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- Member of: ASU Electronic Theses and Dissertations
- Resource Type: Text
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
The unprecedented amount and sources of information during the COVID-19 pandemic resulted in an indiscriminate level of misinformation that was confusing and compromised healthcare access and delivery. The World Health Organization (WHO) called this an ‘infodemic’, and conspiracy theories and fake news about COVID-19, plagued public health efforts to contain the COVID-19 pandemic. National and international public health priorities expanded to counter misinformation. As a multi-disciplinary study encompassing expertise from public health, informatics, and communication, this research focused on eliciting strategies to better understand and combat misinformation on COVID-19. The study hypotheses is that 1) factors influencing vaccine-acceptance like socio-demographic factors, COVID-19 knowledge, trust in institutions, and media related factors could be leveraged for public health education and intervention; and 2) individuals with a high level of knowledge regarding COVID-19 prevention and control have unique behaviors and practices, like nuanced media literacy and validation skills that could be promoted to improve vaccine acceptance and preventative health behaviors. In this biphasic study an initial survey of 1,498 individuals sampled from Amazon Mechanical Turk (MTurk) assessed socio-demographic factors, an 18-item test of COVID-19 knowledge, trust in healthcare stakeholders, and measures of media literacy and consumption. Subsequently, using the Positive Deviance Framework, a diverse subset of 25 individuals with high COVID-19 knowledge scores were interviewed to identify these deviants’ information and media practices that helped avoid COVID-19 misinformation. Access to primary care, higher educational attainment and living in urban communities were positive socio-demographic predictors of COVID-19 vaccine acceptance emphasizing the need to invest in education and rural health. High COVID-19 knowledge and trust in government and health providers were also critical factors and associated with a higher level of trust in science and credible information sources like the Centers for Disease Control (CDC) and health experts. Positive deviants practiced media literacy skills that emphasized checking sources for scientific basis as well as hidden bias; cross-checking information across multiple sources and verifying health information with scientific experts. These identified information validation and confirmation practices may be useful in educating the public and designing strategies to better protect communities against harmful health misinformation.
ContributorsSivanandam, Shalini (Author) / Doebbeling, Bradley (Thesis advisor) / Koskan, Alexis (Committee member) / Roschke, Kristy (Committee member) / Chung, Yunro (Committee member) / Arizona State University (Publisher)
Created2023
Description
Urinary tract infections (UTIs) disrupt military women’s service obligations and health. Females are more susceptible to UTIs due to their unique anatomical features and hormone fluctuations affecting vaginal flora. During phase 1 of the menstrual cycle (onset of bleeding, menstrual cycle days 1-5), estrogen levels significantly decrease and inhibit the growth of lactobacilli, good bacteria that are essential in warding off harmful bacteria and infections, particularly pathogens of UTIs. To reduce UTI onset, it is recommended to frequently urinate with sufficient urine void volume to facilitate washing out harmful bacteria from the bladder and urethra. While menstruating, increased fluid consumption to support urination frequency and void volume may be critical, as the urethra and urinary tract are more predisposed to pathogenic bacteria found. Yet, there is a lack of research investigating the impact of hydration on urinary tract health during menstruation. The study sought to examine the effects of increased water fluid intake on the uropathogenic bacterial activity of underhydrated menstruating premenopausal females. Thirteen females underwent a 2x2 randomized crossover trial to evaluate the effectiveness of a) additional 1.89 L of water fluid intake and b) maintain habitual fluid intake on two subsequent phase 1 menses. At each phase 1 menses, fluid intake was gathered on days 2 and 5 to determine the fluid amount consumed. First-morning urinations on days 3 and 6 assessed urogenital bacterial activity. Combining data collection days 2 and 5 per intervention (INT) and control (CON), the mean±SD for total fluid intake was INT 2.99±1.05 and CON 1.85±0.89, resulting in a 62% increase, p< 0.001, η2= 0.459. For days 2 and 5, a 48% and 80% increase in total fluid in from CON to INT was found, ps< 0.01. However, only four cultures detected uropathogenic bacteria from four participants, with no patterns between conditions or days, making it difficult to determine the effectiveness of the intervention. Though the intervention results were undetermined, military women’s hydration, menstruation, and urinary tract health remain prominent health concerns. Efforts to assess their fluid consumption and urination behaviors during menstruation and UTI risks are warranted.
ContributorsVento, Kaila Ann (Author) / Wardenaar, Floris C (Thesis advisor) / Johnston, Carol (Committee member) / Kavouras, Stavros (Committee member) / Koskan, Alexis (Committee member) / Lynch, Heidi (Committee member) / Arizona State University (Publisher)
Created2022
Description
Ensuring access to safe and affordable recreational spaces is vital for promoting well-being, especially in underserved communities facing barriers to physical activity. Shared use agreements, where school facilities are open for public use, offer a promising solution; yet limited research has examined how to maximize usage of these spaces. Framed under Social Cognitive Theory in a socioecological model, this dissertation comprises three studies contributing to this knowledge base to foster active, healthy communities. The first study was a scoping review of usage and physical activity behavior in school shared use spaces, highlighting the potential of shared use agreements to promote physical activity, especially when they included organized activities or space renovations. The study underscores the need for robust evaluations, gender- and population-sensitive interventions, and community engagement to maximize impact. The second study, adopting a pre/post, cross-sectional approach, assessed the impact of a multicomponent intervention on perceptions and usage of a school shared use path in South Phoenix (AZ). No statistically significant changes in usage were observed over time; however, access was a significant predictor of usage. Gender (female, negative) and safety perceptions (positive) were also identified as salient predictors of usage. The findings highlight the critical role of awareness (i.e., perceived access) in enhancing usage of school shared use spaces. The third study was a longitudinal natural experiment, with observational assessments of usage and related physical activity on one school shared use path over 12 months at an elementary school in South Phoenix (AZ). Moderate increases in usage over time were attributed to promotional efforts, social programming, and environmental modifications. Most users (>70%) of the path were observed walking, and were male, Hispanic, and adult. The study suggests that demographic disparities may exist. Implementing broader engagement strategies and understanding safety perceptions may facilitate more representative usage. Collectively, this dissertation provides a comprehensive evaluation of the potential of school shared use spaces to promote physical activity, while underscoring the importance of understanding complex factors influencing the usage of these spaces. Ultimately, the findings contribute knowledge to enhancing the usage of school shared use spaces, adding to the literature on their significance in promoting physical activity and community health, particularly in underserved regions.
ContributorsWilson, Kylie (Author) / Poulos, Allison (Thesis advisor) / Grimm, Kevin (Committee member) / Koskan, Alexis (Committee member) / Kulinna, Pamela Hodges (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Arizona State University (Publisher)
Created2024