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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

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
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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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The purpose of this research was to analyze the EPODE Model for the development community-based interventions against childhood obesity and its transferability on a global scale. The Ensemble, Prevenons L'Obesite des Enfant (EPODE: Together Let's Prevent Childhood Obesity) Model was developed in France following the successful results of a community-based

The purpose of this research was to analyze the EPODE Model for the development community-based interventions against childhood obesity and its transferability on a global scale. The Ensemble, Prevenons L'Obesite des Enfant (EPODE: Together Let's Prevent Childhood Obesity) Model was developed in France following the successful results of a community-based intervention there. The Model is illustrated by four pillars that are essential to program implementation and positive results. These pillars are: political support, research & evaluation, social marketing principles and public/private partnerships. Using these four pillars, the model has been transferred to diverse countries around the globe and has shown results in these diverse locations. In order to understand what makes this model so transferrable to so many diverse locations, this researcher traveled to the Netherlands, Belgium and France visiting program locations and interviewing professionals who have been involved in the development of the model, its modification and implementation. These interviews addressed specific modifications to the model that were made for implementation in the Netherlands and Belgium. This paper outlines the key transferrable components of this model and outlines a proposed model to be used in the United States.
Created2014-05
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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

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