Assessing Family Level Behaviors for Obesity Prevention: Development and Preliminary Validation of the Family Stage of Change Tool

We applied the Transtheoretical Model (TTM) to develop the Family Stage of Change (FSOC) screening tool. Our goal was to provide practitioners an instrument that measures families’ readiness to change obesity preventing behaviors, in order to optimize family-focused obesity-prevention intervention strategies. We evaluated instrument validity by comparing responses on the FSOC to related items on a validated family behavioral and environmental assessment (Family Nutrition and Physical Activity Assessment; FNPA) shown to predict child BMI. Study participants included parents and caregivers (N = 146) of children ages 2-14 years recruited through preschool, elementary, and middle school listservs. Descriptive analyses were conducted on the demographic data, and correlations were run to examine associations between FSOC and FNPA items, domains, and total scores. Strong positive correlations were observed between the individual items (0.44 to 0.75, p < 0.001), domain scores (0.57 to 0.8, p < 0.001), and mean total FSOC and FNPA scores (0.78, p < 0.001) suggesting the FSOC is measuring family level behaviors. Test-retest reliability was evaluated on a subsample of participants (n = 57), and item by item correlations ranged from 0.75 to 1.0, p < 0.001. Our findings suggest the FSOC is a valid and reliable instrument and has the potential to meet an identified need related to family-directed, obesity prevention efforts.