1. 4/6/2012
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, Kinesiology
Flor Romero de Slowing, Interdisciplinary Graduate Studies
Iowa State University
Janie 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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2. 4/6/2012
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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3. 4/6/2012
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
Poverty related to Child Obesity
25
20
15
Child Obesity
10
5
0
< 100% FPL 200-399% FPL > 500% FPL
3

4. 4/6/2012
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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5. 4/6/2012
Wave 1- 382 families
http://ruralfamiliesspeak.org/
Race/ethnicity white
Latino
Black
Native
American
Asian/Pacific
Islander
5

6. 4/6/2012
Marital Status
Single/never
married
Divorced/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
Underweight
Normal weight
Overweight
Obese
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7. 4/6/2012
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 items
3. Center for Epidemiologic Studies Short Depression
Scale (CES-D 10) - identifies depressive symptomology
4. 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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8. 4/6/2012
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 CES-D Depression Scale Financial Distress/
Routines Scale Financial Well-being Scale
FNPA
Pearson Correlation 0.226** -.205** -.118*
Sig. (2 tailed) 0.00 0.00 .024
N 295 361 361
What we learned…. FNPA Family Rituals
and Daily
CES-D
Depression
Financial
Distress/
Financial Well-
Routines Scale Scale
A higher FNPA score for… being Scale
Latinas
• Latinas was associated with a Pearson
higher family routine score Correlation
Sig. (2 tailed)
0.239*
.011
• whites was associated with a N
White
112
higher family routine score, lower Pearson
maternal depression and lower Correlation
Sig. (2 tailed)
.237**
.004
-.275**
.000
-.144
.050
financial stress N 147 186 186
American Indians
• American Indians was associated Pearson
with a higher family routine score Correlation
Sig. (2 tailed)
.799**
.010
-.698**
.006
and lower maternal depression N 9 14
Asian
• Asians was associated with lower Pearson
maternal depression Correlation
Sig. (2 tailed)
-.832**
.005
N 9
8

9. 4/6/2012
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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10. 4/6/2012
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)
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