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Participatory design of a comprehensive playground intervention manual for obesity mitigation in Phoenix, AZ

Description

In the past three decades alone, the United States has witnessed a dramatic rise in the prevalence of obesity and overweight in adults and children. Efforts towards obesity mitigation and prevention have produced promising recommendations and researchers and practitioners alike acknowledge that real solutions must match the complexity of the…

In the past three decades alone, the United States has witnessed a dramatic rise in the prevalence of obesity and overweight in adults and children. Efforts towards obesity mitigation and prevention have produced promising recommendations and researchers and practitioners alike acknowledge that real solutions must match the complexity of the problem. Comprehensive approaches that target environmental, economic, socio-cultural, and knowledge-based factors that influence diet and physical activity are highly recommended. However, the literature yields little in the way of what such comprehensive obesity interventions actually entail and how they ought to be developed. In particular, there are knowledge gaps in how various stakeholder groups can bridge institutional barriers to collaborate in ways that maximize resources, build upon synergies, and avoid duplication of efforts; and how specific recommendations are actually implemented. This thesis aims to contribute to an emerging body of literature that fills this gap by presenting a practical case study on how to create a playground obesity intervention in the Gateway District of Phoenix, Arizona, in collaboration with researchers, health professionals, neighborhood residents, and city officials. The objectives were two-fold: 1. To outline concrete steps that will allow an organization to create a playground linked with healthy kids education program that aims to increase physical activity, perceptions of safety, and community cohesion; 2. To outline how diverse stakeholders can collaborate effectively to create such a cohesive, complex obesity intervention. A detailed, actionable intervention manual was drafted through semi-structured interviews, literature review, a survey, a stakeholder workshop, and an extended peer-review. The manual describes the sequence of actions necessary for creating an innovative playground that reinforces learning, encourages creative play, and increases physical activity. The sequence of actions was linked with existing local assets, stakeholder roles and responsibilities, costs, and potential barriers. This manual, as well as the process itself, can serve as a transferable model for helping organizations come together to build the capacity required in order to tackle complex health challenges.

ContributorsXiong, Angela (Author) / Wiek, Arnim (Thesis advisor) / Golub, Aaron (Committee member) / Otu, Essen (Committee member) / Arizona State University (Publisher)

Created2013

Food environment around school and students' weight status: a study of four New Jersey low-income communities

Description

Childhood obesity has been on the rise for the past decade, and it has been hypothesized that students' food choices may be influenced by easy access to food outlets near their schools that provide unhealthful options. But the results of recent studies on the relationship between the food environment around…

Childhood obesity has been on the rise for the past decade, and it has been hypothesized that students' food choices may be influenced by easy access to food outlets near their schools that provide unhealthful options. But the results of recent studies on the relationship between the food environment around schools and student weight status are mixed and often contradictory. Most studies have used measures of weight and height that were self-reported by students, or have relied on data from a relatively small sample of students. I examine the association between weight status among school students and the food environment surrounding their schools using professionally-measured, student-level data across the full school-age spectrum. De-identified data were obtained for over 30,000 K-12 students in 79 public schools located in four New Jersey cities. Locations of alternative food-outlets (specifically, supermarkets, convenience stores, small grocery stores, and limited-service restaurants) were obtained from commercial sources and geocoded to develop proximity measures. A simplified social-ecological framework was used to conceptualize the multi-level the association between students' BMI and school proximity to food outlets and multivariate analyses were used to estimate this relationship controlling for student- and school-level factors. Over twenty percent of the students were obese, compared to the national average at 17% (Ogden, Carroll, Kit, & Flegal, 2012). On average, students had 2.6 convenience stores, 2.9 limited-service restaurants, and 0.1 supermarkets within a quarter mile of their school. This study suggests that easy access to small grocery stores (which this study uniquely examines as a separate food outlet category) that offer healthy choices including five types of fresh vegetable, five types of fresh fruits, low-fat dairy, and lean meats is associated with lower BMI z score and lower probability of being obese for middle and high school students. This suggests that improving access to such small food outlets may be a promising area for future investigation in obesity mitigation research. Also, this study separates students of pre-schools, kindergartens and elementary schools (neighborhood schools) from that of the middle and high schools (non-neighborhood) schools because the two groups of schools have different neighborhood characteristics, as well as open-school and bussing policies that result in different levels of exposure that students have to the food outlets around the schools. The result of this study suggests that the relationship between students' weight outcomes and food environment around schools is different in the two groups of schools.

ContributorsTang, Xuyang (Author) / Abbott, Joshua K (Thesis advisor) / Ohri-Vachaspati, Punam (Thesis advisor) / Aggarwal, Rimjhim (Committee member) / Arizona State University (Publisher)

Created2013

An attributional explanation of consumers' responses to government regulations and corporate social responsibility, with implications for childhood obesity

Description

There have been multiple calls for research on consumers' responses to social issues, regulatory changes, and corporate behavior. Thus, this dissertation proposes and tests a conceptual framework of parents' responses to government regulations and corporate social responsibility (CSR) that address juvenile obesity. This research builds on Attribution Theory to examine…

There have been multiple calls for research on consumers' responses to social issues, regulatory changes, and corporate behavior. Thus, this dissertation proposes and tests a conceptual framework of parents' responses to government regulations and corporate social responsibility (CSR) that address juvenile obesity. This research builds on Attribution Theory to examine the impact of government regulations and CSR on consumers' attitudes and their subsequent behavior. Three pilot studies and three main experiments were conducted; a between-subjects and randomized experimental design being used to capture the effects of regulations and corporate actions on product satisfaction, company evaluations, and behavioral intentions, while examining the mediating role of attributions of responsibility for a negative product outcome. This research has implications for policy makers and marketing practitioners and scholars. This is the first study to offer a new perspective, based on attributions of blame, to explain the mechanism that drives consumers' responses to government regulations. Considering numerous calls for government actions that address childhood obesity, it is important to understand how and why consumers respond to such regulations. The results illustrated that certain policies may have unintended consequences due to unexpected attributions of blame for unhealthy products. Only recently have researchers tried to address the psychological mechanism through which CSR has an impact on consumers' attitudes and behavior. To date, few studies have investigated attributions as a mediating variable in the transfer of CSR associations on consumer responses. Nonetheless, this is the first study that concentrates on attributions of responsibility, per se, to explain the impact of CSR on company evaluations. This dissertation extends previous research, where locus, stability, and controllability mediated the relationship between CSR and attributions of blame; the degree of blame being consequential to brand evaluations. The current results suggest that attributions of responsibility, per se, mediate the impact of CSR on company evaluations. Additionally, attributions of blame are measured as the degree to which consumers take personal responsibility for a negative product outcome. This highlights a new role of the CSR construct, as a moderator of consumers' self-serving bias, a fundamental psychological response that has been neglected in the marketing literature.

ContributorsDumitrescu, Claudia (Author) / Shaw Hughner, Renée (Thesis advisor) / Schmitz, Troy G. (Committee member) / Seperich, George (Committee member) / Shultz, Ii, Clifford J. (Committee member) / Arizona State University (Publisher)

Created2013

Determinants of the home food environment

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…

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

Observed parenting practices in early childhood as predictors of child weight status and behavioral problems at age 10

Description

Pediatric obesity is a public health concern due to its elevated prevalence rates and its relation to concurrent and long-term physical and psychosocial consequences. Pediatric obesity has been found to be associated with problem behaviors, albeit with inconsistent findings. The mechanism of this relation is unclear. It is possible…

Pediatric obesity is a public health concern due to its elevated prevalence rates and its relation to concurrent and long-term physical and psychosocial consequences. Pediatric obesity has been found to be associated with problem behaviors, albeit with inconsistent findings. The mechanism of this relation is unclear. It is possible that they have a shared etiology. Self-regulation and parenting practices are two factors that have been implicated in the development of problem behaviors and are garnering evidence for their relation with pediatric obesity. The goal of the present study was to examine whether self-regulation (SREC), positive behavior support (PBSEC), and coercive limit-setting (CLSEC) in early childhood are shared etiological factors of pediatric obesity and problem behaviors. Using multinomial logistic regression the likelihood of belonging to four outcome groups (Comorbid, Problem behavior only, Overweight only, and Typically developing) at age 10 based on these factors was assessed. Analyses controlled for intervention group assignment, child gender, child African-American or Bi-racial, child Hispanic, cumulative risk, child body size impression at age 2, and parent body size impression at baseline. In the models examining SREC alone, for every 1 standard deviation increase in SREC, there was a reliable reduction in the odds of the child belonging to the comorbid and problem behavior only groups at age 10, compared to the typically developing group (OR = 0.386, 95% CI [0.237, 0.628], OR = 0.281, 95% CI [0.157, 0.503], respectively). This relation was maintained when SREC was in the same model as PBSEC and CLSEC. PBSEC and CLSEC alone did not impact the likelihood of belonging to any of the outcome groups. A significant interaction was found between SREC and CLSEC, such that at high levels of both SREC and CLSEC the odds of a child belonging to the overweight only group at age 10 increased, compared to the typically developing group. Results highlight CLSEC as a parenting practice that may place a highly regulated child at risk for becoming overweight. Overall, the findings suggest that problem behaviors and pediatric obesity do not have a shared etiology.

ContributorsMontano, Zorash (Author) / Dishion, Thomas J (Thesis advisor) / Gonzales, Nancy (Committee member) / Perez, Marisol (Committee member) / Enders, Craig (Committee member) / Arizona State University (Publisher)

Created2016

Stress reactivity as a predictor of emotional eating

Description

Childhood obesity is associated with many well established health risks as well as high annual public health costs. Because of this, the childhood obesity literature has highlighted the need to detect at-risk groups in order to implement targeted preventions. Emotional eating has been identified as an unhealthy behavior and a…

Childhood obesity is associated with many well established health risks as well as high annual public health costs. Because of this, the childhood obesity literature has highlighted the need to detect at-risk groups in order to implement targeted preventions. Emotional eating has been identified as an unhealthy behavior and a risk factor for overweight status among children though very little is known about what predisposes children to emotionally eat. Stress has often been found to elicit emotional eating but most studies looking at this relationship have relied on self-reports in adult and clinical samples. Thus, the current study seeks to investigate the relationship between stress reactivity (measured using heart rate variability) and emotional eating in a sample of 247 children between the ages of 4-6. Furthermore, levels of control may moderate the relationship between stress reactivity (HRV) and emotional eating. Linear regression analysis was used to explore these relationships. It was expected that higher levels of reactivity to stress would predict an increased likelihood of emotional eating. This association was expected to be attenuated among children with higher levels of inhibitory control and attentional focusing as well as lower levels of impulsivity. However, the hypothesized findings were not supported by the data. Despite these null findings, and in light of several limitations, it is still hypothesized that emotional eating involves physiological and impulsivity/effortful control processes. Implications of future research are discussed.

ContributorsOhrt, Tara K (Author) / Perez La Mar, Marisol (Thesis advisor) / Luecken, Linda (Committee member) / Lemery, Kathryn (Committee member) / Arizona State University (Publisher)

Created2016

The New Jersey Childhood Obesity Survey: Chartbook, Vineland, Summer 2010

Description

The New Jersey Childhood Obesity Study was designed to provide vital information for planning, implementing, and evaluating interventions aimed at preventing childhood obesity in five New Jersey municipalities: Camden, Newark, New Brunswick, Trenton, and Vineland. These five communities are being supported by the Robert Wood Johnson Foundation’s New Jersey Partnershi…

The New Jersey Childhood Obesity Study was designed to provide vital information for planning, implementing, and evaluating interventions aimed at preventing childhood obesity in five New Jersey municipalities: Camden, Newark, New Brunswick, Trenton, and Vineland. These five communities are being supported by the Robert Wood Johnson Foundation’s New Jersey Partnership for Healthy Kids program to plan and implement policy and environmental change strategies to prevent childhood obesity. Effective interventions for addressing childhood obesity require community-specific information on

who is most at risk and on contributing factors that can be addressed through tailored interventions that meet the needs of the community. Based on comprehensive research, a series of reports are being prepared for each community to assist in planning effective interventions.

The main components of the study were:

• A household telephone survey of 1700 families with 3–18 year old children,

• De-identified heights and weights measured at public schools,

• Assessment of the food and physical activity environments using objective data.

This report presents the results from the household survey. Reports based on school body mass index (BMI) data and food and physical activity environment data are available at www.cshp.rutgers.edu/childhoodobesity.htm.

ContributorsLloyd, Kristen (Author) / Ohri-Vachaspati, Punam (Author) / Brownlee, Susan (Author) / Yedidia, Michael J., 1946- (Author) / Gaboda, Dorothy (Author) / Chao, Jolene (Author) / Rutgers Center for State Health Policy (Contributor) / Robert Wood Johnson Foundation. National Program Office (Funder)

Created2010

The New Jersey Childhood Obesity Survey: Chartbook, Newark, Summer 2010

Description

The New Jersey Childhood Obesity Study was designed to provide vital information for planning, implementing, and evaluating interventions aimed at preventing childhood obesity in five New Jersey municipalities: Camden, Newark, New Brunswick, Trenton, and Vineland. These five communities are being supported by the Robert Wood Johnson Foundation’s New Jersey Partnershi…

The New Jersey Childhood Obesity Study was designed to provide vital information for planning, implementing, and evaluating interventions aimed at preventing childhood obesity in five New Jersey municipalities: Camden, Newark, New Brunswick, Trenton, and Vineland. These five communities are being supported by the Robert Wood Johnson Foundation’s New Jersey Partnership for Healthy Kids program to plan and implement policy and environmental change strategies to prevent childhood obesity. Effective interventions for addressing childhood obesity require community-specific information on

who is most at risk and on contributing factors that can be addressed through tailored interventions that meet the needs of the community. Based on comprehensive research, a series of reports are being prepared for each community to assist in planning effective interventions.

The main components of the study were:

• A household telephone survey of 1700 families with 3–18 year old children,

• De-identified heights and weights measured at public schools,

• Assessment of the food and physical activity environments using objective data.

This report presents the results from the household survey. Reports based on school body mass index (BMI) data and food and physical activity environment data are available at www.cshp.rutgers.edu/childhoodobesity.htm.

ContributorsBrownlee, Susan (Author) / Ohri-Vachaspati, Punam (Author) / Lloyd, Kristen (Author) / Yedidia, Michael J., 1946- (Author) / Gaboda, Dorothy (Author) / Chao, Jolene (Author) / Rutgers Center for State Health Policy (Contributor) / Robert Wood Johnson Foundation. National Program Office (Funder)

Created2010

The New Jersey Childhood Obesity Study: Physical Activity Environment Maps, Camden

Description

The maps in this chartbook describe the physical activity environment in Camden in terms of geographic distribution of parks and physical activity facilities. Research shows that people who have access to these facilities are more likely to be physically active.

• The maps in this chartbook were created using physical activity facilities data from a commercial…

The maps in this chartbook describe the physical activity environment in Camden in terms of geographic distribution of parks and physical activity facilities. Research shows that people who have access to these facilities are more likely to be physically active.

• The maps in this chartbook were created using physical activity facilities data from a commercial database (lnfoUSA, 2008), data from city departments, as well as information obtained from systematic web searches. The maps present data for the city of Camden and for a 1 mile buffer area around Camden.

• Physical activity centers include private and public facilities which offer physical activity opportunities for children 3-18 years of age.

• Physical activity environment maps are compared with Census 2000 data to visualize accessibility of physical activity opportunities in neighborhoods with different characteristics.

• Poverty level presented in this chartbook are based on the 2000 Federal Poverty Guidelines.

• Crime rates in Camden are presented at the census block group level as relative crime risk (CrimeRisk) obtained from a commercial data source (Applied Geographic Solutions, 2008). CrimeRisk - an index value derived from modeling the relationship between crime rates and demographics data - is expressed as the risk of crime occurring in a specific block group relative to the national average. For this chartbook, data on total CrimeRisk, which includes personal and property crimes, are reported.

ContributorsOhri-Vachaspati, Punam (Author) / Tulloch, David (Author) / Petlick, Nirvana (Author) / Chao, Jolene (Author) / Yedidia, Michael J., 1946- (Author) / Rutgers Center for State Health Policy (Contributor) / Robert Wood Johnson Foundation. National Program Office (Funder)

Created2010

The New Jersey Childhood Obesity Study: Physical Activity Environment Maps, New Brunswick

Description

The maps in this chartbook describe the physical activity environment in New Brunswick in terms of geographic distribution of parks and physical activity facilities. Research shows that people who have access to these facilities are more likely to be physically active.

• The maps in this chartbook were created using physical…

The maps in this chartbook describe the physical activity environment in New Brunswick in terms of geographic distribution of parks and physical activity facilities. Research shows that people who have access to these facilities are more likely to be physically active.

• The maps in this chartbook were created using physical activity facilities data from a commercial database (lnfoUSA, 2008), data from city departments, as well as information obtained from systematic web searches. The maps present data for the city of New Brunswick and for a 1 mile buffer area around New Brunswick.

• Physical activity centers include private and public facilities which offer physical activity opportunities for children 3-18 years of age.

• Physical activity environment maps are compared with Census 2000 data to visualize accessibility of physical activity opportunities in neighborhoods with different characteristics.

• Poverty level presented in this chartbook are based on the 2000 Federal Poverty Guidelines.

• Crime rates in New Brunswick are presented at the census block group level as relative crime risk (CrimeRisk) obtained from a commercial data source (Applied Geographic Solutions, 2008). CrimeRisk - an index value derived from modeling the relationship between crime rates and demographics data - is expressed as the risk of crime occurring in a specific block group relative to the national average. For this chartbook, data on total CrimeRisk, which includes personal and property crimes, are reported.

ContributorsOhri-Vachaspati, Punam (Author) / Tulloch, David (Author) / Petlick, Nirvana (Author) / Chao, Jolene (Author) / Yedidia, Michael J., 1946- (Author) / Rutgers Center for State Health Policy (Contributor) / Robert Wood Johnson Foundation. National Program Office (Funder)

Created2010

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