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Mothers and babies form an inseparable biological and social unit; the health and nutrition of one group cannot be divorced from the health and nutrition of the other.”-World Health Organization. The aim of this study was to evaluate the effectiveness of the Loving Support Peer Counseling (LSPC) program, under the WIC program in the state of Georgia, on breastfeeding duration rates among African American postpartum primiparas women. This observational study analyzed state-level data from January 2017 through December 2018. A cross-sectional design was used to evaluate the effectiveness of the Loving Support Peer Counseling Program (LSPC) in six of the 18 public health districts on breastfeeding duration among African American postpartum primiparas women. Descriptive statistics of demographic and socioeconomic characteristics and logistic regression analysis were used to examine the association between timing of WIC entry and breastfeeding duration. Therefore, this study used a Socioecological Model (SEM) to highlight the disparities in breastfeeding outcomes among African American postpartum primiparas women at six and 12 months. Health districts by breastfeeding rates showed a statistically significant difference for women (χ2 = 9.3) enrolled in the Loving Support Peer Counseling (LSPC) program. Health districts with lower reported breastfeeding rates enrolled slightly higher percentages of women in the program during the prenatal period compared to the high breastfeeding rate districts. Type of contact played an important role on breastfeeding duration, with the odds of breastfeeding at six months being greater for women who received face-to-face contacts (adjusted OR = 1.60, 95% confidence interval [CI] = 1.15 to 2.21). Other factors did not contribute to breastfeeding cessation at six and 12-month intervals. The results suggest that the Loving Support Peer Counseling (LSPC) program increased breastfeeding duration among African American postpartum primiparas women enrolled in the program.

Abstract: The purpose of this thesis was to explore the perspectives of sport parents to understand factors, in particular messages that impact parents and their decisions within the context of children’s sport and free play. Guided by interpretive description (ID), data were collected through interviews with 12 parents who had children between the ages of 8 to 10 years old, registered in a club soccer program. A socioecological framework applied to this study highlighted a multitude of factors, from various levels of influence that impacted parents’ perspectives and decisions within the contexts of children’s sport and free play. In the first manuscript, interviews revealed that parents’ perspectives on children’s sport and free play were influenced by their own personal childhood experiences and framed within the notion that times have changed. Parents viewed competitive team sport participation as a priority over free play, particularly for the development of life skills, socialization, and a sense of community. Free play was primarily viewed for the benefits of relaxation and down time, yet was also associated with increased opportunities for problem behaviours. Schools were seen to play an important role in the sport and free play opportunities and experiences of children. Broader levels of influence in social and physical environments (i.e., sport organizations, coaches, local parenting norms, parenting ideologies) impacted the decisions and behaviours of parents within the context of sport and free play, particularly the accelerated pace of children’s sports, and safety concerns in free play. Parents generally embraced the busier lives that are prevalent in our current milieu. Furthermore, parents generally viewed the multitude of opportunities for children to be involved in, positively. The findings of this study highlighted a gap in the literature with regard to free play in middle childhood, and parents’ understanding of the benefits of it. Furthermore, this study points to the need to consider addressing broader levels of influence, such as physical and social environments in supporting healthful and positive behaviours in the context of children’s sport, free play, and IAM. In exploring the impact of messages in the second manuscript, interviews suggested that formal messages (i.e., mass media commercials, social media, etc.) had limited direct impact on parents’ decisions within children’s sport and free play except to validate decisions already made. Parenting ideologies, local parenting norms, and parenting labels inherent in children’s sport and free play (i.e., helicopter parent, hockey parent, etc.) did influence parent behaviours and decisions. Parents wanted to be the ‘good parents’ rather than ‘that’ parent which are often highlighted in popular media and empirical studies. These parents observed, and opposed the strong presence of the 10,000 hours of deliberate practice theory (Ericsson, Krampe, & Tesch-Römer, 1993) influencing children’s sports experiences, and felt that it challenged their decisions to have multisport children. Furthermore, parents expressed how messages and the information they received were often contradictory. The findings of this study acknowledge that parents recognized the importance of sport and free play yet suggest a tension exists between them highlighting the notion that play is often presented in opposition to sport.

Rural Americans are medically underserved groups and are at greater risk of becoming obese than urban Americans. The purpose of this qualitative study was to determine the perceived causes of obesity in six counties of rural Kentucky and to determine how to customize strategies to reduce obesity in these areas. University of Kentucky Cooperative Extension Service Agents formed coalitions in each of the six counties to assess their communities’ needs and assets to inform plans for implementing evidence-based obesity interventions. Between February and August of 2015, the coalitions were convened for a total of 11 meetings. Each of the coalition meetings was audio recorded, transcribed, and coded using NVivo 11 qualitative analysis software. Coalition members in these rural counties of Kentucky recognized aspects of their culture, poor dietary choices, and inactivity as the major reasons obesity is a problem in their county. Participants reported high prevalence of fast food restaurants, lack of access to healthy foods and physical activity resources, technology, and lack of time as barriers to healthy behaviors. These findings provide insight to inform tailored, evidence-based interventions for rural communities. Improving access to healthy foods and physical activity resources in rural areas may improve healthy behaviors and reduce obesity prevalence.

Background: Asthma is a chronic illness that affects people of all age groups. Approximately 12% and 9% of children and adults, respectively, have asthma in Georgia. Asthma affects groups of people differently, with African Americans being twice as likely to be hospitalized for asthma. Hospitalizations related to asthma cost Georgians over $100 million dollars. The symptoms of coughing and wheezing can have a detrimental effect on the productivity of the asthmatic as well as lead to exorbitant medical costs for the asthmatic. This study examines the associations between known risk factors and asthma prevalence in a displaced housing population in Atlanta, GA. Methods: Researchers recruited residents of former public housing communities BEFORE/ AFTER demolishment. Data were collected by interview by research staff supported by the Georgia State University Partnership for Urban Health Research Center. The second set of interviews were collected from the same sample population, no additional recruiting was done. This second cross-sectional wave (out of 4 total) of interviews is the data source analyzed in this study. Chi-square tests were run to examine associations of risk factors with having an asthma diagnosis within the last 12 months. Results: There were 310 complete interviews obtained with public housing residents during the second wave of data collection. Results showed that 13% (n= 40) of respondents reported an asthma diagnosis within the last 12 months. Chi-square analyses demonstrated statistically significant associations between the following variables: Presence of Leaky Roof, Presence of Mice and Rats, and Going Without Necessary Medication. Conclusions: Results of this study reveal important relationships between risk factors associated with asthma among public housing residents recently displaced from their communities. Risk factors representative of individual, interpersonal, and community levels of influence demonstrate clear associations with asthma for this vulnerable population. Continued investigation on the predictive value of risk factors related to asthma among residents of public housing communities is warranted. Deepening understanding of how a person, the environment, and their behaviors are connected will inform more sensitive public housing decisions—that ultimately, hold the promise of improving asthma prevalence, maintenance, and outcomes for the 1,000s of sufferers in Georgia alone.