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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 purpose of this study was to examine whether a workplace environmental intervention would improve work-related outcomes including productivity, presenteeism and cognition. The secondary aim was to investigate whether work-related outcomes are correlated to observed changes in sitting time, physical activity, and sleep. The study was introduced as part of a naturalistic environmental change in which university staff and faculty were relocated into a new building (n=23). The comparison group consisted of university staff within the same college with no imminent plans to re-locate during the intervention period; there were no environmental changes to this workplace (n =10). Participants wore two behavioral monitoring devices, activPAL and GeneActiv, for 7 consecutive days at two time points (immediately prior and 16 weeks following the office relocation). Measures of productivity and presenteeism were obtained via four validated questionnaires and participants underwent cognitive performance testing. Baseline adjusted analysis of covariance statistical analyses were used to examine differences between groups in work-related outcomes. A residual analysis in regression was conducted to determine the differences between observed changes in sitting time, physical activity and sleep, and work-related outcomes. The results showed that a reduction in work hour sitting time was not detrimental to work related outcomes. Decreased sitting was observed to potentially improve presenteeism and absenteeism. Additionally, physical activity was shown to modestly improve productivity, presenteeism and absenteeism. Poor sleep patterns were associated with work impairment and increased absenteeism.
ContributorsPark, Anna (Author) / Buman, Matthew (Thesis advisor) / Crespo, Noe (Committee member) / Chisum, Jack (Committee member) / Arizona State University (Publisher)
Created2014
Description
Availability and accessibility of foods in the home influence dietary behaviors. However, much of the literature involving measurement of the home food environment (HFE) has examined only self-reported data, and home food inventory tools have not been used to assess behavior change intervention efficacy. Thus, this quasi-experimental study was conducted to test the preliminary efficacy of a 10-week dietary behavioral intervention on the HFE, measured through the presence of fruits, vegetables, and sources of sugars in the household. Participants included 23 parents (21 females; age=36±5.5) of children 6-11 years old living in an ethnically diverse community within a Southwestern metropolitan area. Sociodemographic information was collected at baseline using a survey. A modified version of the Home Food Inventory was completed in the homes of participants by trained research assistants at baseline and following termination of the intervention. Relative to baseline, the intervention resulted in significant increases in availability of different types of fruits (7.7±3.2 vs. 9.4±3.1; p=0.004) and high fiber/low sugar cereal (2.3±1.4 vs. 2.7±1.4; p=0.033). There was a significant reduction in availability of sugar-sweetened beverages (3.2±1.9 vs. 1.7±1.3; p=0.004), and an increase in the number of households with accessible 100% fruit juice (3 vs. 17 households; p=0.001) and bottled/contained water (9 vs. 22 households; p<0.001). Moreover, there were meaningful changes in the number of households with accessible chocolate milk (7 vs. 0), strawberry milk (3 vs. 0), and diet soda pop (2 vs. 0). There was a significant increase in the number of households with accessible ready-to-eat vegetables (8 vs. 19 households; p=0.007), and ready-to-eat fruit (8 vs. 17; p=0.022), and a significant reduction in available prepared desserts (3.0±2.0 vs. 1.7±1.3; p=0.005), and candy (2.0±1.7 vs. 0.6±0.7; p<0.001). There were no significant changes in availability of vegetables and sugar-laden cereals, or accessibility of fresh fruit, fresh vegetables, dry cereal, candy, soda pop, desserts, and sports/fruit drinks. Overall, results suggest that the current dietary behavior change intervention resulted in positive changes in the HFE. Further research to confirm these results in a randomized controlled trial is warranted.
ContributorsCassinat, Rachel (Author) / Vega-Lopez, Sonia (Thesis advisor) / Bruening, Meredith (Committee member) / Crespo, Noe (Committee member) / Arizona State University (Publisher)
Created2015
Description
Background: Latinos have disproportionately high rates of obesity and type 2 diabetes. Family-based interventions may reduce chronic disease risk among Latinos across generations.
Purpose: To assess the efficacy of Athletes for Life (AFL), a 12-week community-and-family-based behavioral intervention, for improving diet, physical activity (PA), anthropometrics, fitness, and biochemical outcomes among mostly Latino parents.
Methods: Parents with at least one child 6-11 years of age were randomized to active AFL participation (n=14) or a wait-list control (n=14) group. AFL consisted of twice weekly 90 minute sessions (45 minutes of nutrition-focused lessons and 45 minutes of PA participation) designed to promote fruit and vegetable consumption, reduction of sugar intake, and increasing habitual PA. Data were collected prior to and immediately after the 12 week intervention.
Results: Participants (37.9±7.2y) were mostly Latino (93%), Spanish speaking (68%), and women (93%). Relative to participants in the control group, AFL participants had a significant reduction in body fat (-1.1±1.2% vs. 0.2±1.2%; p=0.014), resting (-7.6±10.2 bpm vs. +2.1±6.8 bpm; p<0.01), exercise (-8.4±8.7 bpm vs. +0.4±7.3 bpm; p<0.01), and recovery heart rate (-11.9±12.8 bpm vs. -0.3±11.4 bpm; p=0.01), and one mile run time (-1.5±1.0 min vs. -0.1±0.9 min; p<0.01), and a significant increase in estimated VO2 peak (+1.9±1.9 ml/kg/min vs. 0.0±1.8 ml/kg/min; p=0.01). AFL participants also reported an increase in the number of days/week accumulating 30 minutes of MVPA (+0.8±3.2 vs. -1.5±2.3; p=0.004) and daily servings of fruits (+1.3±1.4 vs. +0.3±1.4; p<0.05) and vegetables (+1.8±1.7 vs. +0.1±1.2; p<0.05), relative to control participants. There were no significant differences between groups in changes in diet assessed by 3-day food record, accelerometer-measured PA, weight, blood pressure, visceral fat, biomarkers for cardiovascular disease or nutritional biomarkers.
Conclusions: Despite the lack of effects on diet and PA behaviors, AFL shows promising preliminary efficacy for reducing body fat and improving fitness among adult participants. Future research aimed at improving fitness among Latino parents with family-based intervention is warranted.
Purpose: To assess the efficacy of Athletes for Life (AFL), a 12-week community-and-family-based behavioral intervention, for improving diet, physical activity (PA), anthropometrics, fitness, and biochemical outcomes among mostly Latino parents.
Methods: Parents with at least one child 6-11 years of age were randomized to active AFL participation (n=14) or a wait-list control (n=14) group. AFL consisted of twice weekly 90 minute sessions (45 minutes of nutrition-focused lessons and 45 minutes of PA participation) designed to promote fruit and vegetable consumption, reduction of sugar intake, and increasing habitual PA. Data were collected prior to and immediately after the 12 week intervention.
Results: Participants (37.9±7.2y) were mostly Latino (93%), Spanish speaking (68%), and women (93%). Relative to participants in the control group, AFL participants had a significant reduction in body fat (-1.1±1.2% vs. 0.2±1.2%; p=0.014), resting (-7.6±10.2 bpm vs. +2.1±6.8 bpm; p<0.01), exercise (-8.4±8.7 bpm vs. +0.4±7.3 bpm; p<0.01), and recovery heart rate (-11.9±12.8 bpm vs. -0.3±11.4 bpm; p=0.01), and one mile run time (-1.5±1.0 min vs. -0.1±0.9 min; p<0.01), and a significant increase in estimated VO2 peak (+1.9±1.9 ml/kg/min vs. 0.0±1.8 ml/kg/min; p=0.01). AFL participants also reported an increase in the number of days/week accumulating 30 minutes of MVPA (+0.8±3.2 vs. -1.5±2.3; p=0.004) and daily servings of fruits (+1.3±1.4 vs. +0.3±1.4; p<0.05) and vegetables (+1.8±1.7 vs. +0.1±1.2; p<0.05), relative to control participants. There were no significant differences between groups in changes in diet assessed by 3-day food record, accelerometer-measured PA, weight, blood pressure, visceral fat, biomarkers for cardiovascular disease or nutritional biomarkers.
Conclusions: Despite the lack of effects on diet and PA behaviors, AFL shows promising preliminary efficacy for reducing body fat and improving fitness among adult participants. Future research aimed at improving fitness among Latino parents with family-based intervention is warranted.
ContributorsChavez, Adrian (Author) / Vega-Lopez, Sonia (Thesis advisor) / Crespo, Noe (Committee member) / Hekler, Eric (Committee member) / Shaibi, Gabriel (Committee member) / Bruening, Meg (Committee member) / Arizona State University (Publisher)
Created2015
Description
Background: Healthy eating plays critical roles in the prevention of many chronic diseases, but there are many barriers in life that prevent people from adopting and maintaining healthy diets. Thus, identifications of barriers that people perceive they have in trying to eat healthy can guide the strategies for dietary behavior change interventions by taking account of the barriers. Objective: The purpose of this study was to identify and quantify the perceived barriers to healthy eating (PBHE), to investigate the relationship between socioeconomic factors and PBHE, and to explore the associations between PBHE and dietary intake among parents of elementary-school aged children living in South Phoenix, AZ. Methods: Socioeconomic factors and PBHEs were obtained via survey and diet was assessed by two interviewer-assisted 24 h diet recalls. The associations between employment and PBHEs, education and PBHEs, and household monthly income and PBHEs were analyzed by Mann-Whitney Test, Kruskal Wallis Test, and Spearman’s correlation test, respectively. The relationship between PBHEs and dietary intake were analyzed by Spearman’s correlation test. Linear regression was used to assess the associations between total PBHE, and dietary intake (including added sugar, fruit and vegetable), adjusted by covariates (including socioeconomic status, birth country, age and gender). Results: Of 149 participants who completed the survey (mean age = 38.47±7.08 y), 136 completed the 24 h diet recalls. The mean reported total, social support, emotions and daily mechanics PBHE scores were 2.63±0.91, 2.52±1.16, 2.71±1.06, and 2.58±0.95, respectively, out of a 5-point scale. Daily fruit, vegetable, sugar-sweetened beverage, sweetened foods, and added sugar intake were reported as 1.66±1.56 servings, 2.45±1.43 servings, 1.19±1.30 servings, 2.02±2.12 servings and 49.93±31.17 g, respectively. Employment status was significantly associated with total PBHE (Z = -2.28, p=0.023), and support PBHE (Z = -2.623, p=0.009). Education was significantly related to total PBHE (χ2 = -7.987, p=0.046), and daily mechanics PBHE (χ2= 11.735, p=0.008). Household monthly income levels were significantly correlated to daily mechanics PBHE (r = -0.265, p=0.005). Added sugar was positively correlated with total PBHE (r=0.202, p=0.020), emotions PBHE (r=0.239, p=0.006), and daily mechanics PBHE (r=0.179, p=0.040). Sugar sweetened beverage intake was significantly related to emotions PBHE (r=0.183, p=0.035). When adjusting for socioeconomic factors in the regression analysis, there was no significant association between PBHE and diet intake. Conclusion: Overall, results suggest PBHEs listed in this study are mainly associated with socioeconomic factors, but they are not related to diet intake. Future studies will focus on the precise role of overcoming some identified barriers in improving healthy eating behaviors, and the causality between barriers and healthy eating.
ContributorsQiu, Chongying (Author) / Vega-Lopez, Sonia (Thesis advisor) / Crespo, Noe (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2018
Description
Although many studies have looked into the relationship between home food availability and dietary intake, few have assessed actual change in the home food environment as a result of an intervention program. This secondary data analysis of the Athletes for Life 3 (AFL3) program investigated the efficacy of a randomized controlled 12-week community-based, family-focused exercise and dietary behavior intervention program in improving the home food environment of families with children between the ages of 6 and 11 years old. A total of twenty-six adults from Phoenix, Arizona allowed research staff into their homes to assess variety of food availability, using a modified version of the Home Food Inventory and were randomized to either the AFL3 program or wait-list control group. The main outcomes of interest were change in availability of vegetables, fruits, sugar-sweetened beverages and desserts and WIC-approved breakfast cereal. There was a significant increase in the number of vegetable items (3.88 ± 0.85; p=0.006) and WIC-approved cereal items (1.16 ± 0.31; p=0.003) in the homes of the intervention participants, relative to the wait-list control group. Additionally, there was a significant decrease in the number of sugar-sweetened beverage items (1.18 ± 0.31; p=0.014) available in wait-list control participant homes. There were no other significant findings related to home food availability. Furthermore, dietary intake among adult participants did not significantly change as a result of change in home availability. In conclusion, the AFL3 intervention program was successful in eliciting small but significant changes at a household level related to vegetable and WIC-approved breakfast cereal availability.
ContributorsGhan, Emily (Author) / Vega-Lopez, Sonia (Thesis advisor) / Bruening, Meg (Committee member) / Crespo, Noe (Committee member) / Todd, Michael (Committee member) / Arizona State University (Publisher)
Created2016
Description
Food shopping practices are important in promoting healthy eating habits. Whereas previous behavioral interventions have assessed the effects of such interventions on parent and child health behaviors and quality, few have examined their impact on food shopping practices. This study used a randomized controlled trial design to investigate the efficacy of Athletes for Life (AFL), a 12-week community-based, family-focused intervention program that targeted physical activity and dietary behavior, on food shopping practices among Latino parents with elementary school-aged children. A total of 140 Latino adults were randomized to the AFL intervention or a wait-list control group. AFL included weekly sessions that focused on nutrition education, meal planning, grocery shopping, and physical activity. Participants completed surveys at baseline and after the 12-week program to assess their frequency of use of healthy food shopping practices (i.e., nutrition facts panel use, ingredients list use, grocery list utilization), and whether they refer to specific nutrients within the nutrition facts panel. Intervention effects on the frequency of use of food shopping practices were analyzed using a logistic binomial regression. Effects on consulting specific nutrients within the nutrition facts panel were analyzed using a Quade’s analysis of covariance. Results showed that there was a significant increase in the utilization of grocery lists (2.45±1.42 vs. 1.64±1.57, p=.011, F=6.664), nutrition facts panels (2.76±1.30 vs. 1.40±1.24, p=<.0001, F=47.128), and ingredients lists (2.79±1.26 vs. 1.58±1.51, p=<.0001, F=20.055) among the intervention group participants. Additionally, participants in the intervention group increased their use of nutrition facts panels to look up individual nutrients, particularly calories (OR=4.162, 95% CI=1.762-9.833, p=.009), carbohydrates (OR=7.889, 95% CI=2.136-29.137, p=.018), protein (OR=12.013, 95% CI=2.479-58.222, p=.018), and sodium (OR=4.247, 95% CI=1.624-11.105, p=.027), compared to baseline use. These findings demonstrate that the AFL intervention program was successful in implementing a positive change among parents, which will presumably allow parents to make improvements in their food shopping behaviors that may in turn have an effect on their home food environment and dietary intake among adults and children within the home.
ContributorsCampoy, Mariah Rose (Author) / Vega-Lopez, Sonia (Thesis advisor) / Crespo, Noe (Committee member) / McCoy, Maureen (Committee member) / Arizona State University (Publisher)
Created2023
Description
Background: Although childhood engagement in physical activity has received growing attention, most children still do not meet the recommended daily 60 minutes of moderate to vigorous physical activity [MVPA]. Children of ethnic minorities are less likely to meet the guidelines. Interventions have been implemented in various settings to increase child physical activity levels, yet these efforts have not yielded consistent results. The purpose of this study was to assess the preliminary effects of a community-based intervention on light physical activity and MVPA among 6-11 year old children. Methods: The present study was part of a larger study called Athletes for Life [AFL], a family-based, nutrition-education and physical activity intervention. The present study focused on physical activity data from the first completed cohort of participants (n=29). This study was a randomized control trial in which participating children were randomized into a control (n=14) or intervention (n=15) group. Participants wore accelerometers at two time points. Intervention strategies were incorporated to increase child habitual physical activity. Analyses of covariance were performed to test for post 12-week differences between both groups on the average minutes of light physical activity and MVPA minutes per day.
Results: The accelerometer data demonstrated no significant difference in light physical activity or MVPA mean minutes per day between the groups. Few children reported engaging in activities sufficient for meeting the physical activity guidelines outside the AFL program. Of the 119 total distributed child physical activity tracker sheets (7 per family), 55 were returned. Of the 55 returned physical activity tracker sheets, parents reported engaging in physical activity with their children only 7 times outside of the program over seven weeks.
Conclusion: The combined intervention strategies implemented throughout the 12-week study did not appear to be effective at increasing habitual mean minutes per day spent engaging in light and MVPA among children beyond the directed program. Methodological limitations and low adherence to intervention strategies may partially explain these findings. Further research is needed to test successful strategies within community programs to increase habitual light physical activity and MVPA among 6-11 year old children.
Results: The accelerometer data demonstrated no significant difference in light physical activity or MVPA mean minutes per day between the groups. Few children reported engaging in activities sufficient for meeting the physical activity guidelines outside the AFL program. Of the 119 total distributed child physical activity tracker sheets (7 per family), 55 were returned. Of the 55 returned physical activity tracker sheets, parents reported engaging in physical activity with their children only 7 times outside of the program over seven weeks.
Conclusion: The combined intervention strategies implemented throughout the 12-week study did not appear to be effective at increasing habitual mean minutes per day spent engaging in light and MVPA among children beyond the directed program. Methodological limitations and low adherence to intervention strategies may partially explain these findings. Further research is needed to test successful strategies within community programs to increase habitual light physical activity and MVPA among 6-11 year old children.
ContributorsQuezada, Blanca (Author) / Crespo, Noe (Thesis advisor) / Huberty, Jennifer (Committee member) / Vega-Lopez, Sonia (Committee member) / Arizona State University (Publisher)
Created2015