In chapter 1, a comprehensive meta-analysis is conducted to synthesize the effectiveness, cost, and cost-effectiveness of lifestyle diabetes prevention interventions and compare effects by intervention delivery agent and channel. Sixty-nine studies meet inclusion criteria. The results show that participants receiving intervention with nutrition education experienced a reduction of 2.07 kg (95% CI: 1.52 to 2.62; p<0.001; 95% CI: 88.61% to 92.87%) in weight at 12 months with effect sizes over time ranging from small (0.17, 95% CI: 0.04 to 0.30; p=0.012; 95% CI: 80.42% to 91.14%) to medium (0.65, 95% CI: 0.49 to 0.82; p<0.001; 95% CI: 98.52% to 98.94). In sum, lifestyle interventions are effective in reducing body weight and glucose-related outcomes. Dietitian-delivered interventions achieve greater weight reduction compared to those delivered by other personnel.
In chapter 2, this study attempts to examine the effects of household relative deprivation on children's health outcomes. A modified household production model is developed with energy intake, energy expenditure and a composite good as main inputs in the health production. A two-stage Stackelberg game facilitates the need to model the parent-child interaction which follows similar structure as You and Davis (2011). We use three measurements of relative deprivation based on per capita household income and four reference groups based on combinations of geographic and demographic characteristics. The results show that relative deprivation is negatively associated with child health.
In chapter 3, we define "process benefits" as the direct effect on utility from engaging in an activity and examine how "process benefits" associated with food activities, both uptake and duration, are related to factors such as socio-economic status and demographics. A household production model is utilized to demonstrate the vital role of process benefits in home food production and the implications it will have for nutrition based policies targeting resources. The results display that the process benefits are associated with some demographic characteristics. This implies that shortfalls in food activities are not simply a matter of technology or resource shortfalls, but also reflect disutility associated from these activities which in turn will attenuate the impact of policies design to merely address resource shortfalls. / Ph. D. / Evaluation of programs is a vital part in health economics for it is important in understanding the effect and limitation of a program from an economic perspective. Three applications are included in this dissertation. The first application is to synthesize the overall effectiveness of diabetes prevention program including nutrition education; the second application is to evaluate if there is a negative association between relative deprivation and children’s health outcomes; the third one is to explain the small effect of nutrition policy, such as SNAP.
Type 2 diabetes (T2D) has increased significantly worldwide, leading to substantial increases in total economic costs in the US. A proliferation of studies have attempted to translate lifestyle interventions into clinical and community practice in an attempt to halt this growing public health epidemic. Therefore, there is a need to investigate the effectiveness of interventions including nutrition education for diabetes prevention. The results show that diabetes prevention program with nutrition education is effective in reducing body weight and glucose-related outcomes.
China has reached the fastest rate of growth in economy since the implementation of reform and become the world’s second largest economy. However, improvement in health fails to accompany the massive growth in material living standards for the Chinese population. This observation prompts us to investigate the relative deprivation hypothesis. The results show that children who are more relatively deprived have poor health outcomes.
Food assistance programs, e.g., Supplemental Nutrition Assistance Program (SNAP), have been developed to improve people’s health. However, the nutrition level recommended by those programs are still not met for the targeted population. The results show that respondents who enjoy cooking spend more time on activities related to food production, such as food preparation, presentation and clean up. And the small effect of nutrition policies is due to the disutility from the process of food production.
| Identifer | oai:union.ndltd.org:VTETD/oai:vtechworks.lib.vt.edu:10919/78247 |
| Date | 22 June 2017 |
| Creators | Sun, Yu |
| Contributors | Agricultural and Applied Economics, You, Wen, Davis, George C., Ge, Suqin, Davy, Brenda M. |
| Publisher | Virginia Tech |
| Source Sets | Virginia Tech Theses and Dissertation |
| Detected Language | English |
| Type | Dissertation |
| Format | ETD, application/pdf |
| Rights | In Copyright, http://rightsstatements.org/vocab/InC/1.0/ |
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