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Author ORCID Identifier


Open Access Dissertation

Document Type


Degree Name

Doctor of Philosophy (PhD)

Degree Program

Public Health

Year Degree Awarded


Month Degree Awarded


First Advisor

Susan Sturgeon

Second Advisor

Nicole VanKim

Third Advisor

Elizabeth Bertone-Johnson

Fourth Advisor

Linda Griffin

Fifth Advisor

Jennifer Emond

Subject Categories



Childhood overweight/obesity is an epidemic in the US. Modifiable risk factors, such as intake of foods that are highly processed, are heavily marketed to children. Exposure to food advertisements, along with home environment factors, family meal styles, and digital media habits shapes children’s preferences, tastes, and habits. Predictors of ultra-processed food (UPF) intake in children are unclear and the potential effect of ad exposure on UPF intake is unknown. It is also unknown if there are distinct response patterns among a collection of potentially obesity-related factors, and if distinct groups affect child BMI. Additionally, more qualitative research is needed to understand if children are aware of being targets for unhealthy food advertising.

Therefore, chapter one examines child, parent and household characteristics, and ad exposure as risk factors for child UPF intake. Chapter two is a latent class analysis on a collection of potentially obesity-related factors including child fast food frequency, food preparation, family meal styles, and digital media behaviors to identify distinct, heterogenous response patterns of these factors and the potential effect on child BMI. Chapter three includes results from a qualitative study where we recruited and interviewed 21 children aged 9 to 11 years about their lived experience and perceptions of being advertised to on digital media platforms.

Our findings suggest that children are consuming high amounts of UPF. UPF intake was positively associated with increasing child age, greater hours of watching TV, and more frequent parent soda and fast food intake and was negatively associated with higher parent education and a reported race or ethnicity other than non-Hispanic White. UPF intake was not associated with weight change. We also found distinct classes based on eating behaviors and home environment habits and found an increased odds of overweight/obesity for one class, with higher probability of more frequent fast food and takeout intake, fewer dinners with family, and not offering children eating choices. Finally, we found children generally recognized food advertisements, were able to describe them and show us examples. Despite self-identifying ads and understanding the intent of advertising, many children were still receptive to the ads.


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Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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