Master of Landscape Architecture / Department of Landscape Architecture/Regional and Community Planning / Hyung Jin Kim / A significant decline of mental and physical health exists within college students today (ACHA, 2014; Gallagher, 2006). Recently, to promote mental health, restorative landscapes have emerged as a trend in healthcare environments by formalizing the healing properties of nature within a designed environment. Humans have been shown to undergo a measurable relief of stress, improved attention, and an improved overall sense of well-being when exposed to a restorative landscape setting. Opportunities exist for university campuses to more advantageously employ the mental health benefits of restorative landscapes. Furthermore, to address physical health, the university campus holds unique opportunities to increase students’ physical activity through promotion of active lifestyles using active modes of transportation. Campus streets, based on their lack of affordances to promote mental and physical health as well as their inherent connectivity to key campus buildings and spaces are investigated as a site for a designed solution. A recent trend of campus street conversions to pedestrian malls is identified and explored as a tool to facilitate creation of a restorative and active campus. The project, based in two fundamental research questions, investigates how campus street design can improve the collective mental health of college students, and how campus street design can promote physical health. Literature review analysis reveals theories and principles of restorative landscape and campus design. The project unites these findings with case study analysis to form a framework to facilitate the design of restorative environments within a university campus. Pragmatic evidence of built environment interventions has been synthesized from literature review and case study analysis into an additional framework to increase physical activity through active transportation. Kansas State University’s campus has been identified as a suitable case for a design proposal. Planning and design decisions at three nested scales are made to illustrate how the frameworks may be applied to reclaim a campus street as an active and restorative “garden street.” In the context of declining mental and physical health among college students, the synthesis of principles related to restorative landscape design and active transportation presents a valuable structure to mitigate declining mental and physical health of students.

Doctor of Philosophy / Department of Human Nutrition / David A. Dzewaltowski / Consumption of fruits and vegetables (FV) contributes to healthy growth and development among youth. For effective intervention development, an understanding of the underlying casual influences on consumption is needed. The current dissertation is intended to identify whether influences on youth fruit and vegetable consumption (FVC) vary by age, gender, ethnicity and socioeconomic status (SES). The series of four chapters focus on self-efficacy for FVC and proxy efficacy to influence other adults to provide supportive FV environments. Chapter One reviews studies examining the influences on youth FVC. Consistently across studies, FV preferences and FV availability influenced youth FVC. Chapter Two and Chapter Three report studies documenting that children's confidence (proxy efficacy) to influence parents to make FV available and to influence other adults (after-school staff) to make FV available are independent but related constructs to self-efficacy to eat fruits and self-efficacy to eat vegetables. Differences were found in these constructs according to school demographic variables and youth demographic variables. Chapter Two reports that youth attending elementary schools with lower concentrations of racial/ethnic diversity and higher concentrations of high SES were more confident in influencing their parents to make FV available than youth attending schools with higher concentrations of racial/ethnic diversity and higher concentrations of low SES. Although analyses of cross sectional data collected on elementary-aged youth presented in Chapter 3 showed no demographic differences at the school level, Chapter Four examined longitudinal data across sixth-, seventh- and eighth-grade and found demographic differences using youth level variables. Across the middle school years, youth declined in proxy efficacy and racial/ethnic minority youth declined at a significantly faster rate than white youth. Each year, male and lower SES youth were significantly lower in proxy efficacy than females and higher SES youth, respectively. Thus, school or youth demographic differences in self-efficacy and proxy efficacy may contribute to the understanding of why males and lower SES youth eat less FV than females and higher SES youth.

Master of Public Health / Public Health Interdepartmental Program / Daniel Y.C. Fung / In the military, documenting the occurrence of foodborne illnesses is a challenge. During peacetime only about ten percent of all foodborne illnesses are reported or properly diagnosed. Between 1998 and 1999, the Army had documented over 800 cases involving food or waterborne diseases. Service members are classified as highly susceptible when they are deployed or participating in extended field training exercises. Physical and emotional stress weakens the immune system, as does fatigue. These situations can be further aggravated by soldiers taking medications and/or exposed to exotic diseases or extreme environmental conditions. Thus it is very important for the United States Army to have a very good food safety, security, and protection system in place to maintain a readily deployable force. The United States Army monitors food safety, security, and defense through an extensive network of multiple organizations within and outside the army by researching from the fields of microbiology, sociology, economics, bioterrorism, etc. This network monitors food procured by the army from the source to the consumer and maintains accountability throughout the process. This report takes a look at the multiple organizations and the various strategies entailed in implementing food safety, security, and protection within the army and the entire Department of Defense. It emphasizes on some of the strategies that can be developed and applied in civilian establishments to improve the efficiency of the establishments. Such strategies include the implementation of the Prime Vendor System and the World Wide Web directory of sanitary approved sources which help to improve the ability to monitor the food with fewer personnel and also improve security and defense through solicitations and contracts. These strategies have been so effective that they are being used not only for food but for general logistics.

Doctor of Philosophy / Department of Human Nutrition / David A. Dzewaltowski / The prevalence of obesity within the U.S. has risen dramatically in the past thirty years. Recent changes in food and physical activity environments may contribute to increased obesity prevalence, suggesting that disparities in these environments may be linked to the increased risk of obesity observed in low-income, and racial/ethnic minority women. This dissertation characterizes the local food environment experienced by low-income women who participate in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Kansas, evaluates whether characteristics of the local food environment contribute to obesity risk, and examines how these relationships vary across the urban-rural continuum. Chapter One reviews the relevant literature examining the association between obesity and local food environments, and identifies three testable hypotheses that serve as the framework for later chapters. Chapter Two characterizes the local food environment and examines geographic, racial, ethnic, and socioeconomic disparities in the availability of small grocery stores and supermarkets. Chapter Three examines the association between store availability and obesity risk at an individual level among participants in the WIC Program, while Chapter Four utilizes multi-level modeling to examine the relationships between tract deprivation, tract store availability and body mass index (BMI). Significant geographic disparities were observed in the availability of small grocery and supermarkets. Racial and ethnic disparities observed within tracts were not observed when examining store availability in a 1-mile radius around the residence of WIC mothers. The majority of women participating in the WIC program resided within a 1-mile radius of a small grocery store, and micropolitan and metropolitan WIC mothers had a multiplicity of food stores available within a 3-mile radius of residence. Food store availability was associated with increased obesity risk only in micropolitan areas. The availability of food stores did not mediate the association between tract deprivation and BMI, which varied across the urban-rural continuum. Overall, these results suggest that the relationship between local food environments and eating behaviors is complex, that limited store availability does not contribute to increased obesity risk in vulnerable populations, and that the association between local food environments and obesity risk varies across the urban-rural continuum.

Master of Science / Department of Journalism and Mass Communications / Joye C. Gordon / This experimental research adopts a typology of frames by Levin, Gaeth, and Schneider (1998) and seeks to a) determine what combination of attribute and goal frames produces the strongest effect on vaccination behavior; b) ascertain to what extent personal relevance of vaccination moderates this framing effect; and c) explore how individual pre-existing characteristics, such as recent vaccination history, vaccine risk perception, vaccine dread, and general attitude toward vaccination influence the persuasive power of framed messages. The study, designed as field experiment 2 (+/- attribute frame) x 2 (+/- goal frame) x 2(involvement), recruited 476 adult female participants that were exposed online to four experimental framing manipulations and a control condition. The main effect is consistent with the typology of frames — the combination of the positive attribute and the negative goal frame was the only condition that was significantly more persuasive than the control condition. Participants who had children or were pregnant, for whom vaccination was more relevant and meaningful, have not reacted to message framing differently. However, general pre-existing attitudes towards vaccines, perception of vaccine safety, perception of vaccine efficacy, vaccine dread, and vicarious experience with vaccine side effects, appear to be associated with antecedents of vaccination behavior. Overall, this study has focused on ecological validity,aiming at the applicability of framing theory in the context of health communication.

Master of Science / Department of Biology / Samantha M. Wisely / Nearly 30% of emerging infectious diseases are caused by vector-borne pathogens with wildlife origins, posing a risk for public health, livestock, and wildlife species of conservation concern. Understanding the spatial patterns of exposure to dipteran vectors and their associated pathogens is critical for epidemiological research to target prevention and control of vector-borne infectious diseases. In recent years, Western Equine encephalitis, St. Louis encephalitis, West Nile Virus encephalitis and avian malaria have not only been a public health concern but also a conservation concern, specifically the conservation of grassland nesting birds. Although the central Great Plains is the most specious region for grassland nesting birds, their role in the enzootic (primary) amplification cycle of infectious diseases may lead to further population depressions, and could potentially result in spill-over events to humans and livestock. The goals of my thesis were 1) to identify the underlying causes of spatio-temporal abundance patterns of mosquito vectors within the grasslands of the eastern Smoky Hills, and 2) to create probabilistic distributions of functional disease vectors, to evaluate disease risk in Greater Prairie-chicken (Tympanuchus cupido, surrogate species for other grassland nesting birds). First, I found that temporal dynamics in mosquito abundances were explained by maximum and minimum temperature indices. Spatial dynamics in mosquito abundances were best explained by environmental variables, such as curvature, TWI (Topographic Wetness Index), distance to woodland and distance to road. Second, the overall predictive power of the ecological niche models of important vector species in the grasslands of the Smoky Hills was better than random predictions, indicating that the most important predictor variables in their distribution were: distance to water, TWI, AASHTO (soil particle size distribution), and mean temperature during the coldest quarter. Furthermore, the spatial analysis indicated that Greater Prairie-chicken nest in areas with a higher probability of vector occurrence than other potentially available habitats within the grasslands. However, I failed to detect a significant difference in the probability of vector occurrence at nest of infected versus uninfected females. Understanding the distribution and abundance patterns of vectors of infectious diseases can provide important insights for wildlife conservation as well as public health management.

Master of Science / Department of Journalism and Mass Communications / William Adams / Mental illness and suicide present vexing challenges for journalists who seek to elevate public understanding of public health issues and remedies. Using the theoretical frameworks of media agenda setting and issue framing, content analysis was used to examine a nationwide sample of newspapers stories for evidence of media familiarity with prevailing norms for community mental health care and suicide prevention. Stories examined showed little evidence of such expertise, leaving questions about the ability of journalists — and their readers — to differentiate between standard and substandard mental health care systems. Long-term change in public policy about mental illness and suicide prevention will likely depend on the ability of special interests to capture and keep media attention as well as media management decisions to assign mental health coverage to general assignment reporters or place it in the hands of journalists with specialized training.

Master of Science / Department of Human Nutrition / Koushik Adhikari / Obesity in adolescence is associated with a complex web of ecological, psychosocial, and physiological factors, and many of these factors relate to nutrition and physical activity behaviors. Before interventions are developed, researchers need to know what factors specifically influence an adolescent’s food choices and physical activity within the community context. Cultural norms, school environment, and neighborhood attributes are examples of factors that may vary across different communities, and accounting for this variation can be quite challenging, unless community perspectives are acknowledged. The use of qualitative data from focus groups has shown to be an effective way of gathering community perspectives about the diversity of their views and experiences. The current study used focus groups to reveal facilitators and barriers to healthy eating behavior and physical activity engagement in 6th to 8th grade youth in a low-income community in South-Western Kansas. This methodology enabled community members (adolescents, parents, and teachers) to discuss and articulate their perceptions in relation to 6th to 8th grade youth’s eating habits and physical activity, and assessed available resources, needs, and opportunities for developing effective and sustainable intervention approaches in the community. Using the socio-ecological model, individual influences (e.g., taste preferences), social influences (e.g., parent and peer influences), and larger contextual influences (e.g., school) on early adolescent health were assessed. This information will be used to develop interventions addressing factors at these different levels of influence that are needed to improve eating habits and physical activity of youth in the community.

Master of Public Health / Department of Diagnostic Medicine/Pathobiology / Michael W. Sanderson / A zoonotic disease is any disease or infection that is naturally transmissible from vertebrate animals to humans. Over 200 zoonoses have been described (Zoonoses and the Human-Animal-Ecosystems Interface, 2013). Many zoonotic viruses are arboviruses, viruses transmitted by an infected, blood-sucking, arthropod vector (Hunt, 2010). There are several endemic arboviruses in the United States; some foreign arboviruses, such as Rift Valley fever (RVF) virus, are potential bioterrorism agents (Dar, 2013). Arboviruses, both endemic and foreign, threaten public health (Gubler, 2002) and therefore disease surveillance, vector control and public education are all vital steps in minimizing arboviral disease impact in the United States. Mosquito-borne disease threats, such as West Nile virus and Rift Valley fever, are constant concerns in the United States and globally. Current strategies to prevent and control mosquito-borne diseases utilize vector distribution, seasonal and daylight timing, and variation in population numbers. Climate factors, such as availability of still water for development of immature mosquitoes, shade, and rainfall, are known to influence population dynamics of mosquitoes. Using 1995-2011 mosquito population surveillance data from Fort Riley, Kansas, we compared population numbers of Culex tarsalis (Diptera: Culicidae), a vector of several arboviruses including West Nile virus and potentially Rift Valley fever, to a satellite-derived index of climate, the Normalized Difference Vegetation Index (NDVI) anomaly. No correlation between the population numbers and NDVI anomaly was observed, which contrasts with results from similar analyses in other locations. These findings suggest a need for continued investigation into mosquito population dynamics in additional ecological regions of the United States to better describe the heterogeneity of environment-population relationships within and among mosquito species.

Master of Science / Department of Human Nutrition / Brian Lindshield / Fortified blended foods (FBF) are used for the prevention and treatment of moderate acute malnutrition (MAM) in nutritionally vulnerable individuals, particularly children. A recent review of current FBF recommended the addition of animal source food (ASF), in the form of whey protein concentrate (WPC), to FBF, especially corn soy blend. The justifications for this recommendation include the potential of ASF to increase length, weight, muscle mass accretion, and recovery from wasting, as well as improve the product protein quality and provide essential growth factors. Evidence was collected from the following four different types of studies: 1) epidemiological, 2) ASF versus no intervention or a low-calorie control, 3) ASF versus an isocaloric non-ASF, and 4) ASF versus an isocaloric, isonitrogenous non-ASF. Epidemiological studies consistently associated improved growth outcomes with ASF consumption; however, little evidence from isocaloric and isocaloric, isonitrogenous interventions was found to support the inclusion of meat or milk in FBF. Evidence suggests that whey may benefit muscle mass accretion, but not linear growth. Overall, there is little evidence to support the costly addition of WPC to FBFs. Further randomized isocaloric, isonitrogenous ASF interventions with nutritionally vulnerable children are needed.