Background: Smartphone diet tracking applications (apps) are increasing in popularity but may not adequately address the important concerns of proper intake and of diet quality. Two novel weight loss apps were designed based on the popular dietary frameworks: MyPlate and FoodLists. MyPlate, the dietary guidelines put forth by the U.S. government, encourages a balanced diet from five primary food groups, but does not specify intake limits. The Food Lists set upper intake limits on all food groups except vegetables, and these guidelines extend to include fats, sweets, and alcohol.

Objective: The purpose of this randomized controlled trial was to determine whether adherence to a weight loss app providing intake limits and more food group detail (the Food Lists app) facilitated more weight loss and better diet quality than adherence to a weight loss app based on the MyPlate platform. An additional objective was to examine whether higher app adherence would lead to greater weight loss.

Design: Thirty seven adults from a campus population were recruited, randomized, and instructed to follow either the Food Lists app (N=20) or the MyPlate app (N=17) for eight weeks. Subjects received one 15 minute session of diet and app training at baseline, and their use of the app was tracked daily. Body mass was measured at baseline and post-test.

Participants/setting: Healthy adults from a university campus population in downtown Phoenix, Arizona with BMI 24 to 40, medically stable, and who owned a smartphone.

Main outcome measures: Outcome measures included weight change, days of adherence, and diet quality change. Secondary measures included BMI, fat %, and waist circumference.

Statistical analysis: Descriptive statistics (means and standard errors); Repeated measures ANOVAs analyzing weight, diet quality, and BMI; Pearson and Spearman correlations analyzing adherence and weight loss.

Results: Repeated measures ANOVAs and correlations revealed no significant mean differences in primary outcome variables of weight loss, adherence, or diet quality (P=0.140; P=0.790; P=0.278). However, there was a significant mean reduction of BMI favoring the group using the Food Lists app (P=0.041).

Conclusion: The findings strengthen the idea that intake limits and food group detail may be associated with weight loss. Further investigation is warranted to determine whether longer use of the Food Lists app can produce more significant dieting successes and encourage healthier behavioral outcomes.

Background: Latinos have disproportionately high rates of obesity and type 2 diabetes. Family-based interventions may reduce chronic disease risk among Latinos across generations.

Purpose: To assess the efficacy of Athletes for Life (AFL), a 12-week community-and-family-based behavioral intervention, for improving diet, physical activity (PA), anthropometrics, fitness, and biochemical outcomes among mostly Latino parents.

Methods: Parents with at least one child 6-11 years of age were randomized to active AFL participation (n=14) or a wait-list control (n=14) group. AFL consisted of twice weekly 90 minute sessions (45 minutes of nutrition-focused lessons and 45 minutes of PA participation) designed to promote fruit and vegetable consumption, reduction of sugar intake, and increasing habitual PA. Data were collected prior to and immediately after the 12 week intervention.

Results: Participants (37.9±7.2y) were mostly Latino (93%), Spanish speaking (68%), and women (93%). Relative to participants in the control group, AFL participants had a significant reduction in body fat (-1.1±1.2% vs. 0.2±1.2%; p=0.014), resting (-7.6±10.2 bpm vs. +2.1±6.8 bpm; p<0.01), exercise (-8.4±8.7 bpm vs. +0.4±7.3 bpm; p<0.01), and recovery heart rate (-11.9±12.8 bpm vs. -0.3±11.4 bpm; p=0.01), and one mile run time (-1.5±1.0 min vs. -0.1±0.9 min; p<0.01), and a significant increase in estimated VO2 peak (+1.9±1.9 ml/kg/min vs. 0.0±1.8 ml/kg/min; p=0.01). AFL participants also reported an increase in the number of days/week accumulating 30 minutes of MVPA (+0.8±3.2 vs. -1.5±2.3; p=0.004) and daily servings of fruits (+1.3±1.4 vs. +0.3±1.4; p<0.05) and vegetables (+1.8±1.7 vs. +0.1±1.2; p<0.05), relative to control participants. There were no significant differences between groups in changes in diet assessed by 3-day food record, accelerometer-measured PA, weight, blood pressure, visceral fat, biomarkers for cardiovascular disease or nutritional biomarkers.

Conclusions: Despite the lack of effects on diet and PA behaviors, AFL shows promising preliminary efficacy for reducing body fat and improving fitness among adult participants. Future research aimed at improving fitness among Latino parents with family-based intervention is warranted.

Urban areas face a host of sustainability problems ranging from air and water quality, to housing affordability, and sprawl reducing returns on infrastructure investments, among many others. To address such challenges, cities have begun to envision generational sustainability transitions, and coalesce transition arenas in context to manage those transitions. Transition arenas coordinate the efforts of diverse stakeholders in a setting conducive to making evidence-based decisions that guide a transition forward. Though espoused and studied in the literature, transition arenas still require further research on the specifics of agent selection, arena setting, and decision-making facilitation. This dissertation has three related contributions related to transition arenas. First, it describes a process that took place within Phoenix that focused on identifying, recruiting, and building the capacity of potential transition agents for a transition arena. As part of this, a first draft suggestion of plausible steps to take for identifying, recruiting, and building a team of transition agents is proposed followed by a brief discussion on how this step-by-step process could be evaluated in subsequent work. Second, building on such engagement, this dissertation then offers criteria for transition agent selection based on a review of the literature that includes the setting in which a transition arena occurs, and strategies to support successful facilitation of decision-making in that setting. Third, those criteria are operationalized to evaluate the facilitation of a specific decision (draft of a new transportation plan) in a specific transition arena: the Citizens Committee for the future of Phoenix Transportation. The goal of this dissertation is to articulate a first-draft framework for guiding the development and scientific evaluation of transition arenas. Future work is required to empirically validate the framework in other real-world transition arenas. A feasible research agenda is provides to support this work.

There are multivariate factors that not only play a role in an individual's ability to lose weight, but may create barriers to his or her success. One such factor is internalized weight bias (IWB), which is inversely associated with weight loss outcomes and body satisfaction, and directly associated with psychosocial maladjustments such as depression and binge eating. This study examined the relationship between internalized weight bias and weight loss outcomes using a coding scheme developed for an online weight loss forum to see whether results would be consistent with self-administered surveys that measure IWB. The coding scheme was developed using an exploratory factor analysis of a survey composed of existing measures of IWB. Participants' posts within an online weight loss forum were coded and participants given a weekly IWB score that was compared to weekly weight loss using mixed model analysis. No significance was found between IWB and weight loss outcomes in this study, however, the coding scheme developed is a novel approach to measuring IWB, and the categories identified from latent constructs of IWB may be used in the future to determine the dimensions that exist within it. Ultimately, a better understanding of IWB could lead to the development of targeted weight loss interventions that address the beliefs and attitudes held by individuals who experience it.

Children are five times more likely to be overweight at the age of 12 years if they are overweight during the preschool period, and 60% of overweight preschoolers are overweight at the age of 12 years (Matusik & Malecka-Tendera, 2011). Primary care interventions are urgently needed to improve healthy lifestyle behaviors in families. Parental influence plays an important factor in the development of healthy behaviors in children. Cognitive behavioral interventions have demonstrated preliminary success in promoting healthy lifestyle behaviors in both adults and children. Mobile technology used to supplement interventions aimed at behavior change offers an outlet to bridge gaps in health disparities and generate innovative evidence. Therefore, the purpose of this research was to establish the feasibility, acceptability, and preliminary effects of a cognitive-behavioral intervention (TEXT2COPE) synergized with mobile technology on the healthy lifestyle behaviors of parents of overweight and obese preschoolers. Primary aims of the proposed pilot study were to (a) examine the feasibility and acceptability of the TEXT2COPE program among parents of overweight or obese preschoolers with mobile phones; (b) evaluate the preliminary effects of the TEXT2COPE program on healthy lifestyle behaviors in families with overweight or obese preschoolers; and (c) evaluate the relationship among the study variables (i.e., cognitive beliefs, perceived difficulty, and healthy lifestyle behaviors). Findings indicate that this program is feasible and acceptable in this population. The intervention improved healthy lifestyle beliefs and behaviors in parents. Further supported are the interconnected relationships between parental beliefs, thoughts, and behaviors.

In recent years, overall consumption of meat products has been decreasing, and at the same time vegetarianism is on the rise. A variety of factors are likely driving changes in consumers' attitudes towards, and consumption of, meat products. Although concern regarding animal welfare may contribute to these trends, growing consumer interest in the roles that production and processing of meat play in terms of environmental degradation could also impact individuals' decisions about the inclusion of meat in their diets. Because these factors could be related to moral attitudes as well, the purpose of this study was to explore the relations among meat consumption, general environmental attitudes, and moral `foundations' of decision-making, including concern about minimizing `harm' and maximizing `care,' as well as issues of `purity' and `sanctity.' A survey was conducted among current college students using the New Ecological Paradigm scale and the Moral Foundations Questionnaire to assess environmental and moral attitudes. A food frequency questionnaire was used to assess meat consumption. Multiple linear regression analyses explored the relations of environmental and moral attitudes with meat consumption, controlling for potential confounding variables. The results showed no significant correlations among meat consumption, environmental attitudes or moral foundations of harm/care and purity/sanctity.

This study was designed to influence consumer habits, specifically those relating to purchases of fruits, vegetables, and junk food. Previous studies have clearly shown the ineffectiveness of simply describing the health benefits of eating more fruits and vegetables (F/V). In contrast, this study aimed to change the result by changing the message: providing participants with insight into the hidden agendas of food companies and grocery stores, provide useful tips on how to include children when selecting F/V, and emphasizing the importance of parental modeling in regard to food purchases. Participants of this study were separated into two groups, the tour group and the education group. The tour group was guided through a grocery store where they learned about sales tactics and manipulations used by grocery stores and food companies to influence purchases. Education group participants were provided with an education session focusing on USDA and FDA handouts displaying current educational suggestions for increasing F/V consumption. Grocery store receipts were collected and analyzed to track the progress of both groups. The goal of the study was to identify a method of informing consumers that will produce a significant change in behavior. Increasing F/V consumption, even in relatively small amounts, would be an important step forward in improving the diet and overall health of Americans. This study was the first of its kind to measure purchasing patterns objectively (through analysis of purchase receipts, rather than personal opinion/evaluation surveys) and in a wide-scope retail environment that includes all grocery store purchases by participants. Significant increases or decreases in the amount of money spent on F/V, or the amount (pounds) of F/V purchased were not seen, however a small correlation (r = 0.133) exists when comparing the weight of F/V purchased pre/post intervention. Data from Food Frequency Questionnaires shows participants consuming significantly higher amounts of F/V post intervention (p=0.043). The tour group and education group experienced an average increase of 0.7 servings per day. Future interventions might benefit by extending their scope to include cooking demonstrations, in-home interventions, and education on healthy eating outside of the home.

Unintentional falls among community dwelling older adults are a common, serious and potentially preventable public health problem. In the United States, the annual incidence of fall related injuries per 100,000 persons was 4,616 in 2001, rising to 5,252 in 2008. The annual incidence of fall related deaths per 100,000 persons was 29.3 in 2000, rising to 41.86 in 2006. Older adults are particularly vulnerable to falls as they age. Potential consequences include fractures, emergency room, hospital and nursing home admissions, dependence, confusion, immobilization, depression, and death. Significant modifiable fall risk factors include muscle weakness, gait problems, and balance problems. While researchers have demonstrated the positive effects of balance and leg-strengthening physical activities, the majority of older adults do not engage in them, and the rate of falls continues to increase. Older adults participate in regular physical activity and fitness activities less often than younger populations; disparities are greater among those who are poor and living in rural communities. While knowledge about causes, risk factors, and efficacious physical activity to prevent falls has grown exponentially in the last several decades, bridging the gap between research and practice continues to be a challenge. As a strategy to address the gap between research and practice, this feasibility study utilized a tested theory, the wellness motivation theory, to address motivation for behavioral change in combination with instruction for physical activities proven to reduce fall risk. The study sample included rural, community dwelling older adults at risk of falls. The study included an innovative mobile computer to measure physical activity behavior and to augment motivational content of the intervention. Specific aims of this feasibility study were to: (a) examine the acceptability, demand, and implementation of the wellness motivation intervention (WMI) as well as the technology augmenting the WMI; and (b) evaluate the efficacy of the WMI to influence awareness of social contextual resources, behavioral change processes, physical activity, and fall risk. The WMI delivered in combination with proven multicomponent balance and strength activities was feasible and effectively increased motivation for behavioral change (social support from friends, awareness of social contextual resources, behavioral change processes) and physical activity behavior, and decreased fall risk among rural, community-dwelling older adults at risk of falls in this study. This study is the first step in a program of research focusing on enhancing motivation for physical activity that reduces falls and frailty among older adults.

The Game As Life - Life As Game (GALLAG) project investigates how people might change their lives if they think of and/or experience their life as a game. The GALLAG system aims to help people reach their personal goals through the use of context-aware computing, and tailored games and applications. To accomplish this, the GALLAG system uses a combination of sensing technologies, remote audio/video feedback, mobile devices and an application programming interface (API) to empower users to create their own context-aware applications. However, the API requires programming through source code, a task that is too complicated and abstract for many users. This thesis presents GALLAG Strip, a novel approach to programming sensor-based context-aware applications that combines the Programming With Demonstration technique and a mobile device to enable users to experience their applications as they program them. GALLAG Strip lets users create sensor-based context-aware applications in an intuitive and appealing way without the need of computer programming skills; instead, they program their applications by physically demonstrating their envisioned interactions within a space using the same interface that they will later use to interact with the system, that is, using GALLAG-compatible sensors and mobile devices. GALLAG Strip was evaluated through a study with end users in a real world setting, measuring their ability to program simple and complex applications accurately and in a timely manner. The evaluation also comprises a benchmark with expert GALLAG system programmers in creating the same applications. Data and feedback collected from the study show that GALLAG Strip successfully allows users to create sensor-based context-aware applications easily and accurately without the need of prior programming skills currently required by the GALLAG system and enables them to create almost all of their envisioned applications.