The incidence of overweight conditions among children and adolescents is a growing national concern. Although current literature suggests that parental health behaviors could influence health behaviors of children, studies have not explored the actual predictive relationships of parents' and their children's weight statuses and weight-related behaviors. In addition, current studies have not tested the influence of parental authority, family communication, or demographic characteristics on the relationships. This study first examines factors that contribute to overweight conditions among children and adolescents and the associated costs. Studies of interventions that target children's and adolescents' weight-related health are then reviewed and provide evidence that parental involvement contributes to intervention success. The theory of planned behavior, social cognitive theory, social action theory, and systems theory are discussed and support the notion that parental influences contribute to the development of children's weight-related health behaviors. To test the relationships, 151 young adults and their parents were recruited and completed a series of questionnaires to describe their weight statuses, dietary behaviors, and physical activity behaviors. In addition, the young adult participants completed questionnaires to further describe their parents' parental authorities and their family communication environments during childhood and adolescence. Comparisons of body mass index, average daily energy consumption, average weekly energy expenditure, and physical activity enjoyment of young adult participants and their parents were conducted with correlation analyses and paired-samples t-tests. Further, multiple regression analyses were used to explore the influence of parental authority and family communication, and demographic characteristics were also considered. The empirical results of the current study indicate that, overall, parents' weight statuses and dietary behaviors help predict weight statuses and dietary behaviors of their young adult children. Further, parental authority scales interact with the relationships. At high levels of authoritarian and permissive parental authorities, young adults tend to have weight statuses that are opposite to those of their parents; at high levels of authoritarian parenting, young adults also tend to follow opposite dietary consumption patterns. The findings in this study have implications for professional practice, parenting practices, and the design of intervention activities. Recommendations for future research are provided.

Patronage behavior was investigated in this study with regard to the nutrition orientation of consumers. The objective of this research was to determine if consumers' patronage behavior of grocery stores, health food stores or restaurants would be significantly related to attitudes and concerns toward nutrition and toward attitudes of their overall present and future state of health. This study relied on theories of retail patronage behavior, and empirical evidence from areas of consumer behavior, nutrition, and health to provide the framework for the design of this research. This study employed the use of a questionnaire as the research method. Consumers were surveyed and asked to indicate their patronage and food purchase behaviors, their attitudes and concerns toward nutrition, and their attitudes toward their preventive health. Results and conclusions from this research support the linkage between the nutritional motivations of consumers impacting upon their decisions to patronize specific retail food establishments. That is, consumers' predispositions concerning nutrition influence where and what types of food products are purchased. / Master of Science

The possibility that faulty expectations about success and relapse recovery contributed to poor adherence was examined in this study. Support for such an expectancy model was sought through comparing an index of relative task magnitude to adherence rates. Instructions designed to improve adherence through changing expectations about relapse and relapse recovery were also administered to 46 clients in two clinical nutritional programs. Their adherence rates <in days) were compared to the rates obtained from the records of 64 other clients who did not receive the instructions. To further understand the adherence phenomenon, several other measures were obtained from the treatment subjects. These data were compared to adherence rates in an attempt to identify potential co-variate relationships. Statistical procedures including analysis of variance to determine comparability of subject groups, Pearson Product Moment correlations, t tests of the difference between means, and the Lawshe—Baker Nomograph comparing per cent adherence rates were performed on the data. Obtained results did not support the predicted relationship between relative task magnitude and adherence. This may have been due to differences between subjective assessments of task magnitude and the objective measure used in this study. Although improvement in adherence was noted in both treatment groups, statistical significance was achieved only in the university based clinic. Differences in the settings, assisting nutritionists, and participating subjects could have produced these findings. However, because improvement did occur in both settings, and because the techniques may be easily and inexpensively utilized by clinical nutritionists, these instructions were recommended for inclusion as a routine component of nutritional clinic procedures. No strong co-variate relationships were found between adherence and the additional measures included in the study. The only variables which correlated with adherence more than trivially, emotional response to a verbal food stimulus, and imaging ability, did lend support for this cognitively active method of improving adherence.

Introduction: This dissertation investigates the critical components of school-based food and nutrition education (SBFNE) programs aimed at enhancing their impact on students’ dietary behaviors. Over the past century, significant shifts in the food landscape have altered dietary habits, with a rise in ultra-processed food (UPF) consumption and a decline in fruit and vegetable intake, particularly among children. This trend underscores the importance of SBFNE programs, which, akin to STEAM subjects, are vital for public health. Schools, where children spend much of their time, are ideal settings for implementing comprehensive, research-based SBFNE programs to reconnect students with healthy food sources and promote better eating habits. Research Questions: This three-paper dissertation addresses several key research questions: 1. What educational and programmatic components contribute to effective SBFNE programs? 2. How can these components be synthesized into a comprehensive theoretical framework and practical program evaluation tool? 3. What insights and recommendations can be gathered from a formative evaluation of these tools? Chapter 2 (Article 1): Objective: Identify educational and programmatic components from the research literature that make SBFNE effective in fostering positive dietary behavior among K-12 students. Methodology: An umbrella review of peer-reviewed literature reviews and government reviews on the effectiveness of SBFNE. All included reviews were assessed for methodological quality. Data Analysis: For each included review, a list was made of the components that contribute to the effectiveness of SBFNE to change dietary behavior. These components were compared across reviews. A final list of components contributing to effectiveness of SBFBE was created with their prevalence in the included reviews indicating whether the impact on effectiveness of SBFNE was positive, mixed or not assessed. Key Findings: This umbrella review identified 20 critical components essential for effective SBFNE programs from 44 reviews, encompassing 1,115 unique primary studies conducted between 1900 and 2022. These components, such as cultural inclusivity and connections to school meals, were integrated into a structured theoretical framework based on the Socioecological Model (SEM) with the components mapped to the first four of six SEM levels: individual, interpersonal, community, and organizational. Conclusions: This study is the first to identify and map research-based critical components into an SEM framework, that influence behaviors and outcomes and can be used to further SBFNE research. Chapter 3 (Article 2): Objective: Develop and pilot test a SBFNE program evaluation tool derived from 20 critical components that were integrated into an SEM framework. Methodology: The tool, developed in Google Sheets, employed a 0-3 scoring system to evaluate the integration of each component with an accompanying detailed rating guide. The pilot test involved component ranking exercises, concept mapping, and curriculum lesson reviews with SBFNE program developers (n=3). Data Analysis: Insights from the pilot test led to significant refinements in the tool and data collection protocol. Key Findings: Participants found the ranking exercise uncomfortable due to component interdependencies. They found the concept mapping exercise engaging and intuitive. The program developers found the curriculum review to be tedious and insufficient with only one lesson reviewed, but they thought this type of program review provided valuable guidance for revising and improving SBFNE programs. The interviews were long, usually more than two hours, and transcription was time-consuming. Conclusions: The pilot provided data to refine the program evaluation tool and to refine the data collection protocol for a formative evaluation of the program evaluation tool. Chapter 4 (Article 3): Objective: Conduct a formative, mixed-methods evaluation to refine the integrated SEM and program evaluation tool for SBFNE programs. Methodology: Recruited SBFNE program developers (n=9) who participated in an exercise to categorize 20 critical components for effectiveness of SBFNE, created a concept map on how the 20 components interact, underwent a program review in which programs were scored 0–3 for the 20 components, received recommendations for program improvement for components that scored less than a three, decided on which recommendations they would enact, and provided feedback on the experience. Data Analysis: Descriptive statistics and thematic analysis identified patterns and insights from qualitative responses, leading to revisions in the evaluation tool and a new practice-based tool. Key Findings: For the categorization exercise there was a range of agreement between program developers and the literature on the critical nature of the SBFNE components, with each of the nine participants rating between four and 17 out of the 20 components as essential. The concept maps the program developers created represented the interconnectedness of the components and led to the development of a practice-based logic model. The program review process showed that programs can be scored on how they are using the components, recommendations can be made for components that did not score a three, and program developers can implement the recommendations. The feedback process indicated that program developers found the activities they did for this research useful for refining and improving their programs, to make them more effective at dietary behavior change. Conclusions: The program evaluation tool and new practice-based model showed promise to be used in future research on SBFNE. Conclusions: This dissertation establishes a robust foundation for SBFNE, integrating critical educational and programmatic components with innovative evaluation tools. The integrated SEM and practical program evaluation tools can improve the quality of SBFNE programs, which can help to foster positive dietary behavior change among K-12 students, addressing the rise in UPF consumption and decline in fruit and vegetable intake. This research lays the groundwork for future initiatives aimed at nurturing healthier, informed, and empowered generations.

The present study employed a quantitative, non-experimental, multivariate correlational research design to test a hypothesized model examining associative paths of influence between ecological factors and weight status of urban, African-American adolescent females. Anthropometric and self-report survey data of 182 urban, African- American adolescent females were collected during after-school programs, health and physical education classes, and community events in an urban area in northeast Florida. Descriptive analyses were conducted to characterize the study participants based upon their age, study setting, and weight status. A scale reliability analysis was conducted to assess the internal consistency reliability of the sample data using selected measures within the context of the study’s specific population and subsequently guided the structural equation model (SEM) analyses. The SEM path analysis was used to develop two measurement models to control for observed error variance for variables demonstrating poor internal consistency reliability (diet behaviors and nutrition selfefficacy) and a final structural model to test the associative paths of influence between latent (diet behaviors and nutrition self-efficacy) and manifest variables (teacher social support and friend social support) on weight status. The results of the path analysis indicated that both teacher social support and friend social support demonstrated a positive, indirect influence on child weight status through nutrition self-efficacy and diet behaviors following two different and specific paths of influence. Diet behaviors, in turn, demonstrated a positive, direct effect on child weight status. These findings provide clear implications for educational leaders that call for the integration of health behavior change theory into traditional education and leadership practice and actively addressing the childhood obesity epidemic in the school environment by implementing health behavior change strategies at various ecological environmental levels.