A Multi-Method Measurement of Adolescent Food Environments and Related Health Behaviors and Food Choices: School, Community, and Home Environments
Date of Award
Doctor of Philosophy
Marsha Spence, Elizabeth Anderson Steeves, Elizabeth Johnson, Wenjun Zhou
Background: Many researchers have investigated the role of environments in food behavior. Methods used to assess these environments often involve community members’ participation. Adolescents engaging in food environment assessments may impact health behavior change and food choices. Methods: Development of the Food Environment Curriculum (FEC) included a cyclic action research approach with inclusion of students engaging in food environment data collection as a component of a nutrition high school wellness class. Adolescents (n=17; 13-15 years of age) at one high school, in one wellness class, participated in testing of the FEC. Quantitative testing included pre-and post-surveys assessing fruit and vegetable (F/V) intake and meal pattern. After the FEC, five focus groups were completed (n=30) and a subsample (n=6) from the intervention group participated in a Photovoice project of their food environment. Focus group (exploring relationships between food environments, behaviors, and choices) data were analyzed using multiple coding mechanisms for emergent themes. Data integration of all qualitative and quantitative data (surveys, focus groups, and Photovoice) was re-analyzed using grounded visualization and coded for themes. Themes were used to create a story map using ArcGIS online. Results: No significant changes were found for dietary behaviors from pre-FEC to post-FEC. Focus group findings emphasized the need for convenient, healthier food items that adolescents could control the selection of within their food environments. Themes emerged from the integration of data, including transportation, family support, cooking skills, and the use of technology in meal planning and preparation. Conclusions: Further testing needs to be conducted with a larger group and over a longer time-period to implement the FEC. Additional research is needed to better understand how story maps could be used by and influence adolescents in a larger intervention process. The use of grounded visualization and story map development was a novel way to gain an understanding of adolescent food environments. Results indicated that future food interventions with adolescents may need to consider transportation independence, adolescent control over food choice, and use of technology in meal planning and preparation.
Riggsbee, Kristin Ashley, "A Multi-Method Measurement of Adolescent Food Environments and Related Health Behaviors and Food Choices: School, Community, and Home Environments. " PhD diss., University of Tennessee, 2019.