Results from recent research studies examining the direct effect of local health department obesity prevention efforts on county-level variations in obesity are inconclusive. Local health departments' inability to decrease the prevalence of obesity within their jurisdiction with existing public health resources will likely persist as a result of organizational inefficiencies and limited funding available to provide obesity risk reduction programs and services to communities most adversely affected by the epidemic. To broaden their impact despite these barriers, local health departments would do well to identify other strategies that improve their ability to deliver obesity prevention programs to diverse communities, such as using partnerships with community-based organizations that have relevant obesity prevention expertise.

This dissertation comprises two studies that examine the role of local health department organizational characteristics and area-level factors on the presence of local health department community-based partnerships and the effect of these partnerships on the percentage point change in county-level obesity prevalence. Multiple waves of data from the National Profile Survey of Local Health Departments, U.S. Census Bureau, and the obesity prevalence data from the Behavioral Risk Factor Surveillance System were analyzed using multinomial logistic regression and ordinary least squares regression modeling. Additionally, key informant interviews (n=4) with stakeholders from the Los Angeles County Department of Public Health complemented the secondary data analyses

Results indicated that local health departments are providing a substantial amount of obesity prevention programs through partnerships with other organizations in the local public health system. The probability of partnering to provide obesity prevention programs increased with the size of the population served. The benefit of local health department community-based partnerships for decreasing the county-level prevalence of obesity was not confirmed. Local health departments experience barriers to the formation of community-based partnerships, including the administrative burden associated with the processing of formal contracts.

Findings suggest that local health departments are interested in improving their obesity prevention efforts and value partnerships with community-based organizations. However there are other important agencies that local health departments must partner with for policy adoption and advocacy activities. Local health departments within larger jurisdictions can benefit from the economies of scale and improve their population-based obesity prevention programs. Results suggest that future obesity risk reduction research should continue assessing the benefits achieved from local health department partnerships with community-based organizations.

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Background: Sugar-sweetened beverage (SSB) consumption has markedly increased in the last three decades among U.S. children and adolescents aged 2-18 years. The health effects of SSBs have mostly been examined in the context of obesity, and other metabolic disorders but little is known about how SSBs affect cognitive function. Evidence from animal and human studies suggests that high-fructose corn syrup and sucrose, found in large quantities in SSBs, may have adverse effects on the hippocampus, the learning and memory center of the brain. Nutritional insults to the hippocampus impair cognitive function and may negatively affect children's academic performance (AP). Purpose: The objectives were to examine the association between SSB consumption and AP in school-aged children, and identify modifiable food-related family behaviors associated with high SSB consumption. Methods: Data were obtained from an evaluation of a district wide multi-component school-based intervention which followed 238 fourth and fifth grade students annually from 2006 to 2009. Repeated measures analysis using mixed-effects models was conducted to examine the association between SSB consumption and AP measured by Math and English test scores; race, gender, grade level, mother `s education, mother's employment, intervention level and physical activity were controlled for. Mediation analysis was conducted to determine if family meal behaviors, namely the frequency with which children assist in meal preparation and have dinner with their family, mediate the association between socio-demographic variables and SSB consumption. Results: SSB consumption was inversely associated with English z-score (p<0.05); for every 24-ounces of soda consumed per day, English z-score decreased by 0.19 standard deviation units (3-4% of the mean). African American children had dinner together with their family less frequently than White children (p<0.01) and that as frequency of eating family dinner increased, SSB consumption decreased (p<0.05 among African Americans). Furthermore, African-American children assisted with meal preparation significantly more frequently than White children (p<0.01) but assisting with meal preparation was not significantly related to SSB consumption. Conclusion: SSB consumption is inversely associated with English but not math test score. The association between sociodemographic characteristics and SSB consumption is partially mediated by family meal behaviors. Future studies should explore how SSB consumption may affect cognitive function throughout the life-course and provide a clearer understanding of the biological mechanisms by which SSB consumption may influence AP.

The modern world is densely populated by physical structures that were designed and made by people, from transient arrangements like stacks of books and sandwiches, to enduring constructions like bridges and skyscrapers. Physical assembly– the construction of a new object from existing parts– accounts for some of the most complex acts of human cognition. What are the core cognitive processes that underlie this ability? The study of physical assembly presents unique opportunities and challenges because it relies on interactions between multiple cognitive processes, including perception, working memory, planning, and action selection. This dissertation introduces new experimental methods to investigate these processes, by characterizing the impact of physical assembly experience on our ability to build. Moreover, it explores far-reaching consequences of assembly experience on cognition, including the ability to remember objects, as well as the language we use to communicate about them. Over three chapters, I investigate three consequences of assembly experience. In Chapter 1, I investigate how practice assembling objects changes the procedures we use to construct them, finding that people learn to build more quickly and accurately, and use increasingly consistent procedures to do so. In Chapter 2, I explore how assembling objects impacts our memory of those objects, finding that how well we remember an object depends crucially on the way we encode it during assembly. In Chapter 3, I go beyond the consequences of assembly for individuals to ask how shared assembly experience impacts how collaborators communicate about objects, and find that people coordinate on linguistic conventions for referring to increasingly abstract procedures over time. These results comprise a set of ways that people– individually and collectively– leverage prior assembly experience to improve their ability to build, elucidating one of the most pervasive and complex human behaviors. By clarifying the impact of a creative, generative behavior on our representations of the things we make, these findings have implications for understanding how we relate to the world of constructed objects we inhabit, and the development of technologies that help people create more effectively.

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