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- All Subjects: Breast milk--Collection and preservation--United States.
- Creators: Todd, Michael
Description
Exclusivity and duration of breastfeeding and the provision of human milk in the United States is suboptimal. In the absence of adequate banked donor human milk for distribution to all infants in need, many families choose to engage in the practice of Private Arrangement Milk Sharing (PAMS), partially facilitated through social media, to procure human milk for their infants. Evidence regarding the participant and infant characteristics and risk abatement practices is incomplete. This dissertation describes and explores the characteristics of recipient participants and infants, family constellation, donor screening practices, and related risk abatement strategies. Data was collected via on-line survey as a sub-group of a larger data set including donor participants and international participants. Binary logistic regression modeling of factors that contribute to consistent screening and risk abatement practices and important antecedents to engaging in PAMS was conducted. Results are contextualized within a tailored socioecological framework of factors affecting infant feeding practices. Tailoring was accomplished via qualitative descriptive analysis of participant responses applied to an existing breastfeeding framework. Participants in this sample were predominantly white, married, with a mean age of 32.9 years, with at least some college education and above median income. Risk abatement and screening practices were influenced by support of a healthcare provider during decision-making, college education, infant age and health status, having lactation support, birth type and birth attendant, and the duration and sources sought for learning about milk sharing.
ContributorsBond, Angela Bowen (Author) / Reifsnider, Elizabeth G. (Thesis advisor) / Keller, Colleen (Committee member) / Todd, Michael (Committee member) / Arizona State University (Publisher)
Created2016
Description
This dissertation was guided by the Ecological Model of Physical Activity and Ecological Model of Obesity and sought to determine the relationship between active transportation (AT), physical activity, and cardiometabolic health among adults and ethnic minority women. Chapter 2 presents an investigation into the relationship between walking for AT and cardiometabolic health among adults through systematic review. Chapter 3 presents an exploration of the cross-sectional relationships of AT and moderate-to-vigorous physical activity (MVPA) with cardiometabolic health among African American (AA) and Hispanic/Latina (HL) women from Texas. Chapter 4 presents an investigation into the cross-sectional relationship of AT on cardiometabolic health and physical activity among primarily HL women.
In Chapter 2, walking for AT was found to be related to smaller waist circumference, lower blood pressure, and lower prevalence of abdominal obesity and hypertension, and that differences may exist based on sex. Walking for AT was not clearly defined, and criteria used to determine the presence of cardiometabolic outcomes were inconsistent. No significant relationships between AT and cardiometabolic health were found in Chapter 3 or 4; however, AT users had slightly better cardiometabolic health. AT users had significantly higher levels of self-reported total physical activity compared to those who did not use AT in Chapter 3. Furthermore, a significant relationship was found between MVPA and diastolic blood pressure. Associations differed by ethnicity, with MVPA being inversely related to body fat in both AA and HL women, but to body mass index only in AA women. AT users were found to be seven times more likely to meet 2018 national MVPA recommendations than non-AT users in Chapter 4. Across all studies, measures of AT were subjective and of low quality, potentially limiting the ability to detect significant findings.
High quality randomized controlled studies should be conducted using clearly defined, objective measures of AT, and analyzed based on sex and race/ethnicity. Clinicians should recommend AT use to promote meeting MVPA recommendations where appropriate, potentially resulting in improved cardiometabolic health. Policymakers should advocate for changes to the built environment to encourage AT use and MVPA to improve public health.
In Chapter 2, walking for AT was found to be related to smaller waist circumference, lower blood pressure, and lower prevalence of abdominal obesity and hypertension, and that differences may exist based on sex. Walking for AT was not clearly defined, and criteria used to determine the presence of cardiometabolic outcomes were inconsistent. No significant relationships between AT and cardiometabolic health were found in Chapter 3 or 4; however, AT users had slightly better cardiometabolic health. AT users had significantly higher levels of self-reported total physical activity compared to those who did not use AT in Chapter 3. Furthermore, a significant relationship was found between MVPA and diastolic blood pressure. Associations differed by ethnicity, with MVPA being inversely related to body fat in both AA and HL women, but to body mass index only in AA women. AT users were found to be seven times more likely to meet 2018 national MVPA recommendations than non-AT users in Chapter 4. Across all studies, measures of AT were subjective and of low quality, potentially limiting the ability to detect significant findings.
High quality randomized controlled studies should be conducted using clearly defined, objective measures of AT, and analyzed based on sex and race/ethnicity. Clinicians should recommend AT use to promote meeting MVPA recommendations where appropriate, potentially resulting in improved cardiometabolic health. Policymakers should advocate for changes to the built environment to encourage AT use and MVPA to improve public health.
ContributorsLorenzo, Elizabeth (Author) / Lee, Rebecca E (Thesis advisor) / Todd, Michael (Committee member) / Shin, Cha-Nam (Committee member) / Arizona State University (Publisher)
Created2019