Graduation Date

Spring 5-8-2021

Document Type


Degree Name

Doctor of Philosophy (PhD)


Medical Sciences Interdepartmental Area

First Advisor

Mark D. Shriver

Second Advisor

Keith D. Allen

Third Advisor

Joseph H. Evans

Fourth Advisor

William J. Higgins


Childhood obesity continues to be a significant public health problem in the United States in which approximately 8% to 12% of American children are obese (Cunningham, Kramer, & Narayan, 2014; Mirza et al., 2018; Ogden et al., 2014). Further, 42% of American children are engaging in less than the recommended 60 minutes of daily physical activity (Troiano et al., 2008). Several treatments have been evaluated that have included goal-setting, self-monitoring, performance feedback, and access to arbitrary tangible rewards (e.g., Hyusti, Normand, & Larson, 2011; Van Camp & Hayes, 2012), but these treatments have often failed Luttikhuis et al., 2009; Nooijan et al., 2017). Successfully identifying reinforcers for physical activity may lead to an increase in treatment successes in young children with obesity. Previous studies that evaluated procedures to predict reinforcement of physical activity have notably neglected the participation of children with obesity. In addition, previous studies have not included tangible stimuli as possible reinforcers for increasing physical activity.

The current study evaluated modifications to the Six-Minute Walk Test (6MWT, American Thoracic Society, 2002) to predict individualized reinforcers of physical activity in young children with obesity. Reinforcers identified through these procedures were then compared to arbitrarily identified rewards. Three children with obesity between five and nine years old participated in the study. Results demonstrated that using the modified 6MWT as a reinforcer analysis predicted individualized reinforcers that increased physical activity beyond baseline levels, and identified reinforcers that were more effective than arbitrarily-selected rewards. Future research implications and limitations are discussed.