Reframing family-centred obesity prevention using the Family Ecological Model

Public Health Nutr. 2013 Oct;16(10):1861-9. doi: 10.1017/S1368980012004533. Epub 2012 Oct 22.


Objective: 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.

Design: 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.

Setting: 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.

Subjects: Participants included eighty-nine low-income parents/caregivers of children enrolled in Head Start.

Results: 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.

Conclusions: 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.

Publication types

  • Research Support, American Recovery and Reinvestment Act
  • Research Support, N.I.H., Extramural

MeSH terms

  • Child
  • Cross-Sectional Studies
  • Evaluation Studies as Topic
  • Family Characteristics
  • Family*
  • Feeding Behavior*
  • Female
  • Focus Groups
  • Follow-Up Studies
  • Humans
  • Male
  • Models, Theoretical
  • Obesity / prevention & control*
  • Parenting
  • Social Support