Matching Items (124)
Description
Individual behavior change is a goal of many public policies directed at people of low socioeconomic status. Without evidence of behavioral change, these policies cannot be considered a success: a process of co-production where some level of cooperation between the client and program administrators is required to successfully meet program objectives. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC), is one example of a co-production design. WIC encourages women to engage in healthy behaviors by providing healthy food along with nutrition education to improve the health status of low-income families. However, while WIC is one of the most studied nutrition programs, little attention has been paid to the nutrition education portion or to interactions between staff members and participants. This research draws on the public policy and administration literature about street-level bureaucrats and co-production, which provides a framework for understanding the purposeful, inter-dependent relationships between front-line service providers and clients. However, neither literature explicates the process of interactions that is expected to lead to client behavior change and co-production. The primary contribution of this research is the creation of a grounded theory that identifies and explains the WIC interaction process as one of "negotiating healthy self-government". Based on analysis of three months of observations of WIC encounters in two clinics, this research finds that participants and staff members enter into tacit and explicit negotiations concerning the degree to which participants should govern their family's nutrition-related behavior. Clients actively shape the interactions by demonstrating their discipline and efforts to feed their families, while staff members refine and reinforce self-governing behaviors through assessing action, and providing advice to ensure behaviors meet recommendations. Finally, participants and staff members distinctly link self-governing behavior to identity: "good mothers" feed their children healthy food and govern their behaviors to meet nutritional recommendations. This research has implications for the study of behavior change promotion in public programs by introducing the concept of identity as a mechanism for governance and explicating the interaction process between front-line service providers and clients
ContributorsHand, Laura Catherine (Author) / Catlaw, Thomas J. (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Lucio, Joanna (Committee member) / Arizona State University (Publisher)
Created2014
Description
As part of the recently passed Patient Protection and Affordable Care Act, chain restaurants with 20 or more locations nationwide are required to post calorie information on menus and menu boards in order to help consumers make healthier decisions when dining out. Previous studies that have evaluated menu-labeling policies show mixed results and the majority have been conducted in urban cities along the east coast. This study was the first to look at the effectiveness of menu labeling in a southwest population. The primary objective of this cross-sectional study was to determine if noticing or using calorie menu labels in a fast food restaurant was associated with purchasing fewer calories. A second aim of this study was to evaluate the relationship between socio-demographic characteristics and the likelihood of noticing and using menu labeling. Customer receipts and survey data were collected from 329 participants using street-intercept survey methodology at 29 McDonald's locations in low- and high-income neighborhoods throughout the Phoenix metropolitan area. The study population was 63.5% male, 53.8% non-Hispanic white, and 50.8% low-income. Results showed that almost 60% of the study sample noticed calorie menu labeling and only 16% of participants reported using the information for food or beverage purchases. Income was the only socio-demographic characteristic that was associated with noticing menu labeling, with higher-income individuals being more likely to notice the information (p=0.029). Income was also found to be associated with using menu labels, with higher income individuals being more likely to use the information (p=0.04). Additionally, individuals with a bachelors degree or higher were more likely to use the information (p=0.023) and individuals aged 36 to 49 were least likely to use the information (p=0.046). There were no significant differences in average calories purchased among those who noticed menu labeling; however, those who reported using calorie information purchased 146 fewer calories than those who did not use the information (p=0.001). Based on these findings it is concluded that calorie menu labeling is an effective public policy and that nutrition education campaigns should accompany national menu labeling implementation in order to make the policy more effective across all socio-demographic groups.
ContributorsGreen, Jessie (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Bruening, Meg (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Arizona State University (Publisher)
Created2014
Description
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
Description
While obesity rates have plateaued within the last decade,
two-thirds of the United States
population is currently classified as overweight (defined a
s a body mass index [BMI] of
25-29.9 kg/m²) or obese (a BMI greater than 30 kg/m²). Bariatric
surgical interventions
are not only more effective than behavioral treatments
in the short term but are the only
form of obesity intervention with evidence of consisten
t long-term effectiveness.
However, even among bariatric surgery patients, weight
loss often stabilizes and it is
estimated that more than 20% of bariatric surgery patient
s will regain a significant
amount of weight that was initially lost long-term. Li
ttle research to date has been
conducted on physical activity in post bariatric surgery pati
ents. More specifically, there
have been no studies to date examining the effects of Me
ditative Movement (MM)
programs on body composition in bariatric patients. A s
tudy using an 8-week Tai Chi
Easy program was conducted in female gastric bypass patient
s to explore feasibility of
MM in the bariatric population as well as pre- and post-in
tervention changes in weight,
mindfulness, eating behaviors, body awareness, physical a
ctivity patterns, dietary quality
and mood. Data analysis revealed that there were no s
ignificant changes in weight or
physical activity patterns; however, significant changes w
ere observed in anxiety, overall
body awareness and cognitive restraint in eating. Addit
ionally, a significant decrease in
processed meat consumption and a weak trend towards increa
sed consumption of fruits
may suggest an overall improvement in dietary quality.
two-thirds of the United States
population is currently classified as overweight (defined a
s a body mass index [BMI] of
25-29.9 kg/m²) or obese (a BMI greater than 30 kg/m²). Bariatric
surgical interventions
are not only more effective than behavioral treatments
in the short term but are the only
form of obesity intervention with evidence of consisten
t long-term effectiveness.
However, even among bariatric surgery patients, weight
loss often stabilizes and it is
estimated that more than 20% of bariatric surgery patient
s will regain a significant
amount of weight that was initially lost long-term. Li
ttle research to date has been
conducted on physical activity in post bariatric surgery pati
ents. More specifically, there
have been no studies to date examining the effects of Me
ditative Movement (MM)
programs on body composition in bariatric patients. A s
tudy using an 8-week Tai Chi
Easy program was conducted in female gastric bypass patient
s to explore feasibility of
MM in the bariatric population as well as pre- and post-in
tervention changes in weight,
mindfulness, eating behaviors, body awareness, physical a
ctivity patterns, dietary quality
and mood. Data analysis revealed that there were no s
ignificant changes in weight or
physical activity patterns; however, significant changes w
ere observed in anxiety, overall
body awareness and cognitive restraint in eating. Addit
ionally, a significant decrease in
processed meat consumption and a weak trend towards increa
sed consumption of fruits
may suggest an overall improvement in dietary quality.
ContributorsSmith, Lisa L. (Author) / Larkey, Linda K (Thesis advisor) / Ainsworth, Barbara (Committee member) / Chisum, Jack (Committee member) / Ohri-Vachaspati, Punam (Committee member) / McClain, Darya (Committee member) / Arizona State University (Publisher)
Created2014
Description
Determining the factors associated with the availability of healthy and unhealthy foods in the household may help in understanding the varying complexities that contribute to obesity among children and help design interventions to impact children's food consumption behaviors. This study examined factors that are associated with the availability of healthy and unhealthy foods in children's home food environments (HFE). Data was collected from a random-digit-dial telephone survey of 1708 households, with at least one child between 3-18 years of age, located in five low-income New Jersey cities. HFE was assessed based on responses to a set of six items that measured availability of specific healthy and unhealthy foods in the respondent's home. These items contributed to construction of three HFE scales used as dependent variables in these analyses: healthy HFE, unhealthy HFE, and a ratio of healthy to unhealthy foods in the HFE. Independent variables included household socio-demographics, parental perceptions of their own weight and diet health, frequency of family meals, proximity to food outlets, and perception of access to healthy foods in the neighborhood food environment. Significant differences were observed in the HFE by race and ethnicity, with Non-Hispanic black children having fewer healthy foods and Non-Hispanic white children having more unhealthy food items available at home. Parents who reported being overweight or obese had a healthier HFE and those perceiving their own eating as healthy had more healthy and less unhealthy foods in the household. Food-secure households had more unhealthy compared to healthy foods at home. Households located farther from a supermarket had a greater number of unhealthy food items and a lower healthy/unhealthy food availability ratio. Parental perception of better access to fruits and vegetables and low-fat foods was associated with availability of a greater number of healthy food items at home. Overall, the HFE varied by parental and demographic characteristics, parental perceptions about the food environment and the actual features of the built neighborhood food environment.
ContributorsBerry, Andrea (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Johnston, Carol (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Arizona State University (Publisher)
Created2012
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 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
Description
Objectives
This cross-sectional study sought to assess the eating and physical activity behaviors among in-state and out-of-state college freshmen attending Arizona State University and to determine if social connectedness mediated the relationship between residency status and eating and physical activity behaviors.
Methods
College freshmen from two dormitories were recruited for participation from Arizona State University’s Tempe campus. A 128-item survey assessing demographics, college life, eating and physical activity behaviors, and social connectedness was administered. In addition, participants completed up to three days of dietary recall. Multivariate linear regression models, adjusting for age, gender, race, ethnicity, highest parental education, dormitory, Pell grant status, number of dietary recalls, and availability of a weekend day of dietary recall were used to assess the relationships between residency status, social connectedness, and eating and physical activity behaviors.
Results
No associations were observed between residency status and calories, grams and percentage of calories from fat, and added sugar. There was a statistically significant association between residency status and moderate-to-vigorous physical activity (MVPA). In-state students reported 21 minutes less per day of MVPA than out-of-state students did (β=-20.85; 95% CI=-30.68, -11.02; p<0.001). There was no relationship between residency status and social connectedness. Social connectedness and eating and physical activity behaviors were not associated. Social connectedness did not mediate the relationship between residency status and eating and physical activity behaviors.
Conclusions
In-state and out-of-state students differed in their MVPA; however, this relationship was not mediated by social connectedness. Further studies are needed to confirm the relationship between MVPA and residency status. In addition, more studies are needed to assess the relationship between social connectedness and MVPA.
This cross-sectional study sought to assess the eating and physical activity behaviors among in-state and out-of-state college freshmen attending Arizona State University and to determine if social connectedness mediated the relationship between residency status and eating and physical activity behaviors.
Methods
College freshmen from two dormitories were recruited for participation from Arizona State University’s Tempe campus. A 128-item survey assessing demographics, college life, eating and physical activity behaviors, and social connectedness was administered. In addition, participants completed up to three days of dietary recall. Multivariate linear regression models, adjusting for age, gender, race, ethnicity, highest parental education, dormitory, Pell grant status, number of dietary recalls, and availability of a weekend day of dietary recall were used to assess the relationships between residency status, social connectedness, and eating and physical activity behaviors.
Results
No associations were observed between residency status and calories, grams and percentage of calories from fat, and added sugar. There was a statistically significant association between residency status and moderate-to-vigorous physical activity (MVPA). In-state students reported 21 minutes less per day of MVPA than out-of-state students did (β=-20.85; 95% CI=-30.68, -11.02; p<0.001). There was no relationship between residency status and social connectedness. Social connectedness and eating and physical activity behaviors were not associated. Social connectedness did not mediate the relationship between residency status and eating and physical activity behaviors.
Conclusions
In-state and out-of-state students differed in their MVPA; however, this relationship was not mediated by social connectedness. Further studies are needed to confirm the relationship between MVPA and residency status. In addition, more studies are needed to assess the relationship between social connectedness and MVPA.
ContributorsNelson, Stephanie A. (Stephanie Anne), 1958- (Author) / Bruening, Meg (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Whisner, Corrie (Committee member) / Arizona State University (Publisher)
Created2016
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 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
Description
Despite the literature suggesting that fruits and vegetables (F&V) can have a protective outcome against overweight, obesity and chronic diseases, consumption is still inadequate. In order to address under consumption of F&V among children, schools have become a platform for a variety of food programs. The Fresh Fruit and Vegetable Program (FFVP), a United States Department of Agriculture (USDA) initiative, aims to increase exposure and consumption of F&V in low-income school children by providing F&V snacks. Participation in FFVP has been associated with higher preference and consumption of F&V and research also suggests that the program has the potential to decrease rates of overweight and obesity. The benefits of this program have been found to extend outside of the school setting, with higher requests for F&V at home and at the grocery store. This study aims to explore how children’s participation in the FFVP influences home food environments and shopping practices through qualitative analysis focus group data. Four focus groups were held with parents (n=25) from three FFVP participating schools. The data was analyzed using an inductive thematic analysis approach to find themes within the discussions. The findings were grouped into three categories: General Perceptions of FFVP, Impact of FFVP on the Home Food Environment, and Impact of FFVP on Shopping Practices. For General Perceptions of FFVP, themes were: Children learn about and enjoy F&V, awareness of farm to school programs, and children make healthier choices. Impact of FFVP on the Home Food Environment included the themes: Choosing heathier foods and snacks, parent F&V behaviors, children request F&V at home, and children talk about or bring F&V home. Finally, Impact of FFVP on Shopping Practices included the themes: children’s involvement in shopping, children request to buy F&V, children request non-produce items, and parents decline or limit unhealthy requests. This qualitative study provides valuable insights about how FFVP participation influences child and family behaviors towards F&V at home and in the grocery store. School food programs, such as the FFVP, have a positive influence on F&V related behaviors among children and should be continued and expanded.
ContributorsAcosta Ortiz, Marina (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / DeWeese, Robin (Thesis advisor) / Gruner, Jessie (Committee member) / Arizona State University (Publisher)
Created2018
Description
Objective: Parents play a critical role in their child's diets, yet there is lack of research in
the US comparing parental perception of their child’s diet with quantitatively assessed diet quality. We examined the association between parent perception of their child’s overall diet and the child’s diet quality, as measured by frequency of consumption of key food categories.
Methods: Secondary analysis was conducted using data from two independent cross- sectional panels of surveys with parents of a 3-18 year old child. Data collection took place in 2009-2010 and 2014, the random sample was drawn from low-income cities. Well-established survey questions assessed parental perception of their child’s diet and frequency of consumption of fruits, vegetables, sugar-sweetened beverages (SSB), fast food and unhealthy snacks. Diet quality scores were calculated for each child, with higher scores reflective of healthier diets (max score= 40). Ordered logistic regressions examined associations between parental perception and consumption of food categories. Multinomial logistic regressions examined associations between levels of concordance in parent perception and diet scores by demographic sub-groups.
Results: Almost half of children were non-Hispanic black (46%) and 40% were Hispanic. Overall 52% of parents strongly agreed, 33% somewhat agreed, 10% somewhat disagreed, and 4% strongly disagreed that their child eats a healthy diet. The mean diet quality score for the sample was 20.58 ± 6.7. Children from our sample with the unhealthiest diet had a mean frequency of fruit intake = 0.8 times/day and SSBs = 2.2 times/day. Children with the healthiest diet had a mean consumption of fruit=1.7/day and
SSBs= 0.4/day. Parental perception of their child’s diet was significantly higher when their child consumed more fruit (p<0.001) and vegetables (p<0.001) and lower when their child consumed more fast food (p<0.001), SSBs (p=0.01) and unhealthy snacks (p=0.02). Over half of parents overestimated the healthfulness of their child’s diet (61%). Parent, child and household demographics did not moderate this association.
Conclusions: Although parental perceptions that their child eats healthy are associated when their child eats more healthy foods and less unhealthy foods, parents’ perceptions still do not align with their child’s diet.
the US comparing parental perception of their child’s diet with quantitatively assessed diet quality. We examined the association between parent perception of their child’s overall diet and the child’s diet quality, as measured by frequency of consumption of key food categories.
Methods: Secondary analysis was conducted using data from two independent cross- sectional panels of surveys with parents of a 3-18 year old child. Data collection took place in 2009-2010 and 2014, the random sample was drawn from low-income cities. Well-established survey questions assessed parental perception of their child’s diet and frequency of consumption of fruits, vegetables, sugar-sweetened beverages (SSB), fast food and unhealthy snacks. Diet quality scores were calculated for each child, with higher scores reflective of healthier diets (max score= 40). Ordered logistic regressions examined associations between parental perception and consumption of food categories. Multinomial logistic regressions examined associations between levels of concordance in parent perception and diet scores by demographic sub-groups.
Results: Almost half of children were non-Hispanic black (46%) and 40% were Hispanic. Overall 52% of parents strongly agreed, 33% somewhat agreed, 10% somewhat disagreed, and 4% strongly disagreed that their child eats a healthy diet. The mean diet quality score for the sample was 20.58 ± 6.7. Children from our sample with the unhealthiest diet had a mean frequency of fruit intake = 0.8 times/day and SSBs = 2.2 times/day. Children with the healthiest diet had a mean consumption of fruit=1.7/day and
SSBs= 0.4/day. Parental perception of their child’s diet was significantly higher when their child consumed more fruit (p<0.001) and vegetables (p<0.001) and lower when their child consumed more fast food (p<0.001), SSBs (p=0.01) and unhealthy snacks (p=0.02). Over half of parents overestimated the healthfulness of their child’s diet (61%). Parent, child and household demographics did not moderate this association.
Conclusions: Although parental perceptions that their child eats healthy are associated when their child eats more healthy foods and less unhealthy foods, parents’ perceptions still do not align with their child’s diet.
ContributorsEliason, Jessica (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / DeWeese, Robin (Committee member) / Vega-Lopez, Sonia (Committee member) / Arizona State University (Publisher)
Created2019