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- All Subjects: Nutrition
- Creators: Ohri-Vachaspati, Punam
Description
The purpose of this research was to analyze the EPODE Model for the development community-based interventions against childhood obesity and its transferability on a global scale. The Ensemble, Prevenons L'Obesite des Enfant (EPODE: Together Let's Prevent Childhood Obesity) Model was developed in France following the successful results of a community-based intervention there. The Model is illustrated by four pillars that are essential to program implementation and positive results. These pillars are: political support, research & evaluation, social marketing principles and public/private partnerships. Using these four pillars, the model has been transferred to diverse countries around the globe and has shown results in these diverse locations. In order to understand what makes this model so transferrable to so many diverse locations, this researcher traveled to the Netherlands, Belgium and France visiting program locations and interviewing professionals who have been involved in the development of the model, its modification and implementation. These interviews addressed specific modifications to the model that were made for implementation in the Netherlands and Belgium. This paper outlines the key transferrable components of this model and outlines a proposed model to be used in the United States.
ContributorsNielsen, Abigail Fanchon (Author) / Ohri-Vachaspati, Punam (Thesis director) / Barroso, Cristina (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution and Social Change (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2014-05
Description
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
Description
The purpose of this investigation was to evaluate the influence of tap water safety perceptions on plain water intake (PWI) and hydration status in US Latinx adults. Participants (n=492; age, 28±7 y; 37.4% female) completed an Adapted Survey of Water Issues in Arizona and household watersecurity experience-based scales. A sub-sample (n=55; age, 33±14 y; body mass index, 27.77±6.60 kg·m2) completed dietary recalls on two weekdays and one weekend day via Automated Self-Administered 24-hour Dietary Assessment Tool to determine average PWI and total water intake (TWI). A 24-h urine sample was collected on one recall day and analyzed for urine osmolality (UOsm). Binary logistic regression determined odds ratios (OR) for the odds of perceiving tap water to be unsafe. Hierarchical linear regression was employed with 24-h UOsm and PWI as primary outcomes for the sub-sample. Overall, 51.2% of all participants and 52.7% of the sub-sample mistrust their tap water safety. The odds of mistrusting tap water were significantly greater (P<0.05) for each additional favorable perception of bottled over tap water (OR=1.94, 95% CI=1.50, 2.50), each additional negative home tap water experience (OR=1.32, 95% CI=1.12, 1.56), each additional use of alternatives and/or modifications to home tap water (OR=1.25, 95% CI=1.04, 1.51), and decreased water quality and acceptability (OR=1.21, 95% CI=1.01, 1.45). The odds of mistrusting tap water were significantly lower (P<0.05) for those whose primary source of drinking water is the public supply (municipal) (OR=0.07, 95% CI=0.01, 0.63) and for those with decreased water access (OR=0.56, 95% CI=0.48, 0.66). There were no differences (n=55, P>0.05) in TWI (2,678±1,139 mL), PWI (1,357±971), or 24-h UOsm (460±234 mosm·kg-1). Tap water safety perceptions did not significantly explain variance in PWI or 24-h UOsm (P > 0.05). In conclusion, Latinx mistrust in tap water safety is prevalent. Mistrust appears to be influenced by organoleptic perceptions and to lead to reliance on alternatives to the home drinking water system. Perceptions of tap water safety do not appear to be related to PWI, TWI, or hydration status in Latinx adults.
ContributorsColburn, Abigail (Author) / Kavouras, Stavros (Thesis advisor) / Buman, Matthew (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Vega-Lopez, Sonia (Committee member) / Wutich, Amber (Committee member) / Arizona State University (Publisher)
Created2022
Description
Objective: To determine the consumption frequency of foods with added sugar among smoking groups: nonsmokers, cigarette smokers, vapers, and dual users in young adults ages 18-24.
Methods: An observational cross-sectional study was conducted using an online Qualtrics survey that included questions on demographics, smoking habits, and added sugar content and was distributed across multiple platforms for 3 months. There were 47 qualifying participants that completed the survey.
Results: There were not many cigarette user or dual user respondents, so the groups studied were modified to nonsmokers and vapers+dual users (VDU) and nonsmokers vs. nicotine users that consisted of cigarette smokers, e-cigarette users, and dual users. There were 30 (63.8%) nonsmokers, 16 (34.1%) VDU, and 17 or 36.2% of all nicotine users recorded. The added sugar consumption frequency by the three groups was similar with scores of 1.37, 1.50, and 1.54 for nonsmokers, vapers+dual users, and nicotine users, respectively.
Conclusion: There was a high number of reported vapers in this study, and nonsmokers had the lowest added sugar consumption frequency closely followed by the VDU and all nicotine users group. All groups studied had relatively low added sugar scores. More research is needed to successfully compare the added sugar content of the four intended groups.
Policy Implications: Anti-vaping policies should be targeted to this group.
ContributorsPeterson, Tiffany (Author) / Leischow, Scott (Thesis director) / Ohri-Vachaspati, Punam (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2022-05
ContributorsOhri-Vachaspati, Punam (Contributor) / Truong, S (Contributor) / Lorts, Cori (Contributor) / DeWeese, Robin (Contributor) / ASU School of Nutrition and Health Promotion (Contributor) / ASU Graduate and Professional Student Association (Funder)
Created2017-03
Description
The Supplemental Nutrition Assistance Program (SNAP) participants have been shown to have worse dietary behaviors compared to eligible non-participants. It is suggested that individuals who self-select into SNAP have unhealthy diets prior to program participation. This study examined the association between low-income adults’ SNAP participation status and dietary behaviors over time. A sample of households from low-income high-minority cities were surveyed at baseline (T1) and 2-4 years later (T2). Analyses were restricted to adults with household income < 200% of the federal poverty line (n=338). Participants were grouped into the four following categories: Long-term (n=171): SNAP participation at T1 and T2; Previous (n=47): SNAP participation at T1 but not T2; Current (n=38): SNAP participation at T2 but not T1; and Never (n=132): no SNAP participation at T1 or T2. Self-reported daily consumption frequency of whole fruits, fruit juice, vegetables, sugar-sweetened beverages (SSBs), and snacks were measured through self-reports. To observe dietary differences based on SNAP participation status, T2 behaviors of all groups were compared to those of the Never group. To observe dietary differences prior to SNAP participation, T1 behaviors were compared between Current and Never groups. There were no significant differences in dietary behaviors at T1 (prior to SNAP participation) between Never and Current participants providing no evidence of self-selection of unhealthy households into SNAP. Only marginal differences were found between SNAP participation status and dietary behaviors at T2. Improvements in SNAP participants’ diets may benefit from focusing on policy changes that encourage healthy dietary habits during participation in the program.
ContributorsUehara, Sarah (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Acciai, Francesco (Thesis advisor) / Ojinnaka, Chinedum (Committee member) / Arizona State University (Publisher)
Created2023
Description
In 2020, approximately 55% of households facing food insecurity participated in one or more of the three largest federal nutrition assistance programs. Food insecurity rates have been relatively unchanged since 2019 but federal nutrition assistance programs have continued to see a decline in participation. Many families meet the income guidelines to participate in both the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Assistance Program for Women, Infants and Children (WIC) programs, yet almost half of those participants are not utilizing WIC. The WIC program is an essential safety net for low-income families to combat food insecurity and improve diet quality. The purpose of this study was to examine differences in household characteristics among families participating in SNAP only and households participating in both SNAP and WIC. Additionally, we examined potential barriers and facilitators to participating in WIC among WIC-eligible SNAP participants. Hispanics made up 40% of SNAP Only households and about 65% of SNAP and WIC. Households with a larger number of beneficiaries and those with an infant in the household were more likely to participate in both SNAP and WIC. The main barriers identified by respondents previously enrolled in WIC were a lack of knowledge regarding WIC eligibility and issues with appointments. The two most common misconceptions regarding WIC eligibility were being unaware that simultaneous enrollment in both programs was allowable, and being unaware that household members were still eligible for WIC services. For the facilitators toward WIC enrollment, more than half of respondents knew to enroll in WIC when they needed nutrition or breastfeeding assistance. Results from this study suggest the need for targeted outreach campaigns that highlight the possibility and benefits of dual participation in SNAP and WIC. Understanding how SNAP can increase enrollment in WIC demonstrates to policymakers the benefits of streamlining the certification process.
ContributorsWaxman, Cayla (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Wadhera, Devina (Committee member) / Whisner, Corrie (Committee member) / Melnick, Emily (Committee member) / Arizona State University (Publisher)
Created2023
Description
Food insecurity is an economic and social condition involving limited or uncertain access to food. The problem of food insecurity in communities is influenced by economic conditions, food deserts, and barriers to accessing healthy food. Individuals experiencing food insecurity often endure concurrent problems of financial instability, hunger, and poor mental and physical health. Public and non-profit services in the U.S., such as the federally supported Supplemental Nutrition Assistance Program (SNAP) and community food banks, provide food-related assistance to individuals who are at a high risk of experiencing food insecurity. Unfortunately, many individuals who qualify for these services still experience food insecurity due to barriers preventing them from accessing food, which may include inadequate finances, transportation, skills, and information. Effective approaches for removing barriers that prevent individuals from accessing food are needed to mitigate the increased risk of hunger, nutritional deficiencies, and chronic disease among vulnerable populations. This dissertation tested a novel food insecurity intervention using informational nudges to promote food security through the elimination of information barriers to accessing food. The intervention used in this mixed-methods feasibility study consisted of informational nudges in the form of weekly text messages that were sent to food pantry clients experiencing food insecurity. The study aims were to test the efficacy and acceptability of the intervention by examining whether the informational nudges could enhance food pantry utilization, increase SNAP registration, and promote food security. Quantitative study results showed a lower prevalence of food insecurity in the intervention group than the control group. Qualitative findings revealed how the intervention group found the text messages to be helpful and informative. These study findings can enhance future food insecurity interventions aiming to eliminate barriers that prevent individuals who are food insecure from accessing healthy food.
ContributorsRoyer, Michael F. (Author) / Wharton, Christopher (Thesis advisor) / Buman, Matthew (Committee member) / Der Ananian, Cheryl (Committee member) / MacKinnon, David (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Arizona State University (Publisher)
Created2023
Description
The U.S. Department of Agriculture’s (USDA) National School Lunch Program and School Breakfast Program provide nutritious meals to school-age children. USDA’s Community Eligibility Provision (CEP) is designed to extend the reach of these programs by allowing schools in low-income areas to provide free school meals to all students at no cost to families. CEP has been shown to increase school meal participation, nutritional intake, academic achievement, and attendance in previous research studies. This study aims to examine the impact of long-term CEP participation on student weight outcomes. Nurse-measured height and weight data for school years 2013-14 to 2019-20 were collected from 141 K-12 public schools in four low-income cities. School-level prevalence of obesity was calculated from students’ heights and weights using the Centers for Disease Control and Prevention protocol. CEP participation for each school year was obtained from the state Department of Education. Schools in the sample began participating in CEP at different times yielding varying numbers of years of CEP exposure over the study period. Multivariable analyses examined the relationship between school CEP exposure and the prevalence of obesity, controlling for school-level covariates. Multivariable analyses showed that for every additional year of CEP participation, the school-level prevalence of obesity was 0.4% lower (p=0.018). The regression-adjusted obesity prevalence for schools that never participated in CEP was 28.0%, while the obesity prevalence for schools with 6 years of CEP participation was 25.4%. The lower prevalence of obesity in CEP-participating schools was primarily driven by elementary schools. These results suggest that the benefits of CEP participation can cumulate over time, significantly reducing school-level obesity prevalence over time.
ContributorsDykstra, Tatum Nicole (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Acciai, Francesco (Committee member) / McCoy, Maureen (Committee member) / Arizona State University (Publisher)
Created2024
Description
Background: Higher intake of carbohydrates in the evening and later eating times has been associated with higher total energy intake (TEI)1-3 and higher risk of being overweight or obese.1,4 Though existing evidence indicates a link between added sugars intake and increased body mass index (BMI), the effect of daily patterns of added sugars intake on TEI and BMI is unknown. Research on added sugars has relied on self-report dietary assessments with limited days of dietary data, resulting in unreliable estimates. The purpose of this thesis was to describe patterns of added sugars consumption, and to investigate the relationship between dietary sugars, eating patterns, TEI, and BMI using 15-days of dietary data from a feeding study. Methods: 40 participants age 18 to 70 years completed a 15-d highly controlled feeding study which imitated their normal diet, while recording meal times. Meals and snacks were coded based on participant identified, time-of-day, and meal content specific criteria. All consumed foods and beverages were carefully weighed and entered into the Nutrition Data System for Research (NDSR) for analysis. Pearson correlation, independent t-test, one-way repeated measures analysis of variance (ANOVA) with post hoc tests, and multiple linear regressions were used to investigate the association between patterns of added sugars and energy intake, as well as eating frequency (EF), with TEI and BMI. Results: 15-d median added sugars intake was 9.7% of total calories. The highest contribution to added sugars intake (% of g/d) came from snacks (44%) in women and from afternoon (39%) consumption in men. The highest contribution to TEI came from dinner (30%) and afternoon (34%) consumption in women, and from lunch (31%) or dinner (30%) and afternoon (35%) consumption in men. Total eating occasion (EO) frequency had a negative association with TEI (r = -0.31) and no association with % energy from added sugars. In multivariate regression models, besides sex, % energy from beverages only (Adjusted R2 = 0.41) and % added sugars from dinner (Adjusted R2 = 0.39) were significant predictors of TEI, while none of the variables were associated with BMI. Conclusion: Changing one’s pattern of eating, (EF and % energy from beverages only and % added sugars from dinner), may reduce TEI, potentially reducing BMI.
ContributorsGunnerson, Hannah Marie (Author) / Tasevska, Natasha (Thesis advisor) / Johnston, Carol (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Arizona State University (Publisher)
Created2019