Matching Items (13)
Filtering by
- All Subjects: Behavioral Sciences
- All Subjects: public policy
- Creators: Ohri-Vachaspati, Punam
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
Description
Background: Previous research suggests a healthy eater schema (i.e., identifying yourself as a healthy eater) may be a useful concept to target in interventions. A "stealth" intervention that discussed the moral issues related to food worked better at promoting healthful eating than an intervention focused on the health benefits. No research has explored the relationship between moral foundations, a theoretical model focused on delineating core "foundations" for making a moral decision, and healthy eater self-identity or self-efficacy. Purpose: We explored the relationship between moral foundations (i.e., harm/care, fairness/reciprocity, in-group/loyalty, authority/respect, & purity/sanctity) and health eater self-identity and fruit and vegetable self-efficacy (FVSE). Methods: 542 participants completed an online cross-sectional survey, which included moral foundations (i.e., MFQ), political views, healthy eater self-identity (i.e., HESS), and FVSE measures. Logistic regression was used to assess the relationship between moral foundations between healthy eater self-identity after controlling for age, gender, major, BMI, and political beliefs. OLS regression was used to explore the relationship between self-efficacy and the moral foundations after controlling for the covariates. Results: 75.6% of the sample were college students, with a mean age of 25.27 (SD=8.61). 25.1% of students were nutrition majors. Harm/care, authority/respect, and ingroup/loyalty were significantly associated with healthy eater schema, (i.e., OR=1.7, p<.001, OR=1.5, p=.009, and OR=1.4, p=.027, respectively). Ingroup/loyalty, authority/respect, and purity/sanctity were related to FVSE (p=.006, p=.002, p=.04, respectively). Conclusion: Among college students, harm/care and authority/respect were associated with a healthy eater schema. Future research should explore possible uses of these moral foundations in interventions (e.g., a plant-based diet based on reduced harm to animals or eating fewer processed views based on "traditional" values).
ContributorsKiser, Sarah (Author) / Hekler, Eric B. (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Johnston, Carol (Committee member) / Arizona State University (Publisher)
Created2013
Description
Health knowledge alone does not appear to lead to sustained healthy behavior, suggesting the need for alternative methods for improving diet. Recent research shows a possible role of moral contexts of food production on diet related behaviors; however no studies have been conducted to specifically explore the relationship between moral constructs and food consumption. This study examined the relationship between fast food consumption and two measures of morality, Moral Foundations Questionnaire (MFQ), specifically harm/care and purity/sanctity foundations, and the Ethical Concern in food choice (EC) questionnaire, which includes animal welfare, environment protection, political values, and religion subscales. The study also examined the association between the measures of morality. 739 participants, primarily female (71.4%) and non-Hispanic Whites (76.5%), completed an online survey that included the MFQ, the EC questionnaire, and a brief fast food screener. Participant's morality scores in relation to their fast food consumption were examined first using bivariate ANOVA analysis and then using logistic regression to control for covariates. The MFQ foundations were compared with the EC subscales using Pearson correlation coefficient. Significant bivariate relationships were seen between fast food consumption and the MFQ's purity/sanctity foundation and EC's religion subscales (p<0.05). However these significant bivariate relationships did not hold after controlling for gender, race, university education, and religion in the logistic regression analysis. The foundations of the MFQ were positively correlated with the subscales for the EC questionnaire (r values ranging from .233-.613 (p<0.01). MFQ's purity/sanctity foundation and EC's religion subscale were the two most highly correlated (r=.613, p<0.01) showing that moral intuitions may be associated with eating decision making. The study did not find significant associations between MFQ or EC scores and fast food consumption.
ContributorsMartinelli, Sarah (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Hekler, Eric B. (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Johnston, Carol (Committee member) / Arizona State University (Publisher)
Created2013
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
The U.S. Department of Agriculture’s (USDA) National School Lunch Program and School Breakfast Program provide nutritious meals to school-age children. USDA’s Community Eligibility Provision (CEP) is designed to extend the reach of these programs by allowing schools in low-income areas to provide free school meals to all students at no cost to families. CEP has been shown to increase school meal participation, nutritional intake, academic achievement, and attendance in previous research studies. This study aims to examine the impact of long-term CEP participation on student weight outcomes. Nurse-measured height and weight data for school years 2013-14 to 2019-20 were collected from 141 K-12 public schools in four low-income cities. School-level prevalence of obesity was calculated from students’ heights and weights using the Centers for Disease Control and Prevention protocol. CEP participation for each school year was obtained from the state Department of Education. Schools in the sample began participating in CEP at different times yielding varying numbers of years of CEP exposure over the study period. Multivariable analyses examined the relationship between school CEP exposure and the prevalence of obesity, controlling for school-level covariates. Multivariable analyses showed that for every additional year of CEP participation, the school-level prevalence of obesity was 0.4% lower (p=0.018). The regression-adjusted obesity prevalence for schools that never participated in CEP was 28.0%, while the obesity prevalence for schools with 6 years of CEP participation was 25.4%. The lower prevalence of obesity in CEP-participating schools was primarily driven by elementary schools. These results suggest that the benefits of CEP participation can cumulate over time, significantly reducing school-level obesity prevalence over time.
ContributorsDykstra, Tatum Nicole (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Acciai, Francesco (Committee member) / McCoy, Maureen (Committee member) / Arizona State University (Publisher)
Created2024
Description
Features of the built environment (BE) are related to a wide range of health factors, including leisure-time physical activity (PA) and active forms of transportation. For working adults, worksite neighborhood is likely an important BE to better understand the impact of various factors on PA patterns. Compared to home neighborhood walkability research, worksite walkability has received relatively less attention. The objective of this project was to identify if worksite walkability was significantly associated with PA behavior.
Aims: to evaluate 1) the PA variation explained by work walkability, 2) the moderating effects of person-level characteristics to the relationship between PA and work walkability, and 3) the differences in the rate of change in PA over time by worksite walkability.
Methods: self-report and accelerometer measured PA at baseline (aim 1, 2); longitudinal accelerometer PA during the initial 56 days of a behavioral intervention (aim 3). Adults were generally healthy and reported part- or full-time employment with a geocodeable address outside the home. Geographic Information Systems (GIS) measured walkability followed established techniques (i.e., residential, intersection, and transit densities, and land-use-mix).
Results: On average, worksite walkability did not show direct relationships with PA (aim 1); yet certain person-level characteristics moderated the relationships: sex, race, and not having young children in the household (aim 2). During 56 days of intervention, the PA rate of change over time showed no evidence of a moderating effect by worksite walkability.
Discussion: Worksite walkability was generally not shown to relate to the overall PA. However, specific subgroups (women, those without young children) appeared more responsive to their worksite neighborhood walkability. Prior literature shows certain demographics respond differently with various BE exposures, and this study adds a potentially novel moderator of interest regarding young children at home. Understanding who benefits from access to walkable BE may inform targeted interventions and policy to improve PA levels and foster health equity.
Aims: to evaluate 1) the PA variation explained by work walkability, 2) the moderating effects of person-level characteristics to the relationship between PA and work walkability, and 3) the differences in the rate of change in PA over time by worksite walkability.
Methods: self-report and accelerometer measured PA at baseline (aim 1, 2); longitudinal accelerometer PA during the initial 56 days of a behavioral intervention (aim 3). Adults were generally healthy and reported part- or full-time employment with a geocodeable address outside the home. Geographic Information Systems (GIS) measured walkability followed established techniques (i.e., residential, intersection, and transit densities, and land-use-mix).
Results: On average, worksite walkability did not show direct relationships with PA (aim 1); yet certain person-level characteristics moderated the relationships: sex, race, and not having young children in the household (aim 2). During 56 days of intervention, the PA rate of change over time showed no evidence of a moderating effect by worksite walkability.
Discussion: Worksite walkability was generally not shown to relate to the overall PA. However, specific subgroups (women, those without young children) appeared more responsive to their worksite neighborhood walkability. Prior literature shows certain demographics respond differently with various BE exposures, and this study adds a potentially novel moderator of interest regarding young children at home. Understanding who benefits from access to walkable BE may inform targeted interventions and policy to improve PA levels and foster health equity.
ContributorsHurley, Jane Cathleen (Author) / Adams, Marc A (Thesis advisor) / Todd, Mike (Committee member) / Hooker, Steven P (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Ainsworth, Barbara (Committee member) / Arizona State University (Publisher)
Created2019
Description
Objective: The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a federally-funded program that provides supplemental food packages, nutrition education, and healthcare referrals to low-income women, infants, and children under 5, who are at the highest nutritional risk. This study explores if household WIC participation is associated with healthier dietary behaviors among age-ineligible children (5-18-years-old) in WIC households. Consumption frequency of fruits, vegetables, 100% juice, sugar-sweetened beverages (SSBs), and energy-dense snacks (sweet and salty snacks) among children from WIC and income-qualifying non-WIC households were compared.
Methods: Data were obtained from two cross-sectional panels (2009-10 and 2014) of the New Jersey Child Health Study conducted in four low-income New Jersey cities. Questions from previously validated surveys assessed consumption frequency of fruits, vegetables, SSBs, and sweet and salty snacks. Analyses were confined to 570 children between 5-18 yrs; of which 365 (5-11 yrs: 237, 12-18 yrs: 128) resided in WIC participating households and 205 (5-11 yrs: 138, 12-18 yrs: 67) in income-qualifying non-WIC households. Over half of the sample was African American and 43% were Hispanic. Multivariable analyses were conducted to compute incidence rate ratios (IRRs) using negative binomial regression to compare the differences in eating behaviors of children in WIC vs. Non-WIC households
Results: Household WIC participation was associated with a slightly higher frequency of vegetable consumption among 12-18-year-old children (IRR= 1.25, p=.05); differences were significant among older males (12-18-years-old) (p=.006), and not in females.
Frequency of 100% juice consumption was significantly higher among younger females (5-11-years-old) in WIC households who consumed juice about 44% more frequently (p=.02) compared to similar age girls in non-WIC households. Hispanic children in WIC households reported a lower frequency of SSBs consumption (p=.01); this association was only true among males (p=.02).
Conclusions: Household WIC participation is associated with healthier dietary behaviors among age-ineligible children living in the households, suggesting a positive spillover effect of the program. Proposed changes to WIC packages are likely to have dietary implications not only for WIC participants but also for non-participating children residing in WIC households,
Methods: Data were obtained from two cross-sectional panels (2009-10 and 2014) of the New Jersey Child Health Study conducted in four low-income New Jersey cities. Questions from previously validated surveys assessed consumption frequency of fruits, vegetables, SSBs, and sweet and salty snacks. Analyses were confined to 570 children between 5-18 yrs; of which 365 (5-11 yrs: 237, 12-18 yrs: 128) resided in WIC participating households and 205 (5-11 yrs: 138, 12-18 yrs: 67) in income-qualifying non-WIC households. Over half of the sample was African American and 43% were Hispanic. Multivariable analyses were conducted to compute incidence rate ratios (IRRs) using negative binomial regression to compare the differences in eating behaviors of children in WIC vs. Non-WIC households
Results: Household WIC participation was associated with a slightly higher frequency of vegetable consumption among 12-18-year-old children (IRR= 1.25, p=.05); differences were significant among older males (12-18-years-old) (p=.006), and not in females.
Frequency of 100% juice consumption was significantly higher among younger females (5-11-years-old) in WIC households who consumed juice about 44% more frequently (p=.02) compared to similar age girls in non-WIC households. Hispanic children in WIC households reported a lower frequency of SSBs consumption (p=.01); this association was only true among males (p=.02).
Conclusions: Household WIC participation is associated with healthier dietary behaviors among age-ineligible children living in the households, suggesting a positive spillover effect of the program. Proposed changes to WIC packages are likely to have dietary implications not only for WIC participants but also for non-participating children residing in WIC households,
ContributorsSteeves, Stephanie N (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Tasevska, Natasha (Committee member) / DeWeese, Robin (Committee member) / Arizona State University (Publisher)
Created2019
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
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