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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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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
Food security literature has a heavy emphasis on physical barriers, often employing spatial analysis or market-based approaches, but the human dimensions of food security remain unexplored. This has resulted in a disconnect between the understanding of the problem and proposed interventions, as the contextual factors and lived experiences of residents

Food security literature has a heavy emphasis on physical barriers, often employing spatial analysis or market-based approaches, but the human dimensions of food security remain unexplored. This has resulted in a disconnect between the understanding of the problem and proposed interventions, as the contextual factors and lived experiences of residents are not considered. There are many barriers and opportunities for food security that are not spatially fixed (e.g. family relations, social capital) that may be important but are unrepresented in these types of studies. In order to capture these barriers and opportunities, community stakeholders need to play a fundamental role in the problem analysis and visioning stages. This study utilized community-based participatory research methods to engage an important stakeholder in the future food environment, youth, to 1) understand how the youth of Canyon Corridor describe their food environment, and thus capture contextual aspects of food security 2) adapt CBPR methods to engage youth in a visioning session to elicit their ideal community food environment and 3) determine if these applications of CBPR can empower youth of Canyon Corridor to mobilize towards a more secure food environment. I found that while the youth did identify many barriers to food security (i.e. transportation, cost, availability), this community also had significant strengths, particularly social capital, that allowed them to overcome what would be food insecurity. Despite their conclusions on food security, youth did desire many changes for the future food environment and felt increased empowerment after the workshops. Thus this shows the need for incorporating methods that also acknowledge the role of social and individual factors and how they interrelate with the physical environment in relation to food security.
ContributorsSchoon, Briar (Author) / Eakin, Hallie (Thesis advisor) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Szkupinski-Quiroga, Seline (Committee member) / Arizona State University (Publisher)
Created2012
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Description
Determining the factors associated with the availability of healthy and unhealthy foods in the household may help in understanding the varying complexities that contribute to obesity among children and help design interventions to impact children's food consumption behaviors. This study examined factors that are associated with the availability of healthy

Determining the factors associated with the availability of healthy and unhealthy foods in the household may help in understanding the varying complexities that contribute to obesity among children and help design interventions to impact children's food consumption behaviors. This study examined factors that are associated with the availability of healthy and unhealthy foods in children's home food environments (HFE). Data was collected from a random-digit-dial telephone survey of 1708 households, with at least one child between 3-18 years of age, located in five low-income New Jersey cities. HFE was assessed based on responses to a set of six items that measured availability of specific healthy and unhealthy foods in the respondent's home. These items contributed to construction of three HFE scales used as dependent variables in these analyses: healthy HFE, unhealthy HFE, and a ratio of healthy to unhealthy foods in the HFE. Independent variables included household socio-demographics, parental perceptions of their own weight and diet health, frequency of family meals, proximity to food outlets, and perception of access to healthy foods in the neighborhood food environment. Significant differences were observed in the HFE by race and ethnicity, with Non-Hispanic black children having fewer healthy foods and Non-Hispanic white children having more unhealthy food items available at home. Parents who reported being overweight or obese had a healthier HFE and those perceiving their own eating as healthy had more healthy and less unhealthy foods in the household. Food-secure households had more unhealthy compared to healthy foods at home. Households located farther from a supermarket had a greater number of unhealthy food items and a lower healthy/unhealthy food availability ratio. Parental perception of better access to fruits and vegetables and low-fat foods was associated with availability of a greater number of healthy food items at home. Overall, the HFE varied by parental and demographic characteristics, parental perceptions about the food environment and the actual features of the built neighborhood food environment.
ContributorsBerry, Andrea (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Johnston, Carol (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Arizona State University (Publisher)
Created2012
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Description
This study utilized targeted messages and expert and referent sources in an effort to promote physical activity behavior in college students. College students aged 18-25, excluding collegiate athletes, were randomized into three conditions using their current physical activity level. Two of the conditions received targeted messages highlighting three primary components

This study utilized targeted messages and expert and referent sources in an effort to promote physical activity behavior in college students. College students aged 18-25, excluding collegiate athletes, were randomized into three conditions using their current physical activity level. Two of the conditions received targeted messages highlighting three primary components of social cognitive theory - self-efficacy, outcome expectations, and goals - while the third condition received no messages. In addition, the experimental conditions received the messages from either an expert (i.e., a personal trainer) or a referent (i.e., a close friend). In this way, this experiment analyzed whether receiving social cognitive theory messages increased physical activity indicators compared to the control condition, as well as if the message source caused differences in the physical activity indicators. Moreover, participants completed Time 1 and Time 2 measures to determine if receiving messages or not caused changes over a one week time period. Seven physical activity indicators were assessed: self-efficacy, positive outcome expectations, negative outcome expectations, attitudes, response-efficacy, intentions, and physical activity behavior. Results revealed that both the personal trainer and close friend conditions had significantly higher scores than the control condition for intentions at Time 1 and Time 2, as well as physical activity behavior at Time 2. Moreover, the personal trainer condition had significantly higher positive outcome expectations compared to both the friend and control conditions. No other significant differences were found across conditions for Time 1 attitudes, response-efficacy, negative outcome expectations, self-efficacy, and Time 2 attitudes, and self-efficacy. Overall, targeted messages were effective in increasing physical activity intentions and behavior regardless of the message source.
ContributorsMarmo, Jennifer Lauren (Author) / Roberto, Anthony J. (Thesis advisor) / Mongeau, Paul A. (Committee member) / Ainsworth, Barbara E. (Committee member) / Arizona State University (Publisher)
Created2012
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Description
The health enhancing effects of physical activity are well documented in the literature. However, women continue to report lower participation in exercise and physical activity (PA) compared to men. As women age an overall trend in decreased activity is observed. The primary place of activity reported in women is the

The health enhancing effects of physical activity are well documented in the literature. However, women continue to report lower participation in exercise and physical activity (PA) compared to men. As women age an overall trend in decreased activity is observed. The primary place of activity reported in women is the home and one of the most commonly reported reasons for lack of physical activity is the lack of time. Few instruments have been developed that focus on the activity patterns of women. The Cross Cultural Physical Activity Study that this study was based on targeted women of color to assess the types of activity and constraints to activity experienced by African American and Native American women over 40 years old. This secondary data analysis focused on the psychometric properties of two scales used in the above study, The Physical Recreation Questionnaire (PRQ) and The Typical Week Physical Activity Survey (TWPAS). An exploratory factor analysis (EFA) was conducted on the 18 items from the Physical Recreation Questionnaire (PRQ) which focused on constraints to PA. The results of the EFA were a poor fit of a two factor model. The three factor model had a favorable fit in the EFA. Confirmatory factor analysis (CFA) was then conducted on the 18 items in the PRQ. Results of the CFA supported the presence of three latent variables: enjoyment of PA, constraints to PA, and negotiation of constraints to PA. The Typical Week Physical Activity Survey (TWPAS) is a 35 item measure of moderate PA that includes the activities most often reported by women. The purpose of the TWPAS was to capture habitual PA that might not be recorded in other PA questionnaires. The TWPAS was correlated with criterion measures of PA records, treadmill, accelerometer, and BMI. Although correlations were small, they were in the expected direction with the criterion measures. The evaluation of the instruments supported the presence of the construct of constraints to PA in the PRQ and the measurement of moderate intensity PA in the TWPAS.
ContributorsBishop, Jewel (Author) / Ainsworth, Barbara (Thesis advisor) / Komnenich, Pauline (Committee member) / Arizona State University (Publisher)
Created2012
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Description
Excessive gestational weight gain (GWG) during pregnancy is a major public health concern. Studies have reported more than 70% of pregnant women gain excessive weight which may pose increased maternal and fetal risks. Little is known about the relationships of GWG to behavioral factors (i.e., physical activity, sleep, social support)

Excessive gestational weight gain (GWG) during pregnancy is a major public health concern. Studies have reported more than 70% of pregnant women gain excessive weight which may pose increased maternal and fetal risks. Little is known about the relationships of GWG to behavioral factors (i.e., physical activity, sleep, social support) and maternal mental health (i.e., stress, anxiety, depression) during pregnancy. This descriptive, cross-sectional study explored the relationships of GWG to behavioral factors and maternal mental health during pregnancy. Secondarily, this study described the preferences, uses of, and interests in alternative approaches as well as the mental health differences between users and non-users of alternative approaches during pregnancy. A national survey was administered to women ≥8 weeks pregnant, ≥18 years old, and residing in the United States (N=968). Bivariate correlations were used to determine relationships between GWG and variables of interest. Independent t-tests were used to observe mental health differences between users and non-users of alternative approaches. Data were analyzed throughout pregnancy and by trimester. Throughout pregnancy, significant relationships were found in GWG to stressful events (r=-.112, p<.01), depression (r=.066, p<.05), mindfulness (r=-.067, p<.05), and sleep (r=.089, p<.01). When GWG was assessed by trimester, stressful events were significant in the second (r=-.216, p<.01) and third trimesters (r=-.085, p<.05). Depression remained positively related to GWG in the first (r=.409, p<.01) and second trimesters (r=.162, p<.01). A positive relationship emerged between GWG and anxiety in the first trimester (r=.340, p<.01) and physical activity became significant in the second (r=-.136; p<.05) and third trimesters (r=-.100; p<.05). Mindfulness was the only variable significantly related to GWG throughout all time points. Mean anxiety (d=.236; p=.001) and depression (d=.265; p<.001) scores were significantly lower in users compared to non-users of alternative approaches throughout pregnancy and when assessed by trimester anxiety (d=.424; p=.001) and depression (d=.526; p<.001) were significant in the second trimester. This study provides a framework for future analyses in GWG and maternal mental health. The information presented here may inform future interventions to test the effectiveness of alternative approaches to simultaneously manage maternal mental health and GWG due to the integrative nature of alternative approaches.
ContributorsMatthews, Jennifer L. (Author) / Huberty, Jennifer L (Thesis advisor) / Leiferman, Jenn (Committee member) / Larkey, Linda (Committee member) / McClain, Darya (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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Description
Nearly seven decades ago, the US government established grants to the states for family planning and acknowledged the importance of enabling all women to plan and space their pregnancies, regardless of personal income. Since then, publicly-funded family planning services have empowered millions of women, men, and adolescents to achieve their

Nearly seven decades ago, the US government established grants to the states for family planning and acknowledged the importance of enabling all women to plan and space their pregnancies, regardless of personal income. Since then, publicly-funded family planning services have empowered millions of women, men, and adolescents to achieve their childbearing goals. Despite the recognized importance of subsidized family planning, services remain funded in a piecemeal fashion. Since the 1940s there have been numerous federal funding sources for family planning, including the Title V Maternal and Child Health Services Program, Office of Economic Opportunity grants, Title XX Social Services Program, Title X Family Planning Program, Medicaid, and the State Children’s Health Insurance Program, alongside state and local support. Spending guidelines allow states varying degrees of flexibility regarding allocation, to best serve the local population. With nearly two billion dollars spent annually on subsidized family planning, criticism often arises surrounding effective local program spending and state politics influencing grant allocation. Political tension regarding the amount of control states should have in managing federal funding is exacerbated in the context of family planning, which has become increasingly controversial among social conservatives in the twenty-first century. This thesis examines how Arizona’s political, geographic, cultural, and ethnic landscape shaped the state management of federal family planning funding since the early twentieth century. Using an extensive literature review, archival research, and oral history interviews, this thesis demonstrates the unique way Arizona state agencies and nonprofits collaborated to maximize the use of federal family planning grants, effectively reaching the most residents possible. That partnership allowed Arizona providers to reduce geographic barriers to family planning in a rural, frontier state. The social and political history surrounding the use of federal family planning funds in Arizona demonstrates the important role states have in efficient, effective, and equitable state implementation of national resources in successfully reaching local populations. The contextualization of government funding of family planning provides insight into recent attempts to defund abortion providers like Planned Parenthood, cut the Title X Family Planning Program, and restructure Medicaid in the twenty-first century.
ContributorsNunez-Eddy, Claudia (Author) / Maienschein, Jane (Thesis advisor) / Hurlbut, James (Committee member) / O'Neil, Erica (Committee member) / Arizona State University (Publisher)
Created2018
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Description
Despite the literature suggesting that fruits and vegetables (F&V) can have a protective outcome against overweight, obesity and chronic diseases, consumption is still inadequate. In order to address under consumption of F&V among children, schools have become a platform for a variety of food programs. The Fresh Fruit and Vegetable

Despite the literature suggesting that fruits and vegetables (F&V) can have a protective outcome against overweight, obesity and chronic diseases, consumption is still inadequate. In order to address under consumption of F&V among children, schools have become a platform for a variety of food programs. The Fresh Fruit and Vegetable Program (FFVP), a United States Department of Agriculture (USDA) initiative, aims to increase exposure and consumption of F&V in low-income school children by providing F&V snacks. Participation in FFVP has been associated with higher preference and consumption of F&V and research also suggests that the program has the potential to decrease rates of overweight and obesity. The benefits of this program have been found to extend outside of the school setting, with higher requests for F&V at home and at the grocery store. This study aims to explore how children’s participation in the FFVP influences home food environments and shopping practices through qualitative analysis focus group data. Four focus groups were held with parents (n=25) from three FFVP participating schools. The data was analyzed using an inductive thematic analysis approach to find themes within the discussions. The findings were grouped into three categories: General Perceptions of FFVP, Impact of FFVP on the Home Food Environment, and Impact of FFVP on Shopping Practices. For General Perceptions of FFVP, themes were: Children learn about and enjoy F&V, awareness of farm to school programs, and children make healthier choices. Impact of FFVP on the Home Food Environment included the themes: Choosing heathier foods and snacks, parent F&V behaviors, children request F&V at home, and children talk about or bring F&V home. Finally, Impact of FFVP on Shopping Practices included the themes: children’s involvement in shopping, children request to buy F&V, children request non-produce items, and parents decline or limit unhealthy requests. This qualitative study provides valuable insights about how FFVP participation influences child and family behaviors towards F&V at home and in the grocery store. School food programs, such as the FFVP, have a positive influence on F&V related behaviors among children and should be continued and expanded.
ContributorsAcosta Ortiz, Marina (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / DeWeese, Robin (Thesis advisor) / Gruner, Jessie (Committee member) / Arizona State University (Publisher)
Created2018