title: Reframing family-centred obesity prevention using the Family Ecological Model.
abstract: 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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA. kdavison@hsph.harvard.edu
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Davison
authors.forename: Janine M
authors.initials: JM
authors.lastname: Jurkowski
authors.forename: Hal A
authors.initials: HA
authors.lastname: Lawson
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D005069:Evaluation Studies as Topic; D005190:Family; D005191:Family Characteristics; D005247:Feeding Behavior; D005260:Female; D017144:Focus Groups; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D009765:Obesity / Q000517:prevention & control*; D016487:Parenting; D012944:Social Support