A mixed methods analysis of environmental and household chaos: considerations for early-childhood obesity research

Abstract

Background Chaos has implications for child health that may extend to childhood obesity. Yet, results from studies describing associations between chaos and childhood obesity are mixed. New approaches to studying the environments of young children may help to clarify chaos-obesity relationships. Methods We conducted a concurrent mixed methods analysis of quantitative and qualitative data describing home and neighborhood chaos among a diverse cohort of 283 caregiver-toddlers dyads from Ohio. We examined the underlying structure of environmental and household chaos using exploratory factor analysis then sought to validate the structure using qualitative field notes. We generated total scores for factors of chaos and described their distributions overall and according to cohort characteristics. Additionally, we conducted a thematic content analysis of brief ethnographies to provide preliminary construct validity for our indicators of chaos. Results Dyads varied according to household composition, income, education, and race/ethnicity. We found evidence for a multi-factor structure for chaos, which included disorganization and neighborhood noise. Household disorganization scores ranged from 0 to 7.3 and were on average 2.1 (SD = 1.8). Neighborhood noise scores ranged from 0 to 4 and were on average 1.1 (SD = 1.1). Both disorganization and neighborhood noise were associated with indicators of socioeconomic disadvantage, such as lower educational attainment and household income. Qualitative data from households with high and low scores on the two identified factors were aligned in ways that were supportive of construct validity and further contextualized the social and material environments in which chaos occurred. Conclusions Chaos represents a complex construct with implications spanning various disciplines, including childhood obesity research. Previous studies suggest challenges associated with measuring chaos may limit the conclusions that can be drawn about which aspect of chaos (if any) matter most of early childhood weight development. We advance the literature by demonstrating chaos may be comprised of conceptually distinct subdomains. Future childhood obesity prevention research may benefit from more contemporary measure of chaos, such as those relying on direct observations that account for a multifaceted underlying structure.

Adolescents’ reports of chaos within the family home environment: Investigating associations with lifestyle behaviours and obesity

“…Still, it is unclear as to whether the CHAOS questionnaire is robust enough to measure household chaos from an adolescent’s perspective. Additionally, the CHAOS tool focuses mainly on the disorganization dimension of this construct and less so on the instability dimension [ 15 , 17 ]. Some authors, based on the need to better capture the chaos construct and its subdomains, have argued in favor of using a more comprehensive household chaos measurement approach, notably to better capture the instability dimension [ 15 ], to include measurements of specific family routines [ 8 ], and to rely on systematic observations (e.g., direct observations and home tours) [ 15 , 17 ].…”

“…Additionally, the CHAOS tool focuses mainly on the disorganization dimension of this construct and less so on the instability dimension [ 15 , 17 ]. Some authors, based on the need to better capture the chaos construct and its subdomains, have argued in favor of using a more comprehensive household chaos measurement approach, notably to better capture the instability dimension [ 15 ], to include measurements of specific family routines [ 8 ], and to rely on systematic observations (e.g., direct observations and home tours) [ 15 , 17 ]. Studies where specific family routines are assessed (e.g., sleep and meal-time routines and screen time limits) as indicators of household organisation, have reported a statistically significant associations with child overweight [ 8 ].…”

“…Household chaos is a complex construct of the family home environment encompassing two main dimensions, namely instability and turbulence (i.e., recurrent changes in residential location or family composition, lack of family routines), as well as disorganization (i.e., high levels of background noise, crowding, clutter, and a lack of structure) [ 14 – 17 ]. A growing body of research has documented the role of household chaos on obesity-related lifestyle behaviours among children.…”

“…Despite the compelling evidence exposing a relation between chaotic family home environments and less healthy lifestyle behaviours, household chaos has been inconsistently associated with childhood overweight/obesity [ 17 , 25 ]. Although some studies report direct effects of household chaos on child weight status [ 26 ], others report indirect effects [ 27 ] or no effects [ 28 , 29 ].…”