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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

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
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Description
Salad bars are promoted as a means to increase fruit and vegetable consumption among school-age children; however, no study has assessed barriers to having salad bars. Further, it is not known if barriers differ across school level. This cross-sectional study investigated the barriers to having salad bars across school level

Salad bars are promoted as a means to increase fruit and vegetable consumption among school-age children; however, no study has assessed barriers to having salad bars. Further, it is not known if barriers differ across school level. This cross-sectional study investigated the barriers to having salad bars across school level among schools without salad bars in Arizona (n=177). Multivariate binominal regression models were used to determine differences between the barriers and school level, adjusting for years at current job, enrollment of school, free-reduced eligibility rate and district level clustering. The top five barriers were not enough staff (51.4%), lack of space for salad bars (49.7%), food waste concerns (37.9%), sanitation/food safety concerns (31.3%), and time to get through the lines (28.3%) Adjusted analyses indicated two significant differences between barriers across school level: time to get through lines (p=0.040) and outside caterer/vendor (p=0.018) with time to get through lines reported more often by elementary and middle school nutrition managers and outside caterer/vendor reported most often by high school nutrition managers. There were several key barriers reported and results indicate that having an outside vendor/caterer for their meal programs and time to get through the service lines varied across school level. High schools report a higher percent of the barrier outside caterer/vendors and elementary and middle schools report a higher percent of the barrier time to get through the lines. Results indicate that research determining the approximate time it takes students to get through salad bar lines will need to be considered. More research is needed to determine if the barrier time to get through the service lines is due to selection of food items or if it is due to the enrollment size of the lunch period. Future research interventions may consider investigating food safety and sanitation concerns of middle school nutrition managers. Findings may be used to guide ways to decrease barriers in schools without salad bars.
ContributorsKebric, Kelsey (Author) / Bruening, Meg (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Adams, Marc (Committee member) / Arizona State University (Publisher)
Created2016
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Description
Fruit and vegetable consumption among school children falls short of current recommendations. The development of Public-Private Partnerships (PPP), which combine the resources of government entities with the resources of private entities, such as businesses or not-for-profit agencies, has been suggested as an effective approach to address a number of public

Fruit and vegetable consumption among school children falls short of current recommendations. The development of Public-Private Partnerships (PPP), which combine the resources of government entities with the resources of private entities, such as businesses or not-for-profit agencies, has been suggested as an effective approach to address a number of public health concerns, including inadequate fruit and vegetable consumption. The United States Department of Agriculture's (USDA) Fresh Fruit and Vegetable Program (FFVP) provides fruits and vegetables as snacks at least twice per week in low-income elementary schools. In addition to increasing fruit and vegetable consumption behaviors at school, children participating in the FFVP have been found to make more requests for fruits and vegetables in grocery stores and at home, suggesting the impact of the program extends beyond school settings. The purpose of this multicase study was to describe key stakeholders' perceptions about creating PPPs between schools and nearby retailers to cross-promote fruits and vegetables in low-income communities, using the FFVP. Semi-structured interviews were conducted with participants from three cases groups: grocery store/produce managers (n=10), district FFVP personnel (n=5) and school FFVP personnel (n=12). Data were analyzed using a directed content analysis approach using constructs from the Health Belief Model, including benefits, barriers, strategies, and motivation. While findings varied by case group, key benefits of creating a PPP included the potential to increase store sales, to enhance public relations with the community, and to extend the impact of the FFVP to settings outside of schools. Barriers included offering expensive produce through the FFVP, time/labor-associated costs, and needing approval from authorities and supervisors. Strategies for developing a PPP included using seasonal produce and having clear instructions for teachers and staff. Stakeholders reported being motivated to create a PPP by the potential to improve health outcomes in children and by wanting to help the community. Both objective and subjective measures were suggested to measure the success of such a partnership. Finally, the educational component of the USDA's Supplemental Nutrition Assistance Program (SNAP-Ed) has the potential to serve as a catalyst for organizing a PPP between FFVP-participating schools and nearby grocery stores.
ContributorsGruner, Jessie (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Evans, Browynne (Committee member) / Bruening, Meg (Committee member) / Tasevska, Natasha (Committee member) / Hekler, Eric (Committee member) / Arizona State University (Publisher)
Created2017
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Description
Background In the United States (US), first-year university students typically live on campus and purchase a meal plan. In general, meal plans allow the student a set number of meals per week or semester, or unlimited meals. Understanding how students’ use their meal plan, and barriers and facilitators to meal

Background In the United States (US), first-year university students typically live on campus and purchase a meal plan. In general, meal plans allow the student a set number of meals per week or semester, or unlimited meals. Understanding how students’ use their meal plan, and barriers and facilitators to meal plan use, may help decrease nutrition-related issues.

Methods First-year students’ meal plan and residence information was provided by a large, public, southwestern university for the 2015-2016 academic year. A subset of students (n=619) self-reported their food security status. Logistic generalized estimating equations (GEEs) were used to determine if meal plan purchase and use were associated with food insecurity. Linear GEEs were used to examine several potential reasons for lower meal plan use. Logistic and Linear GEEs were used to determine similarities in meal plan purchase and use for a total of 599 roommate pairs (n=1186 students), and 557 floormates.

Results Students did not use all of the meals available to them; 7% of students did not use their meal plan for an entire month. After controlling for socioeconomic factors, compared to students on unlimited meal plans, students on the cheapest meal plan were more likely to report food insecurity (OR=2.2, 95% CI=1.2, 4.1). In Fall, 26% of students on unlimited meal plans reported food insecurity. Students on the 180 meals/semester meal plan who used fewer meals were more likely to report food insecurity (OR=0.9, 95% CI=0.8, 1.0); after gender stratification this was only evident for males. Students’ meal plan use was lower if the student worked a job (β=-1.3, 95% CI=-2.3, -0.3) and higher when their roommate used their meal plan frequently (β=0.09, 99% CI=0.04, 0.14). Roommates on the same meal plan (OR=1.56, 99% CI=1.28, 1.89) were more likely to use their meals together.

Discussion This study suggests that determining why students are not using their meal plan may be key to minimizing the prevalence of food insecurity on college campuses, and that strategic roommate assignments may result in students’ using their meal plan more frequently. Students’ meal plan information provides objective insights into students’ university transition.
Contributorsvan Woerden, Irene (Author) / Bruening, Meg (Thesis advisor) / Hruschka, Daniel (Committee member) / Schaefer, David (Committee member) / Vega-Lopez, Sonia (Committee member) / Adams, Marc (Committee member) / Arizona State University (Publisher)
Created2019
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Description
Background: College freshmen are exposed to a variety of environmental and social factors that can alter changes to health habits and encourage weight gain. Weight-related conversations had with friends may be related to self-perception of weight and alterations to health behaviors, but this association has yet to be assessed in

Background: College freshmen are exposed to a variety of environmental and social factors that can alter changes to health habits and encourage weight gain. Weight-related conversations had with friends may be related to self-perception of weight and alterations to health behaviors, but this association has yet to be assessed in the college population.

Objective: This study aims to examine the relationship between friend advice about weight management, self-perception of weight, and alterations to weight change intentions, physical activity, and eating habits in college freshmen over time.

Methods: College freshmen from ASU with complete data for three time points (n=321) were found to be predominantly female (72.2%) and non-white (53.2%) with a mean age of 17.5±41. Complete data included responses for items included in analysis which were related to friend encouragement about weigh management, self-perception of weight, physical activity, eating behaviors, and weight change intentions. A longitudinal multivariate mediation analysis using negative binomial regression adjusted for sociodemographics and clustering by dorm was used to assess the relationship between 1) friend encouragement about weight management at time 1 and behavioral outcomes at time 3, 2) friend encouragement about weight management at time 1 and self-perception of weight at time 2, and 3) self-perception of weight at time 2 and behavioral outcomes at time 3.

Results: A small proportion of population perceived friend encouragement about weight loss (18.3%) and weight gain (14.4%) at time 1. Half the population (50.9%) had the self-perception of overweight at time 2. At time 3, more than half (54.3%) of individuals performed at least 60 minutes of MVPA and consumed at least ½ a serving of sugar-sweetened beverages each day, while nearly half (48.6%) consumed at least 2 servings of fruits and vegetables each day. Males perceived more friend encouragement to gain weight (27.4%; p<0.01), but more females had the self-perception of overweight (54%; p=0.04) and were attempting to lose weight (59.3%; p<0.01). Individuals who perceived friend encouragement to lose weight at time 1 had a 14.8% greater prevalence (p<0.001) of overweight perception of time two, and a 9.6% and 6.9%; decreased prevalence (p<0.001) of weight change and weight loss intentions (p=0.023) at time three respectively. Individuals who perceived friend encouragement to gain weight had a 34.9% decreased prevalence of (p<0.001) of self-perception of overweight at time 1. In individuals with the self-perception of overweight at time 2, there was a 18.1% increased prevalence (p<0.001) of consuming at least ½ a serving of sugar-sweetened beverages/day and an increased prevalence of 22.8% and 24.0% for weight change intentions and weight loss intentions at time 3 (p<0.001).

Conclusion: These findings suggest that there was not a mediation effect of self-perception of overweight in the relationship between friend encouragement about weight management and behavioral outcomes in the current sample. However, the increased prevalence of overweight perception in individuals who perceived friend encouragement about weight management may inform future interventions to focus on how weight-related conversations with friends is related to overweight perception. More research about the relationship between weight-related conversations had with friends, self-perception of weight, and health behaviors is needed to confirm these findings.
ContributorsThibodeau, Tristan (Author) / Bruening, Meg (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Huberty, Jennifer (Committee member) / Arizona State University (Publisher)
Created2016
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Description
While literature has examined the associations between emotions and overeating, rarely is the relationship between emotions and food choices included. The purpose of this secondary data analysis was to utilize mobile-based ecological momentary assessment (EMA) surveys to determine the associations among negative, positive, apathetic, and mixed emotions and a variety

While literature has examined the associations between emotions and overeating, rarely is the relationship between emotions and food choices included. The purpose of this secondary data analysis was to utilize mobile-based ecological momentary assessment (EMA) surveys to determine the associations among negative, positive, apathetic, and mixed emotions and a variety of food choices in college freshmen living in residence halls. A total of 2142 survey responses from 647 college freshmen were included in this analysis (70.3% female, 51.5% non-white). Mixed model logistic regression assessed the cross-sectional association between emotions and food choices adjusting for gender, race/ethnicity, Pell grant status, highest parental education, and the clustering of repeated measures within person and of students within residence hall. There were no significant associations between negative emotions and food choices. Positive emotions were significantly and inversely associated with eating pizza/fast food (OR=0.6; 95% CI=0.5, 0.8) and cereals (OR=0.6; 95% CI=0.4, 1.0), while apathetic emotions were significantly and positively associated with consuming salty snacks/fried foods (OR=1.6; 95% CI=1.1, 2.5) and inversely associated with consuming sandwiches/wraps (OR=0.5; 95% CI=0.3, 0.8) and meats/proteins (OR=0.6; 95% CI=0.4, 1.0). It was also found that there were several instances of surveys with mixed emotions, in which participants reported feeling two conflicting emotions at once (i.e. positive and negative). Mixed emotions were significantly associated with consuming sweets (OR=1.6; 95% CI=1.2, 2.1), meats/proteins (OR=1.6; 95% CI=1.2, 2.0), and cereals (OR=1.9; 95% CI=1.2, 2.9). Understanding the relationships between different types of emotions and food choices is helpful in understanding the motivation behind healthy versus unhealthy food choices. These findings can be used to develop interventions that encourage positive emotions in college freshmen to better promote healthy food choices and ultimately reduce the risk of weight gain and other health disparities. Future research should examine how college freshmen differ from other college students (i.e. upper classmen and graduate students), particularly related to their emotions and food choices, so that dietary interventions can be better suited to those who are vulnerable.
ContributorsAshurst, Jessica (Author) / Bruening, Meg (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Swan, Pamela (Committee member) / Arizona State University (Publisher)
Created2016