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Relationship between the home environment’s risk for child obesity and family well-being

among rural low income families

Kimberly Greder, Associate Professor and Extension Specialist, Human Development & Family Studies

Michelle Ihmels, Assistant Adjunct Professor, KinesiologyFlor Romero de Slowing, Interdisciplinary Graduate Studies

Iowa State UniversityJanie Burney, Professor and Extension Nutrition Specialist

University of Tennessee Knoxville

• Child obesity - tripled since 1980.

• 1 of 7 low-income, preschool children is obese.

• 17% of children 2—19 years are obese.

• Hispanic boys more likely to be obese than white boys

• Black girls more likely to be obese than white girls.

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What makes up the home environment?

What factors in the home environment does research suggest are associated with risk for child obesity?

Social• Parental role modeling, parenting policies and

strategies (including feeding practices) related to physical activity, food and media behaviors

Physical• Availability and accessibility of food, physical

activity and media

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Parent well-being and parent/child attachment linked to child obesity

Poor child health and obesity linked to ...• Maternal depression• Poor quality maternal/child relationship

Rural people more likely to be inactive and poor

0

5

10

15

20

25

< 100% FPL 200-399% FPL > 500% FPL

Poverty related to Child Obesity

Child Obesity

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Why is it important to understand the link between the home environment and child obesity?

Conference theme: Partnerships to Improve the

Health of the Nation

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Wave 1- 382 familieshttp://ruralfamiliesspeak.org/

Race/ethnicity white

Latino

Black

NativeAmericanAsian/PacificIslander

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Marital StatusSingle/nevermarriedDivorced/widowed

Married

Living with partner

• Avg age of mother = 32years• Avg. annual household income = $15,000 - 19,000• 2/3 of the mothers did not work outside home for pay• 68% participated in SNAP• 51% participated in WIC• 66% participated in Free/Reduced Priced Meals

Mother Body Mass Index

UnderweightNormal weightOverweightObese

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Measures

1. Family Nutrition and Physical Activity (FNPA) screening tool – 21 items- assess home environments that may predispose children to becoming overweight

2. Family Rituals and Daily Routines - 26 items3. Center for Epidemiologic Studies Short Depression

Scale (CES-D 10) - identifies depressive symptomology4. Financial Distress – 7 items

Research questions

1. What is the relationship between mothers’ FNPA score and family and mother variables?

2. Does race/ethnicity mediate the relationship between mothers’ FNPA score and family and mother variables?

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What we learned….The higher the FNPA score, the higher family routines score and lower the maternal depression and financial stress scores.

Family Rituals and Daily Routines Scale

CES-D Depression Scale Financial Distress/Financial Well-being Scale

FNPAPearson CorrelationSig. (2 tailed)N

0.226**0.00295

-.205**0.00361

-.118*.024361

What we learned….A higher FNPA score for…• Latinas was associated with a

higher family routine score• whites was associated with a

higher family routine score, lower maternal depression and lower financial stress

• American Indians was associated with a higher family routine score and lower maternal depression

• Asians was associated with lower maternal depression

FNPA Family Rituals and Daily Routines Scale

CES-D Depression Scale

Financial Distress/Financial Well-being Scale

LatinasPearson CorrelationSig. (2 tailed)N

0.239*.011112

WhitePearson CorrelationSig. (2 tailed)N

.237**

.004147

-.275**.000186

-.144.050186

American IndiansPearson CorrelationSig. (2 tailed)N

.799**

.0109

-.698**.00614

AsianPearson CorrelationSig. (2 tailed)N

-.832**.0059

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What does this mean?

Families that have a health enhancing home environment are also more likely to have…

• daily family routines and practice religious or cultural based rituals

• mothers who are less likely to be depressed• less perceived financial stress

• How can you apply these findings to your work with rural, low-income families that have young children?

• What are you currently doing that you should continue to do?

• What could you do differently? • What additional research is needed?

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Consider the complexity of factors facing some rural low income families that shape eating and activity behaviors. • Lack of transportation can lead to sedentary lifestyles, as well as

not being able to travel to grocery stores with affordable prices or education programs that are not within walking distance.

• Lower education level• Poverty related to food insecurity. Food insecurity can lead to

maladaptive eating patterns and coping strategies that contribute to the “hunger-obesity” paradox

• Access to the Internet for information.

Promote healthful home environments using an interdisciplinary approach. Combine nutrition and health education with strategies used in parenting, resource and financial management education.Help mothers…• Develop family routines and rituals (e.g., eating together as a family)• Reduce stress: Connect to resources (i.e., financial assistance, emotional support,

information); strengthen problem-solving skills• Strengthen resource management and financial literacy skills• Strengthen basic food preparation and meal planning skills that promote healthy eating• Identify simple strategies to help children make healthy food choices (e.g., keep healthy

food choices in refrigerator and cupboards; leave fresh fruit on table vs cookies)• Identify strategies to improve their diets, eating behaviors and activity levels• Learn developmentally appropriate expectations for child eating and activity• Identify strategies to strengthen the parent/child feeding relationship• Identify strategies to help children be active (e.g., media time limits, go for family walk)