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- Creators: Arizona State University
- Creators: Broman, Tannah
- Creators: Agliano, Courtney
- Status: Published
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
In the past three decades alone, the United States has witnessed a dramatic rise in the prevalence of obesity and overweight in adults and children. Efforts towards obesity mitigation and prevention have produced promising recommendations and researchers and practitioners alike acknowledge that real solutions must match the complexity of the problem. Comprehensive approaches that target environmental, economic, socio-cultural, and knowledge-based factors that influence diet and physical activity are highly recommended. However, the literature yields little in the way of what such comprehensive obesity interventions actually entail and how they ought to be developed. In particular, there are knowledge gaps in how various stakeholder groups can bridge institutional barriers to collaborate in ways that maximize resources, build upon synergies, and avoid duplication of efforts; and how specific recommendations are actually implemented. This thesis aims to contribute to an emerging body of literature that fills this gap by presenting a practical case study on how to create a playground obesity intervention in the Gateway District of Phoenix, Arizona, in collaboration with researchers, health professionals, neighborhood residents, and city officials. The objectives were two-fold: 1. To outline concrete steps that will allow an organization to create a playground linked with healthy kids education program that aims to increase physical activity, perceptions of safety, and community cohesion; 2. To outline how diverse stakeholders can collaborate effectively to create such a cohesive, complex obesity intervention. A detailed, actionable intervention manual was drafted through semi-structured interviews, literature review, a survey, a stakeholder workshop, and an extended peer-review. The manual describes the sequence of actions necessary for creating an innovative playground that reinforces learning, encourages creative play, and increases physical activity. The sequence of actions was linked with existing local assets, stakeholder roles and responsibilities, costs, and potential barriers. This manual, as well as the process itself, can serve as a transferable model for helping organizations come together to build the capacity required in order to tackle complex health challenges.
ContributorsXiong, Angela (Author) / Wiek, Arnim (Thesis advisor) / Golub, Aaron (Committee member) / Otu, Essen (Committee member) / Arizona State University (Publisher)
Created2013
Description
Childhood obesity has been on the rise for the past decade, and it has been hypothesized that students' food choices may be influenced by easy access to food outlets near their schools that provide unhealthful options. But the results of recent studies on the relationship between the food environment around schools and student weight status are mixed and often contradictory. Most studies have used measures of weight and height that were self-reported by students, or have relied on data from a relatively small sample of students. I examine the association between weight status among school students and the food environment surrounding their schools using professionally-measured, student-level data across the full school-age spectrum. De-identified data were obtained for over 30,000 K-12 students in 79 public schools located in four New Jersey cities. Locations of alternative food-outlets (specifically, supermarkets, convenience stores, small grocery stores, and limited-service restaurants) were obtained from commercial sources and geocoded to develop proximity measures. A simplified social-ecological framework was used to conceptualize the multi-level the association between students' BMI and school proximity to food outlets and multivariate analyses were used to estimate this relationship controlling for student- and school-level factors. Over twenty percent of the students were obese, compared to the national average at 17% (Ogden, Carroll, Kit, & Flegal, 2012). On average, students had 2.6 convenience stores, 2.9 limited-service restaurants, and 0.1 supermarkets within a quarter mile of their school. This study suggests that easy access to small grocery stores (which this study uniquely examines as a separate food outlet category) that offer healthy choices including five types of fresh vegetable, five types of fresh fruits, low-fat dairy, and lean meats is associated with lower BMI z score and lower probability of being obese for middle and high school students. This suggests that improving access to such small food outlets may be a promising area for future investigation in obesity mitigation research. Also, this study separates students of pre-schools, kindergartens and elementary schools (neighborhood schools) from that of the middle and high schools (non-neighborhood) schools because the two groups of schools have different neighborhood characteristics, as well as open-school and bussing policies that result in different levels of exposure that students have to the food outlets around the schools. The result of this study suggests that the relationship between students' weight outcomes and food environment around schools is different in the two groups of schools.
ContributorsTang, Xuyang (Author) / Abbott, Joshua K (Thesis advisor) / Ohri-Vachaspati, Punam (Thesis advisor) / Aggarwal, Rimjhim (Committee member) / Arizona State University (Publisher)
Created2013
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 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
Description
Training the bench press exercise on a traditional flat bench does not induce a level of instability as seen in sport movements and activities of daily living. Because of this, many new types of equipment have been created in an attempt to induce instability, such as the COR Bench. 15 males and 7 females between the ages of 18 and 30 were recruited for the present study, which tested two forms of instability: using one dumbbell rather than two, and lifting on the COR bench compared to a flat bench. Thusly, EMG was used to measure muscle activity in four separate conditions of unilateral bench press movements: on a flat bench with one dumbbell, on a flat bench with two dumbbells, on the COR Bench with one dumbbell, and on the COR Bench with two dumbbells. Results indicated that lifting with one dumbbell compared to two dumbbells on the flat bench significantly increased muscle activity across all four muscles being analyzed (pectoralis major, p = .005; middle trapezius, p = .008; external obliques, p = .004; and internal obliques, p = .003), but lifting with one dumbbell compared to two dumbbells on the COR Bench only significantly increased muscle activity in the middle trapezius (p = .001), external obliques(p = . 032), and internal obliques (p = .001). The only muscle to exhibit a significant increase in muscle activity when going from one dumbbell on the flat bench to one dumbbell on the COR Bench was the middle trapezius (p = .010). These results imply that the COR Bench itself does not increase muscle activity as much as switching from two dumbbells to one dumbbell, regardless of the bench being used.
ContributorsPatterson, Jeffrey (Author) / Harper, Erin (Thesis director) / Broman, Tannah (Committee member) / Cataldo, Donna (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2013-12
Description
Childhood obesity is associated with many well established health risks as well as high annual public health costs. Because of this, the childhood obesity literature has highlighted the need to detect at-risk groups in order to implement targeted preventions. Emotional eating has been identified as an unhealthy behavior and a risk factor for overweight status among children though very little is known about what predisposes children to emotionally eat. Stress has often been found to elicit emotional eating but most studies looking at this relationship have relied on self-reports in adult and clinical samples. Thus, the current study seeks to investigate the relationship between stress reactivity (measured using heart rate variability) and emotional eating in a sample of 247 children between the ages of 4-6. Furthermore, levels of control may moderate the relationship between stress reactivity (HRV) and emotional eating. Linear regression analysis was used to explore these relationships. It was expected that higher levels of reactivity to stress would predict an increased likelihood of emotional eating. This association was expected to be attenuated among children with higher levels of inhibitory control and attentional focusing as well as lower levels of impulsivity. However, the hypothesized findings were not supported by the data. Despite these null findings, and in light of several limitations, it is still hypothesized that emotional eating involves physiological and impulsivity/effortful control processes. Implications of future research are discussed.
ContributorsOhrt, Tara K (Author) / Perez La Mar, Marisol (Thesis advisor) / Luecken, Linda (Committee member) / Lemery, Kathryn (Committee member) / Arizona State University (Publisher)
Created2016
Description
Childhood obesity is a growing public health concern in the United States. For several years, many interventions have been established to reduce the prevalence of childhood obesity. However, these interventions have not adequately utilized existing models of behavior change, and as a result, have been unsuccessful in increasing levels of physical activity and healthy dietary intake. One such model of change, the Transtheoretical Model, views behavior change as occurring through a series of stages with progression through the stages being facilitated by cognitive and behavioral processes. Within these processes the constructs of consciousness-raising, helping relationships, and self-efficacy have been shown to be most influential in changing behaviors. Thus, the objective of this paper is to evaluate the effectiveness of such constructs and establish a multi-faceted approach to combat this epidemic.
ContributorsWang, Janice (Author) / Broman, Tannah (Thesis director) / Hoffner, Kristin (Committee member) / Baldwin, Marjorie (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2012-12
Description
This dissertation explores the unique role schools play in contributing toward a sustainable future for their communities. This was undertaken by first conducting a thorough review and analysis of the literature on the current utilization of schools as agents of sustainable development, along with an evaluation of schools engaging in this model around the United States. Following this, a framework was developed to aid in the assessment of school-community engagements from the perspective of social change. Sustainability problem solving tools were synthesized for use by schools and community stakeholders, and were tested in the case study of this dissertation. This case study combined methods from the fields of sustainable development, transition management, and social change to guide two schools in their attempts to increase community sustainability through addressing a shared sustainability problem: childhood obesity. The case study facilitated the creation of a sustainable vision for the Phoenix Metropolitan Area without childhood obesity, as well as strategic actions plans for each school to utilize as they move forward on addressing this challenge.
ContributorsLawless, Tamara Hope (Author) / Golub, Aaron (Thesis advisor) / Redman, Charles (Committee member) / Schugurensky, Daniel, 1958- (Committee member) / Arizona State University (Publisher)
Created2013
Description
Food insecurity and childhood obesity are both major public health concerns in the United States of America. Research has not found a definite relationship between childhood obesity and food insecurity to date, with conflicting results being found due to differences in sample sizes and protocol for measuring key variables. Preschoolers (children aged 2-5 years) are a population of particular interest as there tends to be improved health behaviors and greater adaptability to change at this period of growth and development. This study aims to evaluate if there is a relationship between food insecurity and childhood obesity with diet quality as a mediator among preschoolers in the Phoenix area. A secondary data analysis from participants (n=154) from the SAGE (Sustainability via Active Garden Education) research project was used to evaluate food insecurity status, diet quality components (kcal, saturated fat, added sugars, and servings of juice, fruits, and vegetables), and anthropometrics (waist circumference and BMI percentile). No significant associations between food insecurity status, diet quality components, and anthropometric data were found. There was an increased rate of food insecurity and childhood overweight/obesity in this sample compared to state and national averages. Further research of high quality is necessary to determine whether a relationship exists between childhood obesity and food insecurity exists and in what context. Additionally, practice and policy will need to be implemented to decrease rates of food insecurity and childhood obesity among Phoenix preschoolers.
ContributorsGutierrez, Marisa (Author) / Bruening, Meg (Thesis advisor) / Whisner, Corrie (Committee member) / Lee, Rebecca E (Committee member) / Arizona State University (Publisher)
Created2020
Description
Background:
Approximately 1 in 5 U.S. school-aged children are obese. There are many known health complications associated with obesity including premature death. Family-based obesity interventions that promote healthy lifestyle habits are effective at enabling children to make changes needed to avoid long-term health complications associated with obesity. The purpose of this evidence-based practice intervention was to evaluate the effectiveness of a family-based obesity intervention on familial lifestyle behaviors related to nutrition, physical activity, and screen time.
Methods:
Two overweight-obese children (according to CDC criteria) ages 8-12 years old visiting a pediatric primary care clinic in a suburban neighborhood located in the southwest region were recruited to participate in this evidence-based practice intervention based on inclusion and exclusion criteria. Familial lifestyle behaviors were assessed using the Family Health Behavior Scale (FHBS) prior to receiving an educational intervention addressing nutritional, physical activity, and screen time recommendations and again after following these recommendation for 6-weeks. Additionally, scheduled follow-up phone calls were made every 3 or 6-weeks addressing any parental questions that surfaced. Data was insufficient for statistical analysis, however, anecdotal recommendations for future implementation of this intervention resulted.
Results:
Of the two patients who participated, pre- and post-intervention data was only attainable from one patient. That patient did have improved scores within each of the 4 FHBS subscales (parent behaviors, physical activity, mealtime routines, and child behaviors). Overall, 11 of the 27 behaviors assessed improved, 12 behaviors resulted in no change, and 4 behaviors worsened. Recommendations related to a more successful implementation of this intervention in the future include improved provider participation (buy-in), utilization of broader inclusion criteria, consideration of the implementation time-frame, and application of the Health Belief Model for addressing existing barriers for each patient prior to implementing the intervention.
Conclusions:
In order to determine the effectiveness of this intervention a larger sample size and completed post-intervention data are needed. The small sample size and lack of post-intervention data inhibits proper data analyzation and significance from being determined.
ContributorsAgliano, Courtney (Author) / Crawford, Daniel (Thesis advisor)
Created2018-05-02