Matching Items (8)
Filtering by
- All Subjects: Obesity
- All Subjects: Children
- Genre: Academic theses
- Creators: Ohri-Vachaspati, Punam
Description
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
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
The U.S. Department of Agriculture’s (USDA) National School Lunch Program and School Breakfast Program provide nutritious meals to school-age children. USDA’s Community Eligibility Provision (CEP) is designed to extend the reach of these programs by allowing schools in low-income areas to provide free school meals to all students at no cost to families. CEP has been shown to increase school meal participation, nutritional intake, academic achievement, and attendance in previous research studies. This study aims to examine the impact of long-term CEP participation on student weight outcomes. Nurse-measured height and weight data for school years 2013-14 to 2019-20 were collected from 141 K-12 public schools in four low-income cities. School-level prevalence of obesity was calculated from students’ heights and weights using the Centers for Disease Control and Prevention protocol. CEP participation for each school year was obtained from the state Department of Education. Schools in the sample began participating in CEP at different times yielding varying numbers of years of CEP exposure over the study period. Multivariable analyses examined the relationship between school CEP exposure and the prevalence of obesity, controlling for school-level covariates. Multivariable analyses showed that for every additional year of CEP participation, the school-level prevalence of obesity was 0.4% lower (p=0.018). The regression-adjusted obesity prevalence for schools that never participated in CEP was 28.0%, while the obesity prevalence for schools with 6 years of CEP participation was 25.4%. The lower prevalence of obesity in CEP-participating schools was primarily driven by elementary schools. These results suggest that the benefits of CEP participation can cumulate over time, significantly reducing school-level obesity prevalence over time.
ContributorsDykstra, Tatum Nicole (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Acciai, Francesco (Committee member) / McCoy, Maureen (Committee member) / Arizona State University (Publisher)
Created2024
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
Although many studies have looked into the benefits and consequences of consuming breakfast, most have not looked into the unintended consequences of breakfast being served at school; specifically the consumption of an additional breakfast. This cross-sectional study investigated the prevalence and health related outcomes of the consumption of an additional breakfast at school amongst youth using a survey assessing possible predictors (i.e. parental education, morning activities, race), the ASA-kids 24-hr dietary recall, and height and weight measurements. A total of fifty-eight participants (aged 13.5±1.6 years; 55.2% male) were recruited at after school library programs and Boys and Girls Clubs in the Phoenix, Arizona Metro Area during 2014. The main outcomes measured were BMI percentile, total calories, iron, sodium, carbohydrates, added sugar, and fiber. In the study, the prevalence of consumption of an additional breakfast at school at least once a week or more was 32.7%. There were no significant differences between the consumption of an additional breakfast and not an additional breakfast amongst the main outcomes measures. The directionality of the relationship between the consumption of an additional breakfast and overweight/obesity amongst youth was inverse (OR = 0.309; p-value = 0.121), but this was not significant. This study found that the consumption of an additional breakfast at school is not contributing to overweight/obesity in youth, nor does it alter overall caloric and nutrient intake. School breakfast programs are important for providing breakfast and key nutrients to youth.
ContributorsSimpson, Julie (Author) / Bruening, Meg (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Rider, Linda (Committee member) / Arizona State University (Publisher)
Created2015
Description
While obesity rates have plateaued within the last decade,
two-thirds of the United States
population is currently classified as overweight (defined a
s a body mass index [BMI] of
25-29.9 kg/m²) or obese (a BMI greater than 30 kg/m²). Bariatric
surgical interventions
are not only more effective than behavioral treatments
in the short term but are the only
form of obesity intervention with evidence of consisten
t long-term effectiveness.
However, even among bariatric surgery patients, weight
loss often stabilizes and it is
estimated that more than 20% of bariatric surgery patient
s will regain a significant
amount of weight that was initially lost long-term. Li
ttle research to date has been
conducted on physical activity in post bariatric surgery pati
ents. More specifically, there
have been no studies to date examining the effects of Me
ditative Movement (MM)
programs on body composition in bariatric patients. A s
tudy using an 8-week Tai Chi
Easy program was conducted in female gastric bypass patient
s to explore feasibility of
MM in the bariatric population as well as pre- and post-in
tervention changes in weight,
mindfulness, eating behaviors, body awareness, physical a
ctivity patterns, dietary quality
and mood. Data analysis revealed that there were no s
ignificant changes in weight or
physical activity patterns; however, significant changes w
ere observed in anxiety, overall
body awareness and cognitive restraint in eating. Addit
ionally, a significant decrease in
processed meat consumption and a weak trend towards increa
sed consumption of fruits
may suggest an overall improvement in dietary quality.
two-thirds of the United States
population is currently classified as overweight (defined a
s a body mass index [BMI] of
25-29.9 kg/m²) or obese (a BMI greater than 30 kg/m²). Bariatric
surgical interventions
are not only more effective than behavioral treatments
in the short term but are the only
form of obesity intervention with evidence of consisten
t long-term effectiveness.
However, even among bariatric surgery patients, weight
loss often stabilizes and it is
estimated that more than 20% of bariatric surgery patient
s will regain a significant
amount of weight that was initially lost long-term. Li
ttle research to date has been
conducted on physical activity in post bariatric surgery pati
ents. More specifically, there
have been no studies to date examining the effects of Me
ditative Movement (MM)
programs on body composition in bariatric patients. A s
tudy using an 8-week Tai Chi
Easy program was conducted in female gastric bypass patient
s to explore feasibility of
MM in the bariatric population as well as pre- and post-in
tervention changes in weight,
mindfulness, eating behaviors, body awareness, physical a
ctivity patterns, dietary quality
and mood. Data analysis revealed that there were no s
ignificant changes in weight or
physical activity patterns; however, significant changes w
ere observed in anxiety, overall
body awareness and cognitive restraint in eating. Addit
ionally, a significant decrease in
processed meat consumption and a weak trend towards increa
sed consumption of fruits
may suggest an overall improvement in dietary quality.
ContributorsSmith, Lisa L. (Author) / Larkey, Linda K (Thesis advisor) / Ainsworth, Barbara (Committee member) / Chisum, Jack (Committee member) / Ohri-Vachaspati, Punam (Committee member) / McClain, Darya (Committee member) / Arizona State University (Publisher)
Created2014
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 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
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