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Individual behavior change is a goal of many public policies directed at people of low socioeconomic status. Without evidence of behavioral change, these policies cannot be considered a success: a process of co-production where some level of cooperation between the client and program administrators is required to successfully meet program

Individual behavior change is a goal of many public policies directed at people of low socioeconomic status. Without evidence of behavioral change, these policies cannot be considered a success: a process of co-production where some level of cooperation between the client and program administrators is required to successfully meet program objectives. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC), is one example of a co-production design. WIC encourages women to engage in healthy behaviors by providing healthy food along with nutrition education to improve the health status of low-income families. However, while WIC is one of the most studied nutrition programs, little attention has been paid to the nutrition education portion or to interactions between staff members and participants. This research draws on the public policy and administration literature about street-level bureaucrats and co-production, which provides a framework for understanding the purposeful, inter-dependent relationships between front-line service providers and clients. However, neither literature explicates the process of interactions that is expected to lead to client behavior change and co-production. The primary contribution of this research is the creation of a grounded theory that identifies and explains the WIC interaction process as one of "negotiating healthy self-government". Based on analysis of three months of observations of WIC encounters in two clinics, this research finds that participants and staff members enter into tacit and explicit negotiations concerning the degree to which participants should govern their family's nutrition-related behavior. Clients actively shape the interactions by demonstrating their discipline and efforts to feed their families, while staff members refine and reinforce self-governing behaviors through assessing action, and providing advice to ensure behaviors meet recommendations. Finally, participants and staff members distinctly link self-governing behavior to identity: "good mothers" feed their children healthy food and govern their behaviors to meet nutritional recommendations. This research has implications for the study of behavior change promotion in public programs by introducing the concept of identity as a mechanism for governance and explicating the interaction process between front-line service providers and clients
ContributorsHand, Laura Catherine (Author) / Catlaw, Thomas J. (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Lucio, Joanna (Committee member) / Arizona State University (Publisher)
Created2014
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With more than one third of Americans considered to be obese, obesity is a public health issue in the United States. While obesity is linked to and caused by a number of factors, sugar sweetened beverage (SSB) consumption is a major contributor to increased obesity rates. For the purposes of

With more than one third of Americans considered to be obese, obesity is a public health issue in the United States. While obesity is linked to and caused by a number of factors, sugar sweetened beverage (SSB) consumption is a major contributor to increased obesity rates. For the purposes of this paper, SSBs will include any beverage in which sugar is added. This includes juices that are not 100% fruit juice, coffee or tea drinks that are sugar sweetened, energy or sport drinks, and most commonly, soda. Excess sugar in the diet is substantially linked to obesity and negative health effects. SSBs represent the primary source of added sugar in the average American diet. Part I of this paper will discuss obesity as a public health problem and establish the link between consumption of SSBs and poor health effects. Part II will discuss the public policy instrument families and the strengths and weaknesses of each policy approach. Part III will identify current policies specifically focused on curbing SSB consumption. Each policy will be analyzed for efficacy based on available scientific research. Lastly, Part IV will propose new policy alternatives and ways to improve current policies. A final policy recommendation will be presented as an ideal roadmap for policy makers looking to address the link between SSB consumption and obesity.
ContributorsSaria, Matthew Ricardo (Author) / Lucio, Joanna (Thesis director) / Holland, Thomas (Committee member) / School of Public Affairs (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05