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Development and preliminary validation of a Family Nutrition and Physical Activity (FNPA) screening tool
Michelle A Ihmels1, Greg J Welk, Joey C Eisenmann
1Department of Kinesiology, Iowa State University, Ames, Iowa, USA. mihmels@iastate.edu.
Insights
Parents significantly impact children's health. The Family Nutrition and Physical Activity (FNPA) Screening Tool assesses family behaviors and environments linked to childhood overweight risk.
Area of Science:
- Childhood Obesity Research
- Family Health and Behavior Science
- Public Health Screening Tools
Background:
- Parental influence is critical for children's physical activity and nutrition.
- Family environments significantly shape childhood health behaviors.
- Childhood overweight is a major public health concern influenced by family factors.
Purpose of the Study:
- To develop and validate an easy-to-use screening tool for family environmental and behavioral factors.
- To assess family-related risk factors for childhood overweight.
- To create the Family Nutrition and Physical Activity (FNPA) Screening Tool.
Main Methods:
- Developed FNPA tool based on evidence analysis and ten constructs.
- Administered FNPA to parents of first-grade students (n=1085) and linked to BMI data.
- Utilized factor analysis, mixed models, and logistic regression for validation.
Main Results:
- Factor analysis confirmed a unidimensional structure for the FNPA tool.
- FNPA scores correlated with child BMI, with lower scores indicating higher risk.
- Lower FNPA scores were associated with lower income families and increased odds of childhood overweight.
Conclusions:
- The FNPA Screening Tool effectively captures family environmental and behavioral elements.
- The tool demonstrates validity in identifying risks for childhood overweight.
- FNPA can aid in early identification of families at risk for childhood obesity.
Background:
Parents directly influence children's physical activity and nutrition behaviors and also dictate the physical and social environments that are available to their children. This paper summarizes the development of an easy to use screening tool (The Family Nutrition and Physical Activity (FNPA) Screening Tool) designed to assess family environmental and behavioral factors that may predispose a child to becoming overweight.
Methods:
The FNPA instrument was developed using constructs identified in a comprehensive evidence analysis conducted in collaboration with the American Dietetics Association. Two or three items were created for each of the ten constructs with evidence grades of II or higher. Parents of first grade students from a large urban school district (39 schools) were recruited to complete the FNPA screening tool and provide permission to link results to BMI data obtained from trained nurses in each school. A total of 1085 surveys were completed out of the available sample of 2189 children in the district. Factor analysis was conducted to examine the factor structure of the scale. Mixed model analyses were conducted on the composite FNPA score to determine if patterns in home environments and behaviors matched some of the expected socio-economic (SES) and ethnic patterns in BMI. Correlations among FNPA constructs and other main variables were computed to examine possible associations among the various factors. Finally, logistic regression was used to evaluate the construct validity of the FNPA scale.
Results:
Factor analyses revealed the presence of a single factor and this unidimensional structure was supported by the correlation analyses. The correlations among constructs were consistently positive but the total score had higher correlations with child BMI than the other individual constructs. The FNPA scores followed expected demographic patterns with low income families reporting lower (less favorable) scores than moderate or high income families. Children with a total score in the lowest tertile (high risk family environment and behaviors) had an odds ratio (OR) of 1.7 (95% CI = 1.07 - 2.80) compared to children with a total score in the highest tertile (more favorable family environment and behaviors) but this effect was reduced when parent BMI was included as a covariate.
Conclusion:
The results support the contention that the FNPA tool captures important elements of the family environment and behaviors that relate to risk for child overweight.
