Public Health Nutrition


Reframing family-centred obesity prevention using the Family Ecological Model

Kirsten K Davisona1 c1, Janine M Jurkowskia2 and Hal A Lawsona3

a1 Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA

a2 Department of Health Policy, Management and Behavior, School of Public Health, University of Albany, Rensselaer, NY, USA

a3 Department of Educational Administration & Policy Studies and School of Social Welfare, University of Albany, Albany, NY, USA


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.

(Received March 06 2012)

(Revised June 27 2012)

(Accepted July 12 2012)

(Online publication October 22 2012)


  • Ecological Systems Theory;
  • Childhood obesity;
  • Family;
  • Theory;
  • Obesity prevention;
  • Community-based participatory research


c1 Corresponding author: Email