Matching Items (107)
Description
Objective: Increasing fruit/vegetable (FV) consumption and decreasing waste during the school lunch is a public health priority. Understanding how serving style of FV impacts FV consumption and waste may be an effective means to changing nutrition behaviors in schools. This study examined whether students were more likely to select, consume, and waste FV when FVs were cut vs. whole. Methods: Baseline data from the ASU School Lunch Study was used to explore associations between cut vs. whole FV serving style and objectively measured FV selection, consumption, and waste and grade level interactions among a random selection of students (n=6804; 47.8% female; 78.8% BIPOC) attending Arizona elementary, middle, and high schools (N=37). Negative binomial regression models evaluated serving style on FV weight (grams) selected, consumed, and wasted, adjusted for sociodemographics and school.
Results: Students were more likely to select cut FVs (IRR=1.11; 95% CI: 1.04, 1.18) and waste cut FVs (IRR=1.20; 95% CI: 1.04, 1.39); however, no differences were observed in the overall consumption of cut vs. whole FVs. Grade-level interactions impacted students’ selection of FVs. Middle school students had a significantly higher effect modification for the selection of cut FVs (IRR=1.18; p=0.006) compared to high school and elementary students. Further, high school students had a significantly lower effect modification for the selection of cut FVs (IRR=0.83; p=0.010) compared to middle and elementary students. No other grade-level interactions were observed.
Discussion: Serving style of FV may impact how much FV is selected and wasted, but further research is needed to determine causality between these variables.
ContributorsJames, Amber Chandarana (Author) / Bruening, Meredith (Thesis advisor) / Adams, Marc (Thesis advisor) / Koskan, Alexis (Committee member) / Arizona State University (Publisher)
Created2021
Description
Psychologists report effect sizes in randomized controlled trials to facilitate interpretation and inform clinical or policy guidance. Since commonly used effect size measures (e.g., standardized mean difference) are not sensitive to heterogeneous treatment effects, methodologists have suggested the use of an alternative effect size δ, a between-subjects causal parameter describing the probability that the outcome of a random participant in the treatment group is better than the outcome of another random participant in the control group. Although this effect size is useful, researchers could mistakenly use δ to describe its within-subject analogue, ψ, the probability that an individual will do better under the treatment than the control. Hand’s paradox describes the situation where ψ and δ are on opposing sides of 0.5: δ may imply most are helped whereas the (unknown) underlying ψ indicates that most are harmed by the treatment. The current study used Monte Carlo simulations to investigate plausible situations under which Hand’s paradox does and does not occur, tracked the magnitude of the discrepancy between ψ and δ, and explored whether the size of the discrepancy could be reduced with a relevant covariate. The findings suggested that although the paradox should not occur under bivariate normal data conditions in the population, there could be sample cases with the paradox. The magnitude of the discrepancy between ψ and δ depended on both the size of the average treatment effect and the underlying correlation between the potential outcomes, ρ. Smaller effects led to larger discrepancies when ρ < 0 and ρ = 1, whereas larger effects led to larger discrepancies when 0 < ρ < 1. It was useful to consider a relevant covariate when calculating ψ and δ. Although ψ and δ were still discrepant within covariate levels, results indicated that conditioning upon relevant covariates is still useful in describing heterogeneous treatment effects.
ContributorsLiu, Xinran (Author) / Anderson, Samantha F (Thesis advisor) / McNeish, Daniel (Committee member) / MacKinnon, David (Committee member) / Arizona State University (Publisher)
Created2023
Description
Weight stigma is a prevalent issue that has detrimental effects on health for both adolescents and parents. Adolescents are in a formative stage of life, so it is important to understand how parents may impact adolescents’ own experience with weight stigma. Past research has examined adolescent coping, body image, and associated stigma in the context of the parent-child relationship. This cross-sectional study examined self-reported weight stigma experience and internalization within 42 parent/adolescent dyads to provide greater understanding of how adolescents and parents are experiencing and internalizing weight stigma independently and transversely.
ContributorsMillett, Emma (Author) / McEntee, Mindy (Thesis director) / Adams, Marc (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2022-12
Description
Mediation analysis is integral to psychology, investigating human behavior’s causal mechanisms. The diversity of explanations for human behavior has implications for the estimation and interpretation of statistical mediation models. Individuals can have similar observed outcomes while undergoing different causal processes or different observed outcomes while receiving the same treatment. Researchers can employ diverse strategies when studying individual differences in multiple mediation pathways, including individual fit measures and analysis of residuals. This dissertation investigates the use of individual residuals and fit measures to identify individual differences in multiple mediation pathways. More specifically, this study focuses on mediation model residuals in a heterogeneous population in which some people experience indirect effects through one mediator and others experience indirect effects through a different mediator. A simulation study investigates 162 conditions defined by effect size and sample size for three proposed methods: residual differences, delta z, and generalized Cook’s distance. Results indicate that analogs of Type 1 error rates are generally acceptable for the method of residual differences, but statistical power is limited. Likewise, neither delta z nor gCd could reliably distinguish between contrasts that had true effects and those that did not. The outcomes of this study reveal the potential for statistical measures of individual mediation. However, limitations related to unequal subpopulation variances, multiple dependent variables, the inherent relationship between direct effects and unestimated indirect effects, and minimal contrast effects require more research to develop a simple method that researchers can use on single data sets.
ContributorsSmyth, Heather Lynn (Author) / MacKinnon, David (Thesis advisor) / Tein, Jenn-Yun (Committee member) / McNeish, Daniel (Committee member) / Grimm, Kevin (Committee member) / Arizona State University (Publisher)
Created2022
The Association Between Time to Eat and Students Fruit & Vegetable Consumption, Selection, and Waste
Description
Background: Studies have examined student fruit/vegetable (FV) consumption, selection, and waste related to lunch duration and found that longer duration at lunch was associated with greater consumption, selection, and reduced waste. However, few studies have investigated the relationship between time to eat and FVs. The aim of this research is to analyze the relationship between objective time to students took to eat (“time to eat”) as it relates to their fruit and vegetable consumption, selection, and plate waste.in elementary, middle, and high schools. Methods: A secondary analysis of cross-sectional study of 37 Arizona schools to discover the differences in the selection, consumption, and waste of FVs from students (Full N = 2226, Elementary N = 630, Middle School N = 699, High School N = 897) using objective time to eat measures. Zero-inflated negative binomial regressions examined differences in FV grams selected, consumed, and wasted adjusted for sociodemographics including race, ethnicity, eligibility for free or reduced lunch, academic year, and sex and clustering for students within schools. Results are presented across school level (elementary, middle, and high school).
Results: The average time taken to eat ranged from 10-12 minutes for all students. The association of time to eat and lunch duration were not closely related (r=0.03, p = 0.172). In the count model for every additional minute spent, there was a 0.5% greater likelihood of selecting FVs for elementary kids among those who took any FVs. In the zero-inflated model, it was found that there was a statistically significant relationship between time spent eating and the selection of fruits and vegetables. For the total sample and high schoolers, a minute more of eating time was associated with a 4.3% and 8.8% greater odds of selecting FV. This means that longer eating time increased the likelihood of choosing fruits and vegetables. The results indicated that the longer students took to eat, the higher the likelihood of consuming more of FVs. Each 10 more minutes spent eating (i.e., time to eat) is associated with a 5% increase in grams of FV selected relative to mean (for those that chose FV) over 1 week this equates to 32 g increase of FV selected. However, for middle schoolers, the time to eat was not found to be significant in relation to the grams of fruits and vegetables consumed. There was some significance in the sociodemographic factors such as gender (all) and other (middle school). There was a relationship between time taken to eat and waste as a proportion for fruits and vegetables. For example, among those among the students who wasted something (as a proportion of selection), each additional 10 minutes of eating time was associated with a .6% decrease in waste relative to the mean (for those who chose fruits and vegetables) over a week, resulting in a decrease in waste percentage of 16.5%. Among high schoolers, males had a slightly higher odds of wasting a proportion of fruits and vegetables.
Conclusions: This study aimed to examine the association between the time students take to eat during lunch and their fruit and vegetable (FV) consumption, selection, and plate waste. The findings revealed that the time to eat was related to FV consumption, depending on the school level. However, it was not significantly associated with FV selection or waste. The study emphasized the need for further research on time to eat, distinguishing it from the duration of lunch. Longer lunch periods and adequate time could influence better food choices, increased FV consumption, and reduced waste. The study highlighted the importance of interventions and school policies promoting healthier food choices and providing sufficient time for students to eat. Future research should validate these findings and explore the impact of socialization opportunities on promoting healthier eating habits. Understanding the relationship between lunch duration, time to eat, and students' dietary behaviors can contribute to improved health outcomes and inform effective strategies in school settings.
ContributorsDandridge, Christina Marie (Author) / Adams, Marc (Thesis advisor) / Whisner, Corrie (Committee member) / Bruening, Meg (Committee member) / Arizona State University (Publisher)
Created2023
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 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
Description
Tools designed to help match people with behaviors they identify as likely to lead to a successful behavioral outcome remain under-researched. This study assessed the effect of a participant-driven behavior-matching intervention on 1) the adoption of a new behavior related to fruit and vegetable (F&V) consumption, 2) study attrition, and 3) changes in F&V consumption. In this two-arm randomized controlled trial, 64 adults who did not meet standard F&V recommendations were allocated to an intervention (n=33) or control group (n=31). Participants in the intervention group ranked 20 F&V-related behaviors according to their perceived likelihood of engagement in the behavior and their perception of the behavior’s efficacy in increasing F&V consumption. Participants in the intervention group were subsequently shown the list of 20 behaviors in order of their provided rankings, with the highest-ranked behaviors at the top, and were asked to choose a behavior they would like to perform daily for 4 weeks. The control group chose from a random-order list of the same 20 behaviors to adopt daily for 4 weeks. During the study period, text messages were sent to all participants 90 minutes before their reported bedtime to collect Yes/No data reflecting successful behavior engagement each day. The binary repeated-measures data collected from the text messages was analyzed using mixed-effects logistic regression, differences in attrition were assessed using log-rank analysis, and change scores in F&V consumption were compared between the two groups using the Man-Whitney U test. P<0.05 indicated significance. The rate of successful behavior adoption did not differ significantly between the two groups (b=0.09, 95%CI= -0.81, 0.98, p=0.85). The log rank test results indicated that there was no significant difference in attrition between the two groups (χ2=2.68, df=1, p=0.10). F&V consumption increased significantly over the 4 weeks in the total sample (Z=-5.86, p<0.001), but no differences in F&V change scores were identified between the control and intervention groups (Z=-0.21, p=0.84). The behavior-matching tool assessed in this study did not significantly improve behavior adoption, study attrition, or F&V intake over 4 weeks.
ContributorsCosgrove, Kelly Sarah (Author) / Wharton, Christopher (Thesis advisor) / Adams, Marc (Committee member) / DesRoches, Tyler (Committee member) / Grebitus, Carola (Committee member) / Johnston, Carol (Committee member) / Arizona State University (Publisher)
Created2023
Description
Objective: It’s not well understood how youth perceive existing fruit and vegetable (FV) marketing materials available in schools. This ancillary study sought to assess the acceptability of FV marketing materials freely available to schools among adolescents in grades 6-12.
Methods: Middle and high school adolescents (n=40; 50% female; 52.5% Hispanic) in the Phoenix, AZ area were asked to rank marketing materials (n=35) from favorite to least favorite in four categories: table tents, medium posters, large posters and announcements. Favorites were determined by showing participants two items at a time and having them choose which they preferred; items were displayed to each adolescent in a random order. Adolescents participated in a 20-30 minute interview on their favorite items in each category based on acceptance/attractiveness, comprehension, relevance, motivation and uniqueness of the materials. A content analysis was performed on top rated marketing materials. Top rated marketing materials were determined by the number of times the advertisement was ranked first in its category.
Results: An analysis of the design features of the items indicated that most participants (84%) preferred marketing materials with more than 4 color groups. Participant preference of advertisement length and word count was varied. A total of 5 themes and 20 subthemes emerged when participants discussed their favorite FV advertisements. Themes included: likes (e.g., colors, length, FV shown), dislikes (e.g., length, FV shown), health information (e.g., vitamin shown), comprehension (e.g., doesn’t recognize FV), and social aspects (e.g., peer opinion). Peer opinion often influenced participant opinion on marketing materials. Participants often said peers wouldn’t like the advertisements shown: “…kids my age think that vegetables are not good, and they like food more than vegetables.” Fruits and vegetable pictured as well as the information in the marketing materials also influenced adolescent preference.
Conclusion: Students preferred advertisements with more color and strong visual aspects. Word count had minimal influence on their opinions of the marketing materials, while information mentioned and peer opinion did have a positive effect. Further research needs to be done to determine if there is a link between adolescent preferences on FV marketing materials and FV consumption habits.
Methods: Middle and high school adolescents (n=40; 50% female; 52.5% Hispanic) in the Phoenix, AZ area were asked to rank marketing materials (n=35) from favorite to least favorite in four categories: table tents, medium posters, large posters and announcements. Favorites were determined by showing participants two items at a time and having them choose which they preferred; items were displayed to each adolescent in a random order. Adolescents participated in a 20-30 minute interview on their favorite items in each category based on acceptance/attractiveness, comprehension, relevance, motivation and uniqueness of the materials. A content analysis was performed on top rated marketing materials. Top rated marketing materials were determined by the number of times the advertisement was ranked first in its category.
Results: An analysis of the design features of the items indicated that most participants (84%) preferred marketing materials with more than 4 color groups. Participant preference of advertisement length and word count was varied. A total of 5 themes and 20 subthemes emerged when participants discussed their favorite FV advertisements. Themes included: likes (e.g., colors, length, FV shown), dislikes (e.g., length, FV shown), health information (e.g., vitamin shown), comprehension (e.g., doesn’t recognize FV), and social aspects (e.g., peer opinion). Peer opinion often influenced participant opinion on marketing materials. Participants often said peers wouldn’t like the advertisements shown: “…kids my age think that vegetables are not good, and they like food more than vegetables.” Fruits and vegetable pictured as well as the information in the marketing materials also influenced adolescent preference.
Conclusion: Students preferred advertisements with more color and strong visual aspects. Word count had minimal influence on their opinions of the marketing materials, while information mentioned and peer opinion did have a positive effect. Further research needs to be done to determine if there is a link between adolescent preferences on FV marketing materials and FV consumption habits.
ContributorsPisano, Sydney Alexis (Author) / Bruening, Meg (Thesis advisor) / Adams, Marc (Committee member) / Grgich, Traci (Committee member) / Arizona State University (Publisher)
Created2019
Description
Longitudinal recursive partitioning (LRP) is a tree-based method for longitudinal data. It takes a sample of individuals that were each measured repeatedly across time, and it splits them based on a set of covariates such that individuals with similar trajectories become grouped together into nodes. LRP does this by fitting a mixed-effects model to each node every time that it becomes partitioned and extracting the deviance, which is the measure of node purity. LRP is implemented using the classification and regression tree algorithm, which suffers from a variable selection bias and does not guarantee reaching a global optimum. Additionally, fitting mixed-effects models to each potential split only to extract the deviance and discard the rest of the information is a computationally intensive procedure. Therefore, in this dissertation, I address the high computational demand, variable selection bias, and local optimum solution. I propose three approximation methods that reduce the computational demand of LRP, and at the same time, allow for a straightforward extension to recursive partitioning algorithms that do not have a variable selection bias and can reach the global optimum solution. In the three proposed approximations, a mixed-effects model is fit to the full data, and the growth curve coefficients for each individual are extracted. Then, (1) a principal component analysis is fit to the set of coefficients and the principal component score is extracted for each individual, (2) a one-factor model is fit to the coefficients and the factor score is extracted, or (3) the coefficients are summed. The three methods result in each individual having a single score that represents the growth curve trajectory. Therefore, now that the outcome is a single score for each individual, any tree-based method may be used for partitioning the data and group the individuals together. Once the individuals are assigned to their final nodes, a mixed-effects model is fit to each terminal node with the individuals belonging to it.
I conduct a simulation study, where I show that the approximation methods achieve the goals proposed while maintaining a similar level of out-of-sample prediction accuracy as LRP. I then illustrate and compare the methods using an applied data.
I conduct a simulation study, where I show that the approximation methods achieve the goals proposed while maintaining a similar level of out-of-sample prediction accuracy as LRP. I then illustrate and compare the methods using an applied data.
ContributorsStegmann, Gabriela (Author) / Grimm, Kevin (Thesis advisor) / Edwards, Michael (Committee member) / MacKinnon, David (Committee member) / McNeish, Daniel (Committee member) / Arizona State University (Publisher)
Created2019
Description
There is a need to reinvent evidence-based interventions (EBIs) for pediatric anxiety problems to better address the demands of real-word service delivery settings and achieve public health impact. The time- and resource-intensive nature of most EBIs for youth anxiety has frequently been noted as a barrier to the utilization of EBIs in community settings, leading to increased attention towards exploring the viability of briefer, more accessible protocols. Principally, this research reports between-group effect sizes from brief-interventions targeting pediatric anxiety and classifies each as well-established, probably efficacious, possibly efficacious, experimental, or questionable. brief interventions yielded an overall mean effect size of 0.19 on pediatric anxiety outcomes from pre to post. Effect sizes varied significantly by level of intervention: Pre to post-intervention effects were strongest for brief-treatments (0.35), followed by brief-targeted prevention (0.22), and weakest for brief-universal prevention (0.09). No participant or other intervention characteristic emerged as significant moderators of effect sizes. In terms of standard of evidence, one brief intervention is well-established, and five are probably efficacious, with most drawing on cognitive and behavioral change procedures and/or family systems models. At this juncture, the minimal intervention needed for clinical change in pediatric anxiety points to in-vivo exposures for specific phobias (~3 hours), cognitive-behavioral therapy (CBT) with social skills training (~3 hours), and CBT based parent training (~6 hours, eight digital modules with clinician support). This research concludes with a discussion on limitations to available brief EBIs, practice guidelines, and future research needed to capitalize on the viability of briefer protocols in enhancing access to, and impact of, evidence-based care in the real-world.
ContributorsStoll, Ryan (Author) / Pina, Armando A. (Thesis advisor) / Gonzales, Nancy (Committee member) / MacKinnon, David (Committee member) / Perez, Marisol (Committee member) / Arizona State University (Publisher)
Created2019