Assessing Challenges in Low-Income Families to Inform a Life Skills–Based Obesity Intervention

Background. This article describes the formative research undertaken to explore challenges of low-income parents of 3-to 5-year-olds to inform a parent-focused life skills–based intervention to prevent obesity in preschool-aged children. Method. A total of 40 parents completed surveys, 30 parents participated in focus groups, and 5 community stakeholders participated in individual interviews. In each data mode, participants were asked to prioritize a list of challenges centered on parenting, family care, and self-care. Survey data were analyzed descriptively using SAS, while focus groups and interviews were analyzed for emerging themes using ATLAS.ti. Results. Parents reported needing strategies for managing children’s behavior around picky eating, limits/boundaries, tantrums, and routines. Challenges with child behavior management were compounded by parents’ inability to find affordable fun family activities outside the home and difficulties in communicating childrearing expectations to coparents/relatives who assisted with child care. Added to these were other competing priorities (e.g., financial) that led to the neglect of self, including the inability to find “me” time, build relationships, and care for one’s health. Conclusions. Interventions that address parenting, family care and self-care challenges of low-income parents may enhance resilience and support positive changes that can promote healthy development in children, including obesity prevention.

[1]  G. James,et al.  The Ecology of Human Development , 2017 .

[2]  E. V. van Sluijs,et al.  Barriers and facilitators to young children's physical activity and sedentary behaviour: a systematic review and synthesis of qualitative literature , 2017, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[3]  A. Kelly,et al.  Review of Childhood Obesity: From Epidemiology, Etiology, and Comorbidities to Clinical Assessment and Treatment , 2017, Mayo Clinic proceedings.

[4]  Katherine M Flegal,et al.  Trends in Obesity Prevalence Among Children and Adolescents in the United States, 1988-1994 Through 2013-2014. , 2016, JAMA.

[5]  B. Fiese,et al.  Family Resiliency: A Neglected Perspective in Addressing Obesity in Young Children. , 2015, Childhood obesity.

[6]  J. Gittelsohn,et al.  Designing the Healthy Bodies, Healthy Souls Church-Based Diabetes Prevention Program Through a Participatory Process , 2013 .

[7]  M. Pentz,et al.  Translating evidence based violence and drug use prevention to obesity prevention: development and construction of the pathways program. , 2012, Health education research.

[8]  William R. Saltzman,et al.  Evaluation of a family-centered prevention intervention for military children and families facing wartime deployments. , 2012, American journal of public health.

[9]  S. Kremers,et al.  General parenting, childhood overweight and obesity-inducing behaviors: a review. , 2011, International journal of pediatric obesity : IJPO : an official journal of the International Association for the Study of Obesity.

[10]  B. Swinburn,et al.  Parental influence and obesity prevention in pre‐schoolers: a systematic review of interventions , 2011, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[11]  A. Riley,et al.  A Pilot Study of a Family-Focused Intervention for Children and Families Affected by Maternal Depression. , 2011, Journal of family therapy.

[12]  Laura Tach,et al.  Parenting as A “package deal”: Relationships, fertility, and nonresident father involvement among unmarried parents , 2010, Demography.

[13]  C. Olson,et al.  Maternal Mental Health and the Persistence of Food Insecurity in Poor Rural Families , 2009, Journal of health care for the poor and underserved.

[14]  S. Gortmaker,et al.  Televisions in the Bedrooms of Racial/Ethnic Minority Children: How Did They Get There and How Do We Get Them Out? , 2009, Clinical pediatrics.

[15]  Amber S. Messersmith,et al.  A Meta-Analytical Review of Family Communication Patterns and their Associations with Information Processing, Behavioral, and Psychosocial Outcomes , 2008 .

[16]  Mei-Wei Chang,et al.  Motivators and barriers to healthful eating and physical activity among low-income overweight and obese mothers. , 2008, Journal of the American Dietetic Association.

[17]  Keri Black,et al.  A Conceptual Review of Family Resilience Factors , 2008, Journal of family nursing.

[18]  M. Steinhardt,et al.  Evaluation of a Resilience Intervention to Enhance Coping Strategies and Protective Factors and Decrease Symptomatology , 2008, Journal of American college health : J of ACH.

[19]  Andrew M. Ledbetter,et al.  Communication Processes That Mediate Family Communication Patterns and Mental Well‐Being: A Mean and Covariance Structures Analysis of Young Adults From Divorced and Nondivorced Families , 2007 .

[20]  B. Patterson,et al.  Childhood Nutrition: Perceptions of Caretakers in a Low-Income Urban Setting , 2006, The Journal of school nursing : the official publication of the National Association of School Nurses.

[21]  Kenneth W Griffin,et al.  Life Skills Training: Empirical Findings and Future Directions , 2004, Journal of Primary Prevention.

[22]  Donna B. Johnson,et al.  Reaching low-income families: Focus group results provide direction for a behavioral approach to WIC services. , 2004, Journal of the American Dietetic Association.

[23]  Dennis K. Orthner,et al.  The Resilience and Strengths of Low‐Income Families , 2004 .

[24]  K. Seccombe,et al.  "Beating the odds" versus "changing the odds": Poverty, resilience, and family policy. , 2002 .

[25]  L. Birch,et al.  Childhood overweight: a contextual model and recommendations for future research , 2001, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[26]  R. Green,et al.  Family Communication as a Mediator of Child Adjustment to Divorce , 1999 .

[27]  V. Mcloyd,et al.  Socioeconomic disadvantage and child development. , 1998, The American psychologist.

[28]  M. Shanahan,et al.  Poverty, Parenting, and Children's Mental Health. , 1993 .

[29]  V. Mcloyd,et al.  The impact of economic hardship on black families and children: psychological distress, parenting, and socioemotional development. , 1990, Child development.

[30]  R. Simons,et al.  Economic hardship, parenting, and distress in adolescence. , 1989, Child development.

[31]  J. Gittelsohn,et al.  Participatory research for chronic disease prevention in Inuit communities. , 2010, American journal of health behavior.

[32]  James Lalime Discipline Responses Influences Of Parents ' Socioeconomic Status , Ethnicity , Beliefs About Parenting , Stress , And Cognitive-Emotional Processes , 2008 .

[33]  Kenneth W Griffin,et al.  Life skills training as a primary prevention approach for adolescent drug abuse and other problem behaviors. , 2002, International journal of emergency mental health.

[34]  E. Kain,et al.  The relation between family context and perceptions of parental efficacy , 1987 .

[35]  G. Botvin,et al.  Preventing the onset of cigarette smoking through life skills training. , 1980, Preventive medicine.