- Childhood obesity and food insecurity are public health issues that often coexist, and both conditions are more prevalent among rural compared to non-rural populations. Social ecological prevention efforts are recommended, yet limited research has examined how rural family-home environments may influence obesity-preventing and -promoting behaviors. The purpose of this dissertation was to examine whether and how family-home environmental and behavioral factors are associated with body mass index (BMI) and food security in rural children. To accomplish the aims of this project, a mixed methods study was conducted.
For the quantitative phase of this study, relationships between family nutrition and physical activity (FNPA), food security, and children’s BMI and dietary behaviors were examined. Results indicated no significant associations between FNPA and BMI or between FNPA and food security. More favorable FNPA factors were associated with higher consumption of fruits, vegetables, and dairy, and with lower intake of added sugar.
The qualitative phase of this research involved nine semi-structured focus group
interviews, conducted across six rural communities, to explore parent/caregiver perceptions of factors that influence behaviors related to nutrition and physical activity in the home environment. Four major themes that influence family nutrition- and activity-related behaviors were identified, including family eating habits, food procurement, family physical activity, and screen time. Eight themes emerged as environmental supports and/or barriers to family nutrition and physical activity, including seasonal variation, features of home, distance from resources, foods and beverages encouraged and discouraged, screen time limits, financial constraints, outdoor safety, and schedule constraints.
This study provides evidence that certain factors in the family-home are associated with children’s dietary behaviors, and that opportunities for rural children to eat healthfully and be physically active at home are influenced by factors internal and external to the family-home. Understanding how family-home and other environmental factors influence children’s eating and activity behaviors and future health outcomes, as well as how public health efforts may support families in navigating challenges specific to rural areas, is an important area of research that warrants further exploration.