ASU Electronic Theses and Dissertations
This collection includes most of the ASU Theses and Dissertations from 2011 to present. ASU Theses and Dissertations are available in downloadable PDF format; however, a small percentage of items are under embargo. Information about the dissertations/theses includes degree information, committee members, an abstract, supporting data or media.
In addition to the electronic theses found in the ASU Digital Repository, ASU Theses and Dissertations can be found in the ASU Library Catalog.
Dissertations and Theses granted by Arizona State University are archived and made available through a joint effort of the ASU Graduate College and the ASU Libraries. For more information or questions about this collection contact or visit the Digital Repository ETD Library Guide or contact the ASU Graduate College at gradformat@asu.edu.
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Description
There has been a push to create and implement school wellness policies. Childhood obesity statistics suggest that schools may have an important role to play in promoting wellness. Childhood obesity has become a significant problem in the United States. The percentage of obese children in the United States has more than doubled since 1970, and up to 33% of the children in the United States are currently overweight. Among the 33% of children who are overweight, 25% are obese, and 14% have type 2 diabetes, previously considered to be a condition found only in adults. This mixed-method study with a string qualitative component study examined three aspects of federally mandated local wellness polices. The study investigated the policies themselves, how the policies are understood in the local school setting, with a particular focus on the impact the policies have had on school meals. The bulk of the research data was generated through 8 in-depth interviews. The interviews were conducted with key stakeholders within 2 elementary school districts in Arizona. In addition, the evaluation of 20 local wellness polices was conducted via a rubric scoring system. The primary component found to be lacking in local wellness policies was the evaluation method. Recommendations for school districts include the establishment of a clear method of measurement.
ContributorsCrawford, Sara S (Author) / Mccarty, Teresa L. (Thesis advisor) / Molnar, Alex (Thesis advisor) / Montoya, Araceli (Committee member) / Arizona State University (Publisher)
Created2011
Description
This thesis explores concept of "global bioethics" in both its development as well as its current state in an effort to understand exactly where it fits into the larger field of bioethics. Further, the analysis poses specific questions regarding what it may contribute to this field and related fields, and the possibility and scope associated with the continued development of global bioethics as its own discipline. To achieve this, the piece addresses questions regarding current opinions on the subject, the authorities and their associated publications related to global bioethics, and what the aims of the subject should be given its current state. "Global Bioethics" is a term that, while seen frequently in bioethics literature, is difficult to define succinctly. While many opinions are provided on the concept, little consensus exists regarding its application and possible contributions and, in some cases, even its very possibility. Applying ethical principles of health and medicine globally is undoubtedly complicated by the cultural, social, and geographical considerations associated with understanding health and medicine in different populations, leading to a dichotomy between two schools of thought in relation to global bioethics. These two sides consist of those who think that universality of bioethics is possible whereas the opposing viewpoint holds that relativism is the key to applying ethics on a global scale. Despite the aforementioned dichotomy in addressing applications of global bioethics, this analysis shows that the goals of the subject should be more focused on contributing to ethical frameworks and valuable types of thinking related to the ethics health and medicine on a global scale. This is achieved through an exploration of bioethics in general, health as a function of society and culture, the history and development of global bioethics itself, and an exploration of pertinent global health topics. While primarily descriptive in nature, this analysis critiques some of the current discussions and purported goals surrounding global bioethics, recommending that the field focus on fostering valuable discussion and framing of issues rather than the pursuit of concrete judgments on moral issues in global health and medicine.
ContributorsRuffenach, Stephen Charles (Author) / Robert, Jason S (Thesis advisor) / Maienschein, Jane (Committee member) / Hruschka, Daniel J (Committee member) / Arizona State University (Publisher)
Created2011
Description
Encouraging stair use may increase physical activity among college students. The overall goals of this study were to quantitatively and qualitatively evaluate a stair use initiative, which included a mural painting contest in a residential hall. The number of individuals exiting the stairs were counted and interview data were obtained regarding the visibility of the signs and murals and whether the signs or murals influenced stair use. Focus groups and interviews were conducted with the community assistants (CAs) and staff members involved with the project to obtain qualitative data on their perceptions and opinions of the mural painting event. It was hypothesized that the average number of individuals per half hour who used the stairs would significantly increase from baseline to post-test. To examine changes over time in individuals exiting the stairs, a quasi-experimental design was used with one baseline measurement and multiple posttests (n=5). Stair use was determined by counting individuals exiting the stairwells. Time differences in exiting stair use were examined with repeated measures analysis of variance (ANOVA). Descriptive statistics and t-tests were used to analyze interview data. Qualitative data were analyzed using a thematic analysis approach. There was a significant time effect on stair use (F=7.512, p =0.000) and a significant interaction between staircase and time (F=7.518, p=0.000). There was no significant interaction of gender over time (F=.037, p=0.997). A repeated measures ANOVA was conducted on each staircase individually and showed that significant time differences were only found in the Southwest staircase. Based on exit interviews (n=28), most students saw the directional signs (61%) and murals (89.3%). However, neither the signs (71.4%) nor the murals (82.1%) were perceived as influential on stair use. Data from the focus groups and interviews revealed that the mural painting contest did not occur as intended, because the contest piece did not take place. In conclusion, solely having residents of a residential hall paint murals in stairwells was insufficient for increasing stair use. A mural painting contest may be a viable approach if properly planned and implemented.
ContributorsSmith, Shannon (Author) / Der Ananian, Cheryl A. (Thesis advisor) / Ainsworth, Barbara E. (Committee member) / Borror, Connie M. (Committee member) / Ilchak, Debra L. (Committee member) / Swan, Pamela D. (Committee member) / Wharton, Christopher M. (Committee member) / Arizona State University (Publisher)
Created2011
Description
The gold standard for bone measurement is DXA (dual energy X-ray absorptiometry). Typically, to observe changes in bone by DXA, a minimum of a 4-month intervention is required. Serum osteocalcin (OST) (a bone formation marker) and quantitative ultrasound (QUS) of the calcaneus can be used as indicators of bone change but the sensitivity and time course of these indices to short term interventions are unknown. The purpose of this study was twofold: to compare monthly changes in OST and QUS in response to jump training and to evaluate the relationship between DXA, OST and QUS. Young women with QUS t-scores less than 1.0 were randomized into a jump training (J) (n=16) or control (C) (n=16). J consisted of a progressive routine of 1 and 2-footed jumping performed 3 days per week for 4 months. Body composition, QUS and OST were measured at baseline, and monthly for 4 months. DXA and 24-hour dietary recalls were completed at baseline and 4 months. Low attrition rate (12.5%) and high compliance (98%) with the exercise intervention was recorded. No significant correlations between QUS and OST existed. No significant differences were observed between groups at baseline in body composition or bone variables. Monthly increases in OST were observed but there were no significant differences over time between groups in any bone variables. OST and QUS may be indicative of short term bone changes but these variables were not specifically sensitive to the jumping intervention in this population of women.
ContributorsHeumann, Kristin Joelle (Author) / Swan, Pamela D (Thesis advisor) / Alvar, Brent (Committee member) / Chisum, Jack (Committee member) / Lee, Chong (Committee member) / Vaughan, Linda (Committee member) / Arizona State University (Publisher)
Created2011
Description
At first glance, trends in increased hunger and obesity in the United States (US) would seem to represent the result of different causal mechanisms. The United States Department of Agriculture (USDA) reported that nearly 50 million Americans had experienced hunger in 2009. A year later, the Centers for Disease Control and Prevention published a report showing that 68% of the US population was either overweight or obese. Researchers have found that these contrasting trends are actually interrelated. Being so, it is imperative that communities and individuals experiencing problems with food security are provided better access to healthy food options. In response to the need to increase healthy food access, many farmers markets in the US have received funding from the USDA to accept vouchers from federal food security programs, such as the Supplemental Nutrition Assistance Program (SNAP). In Downtown Phoenix, Arizona, one organization accepting vouchers from several programs is the Phoenix Public Market. However, the mere existence of these programs is not enough to establish food security within a community: characteristics of the population and food environments must also be considered. To examine issues of food security and public health, this thesis utilizes geographical information systems (GIS) technology as a tool to analyze specific environments in order to inform program effectiveness and future funding opportunities. Utilizing methods from community-based participatory research (CBPR) and GIS, a mapping project was conducted in partnership with the Market to answer three questions: (1) what is the demographic makeup of the surrounding community? (2) What retailers around the Market also accept food security vouchers? And (3) where are food security offices (SNAP and WIC) located within the area? Both in terms of demographic characteristics and the surrounding food environment, the project results illustrate that the Market is embedded within a population of need, and an area where it could greatly influence community food security.
ContributorsRawson, Brooke (Author) / Vargas, Perla A (Thesis advisor) / Booze, Randy (Committee member) / Vaughan, Suzanne (Committee member) / Arizona State University (Publisher)
Created2011
Description
Many studies have shown that access to healthy food in the US is unevenly distributed and that supermarkets and other fresh food retailers are less likely to be located in low-income minority communities, where convenience and dollar stores are more prevalent grocery options. I formed a partnership with Phoenix Revitalization Corporation, a local community development organization engaged in Central City South, Phoenix, to enhance the community's capacity to meet its community health goals by improving access to healthy food. I used a community-based participatory approach that blended qualitative and quantitative elements to accommodate collaboration between both academic and non-academic partners. Utilizing stakeholder interviews, Nutrition Environment Measures Surveys (NEMS), and mapping to analyze the community's food resources, research revealed that the community lacks adequate access to affordable, nutritious food. Community food stores (n=14) scored an average of 10.9 out of a possible 54 points using the NEMS scoring protocol. The community food assessment is an essential step in improving access to healthy food for CCS residents and provides a baseline for tracking progress to improve residents' food access. Recommendations were drafted by the research partnership to equip and empower the community with strategic, community-specific interventions based on the research findings.
ContributorsCrouch, Carolyn (Author) / Harlan, Sharon (Thesis advisor) / Eakin, Hallie (Committee member) / Aftandilian, David (Committee member) / Arizona State University (Publisher)
Created2011
Description
Extreme hot-weather events have become life-threatening natural phenomena in many cities around the world, and the health impacts of excessive heat are expected to increase with climate change (Huang et al. 2011; Knowlton et al. 2007; Meehl and Tebaldi 2004; Patz 2005). Heat waves will likely have the worst health impacts in urban areas, where large numbers of vulnerable people reside and where local-scale urban heat island effects (UHI) retard and reduce nighttime cooling. This dissertation presents three empirical case studies that were conducted to advance our understanding of human vulnerability to heat in coupled human-natural systems. Using vulnerability theory as a framework, I analyzed how various social and environmental components of a system interact to exacerbate or mitigate heat impacts on human health, with the goal of contributing to the conceptualization of human vulnerability to heat. The studies: 1) compared the relationship between temperature and health outcomes in Chicago and Phoenix; 2) compared a map derived from a theoretical generic index of vulnerability to heat with a map derived from actual heat-related hospitalizations in Phoenix; and 3) used geospatial information on health data at two areal units to identify the hot spots for two heat health outcomes in Phoenix. The results show a 10-degree Celsius difference in the threshold temperatures at which heat-stress calls in Phoenix and Chicago are likely to increase drastically, and that Chicago is likely to be more sensitive to climate change than Phoenix. I also found that heat-vulnerability indices are sensitive to scale, measurement, and context, and that cities will need to incorporate place-based factors to increase the usefulness of vulnerability indices and mapping to decision making. Finally, I found that identification of geographical hot-spot of heat-related illness depends on the type of data used, scale of measurement, and normalization procedures. I recommend using multiple datasets and different approaches to spatial analysis to overcome this limitation and help decision makers develop effective intervention strategies.
ContributorsChuang, Wen-Ching (Author) / Gober, Patricia (Thesis advisor) / Boone, Christopher (Committee member) / Guhathakurta, Subhrajit (Committee member) / Ruddell, Darren (Committee member) / Arizona State University (Publisher)
Created2013
Description
Purpose: The purpose of this study was to examine the acute effects of two novel intermittent exercise prescriptions on glucose regulation and ambulatory blood pressure. Methods: Ten subjects (5 men and 5 women, ages 31.5 ± 5.42 yr, height 170.38 ± 9.69 cm and weight 88.59 ± 18.91 kg) participated in this four-treatment crossover trial. All subjects participated in four trials, each taking place over three days. On the evening of the first day, subjects were fitted with a continuous glucose monitor (CGM). On the second day, subjects were fitted with an ambulatory blood pressure monitor (ABP) and underwent one of the following four conditions in a randomized order: 1) 30-min: 30 minutes of continuous exercise at 60 - 70% VO2peak; 2) Mod 2-min: twenty-one 2-min bouts of walking at 3 mph performed once every 20 minutes; 3) HI 2-min: eight 2-min bouts of walking at maximal incline performed once every hour; 4) Control: a no exercise control condition. On the morning of the third day, the CGM and ABP devices were removed. All meals were standardized during the study visits. Linear mixed models were used to compare mean differences in glucose and blood pressure regulation between the four trials. Results: Glucose concentrations were significantly lower following the 30-min (91.1 ± 14.9 mg/dl), Mod 2-min (93.7 ± 19.8 mg/dl) and HI 2-min (96.1 ± 16.4 mg/dl) trials as compared to the Control (101.1 ± 20 mg/dl) (P < 0.001 for all three comparisons). The 30-min trial was superior to the Mod 2-min, which was superior to the HI 2-min trial in lowering blood glucose levels (P < 0.001 and P = 0.003 respectively). Only the 30-min trial was effective in lowering systolic ABP (124 ± 12 mmHg) as compared to the Control trial (127 ± 14 mmHg; P < 0.001) for up to 11 hours post exercise. Conclusion: Performing frequent short (i.e., 2 minutes) bouts of moderate or high intensity exercise may be a viable alternative to traditional continuous exercise in improving glucose regulation. However, 2-min bouts of exercise are not effective in reducing ambulatory blood pressure in healthy adults.
ContributorsBhammar, Dharini Mukeshkumar (Author) / Gaesser, Glenn A (Thesis advisor) / Shaibi, Gabriel (Committee member) / Buman, Matthew (Committee member) / Swan, Pamela (Committee member) / Lee, Chong (Committee member) / Arizona State University (Publisher)
Created2013
Description
In October, 2009, participants of the Arizona Special Supplemental Nutrition Program for Women, Infants and Children (WIC) began receiving monthly Cash Value Vouchers (CVV) worth between six and 10 dollars towards the purchase of fresh fruits and vegetables. Data from the Arizona Department of Health Services (ADHS) showed CVV redemption rates in the first two years of the program were lower than the national average of 77% redemption. In response, the ADHS WIC Food List was expanded to also include canned and frozen fruits and vegetables. More recent data from ADHS suggest that redemption rates are improving, but variably exist among different WIC sub-populations. The purpose of this project was to identify themes related to the ease or difficulty of WIC CVV use amongst different categories of low-redeeming WIC participants. A total of 8 focus groups were conducted, four at a clinic in each of two Valley cities: Surprise and Mesa. Each of the four focus groups comprised one of four targeted WIC participant categories: pregnant, postpartum, breastfeeding, and children with participation ranging from 3-9 participants per group. Using the general inductive approach, recordings of the focus groups were transcribed, hand-coded and uploaded into qualitative analysis software resulting in four emergent themes including: interactions and shopping strategies, maximizing WIC value, redemption issues, and effect of rule change. Researchers identified twelve different subthemes related to the emergent theme of interactions and strategies to improve their experience, including economic considerations during redemption. Barriers related to interactions existed that made their purchase difficult, most notably anger from the cashier and other shoppers. However, participants made use of a number of strategies to facilitate WIC purchases or extract more value out of WIC benefits, such as pooling their CVV. Finally, it appears that the fruit and vegetable rule change was well received by those who were aware of the change. These data suggest a number of important avenues for future research, including verifying these themes are important within a larger, representative sample of Arizona WIC participants, and exploring strategies to minimize barriers identified by participants, such as use of electronic benefits transfer-style cards (EBT).
ContributorsBertmann, Farryl M. W (Author) / Wharton, Christopher (Christopher Mack), 1977- (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Johnston, Carol (Committee member) / Hampl, Jeffrey (Committee member) / Dixit-Joshi, Sujata (Committee member) / Barroso, Cristina (Committee member) / Arizona State University (Publisher)
Created2013
Community-based development: scaling up the correct use of misoprostol at home births in Afghanistan
Description
Globally, more than 350 000 women die annually from complications during pregnancy and childbirth (UNFPA, 2011). Nearly 99% of these, according to World Health Organization (WHO) trends (2010) occur in the developing world outside of a hospital setting with limited resources including emergency care (WHO, 2012; UNFPA, 2011). The most prevalent cause of death is postpartum hemorrhage (PPH), accounting for 25% of deaths according to WHO statistics (2012). Conditions in Afghanistan are reflective of the scope and magnitude of the problem. In Afghanistan, maternal mortality is thought to be among the highest in the world. The Afghan Mortality Survey (AMS) data implies that one Afghan woman dies about every 2 hours from pregnancy-related causes (AMS, 2010). Lack of empowerment, education and access to health care resources increase a woman's risk of dying during pregnancy (AMS, 2010). This project aims to investigate the prospects of scaling-up the correct use of misoprostol, a prostaglandin E1 analogue, to treat PPH in developing countries where skilled assistance and resources are scant. As there has been little published on the lessons learned from programs already in place, this study is experience-driven, based on the knowledge of industry experts. This study employs a concurrent triangulation approach to synthesize quantitative data obtained from previous studies with qualitative information gathered through the testimonies of key personnel who participated in pilot programs involving misoprostol. There are many obstacles to scaling-up training initiatives in Afghanistan and other low-resource areas. The analysis concludes that the most crucial factors for scaling-up community-based programs include: more studies analyzing lessons learns from community driven approaches; stronger partnerships with community health care workers; overcoming barriers like association with abortion, misuse and product issues; and a heightened global and community awareness of the severity of PPH without treatment. These results have implications for those who actively work in Afghanistan to promote maternal health and other countries that may use Afghanistan's work as a blueprint for reducing maternal mortality through community-based approaches. Keywords: Afghanistan, community-based interventions, community-driven, maternal mortality, MDG5, misoprostol, postpartum hemorrhage, reproduction, scale-up
ContributorsCristy, Candice (Author) / Grossman, Gary (Thesis advisor) / Parmentier, Mary-Jane (Committee member) / Byrd, Denise (Committee member) / Arizona State University (Publisher)
Created2013