Investigating Diets of Asian Youth in the U.S. Using a Theoretical Framework

Childhood overweight and obesity is a significant public health concern, especially among children of different racial and socioeconomic backgrounds. This dissertation provides insight into one such population: Asian youth in the U.S. Three studies - two literature reviews and one quantitative study - compose this dissertation, which aims to understand dietary behaviors of Asian-American youths using a theoretical framework. The first study is a systematic literature review of existing health education/promotion theories and models used to study eating/feeding practices for preschool-aged children. The main purpose of this study was to review and critique theories and constructs utilized in nutrition research on preschool-aged children, while also providing recommendations for strengthening theory utilization and diversifying nutrition research in the future. Forty articles were included, of which 43% had clear identification of theory/constructs and a strong theoretical framework. The most common finding was modeling's effect on children's dietary behaviors, followed by the relationship between parental restriction/control and children's dietary behaviors. The second study was a systematic literature review of dietary behaviors of children of Asian background in the U.S. The aims of this review were three-fold: (a) to review literature regarding Asian-American youths' dietary behaviors, (b) to critically evaluate the methodological quality of such research, and (c) provide recommendations for future nutrition-related research on Asian-American youths. Fifteen articles were included. Major findings included: (a) frequent consumption of milk, fruit, meat, unenriched white rice, vegetables, and high-fat and high-sugar items among Asian-American children and (b) acculturation's effect on Asian-American youths' dietary behaviors. The third study was an investigation of cognitive, behavioral, and environmental influences on dietary behaviors of Asian-American preschool-aged children on WIC using Social Cognitive Theory. Analyses included descriptive statistics and multiple linear regression on a sample of 68 Asian caregiver-child pairs in Texas. Results revealed consumption of 100% juices, fruits, vegetables, and white rice. In addition, adult fruit consumption frequency, adult potato consumption frequency, adult other vegetable consumption frequency, and outcome expectancies were statistically significant predictors of child's fruit and vegetable consumption. The findings from this dissertation will help nutrition education and health professionals culturally tailor obesity prevention programs for Asian Americans

Investigation through the Lens of Guardians of Factors Impacting Student Satisfaction and Behavioral Intention to be Educated by Cartoon Animation in China

This research aims to investigate the factors impacting student satisfaction and behavioral intention to be educated by cartoon animation in Sichuan, China. The quantitative survey was completed by students’ guardians, constructed with information quality, service quality, perceived usefulness, negative economic impacts, negative sociocultural impacts, satisfaction, and behavioral intentions. The target population involves 500 guardians whose children are between grades 1 to 4 and have been educated with cartoon animation in a primary school. The sampling techniques involve judgmental and convenience sampling. Before the data collection, Item Objective Congruence (IOC) Index and the pilot test (n=50) with Cronbach’s Alpha were used. Data were analyzed through confirmatory factor analysis (CFA) and structural equation modeling (SEM). The hypotheses testing was measured with a p-value<0.05. The results were that five out of six hypotheses were supported. Information quality significantly influences perceived usefulness. Perceived usefulness, negative economic impact, and negative sociocultural impacts significantly influence satisfaction. Satisfaction significantly influences behavioral intentions. On the other hand, service quality has no significant influence on perceived usefulness. The findings provide a better understanding for animation developers, educators, and students’ guardians to improve this animated cartoon content and monitor their children’s behavioral intentions for their learning purpose

Physical Activity and Health in Dutch and Chinese Children

Under the global concerns of physical inactivity and the continued growth in the prevalence of childhood obesity, a better understanding of the determinants associated with physical activity (PA) behaviours in preschool children are essential for early prevention and health promotion. In a review, we found that Chinese children were inactive and that little is known about environmental correlates of PA in China (Chapter 2). In this thesis, we identified environmental correlates of PA behaviours in both Dutch and Chinese preschoolers. We found that in both groups, built environmental correlates such as the accessibility of recreational facilities could have a positive influence on preschoolers’ PA, partly indirectly through parental help with engaging in active behaviours (Chapter 3 & 4). To gain more insight in windows of opportunity to stimulate PA, we analyzed the distribution of accelerometry-derived PA and sedentary behaviours throughout the day (Chapter 5 & 6) and its relevance to childhood overweight. We found that the Chinese preschoolers affected by overweight were more sedentary overall compared to preschoolers with no overweight (Chapter 5), but no evidence was found to support that PA behaviours throughout the day were relevant to weight status in Dutch preschoolers (Chapter 6). We suggest that for less active children and children affected by overweight, PA promotion and intervention should start in preschool years, and an effective strategy should involve children and their caregivers, school administrators and teachers, as well as policy makers in ministries of health, education and urban planning

Healthy eating interventions delivered in the family home: a systematic review

Unhealthy eating habits have long term health implications and can begin at a young age when children still consume the majority of their meals at home. As parents are the principal agents of change in children’s eating behaviours, the home environment is the logical location for the delivery of interventions targeting healthy family eating. Despite the recent proliferation of published studies of behaviour-change interventions delivered in the home, there has been little attempt to evaluate what makes such interventions successful. This review provides a systematic evaluation of all healthy eating interventions delivered to families in the home environment to date and seeks to identify the successful elements of these interventions and make recommendations for future work. Thirty nine studies are described, evaluated and synthesised. Results show that evidence- and theory-based interventions tended to be more successful than those that did not report detailed formative or evaluative work although details of theory application were often lacking. Careful analysis of the results did not show any further systematic similarities shared by successful interventions. Recommendations include the need for more clearly theoretically driven interventions, consistent approaches to measuring outcomes and clarity regarding target populations and desired outcomes

Healthy snacks consumption and the Theory of Planned Behaviour. The role of anticipated regret

Two empirical studies explored the role of anticipated regret (AR) within the Theory of Planned Behavior (TPB) framework (Ajzen, 1991), applied to the case of healthy snacks consumption. AR captures affective reactions and it can be defined as an unpleasant emotion experienced when people realize or imagine that the present situation would be better if they had made a different decision. In this research AR refers to the expected negative feelings for not having consumed healthy snacks (i.e., inaction regret). The aims were: a) to test whether AR improves the TPB predictive power; b) to analyze whether it acts as moderator within the TPB model relationships. Two longitudinal studies were conducted. Target behaviors were: consumption of fruit and vegetables as snacks (Study 1); consumption of fruit as snacks (Study 2). At time 1, the questionnaire included measures of intention and its antecedents, according to the TPB. Both the affective and evaluative components of attitude were assessed. At time 2, self-reported consumption behaviors were surveyed. Two convenience samples of Italian adults were recruited. In hierarchical regressions, the TPB variables were added at the first step; AR was added at the second step, and the interactions at the last step. Results showed that AR significantly improved the TPB ability to predict both intentions and behaviours, also after controlling for intention. In both studies AR moderated the effect of affective attitude on intention: affective attitude was significant only for people low in AR

Eye quietness and quiet eye in expert and novice golf performance: an electrooculographic analysis

Quiet eye (QE) is the final ocular fixation on the target of an action (e.g., the ball in golf putting). Camerabased eye-tracking studies have consistently found longer QE durations in experts than novices; however, mechanisms underlying QE are not known. To offer a new perspective we examined the feasibility of measuring the QE using electrooculography (EOG) and developed an index to assess ocular activity across time: eye quietness (EQ). Ten expert and ten novice golfers putted 60 balls to a 2.4 m distant hole. Horizontal EOG (2ms resolution) was recorded from two electrodes placed on the outer sides of the eyes. QE duration was measured using a EOG voltage threshold and comprised the sum of the pre-movement and post-movement initiation components. EQ was computed as the standard deviation of the EOG in 0.5 s bins from –4 to +2 s, relative to backswing initiation: lower values indicate less movement of the eyes, hence greater quietness. Finally, we measured club-ball address and swing durations. T-tests showed that total QE did not differ between groups (p = .31); however, experts had marginally shorter pre-movement QE (p = .08) and longer post-movement QE (p < .001) than novices. A group × time ANOVA revealed that experts had less EQ before backswing initiation and greater EQ after backswing initiation (p = .002). QE durations were inversely correlated with EQ from –1.5 to 1 s (rs = –.48 - –.90, ps = .03 - .001). Experts had longer swing durations than novices (p = .01) and, importantly, swing durations correlated positively with post-movement QE (r = .52, p = .02) and negatively with EQ from 0.5 to 1s (r = –.63, p = .003). This study demonstrates the feasibility of measuring ocular activity using EOG and validates EQ as an index of ocular activity. Its findings challenge the dominant perspective on QE and provide new evidence that expert-novice differences in ocular activity may reflect differences in the kinematics of how experts and novices execute skills

Measuring Determinants of Oral Health Behaviors in Parents of Low-Income Preschool Children

Dental decay is a preventable disease, but it remains the most unmet healthcare need of American children. Untreated dental decay has adverse and long-lasting effects on a child\u27s quality of life. Healthy oral habits among preschool children are essential for a healthy permanent dentition and are achieved primarily by 3 oral health related behaviors: proper dental hygiene, a healthy noncariogenic diet, and regular dental visits. This quantitative study, based on the theory of planned behavior, explored the relationship between these 3 oral health behaviors and 4 determinants: attitude, subjective norms, perceived behavioral control, and intention, using a 71-item questionnaire. The study utilized convenience sampling. A total of 436 parents or caregivers of children enrolled in the North East Independent School District Early Childhood Education program participated in this study; 81.5% were low-income, and 66% reported Hispanic identity. The relationship between variables was evaluated using multiple regression analysis. This study indicated that attitude alone toward a healthy diet and dental hygiene was not a significant predictor of behavior, but the attitude toward dental attendance was significant. Subjective norm, perceived behavior control, and intentions individually and combined were significant predictors of all 3 behaviors, except for subjective norm towards hygiene. Meaningful social change can be achieved by identifying and understanding the underlying motives that evoke planned and deliberate oral health behaviors among parents of preschool children. Targeted messages and cost-effective early interventions can be developed to prevent the onset of dental disease and improve the quality of life for low-income children

Effects of changes in the economic environment on diet- and physical activity-related behaviours and corollary outcomes: a large-scale scoping review.

A PLoS One article based on this work is currently available from: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0075070Changing the economic environment has some potential to influence patterns of diet and physical activity and thereby improve population health and reduce inequalities. We conducted a systematic scoping review to identify and describe current evidence for the effects of either specific interventions that change prices or income, or general exposure to variations in prices or income, on diet- and physical activity-related behaviours, their proximal consequences (food, energy or nutrient intake or energy expenditure) and their more distal consequences (risk factors for non-communicable diseases)