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Health knowledge alone does not appear to lead to sustained healthy behavior, suggesting the need for alternative methods for improving diet. Recent research shows a possible role of moral contexts of food production on diet related behaviors; however no studies have been conducted to specifically explore the relationship between moral

Health knowledge alone does not appear to lead to sustained healthy behavior, suggesting the need for alternative methods for improving diet. Recent research shows a possible role of moral contexts of food production on diet related behaviors; however no studies have been conducted to specifically explore the relationship between moral constructs and food consumption. This study examined the relationship between fast food consumption and two measures of morality, Moral Foundations Questionnaire (MFQ), specifically harm/care and purity/sanctity foundations, and the Ethical Concern in food choice (EC) questionnaire, which includes animal welfare, environment protection, political values, and religion subscales. The study also examined the association between the measures of morality. 739 participants, primarily female (71.4%) and non-Hispanic Whites (76.5%), completed an online survey that included the MFQ, the EC questionnaire, and a brief fast food screener. Participant's morality scores in relation to their fast food consumption were examined first using bivariate ANOVA analysis and then using logistic regression to control for covariates. The MFQ foundations were compared with the EC subscales using Pearson correlation coefficient. Significant bivariate relationships were seen between fast food consumption and the MFQ's purity/sanctity foundation and EC's religion subscales (p<0.05). However these significant bivariate relationships did not hold after controlling for gender, race, university education, and religion in the logistic regression analysis. The foundations of the MFQ were positively correlated with the subscales for the EC questionnaire (r values ranging from .233-.613 (p<0.01). MFQ's purity/sanctity foundation and EC's religion subscale were the two most highly correlated (r=.613, p<0.01) showing that moral intuitions may be associated with eating decision making. The study did not find significant associations between MFQ or EC scores and fast food consumption.
ContributorsMartinelli, Sarah (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Hekler, Eric B. (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Johnston, Carol (Committee member) / Arizona State University (Publisher)
Created2013
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Background: Previous research suggests a healthy eater schema (i.e., identifying yourself as a healthy eater) may be a useful concept to target in interventions. A "stealth" intervention that discussed the moral issues related to food worked better at promoting healthful eating than an intervention focused on the health benefits. No

Background: Previous research suggests a healthy eater schema (i.e., identifying yourself as a healthy eater) may be a useful concept to target in interventions. A "stealth" intervention that discussed the moral issues related to food worked better at promoting healthful eating than an intervention focused on the health benefits. No research has explored the relationship between moral foundations, a theoretical model focused on delineating core "foundations" for making a moral decision, and healthy eater self-identity or self-efficacy. Purpose: We explored the relationship between moral foundations (i.e., harm/care, fairness/reciprocity, in-group/loyalty, authority/respect, & purity/sanctity) and health eater self-identity and fruit and vegetable self-efficacy (FVSE). Methods: 542 participants completed an online cross-sectional survey, which included moral foundations (i.e., MFQ), political views, healthy eater self-identity (i.e., HESS), and FVSE measures. Logistic regression was used to assess the relationship between moral foundations between healthy eater self-identity after controlling for age, gender, major, BMI, and political beliefs. OLS regression was used to explore the relationship between self-efficacy and the moral foundations after controlling for the covariates. Results: 75.6% of the sample were college students, with a mean age of 25.27 (SD=8.61). 25.1% of students were nutrition majors. Harm/care, authority/respect, and ingroup/loyalty were significantly associated with healthy eater schema, (i.e., OR=1.7, p<.001, OR=1.5, p=.009, and OR=1.4, p=.027, respectively). Ingroup/loyalty, authority/respect, and purity/sanctity were related to FVSE (p=.006, p=.002, p=.04, respectively). Conclusion: Among college students, harm/care and authority/respect were associated with a healthy eater schema. Future research should explore possible uses of these moral foundations in interventions (e.g., a plant-based diet based on reduced harm to animals or eating fewer processed views based on "traditional" values).
ContributorsKiser, Sarah (Author) / Hekler, Eric B. (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Johnston, Carol (Committee member) / Arizona State University (Publisher)
Created2013
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Description
Many individual-level behavioral interventions improve health and well-being. However, most interventions exhibit considerable heterogeneity in response. Put differently, what might be effective on average might not be effective for specific individuals. From an individual’s perspective, many healthy behaviors exist that seem to have a positive impact. However, few existing tools

Many individual-level behavioral interventions improve health and well-being. However, most interventions exhibit considerable heterogeneity in response. Put differently, what might be effective on average might not be effective for specific individuals. From an individual’s perspective, many healthy behaviors exist that seem to have a positive impact. However, few existing tools support people in identifying interventions that work for them, personally.

One approach to support such personalization is via self-experimentation using single-case designs. ‘Hack Your Health’ is a tool that guides individuals through an 18-day self-experiment to test if an intervention they choose (e.g., meditation, gratitude journaling) improves their own psychological well-being (e.g., stress, happiness), whether it fits in their routine, and whether they enjoy it.

The purpose of this work was to conduct a formative evaluation of Hack Your Health to examine user burden, adherence, and to evaluate its usefulness in supporting decision-making about a health intervention. A mixed-methods approach was used, and two versions of the tool were tested via two waves of participants (Wave 1, N=20; Wave 2, N=8). Participants completed their self-experiments and provided feedback via follow-up surveys (n=26) and interviews (n=20).

Findings indicated that the tool had high usability and low burden overall. Average survey completion rate was 91%, and compliance to protocol was 72%. Overall, participants found the experience useful to test if their chosen intervention helped them. However, there were discrepancies between participants’ intuition about intervention effect and results from analyses. Participants often relied on intuition/lived experience over results for decision-making. This suggested that the usefulness of Hack Your Health in its current form might be through the structure, accountability, and means for self-reflection it provided rather than the specific experimental design/results. Additionally, situations where performing interventions within a rigorous/restrictive experimental set-up may not be appropriate (e.g., when goal is to assess intervention enjoyment) were uncovered. Plausible design implications include: longer experimental and phase durations, accounting for non-compliance, missingness, and proximal/acute effects, and exploring strategies to complement quantitative data with participants’ lived experiences with interventions to effectively support decision-making. Future work should explore ways to balance scientific rigor with participants’ needs for such decision-making.
ContributorsPhatak, Sayali Shekhar (Author) / Buman, Matthew P (Thesis advisor) / Hekler, Eric B. (Committee member) / Huberty, Jennifer L (Committee member) / Johnston, Erik W., 1977- (Committee member) / Swan, Pamela D (Committee member) / Arizona State University (Publisher)
Created2019
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Description
Behavioral health problems such as physical inactivity are among the main causes of mortality around the world. Mobile and wireless health (mHealth) interventions offer the opportunity for applying control engineering concepts in behavioral change settings. Social Cognitive Theory (SCT) is among the most influential theories of health behavior and has

Behavioral health problems such as physical inactivity are among the main causes of mortality around the world. Mobile and wireless health (mHealth) interventions offer the opportunity for applying control engineering concepts in behavioral change settings. Social Cognitive Theory (SCT) is among the most influential theories of health behavior and has been used as the conceptual basis of many behavioral interventions. This dissertation examines adaptive behavioral interventions for physical inactivity problems based on SCT using system identification and control engineering principles. First, a dynamical model of SCT using fluid analogies is developed. The model is used throughout the dissertation to evaluate system identification approaches and to develop control strategies based on Hybrid Model Predictive Control (HMPC). An initial system identification informative experiment is designed to obtain basic insights about the system. Based on the informative experimental results, a second optimized experiment is developed as the solution of a formal constrained optimization problem. The concept of Identification Test Monitoring (ITM) is developed for determining experimental duration and adjustments to the input signals in real time. ITM relies on deterministic signals, such as multisines, and uncertainty regions resulting from frequency domain transfer function estimation that is performed during experimental execution. ITM is motivated by practical considerations in behavioral interventions; however, a generalized approach is presented for broad-based multivariable application settings such as process control. Stopping criteria for the experimental test utilizing ITM are developed using both open-loop and robust control considerations.

A closed-loop intensively adaptive intervention for physical activity is proposed relying on a controller formulation based on HMPC. The discrete and logical features of HMPC naturally address the categorical nature of the intervention components that include behavioral goals and reward points. The intervention incorporates online controller reconfiguration to manage the transition between the behavioral initiation and maintenance training stages. Simulation results are presented to illustrate the performance of the system using a model for a hypothetical participant under realistic conditions that include uncertainty. The contributions of this dissertation can ultimately impact novel applications of cyberphysical system in medical applications.
ContributorsMartín Moreno, César Antonio (Author) / Rivera, Daniel E (Thesis advisor) / Hekler, Eric B. (Committee member) / Peet, Matthew M (Committee member) / Tsakalis, Konstantinos S (Committee member) / Arizona State University (Publisher)
Created2016
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Description

Purpose: This qualitative research aimed to create a developmentally and gender-appropriate game-based intervention to promote Human Papillomavirus (HPV) vaccination in adolescents. <br/>Background: Ranking as the most common sexually transmitted infection, about 80 million Americans are currently infected by HPV, and it continues to increase with an estimated 14 million new

Purpose: This qualitative research aimed to create a developmentally and gender-appropriate game-based intervention to promote Human Papillomavirus (HPV) vaccination in adolescents. <br/>Background: Ranking as the most common sexually transmitted infection, about 80 million Americans are currently infected by HPV, and it continues to increase with an estimated 14 million new cases yearly. Certain types of HPV have been significantly associated with cervical, vaginal, and vulvar cancers in women; penile cancers in men; and oropharyngeal and anal cancers in both men and women. Despite HPV vaccination being one of the most effective methods in preventing HPV-associated cancers, vaccination rates remain suboptimal in adolescents. Game-based intervention, a novel medium that is popular with adolescents, has been shown to be effective in promoting health behaviors. <br/>Methods: Sample/Sampling. We used purposeful sampling to recruit eight adolescent-parent dyads (N = 16) which represented both sexes (4 boys, 4 girls) and different racial/ethnic groups (White, Black, Latino, Asian American) in the United States. The inclusion criteria for the dyads were: (1) a child aged 11-14 years and his/her parent, and (2) ability to speak, read, write, and understand English. Procedure. After eligible families consented to their participation, semi-structured interviews (each 60-90 minutes long) were conducted with each adolescent-parent dyad in a quiet and private room. Each dyad received $50 to acknowledge their time and effort. Measure. The interview questions consisted of two parts: (a) those related to game design, functioning, and feasibility of implementation; (b) those related to theoretical constructs of the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB). Data analysis. The interviews were audio-recorded with permission and manually transcribed into textual data. Two researchers confirmed the verbatim transcription. We use pre-developed codes to identify each participant’s responses and organize data and develop themes based on the HBM and TPB constructs. After the analysis was completed, three researchers in the team reviewed the results and discussed the discrepancies until a consensus is reached.<br/>Results: The findings suggested that the most common motivating factors for adolescents’ HPV vaccination were its effectiveness, benefits, convenience, affordable cost, reminders via text, and recommendation by a health care provider. Regarding the content included in the HPV game, participants suggested including information about who and when should receive the vaccine, what is HPV and the vaccination, what are the consequences if infected, the side effects of the vaccine, and where to receive the vaccine. The preferred game design elements were: 15 minutes long, stories about fighting or action, option to choose characters/avatars, motivating factors (i.e., rewards such as allowing users to advance levels and receive coins when correctly answering questions), use of a portable electronic device (e.g., tablet) to deliver the education. Participants were open to multiplayer function which assists in a facilitated conversation about HPV and the HPV vaccine. Overall, the participants concluded enthusiasm for an interactive yet engaging game-based intervention to learn about the HPV vaccine with the goal to increase HPV vaccination in adolescents. <br/>Implications: Tailored educational games have the potential to decrease the stigma of HPV and HPV vaccination, increasing communication between the adolescent, parent, and healthcare provider, as well as increase the overall HPV vaccination rate.

ContributorsBeaman, Abigail Marie (Author) / Chen, Angela Chia-Chen (Thesis director) / Amresh, Ashish (Committee member) / Edson College of Nursing and Health Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05