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Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation




Education Sciences

First Advisor

Dr. Melinda Ickes


Childhood obesity continues to be a worldwide problem and is associated with multiple poor health outcomes including diabetes, cancer, and hyperlipidemia. Youth who are overweight or obese also experience greater instances of depression, low self-esteem, and emotional and behavioral disorders. Given the negative impact of childhood obesity, there is a need to gain a clearer understanding of the issue by identifying causes and solutions. To curb the development and perpetuation of this disease, the root causes must be well-understood. The physical environment has often been described as contributing to childhood obesity, including schools, neighborhoods, and the home. Less known, however, is the impact of youth recreation facilities and the food environments associated with them. Because a large percentage of children in the United States participate in organized physical activity or sports, the effects of exposure to this environment should be established. The aims of this study were to conduct a systematic review to determine which domains of the food environments in youth recreation facilities had been previously studied and to investigate the factors influencing parental choices for postgame snacks.

The National Collaborative’s Conceptual Model of Environment Factors Related to Dietary Disease Risk was used as an analytical framework to guide the review. The systematic review included 32 peer-reviewed studies from Canada (n=15), Australia (n=10), United States (n=5), New Zealand (n=1), and England (n=1). All studies were categorized into one of the three NCCOR Food Environment Domains: physical, social and/or person-centered. Within the physical domain, studies addressed food availability in concessions and/or vending machines, foods provided to children by adults, available nutrition information, food marketing, and sport sponsorship. Studies within the social domain addressed food consumption, price promotions, the presence of healthy eating policies and voluntary nutrition guidelines, the implementation of healthy eating policies and voluntary nutrition guidelines, and the efficacy of healthy eating policies and voluntary nutrition guidelines. Person-centered studies included perceptions of the availability and access to food at recreation centers, perceptions of policies or practices, and perceptions of social norms. The systematic review revealed that the food environment in youth recreation facilities does not support a healthy eating pattern and requires a comprehensive approach that addresses the physical, social, and person-centered domains of the food environment.

Factors influencing parental post-game snack choices were assessed using a quantitative survey created using the Social Cognitive Theory as a theoretical basis. Data were collected from 255 parents of youth athletes through an online anonymous survey. An ordinal logistic regression model was conducted predicting the healthiness of postgame snack provided by parents using the constructs of the Social Cognitive Theory as predictor variables. Only self-efficacy (OR=1.21, SE = .064, p< .001), observational learning (OR=1.09, SE=.385, p=.011), and behavioral capabilities (OR=1.61, SE=.214, p< .001) significantly independently predicted the healthiness of postgame snacks. Overall, the model accounted for approximately 11% of the variance in the outcome, McFadden’s pseudo-R2 = .109.

Next, a series of multiple linear regression models were conducted predicting parental self-efficacy using parent demographics as predictor variables. Household income, behavioral capabilities, age, education, marital status, and BMI were all included. On average, parents reporting a household income of more than $99,999 had a self-efficacy score 1.87 points higher than household income of < $50k when controlling for all other variables (p=.006). A significant regression equation was found (F(8,246) = 3.41, p=.001), with an McFadden’s pseudo-R2 = .0999. The preferred model was able to explain 10% of the variability that occurred within parental self-efficacy score. This study determined that all aspects of the food environment in youth recreation facilities should be addressed to improve the health outcomes of those who frequent them. Additionally, a number of significant predictor variables were determined to impact parental decisions regarding postgame snacks for their child and teammates. Implications for future research, opportunities for the field of health promotion and education, as well as interventions targeting parents are discussed.

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Funding Information

This study was supported by the Arvle and Ellen Turner Thacker Research Award within the College of Education at the University of Kentucky in 2021.