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In October, 2009, participants of the Arizona Special Supplemental Nutrition Program for Women, Infants and Children (WIC) began receiving monthly Cash Value Vouchers (CVV) worth between six and 10 dollars towards the purchase of fresh fruits and vegetables. Data from the Arizona Department of Health Services (ADHS) showed CVV redemption rates in the first two years of the program were lower than the national average of 77% redemption. In response, the ADHS WIC Food List was expanded to also include canned and frozen fruits and vegetables. More recent data from ADHS suggest that redemption rates are improving, but variably exist among different WIC sub-populations. The purpose of this project was to identify themes related to the ease or difficulty of WIC CVV use amongst different categories of low-redeeming WIC participants. A total of 8 focus groups were conducted, four at a clinic in each of two Valley cities: Surprise and Mesa. Each of the four focus groups comprised one of four targeted WIC participant categories: pregnant, postpartum, breastfeeding, and children with participation ranging from 3-9 participants per group. Using the general inductive approach, recordings of the focus groups were transcribed, hand-coded and uploaded into qualitative analysis software resulting in four emergent themes including: interactions and shopping strategies, maximizing WIC value, redemption issues, and effect of rule change. Researchers identified twelve different subthemes related to the emergent theme of interactions and strategies to improve their experience, including economic considerations during redemption. Barriers related to interactions existed that made their purchase difficult, most notably anger from the cashier and other shoppers. However, participants made use of a number of strategies to facilitate WIC purchases or extract more value out of WIC benefits, such as pooling their CVV. Finally, it appears that the fruit and vegetable rule change was well received by those who were aware of the change. These data suggest a number of important avenues for future research, including verifying these themes are important within a larger, representative sample of Arizona WIC participants, and exploring strategies to minimize barriers identified by participants, such as use of electronic benefits transfer-style cards (EBT).
ContributorsBertmann, Farryl M. W (Author) / Wharton, Christopher (Christopher Mack), 1977- (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Johnston, Carol (Committee member) / Hampl, Jeffrey (Committee member) / Dixit-Joshi, Sujata (Committee member) / Barroso, Cristina (Committee member) / Arizona State University (Publisher)
Created2013
Description
Objective: Parents play a critical role in their child's diets, yet there is lack of research in
the US comparing parental perception of their child’s diet with quantitatively assessed diet quality. We examined the association between parent perception of their child’s overall diet and the child’s diet quality, as measured by frequency of consumption of key food categories.
Methods: Secondary analysis was conducted using data from two independent cross- sectional panels of surveys with parents of a 3-18 year old child. Data collection took place in 2009-2010 and 2014, the random sample was drawn from low-income cities. Well-established survey questions assessed parental perception of their child’s diet and frequency of consumption of fruits, vegetables, sugar-sweetened beverages (SSB), fast food and unhealthy snacks. Diet quality scores were calculated for each child, with higher scores reflective of healthier diets (max score= 40). Ordered logistic regressions examined associations between parental perception and consumption of food categories. Multinomial logistic regressions examined associations between levels of concordance in parent perception and diet scores by demographic sub-groups.
Results: Almost half of children were non-Hispanic black (46%) and 40% were Hispanic. Overall 52% of parents strongly agreed, 33% somewhat agreed, 10% somewhat disagreed, and 4% strongly disagreed that their child eats a healthy diet. The mean diet quality score for the sample was 20.58 ± 6.7. Children from our sample with the unhealthiest diet had a mean frequency of fruit intake = 0.8 times/day and SSBs = 2.2 times/day. Children with the healthiest diet had a mean consumption of fruit=1.7/day and
SSBs= 0.4/day. Parental perception of their child’s diet was significantly higher when their child consumed more fruit (p<0.001) and vegetables (p<0.001) and lower when their child consumed more fast food (p<0.001), SSBs (p=0.01) and unhealthy snacks (p=0.02). Over half of parents overestimated the healthfulness of their child’s diet (61%). Parent, child and household demographics did not moderate this association.
Conclusions: Although parental perceptions that their child eats healthy are associated when their child eats more healthy foods and less unhealthy foods, parents’ perceptions still do not align with their child’s diet.
the US comparing parental perception of their child’s diet with quantitatively assessed diet quality. We examined the association between parent perception of their child’s overall diet and the child’s diet quality, as measured by frequency of consumption of key food categories.
Methods: Secondary analysis was conducted using data from two independent cross- sectional panels of surveys with parents of a 3-18 year old child. Data collection took place in 2009-2010 and 2014, the random sample was drawn from low-income cities. Well-established survey questions assessed parental perception of their child’s diet and frequency of consumption of fruits, vegetables, sugar-sweetened beverages (SSB), fast food and unhealthy snacks. Diet quality scores were calculated for each child, with higher scores reflective of healthier diets (max score= 40). Ordered logistic regressions examined associations between parental perception and consumption of food categories. Multinomial logistic regressions examined associations between levels of concordance in parent perception and diet scores by demographic sub-groups.
Results: Almost half of children were non-Hispanic black (46%) and 40% were Hispanic. Overall 52% of parents strongly agreed, 33% somewhat agreed, 10% somewhat disagreed, and 4% strongly disagreed that their child eats a healthy diet. The mean diet quality score for the sample was 20.58 ± 6.7. Children from our sample with the unhealthiest diet had a mean frequency of fruit intake = 0.8 times/day and SSBs = 2.2 times/day. Children with the healthiest diet had a mean consumption of fruit=1.7/day and
SSBs= 0.4/day. Parental perception of their child’s diet was significantly higher when their child consumed more fruit (p<0.001) and vegetables (p<0.001) and lower when their child consumed more fast food (p<0.001), SSBs (p=0.01) and unhealthy snacks (p=0.02). Over half of parents overestimated the healthfulness of their child’s diet (61%). Parent, child and household demographics did not moderate this association.
Conclusions: Although parental perceptions that their child eats healthy are associated when their child eats more healthy foods and less unhealthy foods, parents’ perceptions still do not align with their child’s diet.
ContributorsEliason, Jessica (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / DeWeese, Robin (Committee member) / Vega-Lopez, Sonia (Committee member) / Arizona State University (Publisher)
Created2019
Description
Popular culture tends to downplay strong female characters to favor a plethora of male figures that children look up to as heroes. This creates a gender imbalance in exposure to inspirational characters that children can look up to as role models. For our team's creative project, we chose to write and illustrate a children's book mainly targeted at young girls, ages eight to twelve that focuses on the stories of selected female figures of Norse mythology. The five stories in our collection focus on the figures Frigg, Skadi, Elli, Idunn, and Freya and are inspired by the mythology contained in the Prose Edda by Snorri Sturluson and selected medieval texts on the Germanic Lombard tribe. Through our book, Women of Norse Myth: For Little Goddesses, we wanted to introduce children to Norse mythology, a branch of myth that is often overshadowed by more popular mythologies such as Roman and Greek. Additionally, our goal was to bring light to the female figures within Norse myth that are generally given less attention than their male counterparts. Keeping in mind these goals, the stories were adapted from the original myths in a manner that would be suitable for a young audience as well as our aim for female empowerment. The final manuscript contains an introduction to Norse cosmology, introductions to the figures, a glossary of Norse terms used, and the illustrated stories themselves. Together with our combined talents, interests, and goals, Women of Norse Myth: For Little Goddesses was completed, and we hope that someday it can be published and serve as a fun and inspiring storybook for children to read and learn from.
ContributorsFarine, Brittany (Co-author) / Muth, Margaret (Co-author) / Youngjohn, Trystan (Co-author) / Alexander, John (Thesis director) / Wells, Cornelia (Committee member) / Department of English (Contributor) / Department of Psychology (Contributor) / School of Human Evolution and Social Change (Contributor) / School of International Letters and Cultures (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
This study examined whether changes in intervention related gains from the REACH for Personal and Academic Success program, an indicated anxiety prevention school-based protocol, vary as a function of participant youth's exposure to overprotective parenting. This study also examined if ethnicity/race (Caucasian vs. Hispanic/Latino) interacts with overprotective parenting to predict program response. A total of 98 children (M age = 9.70, SD = .07; 77.60% girls; 60.20% Hispanic/Latino) received 1 of 2 protocols (REACH or academic support) and responses were measured at post-treatment and 1-year follow-up. Findings showed that child self-regulation skills improved in the school program (REACH) for children of parents with low levels of overprotection, and child self-regulation skills improved in the control program (academic support) for children of parents with high levels of overprotection. These findings were significant in the Hispanic/Latino subsample, but not in Caucasian youth.
ContributorsBromich, Bobbi Lynn (Author) / Pina, Armando (Thesis director) / Presson, Clark (Committee member) / Hahs, Adam (Committee member) / Department of Psychology (Contributor) / School of International Letters and Cultures (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
The ‘draw and write’ research technique was developed as a bottom-up approach to gaining access to children’s ideas, experiences, and views of the world around them in areas such as health, education, and social issues. While the technique may allow children to participate in research in a way that is less restrictive than other techniques, many critique the method for its adverse ethical concerns, validity, and issues of interpretation and analysis. This article reviews the ‘draw and write’ research technique and its common critiques as well as offers a case study of the ‘draw and write’ technique, performed with children in Acatenango, Guatemala, in order to validate the accuracy of the ‘draw and write’ technique in depicting specific quantitative results.
ContributorsJones, Danielle Lynn (Author) / Maupin, Jonathan (Thesis director) / Hackman, Joe (Committee member) / School of International Letters and Cultures (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
It is well known that the lack of care coordination in the healthcare system causes numerous problems including cost inefficiency and inconsistent care, specifically for complex pediatric and adult patients. Many pediatric patients have complex medical and social service needs which can be expensive for both the patient’s parents and the general healthcare system. Therefore, it is difficult for the healthcare system to deliver the highest quality care possible, due to the number of appointments that have to be scheduled (with some being out of state), the large volume of physical health records, and overall lack of time parents have to coordinate this care while also caring for themselves and other family members. It is integral to find a more efficient way to coordinate care for these patients, in order to improve overall care, cost efficiency, and outcomes. <br/>A number of stakeholders in Arizona came together to work on this problem over several years. They were funded through a PCORI Eugene Washington Engagement grant to investigators at ASU. This project, Take Action for Arizona's Children through Care Coordination: A Bridge to Action was developed in order to further develop a research agenda and build the network (PCOR). Regional conferences were conducted in Flagstaff, Yuma, Phoenix, and Tucson, as well as a final capstone conference held in Phoenix. At these conferences, frustrations, suggestions, and opinions regarding Children with Special Health Care Needs (CSHCN) and navigating the healthcare system were shared and testimonials were transcribed.<br/>This study focused on the capstone conference. The study design was a strategic design workshop; results of the design analysis were analyzed qualitatively using descriptive content analysis. Themes described parent’s common experiences navigating the system, impacts resulting from such experiences, and desires for the care coordination system. Quotes were then grouped into major themes and subthemes for the capstone conference. After these themes were determined, the overarching goals of stakeholders could be assessed, and implementation projects could be described.
ContributorsBrennan, Bayley (Author) / Doebbeling, Bradley (Thesis director) / Lamb, Gerri (Committee member) / College of Health Solutions (Contributor, Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
Description
The purpose of this study was to examine the validity of a modified Assisted Cycling Therapy bicycle for improving depression in children with Down Syndrome (DS). Seven participants completed 2x/week for 8 weeks, 30 minutes at a time of ACT, in which participants’ voluntary pedaling rates were augmented via the bicycle motor, ensuring that they were pedaling at a rate greater than their self-paced rate. Depression was measured using a modified version of the Children’s Depressive Inventory, called the CDI-2. Our study demonstrated that the scores from the CDI-2 decreased, demonstrating less depressive symptomatology after the conclusion of the 8 week intervention. Our results were interpreted via our model of the mechanisms involved in influencing the success of ACT. Future research would include a greater sample size, a more relevant measure of depressive scores, and a consistent data collection environment. However our initial pilot study showed promising results for improving mental health in children with DS.
ContributorsErramuzpe, Sarah (Author) / Ringenbach, Shannon (Thesis director) / Yudell, Michael (Committee member) / Barrett, The Honors College (Contributor) / School of International Letters and Cultures (Contributor) / College of Health Solutions (Contributor)
Created2023-05
Description
Background: Stores authorized by the Supplemental Nutrition Program for Women, Infants, and Children (WIC) have been shown to improve the community food environments of lower-income areas by stocking healthy food items in accordance with the program’s food package guidelines. Whether greater access to WIC-authorized stores is associated with improvements in diet among children from WIC and non-WIC households is not well understood. Methods: Secondary analysis of cross-sectional data collected in 2009-2010 and 2014 for the New Jersey Child Health Study (NJCHS). Surveys from 2,211 urban households with 3-18-year-old children. Counts of WIC stores near children’s homes determined through geo-coding of store and household addresses using roadway network distances of 0.5 and 1.0 mile. Children’s consumption was categorized in age-specific deciles of quantities consumed for each food category examined: fruits, vegetables, sugar from sugar-sweetened beverages, total added sugars. Associations between counts of WIC stores and children’s consumption were examined, first for the full sample, then by household WIC participation.
Results: No significant associations between WIC store counts near children’s homes and consumption were observed in the overall sample at any distance. A small, but significant inverse relationship was seen in total added sugar consumption among children residing in WIC households only, with each additional WIC store within a 0.5 mile roadway network associated with a 0.24-decile lower consumption (p = .047). In age-stratified exploratory analysis, higher vegetable (p = .024) and combined fruits and vegetables (p = .006) consumption were seen in the under 5 age group only.
Conclusions: Living close to more WIC-authorized stores was associated with healthier consumption, but only for a subset of children and only for a few food categories examined. Lack of a consistent pattern of healthier consumption among children suggests that access to WIC stores may have a positive, albeit limited impact on children’s diets.
Results: No significant associations between WIC store counts near children’s homes and consumption were observed in the overall sample at any distance. A small, but significant inverse relationship was seen in total added sugar consumption among children residing in WIC households only, with each additional WIC store within a 0.5 mile roadway network associated with a 0.24-decile lower consumption (p = .047). In age-stratified exploratory analysis, higher vegetable (p = .024) and combined fruits and vegetables (p = .006) consumption were seen in the under 5 age group only.
Conclusions: Living close to more WIC-authorized stores was associated with healthier consumption, but only for a subset of children and only for a few food categories examined. Lack of a consistent pattern of healthier consumption among children suggests that access to WIC stores may have a positive, albeit limited impact on children’s diets.
ContributorsStevens, Clinton (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Gosliner, Wendi (Committee member) / Martinelli, Sarah (Committee member) / Arizona State University (Publisher)
Created2021
Description
Sufficient sleep in childhood is fundamental to proper development as well as preventing behavioral or emotional complications later in adulthood (Gregory & Sadeh, 2012; Bruni, 2010). Sleep is controlled by a 24-hour cycle of hormonal regulation termed the circadian rhythm, which is controlled by different environmental inputs such as light (Reppert & Weaver, 2002). Previous research has also demonstrated that light exposure at night can delay the night phase production of specific hormones that promote sleep (Zeitzer, Dijk, Kronauer, Brown, & Czeisler, 2004; Chang, Aeschbach, Duffy, & Czeisler, 2015), which in turn delays sleep onset. Such studies involving the effects that light may have on sleep have focused on adult subjects, however, and it is important to explore this idea in childhood to promote proper development. The first aim of this study was to examine the effects of light exposure in the hour before bedtime on different measures of sleep in middle childhood. The second aim was to determine the genetic and environmental contributions to light exposure and sleep. A diverse sample of 490 twin children was assessed at 8 years of age. Twins followed a week long protocol in which they wore actigraph watches that collected data on both light and sleep. Zero-order correlations with subsequent multilevel regression analyses showed that any light exposure in the hour before bedtime was significantly positively associated with sleep onset latency. Twin intraclass correlations indicated no heritability for light exposure, but did indicate some heritability ranging from 7-66% for the sleep indicators. Overall, these findings regarding the impacts of sleep in childhood build upon an area of research that has only been explored in adulthood. These impacts of light on sleep in childhood suggest that possible interventions ought to be explored for implementation to minimize the long-term effects of altered sleeping patterns in childhood.
ContributorsScheel, Sydney Elise (Author) / Lemery-Chalfant, Kathryn (Thesis director) / Clifford, Sierra (Committee member) / School of Molecular Sciences (Contributor) / School of International Letters and Cultures (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
The rate of vaccinations has been consistently decreasing in the past years in children of ages 0-18. Multiple factors and barriers contribute to these low rates. This comparative case study investigated the accessibility of information regarding childhood vaccinations to parents in areas with differing poverty levels in the greater Phoenix region, specifically in the West Valley, Downtown Phoenix, and the East Valley. Pediatric clinics, public elementary schools, and public libraries were visited in each area to assess how much information was available where. The analysis produced unexpected results: the West Valley, which had the highest poverty level, contained the most amount of accessible information for parents in many languages, while the East Valley, with a low poverty level, had almost no information accessible to parents of these children. Implications for future research, policy, and practice are discussed. Based on these unexpected results, one recommendation is to develop a pamphlet that could be distributed to these public places to raise awareness of the importance of vaccinations in children to parents.
ContributorsShah, Veedhi (Author) / Bates, Denise (Thesis director) / Castillo, Elizabeth (Committee member) / College of Health Solutions (Contributor) / School of Life Sciences (Contributor) / School of International Letters and Cultures (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05