
ContributorsCampoy, Mariah Rose (Author) / Vega-Lopez, Sonia (Thesis advisor) / Crespo, Noe (Committee member) / McCoy, Maureen (Committee member) / Arizona State University (Publisher)
Created2023