Measures of the home environment related to childhood obesity: a systematic review

Abstract

Objective: Due to a proliferation of measures for different components of the home environment related to childhood obesity, the purpose of the present systematic review was to examine these tools and the degree to which they can validly and reliably assess the home environment. Design: Relevant manuscripts published between 1998 and 2010 were obtained through electronic database searches and manual searches of reference lists. Manuscripts were included if the researchers reported on a measure of the home environment related to child eating and physical activity (PA) and childhood obesity and reported on at least one psychometric property. Results: Of the forty papers reviewed, 48 % discussed some aspect of parenting specific to food. Fifty-per cent of the manuscripts measured food availability/ accessibility, 18 % measured PA availability/accessibility, 20 % measured media availability/accessibility, 30 % focused on feeding style, 23 % focused on parenting related to PA and 20 % focused on parenting related to screen time. Conclusions: Many researchers chose to design new measures for their studies but often the items employed were brief and there was a lack of transparency in the psychometric properties. Many of the current measures of the home food and PA environment focus on one or two constructs; more comprehensive measures as well as short screeners guided by theoretical models are necessary to capture influences in the home on food and PA behaviours of children. Finally, the current measures of the home environment do not necessarily translate to specific subpopulations. Recommendations were made for future validation of measures in terms of appropriate psychometric testing. Keywords Child obesity Home environment Measurement PsychometricsThe prevalence and severity of childhood overweight have increased significantly in the past three decades (1)(2)(3) . Negative sequalae from being overweight during childhood include being at a higher risk for a number of chronic and acute conditions (4) as well as negative social and psychological outcomes (5) . The source for the majority of childhood obesity cases can be attributed to energy imbalance which has been linked to changes in the food and physical activity (PA) environments (6,7) . The home environment has been documented as one that can either facilitate or inhibit healthful eating and PA, and caregivers play a key role in the development of the social and physical environment within a household (8,9) . From a social environment perspective, caregivers serve as role models for PA, dietary and media behaviours and influence the child's health behaviours and weight status through parenting strategies and feeding styles (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) . In addition, a child participates in more PA when a greater amount of space and active toys are available in the home (22,23) . Likewise, access to food items can impact consumption (24,25) . Similarly, when more screen opportunities are available, children are more likely to engage i...

Biological, environmental, and social influences on childhood obesity

“…Higher parental education, parental nurturing, and higher self-esteem reduce obesity risk in girls (22). There is an abundance of evidence that the home food environment (23)(24)(25), shared family meals (26,27), and electronic media use influence children's obesity (28) largely through behavioral pathways. Mothers primarily establish the home food environment and are role models for eating behaviors (29) with evidence of strong correlation between the eating patterns of mothers and children (25,29).…”

2012 – starting with overweight and obesity

“…Three reviews on the home environment and its importance for childhood obesity, on dietary weight-loss interventions in people of African ancestry and on free will and the obesity epidemic are also included in this issue (15)(16)(17) .…”

Psychometric assessment of the Behavior and Attitudes Questionnaire for Healthy Habits: measuring parents’ views on food and physical activity

“…The list included statements associated with health issues (31,33,34) , parental control of child feeding (11,29,30) and aspects of the home environment (11,30,32,33,35) . In multiple cases, extracted items were found on more than one source as also noted by Pinard et al (26) in their systematic review which revealed overlapping constructs assessed on different measures.…”

“…Researchers have also considered other frameworks with KAB-framed interventions among different groups, such as the transtheoretical model (23) and self-efficacy constructs (24,25) . Despite the availability of parent questionnaires to assess nutrition education, a systematic review by Pinard et al showed that use of these tools is limited by the lack of psychometric assessment and the topic thus merits further research (26) .…”