Reframing family-centred obesity prevention using the Family Ecological Model

• Published in: Public health nutrition Vol. 16; no. 10; pp. 1861 - 1869
• Main Authors: Davison, Kirsten K, Jurkowski, Janine M, Lawson, Hal A
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.10.2013
• Subjects: Behavior; Biological and medical sciences; Caregivers; Child; childhood obesity; children; Children & youth; cognition; Community; Cross-Sectional Studies; diet; Ecological models; Evaluation Studies as Topic; Exercise; Families & family life; Family; Family Characteristics; Family size; Feeding Behavior; Female; Focus Groups; Follow-Up Studies; General aspects; Health care; Humans; Intervention; Interventions; issues and policy; Low income groups; Male; Medical sciences; Metabolic diseases; Models, Theoretical; Obesity; Obesity - prevention & control; Parenting; parents; Parents & parenting; physical activity; Prevention; Prevention and actions; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Public housing; quantitative analysis; Social Support; System theory; Community-based participatory research; Family; Ecological Systems Theory; Childhood obesity; Theory; Obesity prevention; Human; Obesity; Family study; Nutrition disorder; Community participation; Prevention; Scientific research; Family environment; Models; Community action for health; Child; Nutritional status
• ISSN: 1368-9800; 1475-2727; 1475-2727
• DOI: 10.1017/S1368980012004533

According to the Family Ecological Model (FEM), parenting behaviours are shaped by the contexts in which families are embedded. In the present study, we utilize the FEM to guide a mixed-methods community assessment and summarize the results. Additionally, we discuss the utility of the FEM and outline possible improvements. Using a cross-sectional design, qualitative and quantitative methods were used to examine the ecologies of parents’ cognitions and behaviours specific to children’s diet, physical activity and screen-based behaviours. Results were mapped onto constructs outlined in the FEM. The study took place in five Head Start centres in a small north-eastern city. The community assessment was part of a larger study to develop and evaluate a family-centred obesity prevention programme for low-income families. Participants included eighty-nine low-income parents/caregivers of children enrolled in Head Start. Parents reported a broad range of factors affecting their parenting cognitions and behaviours. Intrafamilial factors included educational and cultural backgrounds, family size and a lack of social support from partners. Organizational factors included staff stability at key organizations, a lack of service integration and differing school routines. Community factors included social connectedness to neighbours/friends, shared norms around parenting and the availability of safe public housing and play spaces. Policy- and media-related factors included requirements of public assistance programmes, back-to-work policies and children’s exposure to food advertisements. Based on these findings, the FEM was refined to create an evidence-based,temporally structured logic model to support and guide family-centred research in childhood obesity prevention.