Archetypes of Family Health Climates for Nutrition and Physical Activity Among Families in Singapore: A...

Background: Poor lifestyle choices contribute significantly to non-communicable chronic diseases. Given the family's influence on health behaviours, this study aimed to identify distinct family archetypes based on family health climates for physical activity and nutrition to inform targeted family-based health promotion strategies. Methods: Two hundred family dyads (≥15 years old, cohabiting) in Singapore completed a survey assessing family health climates (physical activity and nutrition), together with individual behaviours, and family lifestyle behaviours. Based on family health climate scores, K-means clustering identified family archetypes. Random Forest analysis determined key contributing constructs to the clusters. Chi-square and ANOVA tests compared socio-demographics, family and individual behaviours, and sleep quality across archetypes. Results: Four family health climate archetypes were identified: Survivors (16%) had poor health climate scores for both physical activity and nutrition, lower socioeconomic status, infrequent family meals, and poorer diet and sleep quality. Nourished Sedentary (16%) had a poor climate for physical activity but a positive climate for nutrition, higher socioeconomic status, frequent family meals, and limited physical activity. Satisficers (41%) had moderate health climates for both, with average socioeconomic status and engagement in healthy behaviours. Flourishers (27%) had positive health climates for both higher socioeconomic status, frequent family meals, healthy food choices, and greater physical activity engagement. Conclusions: The identification of four distinct family health climate archetypes demonstrates that health-related behaviours cluster at the family level rather than solely at the individual level. These findings underscore the importance of targeting family systems in health promotion and support the development of tailored, family-specific strategies.