Graduation Year

2026

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Educational and Psychological Studies

Major Professor

Marilyn Stern, Ph.D.

Co-Major Professor

Kathy Bradley-Klug, Ph.D.

Committee Member

Heather Agazzi, Ph.D.

Committee Member

Robert Dedrick, Ph.D.

Committee Member

Sylvia Crowder, Ph.D.

Keywords

Survivorship, Diversity, Healthy Lifestyles, Late Effects

Abstract

Pediatric cancer survivors are at increased risk for obesity and related long-term health complications, highlighting the need for interventions promoting healthy lifestyle behaviors during survivorship. The present study examined caregivers’ fruit and vegetable intake in the full NOURISH-T+ intervention and evaluated whether their dietary outcomes changed from baseline to the 3-month post-assessment and differed by selected caregiver sociodemographic characteristics. The study also examined whether these characteristics accounted for variance in 3-month fruit and vegetable outcomes. Participants included 68 caregivers in the full NOURISH-T+ condition who completed both baseline and 3-month post-assessments. Fruit and vegetable intake was assessed using the Healthy Eating Index-2020 component scores. Analyses included descriptive statistics, paired-samples tests, repeated-measures analyses of variance, and multiple regression models.

Findings provided limited statistical support for the study hypotheses. Caregivers’ fruit and vegetable intake increased slightly over time, but neither change was statistically significant. In addition, changes in fruit and vegetable intake did not differ significantly as a function of caregivers’ language preference for intervention delivery, race/ethnicity, baseline income, education level, or marital status. The regression models were not statistically significant overall, although marital status significantly predicted 3-month fruit outcomes and baseline vegetable intake significantly predicted 3-month vegetable outcomes. These findings suggest that short-term caregiver dietary changes may be modest and that broad sociodemographic characteristics alone may not consistently explain follow-up outcomes. The study contributes to the literature by centering caregivers as meaningful targets of intervention and underscores the importance of examining more proximal behavioral and contextual factors in future family-based health interventions.

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