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There has been a push to create and implement school wellness policies. Childhood obesity statistics suggest that schools may have an important role to play in promoting wellness. Childhood obesity has become a significant problem in the United States. The percentage of obese children in the United States has more

There has been a push to create and implement school wellness policies. Childhood obesity statistics suggest that schools may have an important role to play in promoting wellness. Childhood obesity has become a significant problem in the United States. The percentage of obese children in the United States has more than doubled since 1970, and up to 33% of the children in the United States are currently overweight. Among the 33% of children who are overweight, 25% are obese, and 14% have type 2 diabetes, previously considered to be a condition found only in adults. This mixed-method study with a string qualitative component study examined three aspects of federally mandated local wellness polices. The study investigated the policies themselves, how the policies are understood in the local school setting, with a particular focus on the impact the policies have had on school meals. The bulk of the research data was generated through 8 in-depth interviews. The interviews were conducted with key stakeholders within 2 elementary school districts in Arizona. In addition, the evaluation of 20 local wellness polices was conducted via a rubric scoring system. The primary component found to be lacking in local wellness policies was the evaluation method. Recommendations for school districts include the establishment of a clear method of measurement.
ContributorsCrawford, Sara S (Author) / Mccarty, Teresa L. (Thesis advisor) / Molnar, Alex (Thesis advisor) / Montoya, Araceli (Committee member) / Arizona State University (Publisher)
Created2011
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The effects of preventive interventions are found to be related to participants' responsiveness to the program, or the degree to which participants attend sessions, engage in the material, and use the program skills. The current study proposes a multi-dimensional method for measuring responsiveness to the Family Bereavement Program (FBP), a

The effects of preventive interventions are found to be related to participants' responsiveness to the program, or the degree to which participants attend sessions, engage in the material, and use the program skills. The current study proposes a multi-dimensional method for measuring responsiveness to the Family Bereavement Program (FBP), a parenting-focused program to prevent mental health problems for children who experienced the death of a parent. It examines the relations between individual-level risk-factors and responsiveness to the program, as well as the relations between responsiveness and program outcomes. The sample consists of 90 caregivers and 135 children assigned to the intervention condition of an efficacy trial of the FBP. Caregivers' responsiveness to the 12-week program was measured using a number of indicators, including attendance, completion of weekly "homework" assignments, overall program skill use, perceived helpfulness of the program and program skills, and perceived group environment. Three underlying dimensions of responsiveness were identified: Skill Use, Program Liking, and Perceived Group Environment. Positive parenting and child externalizing problems at baseline were found to predict caregiver Skill Use. Skill Use and Perceived Group Environment predicted changes in caregiver grief and reports of child behavior problems at posttest and 11-month follow-up. Caregivers with better Skill Use had better positive parenting outcomes. Skill use mediated the relation between baseline positive parenting and improvements in positive parenting at 11-month follow-up.
ContributorsSchoenfelder, Erin (Author) / Sandler, Irwin N. (Thesis advisor) / Wolchik, Sharlene (Committee member) / Millsap, Roger (Committee member) / Barrera, Manuel (Committee member) / Arizona State University (Publisher)
Created2012
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This thesis explores concept of "global bioethics" in both its development as well as its current state in an effort to understand exactly where it fits into the larger field of bioethics. Further, the analysis poses specific questions regarding what it may contribute to this field and related fields, and

This thesis explores concept of "global bioethics" in both its development as well as its current state in an effort to understand exactly where it fits into the larger field of bioethics. Further, the analysis poses specific questions regarding what it may contribute to this field and related fields, and the possibility and scope associated with the continued development of global bioethics as its own discipline. To achieve this, the piece addresses questions regarding current opinions on the subject, the authorities and their associated publications related to global bioethics, and what the aims of the subject should be given its current state. "Global Bioethics" is a term that, while seen frequently in bioethics literature, is difficult to define succinctly. While many opinions are provided on the concept, little consensus exists regarding its application and possible contributions and, in some cases, even its very possibility. Applying ethical principles of health and medicine globally is undoubtedly complicated by the cultural, social, and geographical considerations associated with understanding health and medicine in different populations, leading to a dichotomy between two schools of thought in relation to global bioethics. These two sides consist of those who think that universality of bioethics is possible whereas the opposing viewpoint holds that relativism is the key to applying ethics on a global scale. Despite the aforementioned dichotomy in addressing applications of global bioethics, this analysis shows that the goals of the subject should be more focused on contributing to ethical frameworks and valuable types of thinking related to the ethics health and medicine on a global scale. This is achieved through an exploration of bioethics in general, health as a function of society and culture, the history and development of global bioethics itself, and an exploration of pertinent global health topics. While primarily descriptive in nature, this analysis critiques some of the current discussions and purported goals surrounding global bioethics, recommending that the field focus on fostering valuable discussion and framing of issues rather than the pursuit of concrete judgments on moral issues in global health and medicine.
ContributorsRuffenach, Stephen Charles (Author) / Robert, Jason S (Thesis advisor) / Maienschein, Jane (Committee member) / Hruschka, Daniel J (Committee member) / Arizona State University (Publisher)
Created2011
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Description
Encouraging stair use may increase physical activity among college students. The overall goals of this study were to quantitatively and qualitatively evaluate a stair use initiative, which included a mural painting contest in a residential hall. The number of individuals exiting the stairs were counted and interview data were

Encouraging stair use may increase physical activity among college students. The overall goals of this study were to quantitatively and qualitatively evaluate a stair use initiative, which included a mural painting contest in a residential hall. The number of individuals exiting the stairs were counted and interview data were obtained regarding the visibility of the signs and murals and whether the signs or murals influenced stair use. Focus groups and interviews were conducted with the community assistants (CAs) and staff members involved with the project to obtain qualitative data on their perceptions and opinions of the mural painting event. It was hypothesized that the average number of individuals per half hour who used the stairs would significantly increase from baseline to post-test. To examine changes over time in individuals exiting the stairs, a quasi-experimental design was used with one baseline measurement and multiple posttests (n=5). Stair use was determined by counting individuals exiting the stairwells. Time differences in exiting stair use were examined with repeated measures analysis of variance (ANOVA). Descriptive statistics and t-tests were used to analyze interview data. Qualitative data were analyzed using a thematic analysis approach. There was a significant time effect on stair use (F=7.512, p =0.000) and a significant interaction between staircase and time (F=7.518, p=0.000). There was no significant interaction of gender over time (F=.037, p=0.997). A repeated measures ANOVA was conducted on each staircase individually and showed that significant time differences were only found in the Southwest staircase. Based on exit interviews (n=28), most students saw the directional signs (61%) and murals (89.3%). However, neither the signs (71.4%) nor the murals (82.1%) were perceived as influential on stair use. Data from the focus groups and interviews revealed that the mural painting contest did not occur as intended, because the contest piece did not take place. In conclusion, solely having residents of a residential hall paint murals in stairwells was insufficient for increasing stair use. A mural painting contest may be a viable approach if properly planned and implemented.
ContributorsSmith, Shannon (Author) / Der Ananian, Cheryl A. (Thesis advisor) / Ainsworth, Barbara E. (Committee member) / Borror, Connie M. (Committee member) / Ilchak, Debra L. (Committee member) / Swan, Pamela D. (Committee member) / Wharton, Christopher M. (Committee member) / Arizona State University (Publisher)
Created2011
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Description
The gold standard for bone measurement is DXA (dual energy X-ray absorptiometry). Typically, to observe changes in bone by DXA, a minimum of a 4-month intervention is required. Serum osteocalcin (OST) (a bone formation marker) and quantitative ultrasound (QUS) of the calcaneus can be used as indicators of bone change

The gold standard for bone measurement is DXA (dual energy X-ray absorptiometry). Typically, to observe changes in bone by DXA, a minimum of a 4-month intervention is required. Serum osteocalcin (OST) (a bone formation marker) and quantitative ultrasound (QUS) of the calcaneus can be used as indicators of bone change but the sensitivity and time course of these indices to short term interventions are unknown. The purpose of this study was twofold: to compare monthly changes in OST and QUS in response to jump training and to evaluate the relationship between DXA, OST and QUS. Young women with QUS t-scores less than 1.0 were randomized into a jump training (J) (n=16) or control (C) (n=16). J consisted of a progressive routine of 1 and 2-footed jumping performed 3 days per week for 4 months. Body composition, QUS and OST were measured at baseline, and monthly for 4 months. DXA and 24-hour dietary recalls were completed at baseline and 4 months. Low attrition rate (12.5%) and high compliance (98%) with the exercise intervention was recorded. No significant correlations between QUS and OST existed. No significant differences were observed between groups at baseline in body composition or bone variables. Monthly increases in OST were observed but there were no significant differences over time between groups in any bone variables. OST and QUS may be indicative of short term bone changes but these variables were not specifically sensitive to the jumping intervention in this population of women.
ContributorsHeumann, Kristin Joelle (Author) / Swan, Pamela D (Thesis advisor) / Alvar, Brent (Committee member) / Chisum, Jack (Committee member) / Lee, Chong (Committee member) / Vaughan, Linda (Committee member) / Arizona State University (Publisher)
Created2011
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Description
Parenting approaches that are firm yet warm (i.e., authoritative parenting) have been found to be robustly beneficial for mainstream White Americans youths, but do not demonstrate similarly consistent effects among Chinese Americans (CA) adolescents. Evidence suggests that CA adolescents interpret and experience parenting differently than their mainstream counterparts given differences

Parenting approaches that are firm yet warm (i.e., authoritative parenting) have been found to be robustly beneficial for mainstream White Americans youths, but do not demonstrate similarly consistent effects among Chinese Americans (CA) adolescents. Evidence suggests that CA adolescents interpret and experience parenting differently than their mainstream counterparts given differences in parenting values and child-rearing norms between traditional Chinese and mainstream American cultures. The current study tests the theory that prospective effects of parenting on psychological and academic functioning depends on adolescents' cultural frameworks for interpreting and understanding parenting. CA adolescents with values and expectations of parenting that are more consistent with mainstream American parenting norms were predicted to experience parenting similar to their White American counterparts (i.e., benefiting from a combination of parental strictness and warmth). In contrast, CA adolescents with parenting values and expectations more consistent with traditional Chinese parenting norms were predicted to experience parenting and its effects on academic and psychological outcomes differently than patterns documented in the mainstream literature. This study was conducted with a sample of Chinese American 9th graders (N = 500) from the Multicultural Family Adolescent Study. Latent Class Analysis (LCA), a person-centered approach to modeling CA adolescents' cultural frameworks for interpreting parenting, was employed using a combination of demographic variables (e.g., nativity, language use at home, mother's length of stay in the U.S.) and measures of parenting values and expectations (e.g., parental respect, ideal strictness & laxness). The study then examined whether prospective effects of parenting behaviors (strict control, warmth, and their interaction effect) on adolescent adjustment (internalizing and externalizing symptoms, substance use, and GPA) were moderated by latent class membership. The optimal LCA solution identified five distinct cultural frameworks for understanding parenting. Findings generally supported the idea that effects of parenting on CA adolescent adjustment depend on adolescents' cultural framework for parenting. The classic authoritative parenting effect (high strictness and warmth leads to positive outcomes) was found for the two most acculturated groups of adolescents. However, only one of these groups overtly endorsed mainstream American parenting values.
ContributorsLiu, Freda Fangfang (Author) / Gonzales, Nancy A. (Thesis advisor) / Tein, Jenn-Yun (Committee member) / Yoo, Hyung Chol (Committee member) / Barrera, Manuel (Committee member) / Arizona State University (Publisher)
Created2011
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Description
At first glance, trends in increased hunger and obesity in the United States (US) would seem to represent the result of different causal mechanisms. The United States Department of Agriculture (USDA) reported that nearly 50 million Americans had experienced hunger in 2009. A year later, the Centers for

At first glance, trends in increased hunger and obesity in the United States (US) would seem to represent the result of different causal mechanisms. The United States Department of Agriculture (USDA) reported that nearly 50 million Americans had experienced hunger in 2009. A year later, the Centers for Disease Control and Prevention published a report showing that 68% of the US population was either overweight or obese. Researchers have found that these contrasting trends are actually interrelated. Being so, it is imperative that communities and individuals experiencing problems with food security are provided better access to healthy food options. In response to the need to increase healthy food access, many farmers markets in the US have received funding from the USDA to accept vouchers from federal food security programs, such as the Supplemental Nutrition Assistance Program (SNAP). In Downtown Phoenix, Arizona, one organization accepting vouchers from several programs is the Phoenix Public Market. However, the mere existence of these programs is not enough to establish food security within a community: characteristics of the population and food environments must also be considered. To examine issues of food security and public health, this thesis utilizes geographical information systems (GIS) technology as a tool to analyze specific environments in order to inform program effectiveness and future funding opportunities. Utilizing methods from community-based participatory research (CBPR) and GIS, a mapping project was conducted in partnership with the Market to answer three questions: (1) what is the demographic makeup of the surrounding community? (2) What retailers around the Market also accept food security vouchers? And (3) where are food security offices (SNAP and WIC) located within the area? Both in terms of demographic characteristics and the surrounding food environment, the project results illustrate that the Market is embedded within a population of need, and an area where it could greatly influence community food security.
ContributorsRawson, Brooke (Author) / Vargas, Perla A (Thesis advisor) / Booze, Randy (Committee member) / Vaughan, Suzanne (Committee member) / Arizona State University (Publisher)
Created2011
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Many studies have shown that access to healthy food in the US is unevenly distributed and that supermarkets and other fresh food retailers are less likely to be located in low-income minority communities, where convenience and dollar stores are more prevalent grocery options. I formed a partnership with Phoenix Revitalization

Many studies have shown that access to healthy food in the US is unevenly distributed and that supermarkets and other fresh food retailers are less likely to be located in low-income minority communities, where convenience and dollar stores are more prevalent grocery options. I formed a partnership with Phoenix Revitalization Corporation, a local community development organization engaged in Central City South, Phoenix, to enhance the community's capacity to meet its community health goals by improving access to healthy food. I used a community-based participatory approach that blended qualitative and quantitative elements to accommodate collaboration between both academic and non-academic partners. Utilizing stakeholder interviews, Nutrition Environment Measures Surveys (NEMS), and mapping to analyze the community's food resources, research revealed that the community lacks adequate access to affordable, nutritious food. Community food stores (n=14) scored an average of 10.9 out of a possible 54 points using the NEMS scoring protocol. The community food assessment is an essential step in improving access to healthy food for CCS residents and provides a baseline for tracking progress to improve residents' food access. Recommendations were drafted by the research partnership to equip and empower the community with strategic, community-specific interventions based on the research findings.
ContributorsCrouch, Carolyn (Author) / Harlan, Sharon (Thesis advisor) / Eakin, Hallie (Committee member) / Aftandilian, David (Committee member) / Arizona State University (Publisher)
Created2011
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Female infertility can present a significant challenge to quality of life. To date, few, if any investigations have explored the process by which women adapt to premature ovarian insufficiency (POI), a specific type of infertility, over time. The current investigation proposed a bi-dimensional, multi-factor, model of adjustment characterized by the

Female infertility can present a significant challenge to quality of life. To date, few, if any investigations have explored the process by which women adapt to premature ovarian insufficiency (POI), a specific type of infertility, over time. The current investigation proposed a bi-dimensional, multi-factor, model of adjustment characterized by the identification of six latent factors representing personal attributes (resilience resources and vulnerability), coping (adaptive and maladaptive) and outcomes (distress and wellbeing). Measures were collected over the period of one year; personal attributes were assessed at Time 1, coping at Time 2 and outcomes at Time 3. It was hypothesized that coping factors would mediate associations between personal attributes and outcomes. Confirmatory Factor Analysis (CFA), simple regressions and single mediator models were utilized to test study hypotheses. Overall, with the exception of coping, the factor structure was consistent with predictions. Two empirically derived coping factors, and a single standalone strategy, avoidance, emerged. The first factor, labeled "approach coping" was comprised of strategies directly addressing the experience of infertility. The second was comprised of strategies indicative of "letting go /moving on." Only avoidance significantly mediated the association between vulnerability and distress.
ContributorsDriscoll, Mary (Author) / Davis, Mary C. (Thesis advisor) / Aiken, Leona S. (Committee member) / Luecken, Linda J. (Committee member) / Zautra, Alex J. (Committee member) / Arizona State University (Publisher)
Created2011
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An ever expanding body of research has shown that children of divorce are at increased risk for a range of maladaptive outcomes including academic failure, behavior problems, poor psychological adjustment, reduced self-concept, and reduced social competence (Amato, 2001). Furthermore, the widespread prevalence of divorce makes preventing these poor outcomes a

An ever expanding body of research has shown that children of divorce are at increased risk for a range of maladaptive outcomes including academic failure, behavior problems, poor psychological adjustment, reduced self-concept, and reduced social competence (Amato, 2001). Furthermore, the widespread prevalence of divorce makes preventing these poor outcomes a pressing public health concern. The Children of Divorce-Coping with Divorce (CoD-CoD) program is an internet-based selective prevention that was derived from recent research identifying modifiable protective factors in children of divorce including active and avoidant coping, divorce appraisals, and coping efficacy. CoD-CoD addresses these putative mediators through careful adaptation of intervention components previously demonstrated to be effective for children from disrupted families (Pedro-Carroll & Alpert-Gillis, 1997; Stolberg & Mahler, 1994; Sandler, et al., 2003). In the CoD-CoD efficacy trial, 147 children ages 11-16 whose family had received a divorce decree within 48 months of the intervention start date served as participants. Participants were assessed in two waves in order to test the small theory of the intervention as well as the interventions effects on internalizing and externalizing behaviors. Analyses indicated that the program effectively reduced the participants total mental health problems and emotional problems as reported on the Strengths and Difficulties Questionnaire (SDQ) (d = .37) and for total mental health problems this effect was stronger for children with greater baseline mental health problems (d = .46). The program also had mediated effects on both child and parent-reported total mental health problems whereby the program improved coping efficacy for children with low baseline coping efficacy which led to reduced parent-reported mental health problems. To the author's knowledge this is the first randomized controlled trail of internet-based mental health program for children or adolescents which utilizes an active control condition.
ContributorsBoring, Jesse (Author) / Sandler, Irwin (Thesis advisor) / Crnic, Keith (Committee member) / Tein, Jenn-Yun (Committee member) / Horan, John (Committee member) / Arizona State University (Publisher)
Created2011