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Evaluating Attitudes of Obesity and Their Change Processes Among The University of Maine DigitalCommons@UMaine Electronic Theses and Dissertations Fogler Library 8-2003 Evaluating Attitudes of Obesity and their Change Processes among Student Teachers and School Teachers on the World Wide Web Using the Elaboration Likelihood Model Anne L. Hague Follow this and additional works at: http://digitalcommons.library.umaine.edu/etd Part of the Child Psychology Commons, Food Science Commons, and the Human and Clinical Nutrition Commons Recommended Citation Hague, Anne L., "Evaluating Attitudes of Obesity and their Change Processes among Student Teachers and School Teachers on the World Wide Web Using the Elaboration Likelihood Model" (2003). Electronic Theses and Dissertations. 84. http://digitalcommons.library.umaine.edu/etd/84 This Open-Access Dissertation is brought to you for free and open access by DigitalCommons@UMaine. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of DigitalCommons@UMaine. EVALUATING ATTITUDES OF OBESITY AND THEIR CHANGE PROCESSES AMONG STUDENT TEACHERS AND SCHOOLTEACHERS ON THE WORLD WIDE WEB USING THE ELABORATION LIKELIHOOD MODEL Anne L. Hague A.S. New Hampshire Technical Institute, 1982 B.S. University of New Hampshire, 1986 M.S. University of New Hampshire, 1989 A THESIS Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy (in Food and Nutrition Sciences) The Graduate School The University of Maine August, 2003 Advisory Committee: Adrienne A. White, Associate Professor of Human Nutrition, Advisor Rodney Bushway, Chair and Professor of Food Science Richard A. Cook, Associate Professor of Human Nutrition Walter J. Harris, Director of Center for Research and Evaluation and Maine Education Policy Research Institute Katherine Musgrave, Professor Emerita of Human Nutrition O 2003 Anne L. Hague All Rights Reserved EVALUATING ATTITUDES OF OBESITY AND THEIR CHANGE PROCESSES AMONG STUDENT TEACHERS AND SCHOOLTEACHERS ON THE WORLD WIDE WEB USING THE ELABORATION LIKELIHOOD MODEL By Anne L. Hague Advisor: Dr. Adrienne A. White An Abstract of the Thesis Presented in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy (in Food and Nutrition Sciences) August, 2003 Teachers have an active role in helping to prevent and deter stigmatizing acts toward children labeled as "fat." The objective was to examine attitudes of obesity and their change processes among student teachers and schoolteachers, when exposed to a Web-based educational module promoting size acceptance, using the Elaboration- Likelihood Model (ELM). The ELM is a theoretical approach to message-based persuasion specifying conditions under which attitude change occurs. The theory was used to explain the impact of the module (content included etiological factors of obesity, implications of weight loss efforts, and emotionaVpsychosocia1 effects of obesity), high nutrition credibility of the module presenter (PhD, RD), and her appearance (digital image was altered to appear either "fat" or "nonfat") on attitude change. The effect of subject body mass index (BMI) on attitudes was also evaluated. The sample included undergraduate and graduate students from the University of Maine System as well as schoolteachers from the New England region. Subjects (n=258; mean age=26.8f 10.2) were randomly assigned to one of five groups (controVfour treatment groups). The treatment groups evaluated the effect of the module, credibility, credible %on-fat" source, and credible "fat" source on attitude change. Change was assessed on-line at pretest, posttest, and six-week follow-up using the Anti-Fat Attitudes Test (AFAT). AFAT is a Likert scale ranging from 1 = strongly disagree with negative attitude to 5 = strongly agree with negative attitude toward obesity. Additional tests were used to evaluate support for the ELM. Attitude means decreased in treatment groups between pretest (mean scores +standard error ranged from 1.912k0.062 to 1.995zk0.067) to posttest (1.724f 0.262 to 1.815+0.074) (p=0.000) and pretest to follow-up (mean scores ranged from 1.721k0.070 to 1.871+0.078) (pS0.006). Although attitude was not associated with subject BMI, exposure to the credible "fat" presenter more favorably influenced attitudes (i.e. posttest and follow-up) compared to the credible "non-fat" presenter (p<0.025). Communicating the size acceptance paradigm on-line appeared to reduce negative attitudes of obesity regardless of subject BMI. The findings support moderate elaboration based on the ELM. The presence of the credible "fat" source may have increased attention to the size acceptance message. DEDICATION I dedicate this dissertation to my most thoughtful and giving husband, Dave. His endless support and encouragement made this project possible. I am blessed to have a best friend with such a big heart and will always be grateful for his love, understanding, and patience throughout my years as a student. ACKNOWLEDGEMENTS I am especially grateful to Dr. Adrienne White for her endless support, expertise, gentle guidance, and generosity of time. Her willingness to offer assistance and open her "guest room" whenever needed was invaluable and truly appreciated. It has been a privilege to have her as a mentor, and her commitment to teaching and research is inspirational. I will forever remember the many hours of work shared at her dining room table and her fun sense of humor. I am also grateful to Dr. Rod Bushway, Dr. Richard Cook, Dr. Walter Hanis, and Katherine Musgrave for their guidance, expertise, and thoughtful review of this dissertation. Their support and interest in this project is greatly appreciated. I would also like to extend a very special thank you to Dr. William Halteman for his statistical expertise and his many hours of advice and guidance. His endless support and commitment to teaching is admirable and most appreciated. I would also like to thank Debby Burgard, Ph.D., Betty Holmes, M.S., R.D., Joanne Ikeda, M.A., R.D., Katherine Musgrave, M.S., R.D., Ellen Parham, Ph.D., R.D., Sam Smith, Ph.D., and Adrienne White, Ph.D., R.D. for their thoughtful review of the teaching module. Their expertise, time, and willingness to review the intervention piece was greatly appreciated. A very special thank you is also extended to Andrei Strukov and his assistants at the Faculty Center, University of Maine for their technical expertise and assistance in the design and development of the Web-site. Without their support this project may not have been possible. Much appreciation is also extended to the Education faculty, from the University of Maine System, for their support of this research project, and to the subjects for their interest and participation in this study. A word of thanks is also due to Cynthia Riggs, owner of Making It Big catalog, for freely granting permission to use a Web-based image of a model from her catalog for research purposes. This research was made possible, in part, by financial support fiom the College of Natural Sciences, Forestry and Agriculture via the PhD Program Research Assistant position, the 2001-2002 Kappa Omicron Nu Research Fellowship, and the Kappa Omicron Nu local chapter scholarships. Support from the College, department faculty, and the Kappa Omicron Nu organization was most helpful and very much appreciated. Although it is not possible to acknowledge the names of all who have been a part of my "student" years, I am especially grateful to the many dedicated professors at the University of Maine who have "left their mark." Last, but certainly not least, I would like to thank my family and friends for their love, support, patience, and understanding during my many years of "student status." I am especially appreciative to my parents, Ellen and Russell G. Heston, who have always provided much encouragement and support. TABLE OF CONTENTS ... DEDICATION ...................................................................................................................111 ACKNOWLEDGEMENTS ...............................................................................................iv LIST OF TABLES .............................................................................................................ix LIST OF FIGURES ...........................................................................................................xi Chapter 1. INTRODUCTION .......................................................................................................... 1 2 . LITERATURE REVIEW ..............................................................................................4 Etiology of Obesity .................................................................................................. 5 Health Risks Associated with Obesity .....................................................................7 Obesity Treatment .................................................................................................. 11 b bNon-Diet 99 Approach to Obesity........................................................................... 14 Stigmatization of Obesity ...................................................................................... 19 Negative Attitudes Among Children .........................................................24 Negative Attitudes Among Health Care Professionals ..............................26 Negative. Attitudes Among Schoolteachers ............................................... 28 Need for Nutrition Education ................................................................................
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