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Description
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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Description
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
Research provides increasing support of self-worth, non-physical motives, and body image for predicting physical activity in women. However, no empirical tests of these associations have been conducted. Ecological momentary assessment (EMA) has been recognized as useful for understanding correlates of physical activity. This study tested the feasibility of a novel

Research provides increasing support of self-worth, non-physical motives, and body image for predicting physical activity in women. However, no empirical tests of these associations have been conducted. Ecological momentary assessment (EMA) has been recognized as useful for understanding correlates of physical activity. This study tested the feasibility of a novel EMA protocol and explored temporal relationships between daily self-worth and physical activity in middle-aged women. Women aged 35-64 years (N=63; M age=49.2±8.2 years) received text message prompts to an Internet-based mobile survey three times daily for 28 days. The survey assessed momentary activity, self-worth (knowledge, emotional, social, physical, general), and self-efficacy. Women concurrently wore an accelerometer on their non-dominant wrist. Feasibility was assessed via accelerometer wear-time estimates, survey completion rates, and participant feedback. Multilevel models examined the predictive influence of self-worth on daily activity counts. Self-efficacy was also tested due to known relationships with self-worth and physical activity in women. Wear time was high (952.92 ± 100.99 min per day), with only 141 observations lost to non-wear. However, 449 were lost to accelerometer malfunction. Women completed 80.8% of surveys. After excluding missing physical activity data, 67.5% of observations (N=3573) were analyzed. Although women thought the survey was easy to complete, perceptions of the accelerometer were mixed. Approximately 34% of the variance in daily counts was within individuals (ICC=0.66). Average self-efficacy (β=0.005, p=0.009), daily fluctuations in self-efficacy (β=0.001, p<0.001), and daily fluctuations in general self-worth (β=0.04, p=0.003) predicted daily activity. There were significant individual differences in relationships between daily fluctuations in emotional (β=0.006, p=0.02) and general self-worth (β=0.005, p=0.02) and daily activity. The use of text message prompts and an Internet-based mobile survey was feasible for conducting EMA in middle-aged women. Research identifying optimal methods of behavior monitoring in longitudinal studies is needed. Results provide support for small but significant associations among daily fluctuations in self-efficacy and general self-worth and daily activity in middle-aged women. The impact of emotional self-worth may differ across women. Further research examining the transient natures of self-efficacy and general self-worth, improving self-worth scales, and testing momentary strategies to increase women's self-worth and physical activity is warranted.
ContributorsEhlers, Diane K. (Author) / Huberty, Jennifer L (Thesis advisor) / Todd, Michael (Committee member) / Vreede, Gert-Jan de (Committee member) / Hooker, Steven (Committee member) / Buman, Matthew (Committee member) / Arizona State University (Publisher)
Created2014
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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

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.
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
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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
Features of the built environment (BE) are related to a wide range of health factors, including leisure-time physical activity (PA) and active forms of transportation. For working adults, worksite neighborhood is likely an important BE to better understand the impact of various factors on PA patterns. Compared to home neighborhood

Features of the built environment (BE) are related to a wide range of health factors, including leisure-time physical activity (PA) and active forms of transportation. For working adults, worksite neighborhood is likely an important BE to better understand the impact of various factors on PA patterns. Compared to home neighborhood walkability research, worksite walkability has received relatively less attention. The objective of this project was to identify if worksite walkability was significantly associated with PA behavior.

Aims: to evaluate 1) the PA variation explained by work walkability, 2) the moderating effects of person-level characteristics to the relationship between PA and work walkability, and 3) the differences in the rate of change in PA over time by worksite walkability.

Methods: self-report and accelerometer measured PA at baseline (aim 1, 2); longitudinal accelerometer PA during the initial 56 days of a behavioral intervention (aim 3). Adults were generally healthy and reported part- or full-time employment with a geocodeable address outside the home. Geographic Information Systems (GIS) measured walkability followed established techniques (i.e., residential, intersection, and transit densities, and land-use-mix).

Results: On average, worksite walkability did not show direct relationships with PA (aim 1); yet certain person-level characteristics moderated the relationships: sex, race, and not having young children in the household (aim 2). During 56 days of intervention, the PA rate of change over time showed no evidence of a moderating effect by worksite walkability.

Discussion: Worksite walkability was generally not shown to relate to the overall PA. However, specific subgroups (women, those without young children) appeared more responsive to their worksite neighborhood walkability. Prior literature shows certain demographics respond differently with various BE exposures, and this study adds a potentially novel moderator of interest regarding young children at home. Understanding who benefits from access to walkable BE may inform targeted interventions and policy to improve PA levels and foster health equity.
ContributorsHurley, Jane Cathleen (Author) / Adams, Marc A (Thesis advisor) / Todd, Mike (Committee member) / Hooker, Steven P (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Ainsworth, Barbara (Committee member) / Arizona State University (Publisher)
Created2019
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Description
The purpose of this study was to examine the feasibility and preliminary efficacy of a theory-driven and a atheoretical reminder point-of-choice (PoC) prompt interventions on reducing workplace sedentary behavior in office workers with self-reported low usage (<4 hours per day) of their sit-stand workstations in the standing position. The design

The purpose of this study was to examine the feasibility and preliminary efficacy of a theory-driven and a atheoretical reminder point-of-choice (PoC) prompt interventions on reducing workplace sedentary behavior in office workers with self-reported low usage (<4 hours per day) of their sit-stand workstations in the standing position. The design of this study was a cross-over trial including randomization into either the theory-driven or atheoertical reminder condition, after completion of a no prompt control condition. Participants (N=19) included full-time, primarily female, Caucasian, middle-aged office workers. The primary aim of this study was to assess the feasibility of these two PoC prompt conditions on reducing sedentary behaviors through the use of a Therapy Evaluation Questionnaire. The secondary aim of this study was to assess the preliminary efficacy of the two PoC prompt conditions on reducing sedentary behaviors relative to no-prompt control using the activPAL micro device. For the primary aim, descriptive means adjusted for ordering effect were computed. For the secondary aim, mixed-effects regression models were used to cluster for observations within-persons and were adjusted for age, gender, race, job-type, and ordering effects. During the no-prompt control, participants spent 267.90 ± 68.01 sitting and 170.20 ± 69.34 min/8hr workday standing. The reminder PoC prompt condition significantly increased sanding time (b[se] = 24.52 [11.09], p=0.034) while the theory-driven PoC condition significantly decreased time spent in long sitting bouts b[se] = -34.86 [16.20], p=0.036), both relative to no prompt control. No statistically significant reductions in sitting time were seen in either PoC prompt condition. Furthermore, no statistically significant differences between the two PoC prompt conditions were observed. This study provides feasibility insight in addition to objective measures of sedentary behaviors regarding the use of PoC prompt interventions in the workplace.
ContributorsLarouche, Miranda (Author) / Buman, Matthew P (Thesis advisor) / Ainsworth, Barbara E (Thesis advisor) / Huberty, Jennifer L (Committee member) / Arizona State University (Publisher)
Created2018
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Description
Food insecurity is an economic and social condition involving limited or uncertain access to food. The problem of food insecurity in communities is influenced by economic conditions, food deserts, and barriers to accessing healthy food. Individuals experiencing food insecurity often endure concurrent problems of financial instability, hunger, and poor mental

Food insecurity is an economic and social condition involving limited or uncertain access to food. The problem of food insecurity in communities is influenced by economic conditions, food deserts, and barriers to accessing healthy food. Individuals experiencing food insecurity often endure concurrent problems of financial instability, hunger, and poor mental and physical health. Public and non-profit services in the U.S., such as the federally supported Supplemental Nutrition Assistance Program (SNAP) and community food banks, provide food-related assistance to individuals who are at a high risk of experiencing food insecurity. Unfortunately, many individuals who qualify for these services still experience food insecurity due to barriers preventing them from accessing food, which may include inadequate finances, transportation, skills, and information. Effective approaches for removing barriers that prevent individuals from accessing food are needed to mitigate the increased risk of hunger, nutritional deficiencies, and chronic disease among vulnerable populations. This dissertation tested a novel food insecurity intervention using informational nudges to promote food security through the elimination of information barriers to accessing food. The intervention used in this mixed-methods feasibility study consisted of informational nudges in the form of weekly text messages that were sent to food pantry clients experiencing food insecurity. The study aims were to test the efficacy and acceptability of the intervention by examining whether the informational nudges could enhance food pantry utilization, increase SNAP registration, and promote food security. Quantitative study results showed a lower prevalence of food insecurity in the intervention group than the control group. Qualitative findings revealed how the intervention group found the text messages to be helpful and informative. These study findings can enhance future food insecurity interventions aiming to eliminate barriers that prevent individuals who are food insecure from accessing healthy food.
ContributorsRoyer, Michael F. (Author) / Wharton, Christopher (Thesis advisor) / Buman, Matthew (Committee member) / Der Ananian, Cheryl (Committee member) / MacKinnon, David (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Arizona State University (Publisher)
Created2023
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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

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.
ContributorsStevens, Clinton (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Gosliner, Wendi (Committee member) / Martinelli, Sarah (Committee member) / Arizona State University (Publisher)
Created2021