Abstract
OBJECTIVE: To describe a direct observational approach (ie, interactive family board game) to measure familyfunctioning and parenting behaviors of relevance to child weight and weight-related behaviors and to examine family functioning and parenting factors from multiple family dyads (eg, siblings, parent-child) and their associations with child weight and weight-related behaviors. DESIGN: Cross-sectional, mixed-methods study. SETTING: Two home visits were conducted with families 10days apart with a 7-day observational period between home visits. PARTICIPANTS: Children (n = 150) aged 5-7years and their families from 1 of 6 racial and ethnic or immigrant and refugee groups, including African American, Hispanic, Hmong, Native American, Somali, and white, participated in the Family Matters study between 2014 and 2016. MAIN OUTCOME MEASURE: Child weight status and weight-related behaviors (ie, diet quality, physical activity). ANALYSIS: Adjusted logistic and linear regression models with robust SEs were used in analysis. RESULTS: Higher family functioning scores across the majority of family dyads were significantly associated with lower child weight status (P < .05). In addition, some family functioning scores were associated with child diet and physical activity, but not consistently. Parenting behavior scores were inconsistently associated with child weight and weight-related outcomes. CONCLUSIONS AND IMPLICATIONS: Results suggest that the interactive family board game task is a direct observational approach that researchers can use with family members to measure family functioning and parenting behaviors related to childhood obesity. Future interventions may want to consider including multiple family members in both measurement and intervention development to target childhood obesity.