Family health climate scale (FHC-scale): development and validation

Abstract

BackgroundThe family environment is important for explaining individual health behaviour. While previous research mostly focused on influences among family members and dyadic interactions (parent-child), the purpose of this study was to develop a new measure, the Family Health Climate Scale (FHC-Scale), using a family-based approach. The FHC is an attribute of the whole family and describes an aspect of the family environment that is related to health and health behaviour. Specifically, a questionnaire measuring the FHC (a) for nutrition (FHC-NU) and (b) for activity behaviour (FHC-PA) was developed and validated.MethodsIn Study 1 (N = 787) the FHC scales were refined and validated. The sample was randomly divided into two subsamples. With random sample I exploratory factor analyses were conducted and items were selected according to their psychometric quality. In a second step, confirmatory factor analyses were conducted using the random sample II. In Study 2 (N = 210 parental couples) the construct validity was tested by correlating the FHC to self-determined motivation of healthy eating and physical activity as well as the families’ food environment and joint physical activities.ResultsExploratory factor analyses with random sample I (Study 1) revealed a four (FHC-NU) and a three (FHC-PA) factor model. These models were cross-validated with random sample II and demonstrated an acceptable fit [FHC-PA: χ2 = 222.69, df = 74, p < .01; χ2/df = 3.01; CFI = .96; SRMR = .04; RMSEA = .07, CI .06/.08; FHC-NU: χ2 = 278.30, df = 113, p < .01, χ2/df = 2.46, CFI = .96; SRMR = .04; RMSEA = .06, CI .05/.07]. The perception of FHC correlated (p < .01) with the intrinsic motivation of healthy eating (r = .42) and physical activity (r = .56). Moreover, parental perceptions of FHC-NU correlated with household soft drink availability (r = -.31) and perceptions of FHC-PA with the frequency of joint physical activities with the child (r = .51). These patterns were found on the intraindividual and interindividual level.ConclusionsTwo valid instruments measuring the FHC within families were developed. The use of different informants’ ratings demonstrated that the FHC is a family level variable. The results confirm the high relevance of the FHC for individuals’ health behaviour. The FHC and the measurement instruments are useful for examining health-related aspects of the family environment.

Associations Among Work and Family Health Climate, Health Behaviors, Work Schedule, and Body Weight

“…25 This construct, first defined by Niermann et al (2014) encompasses daily health behaviors such as nutrition and physical activity that occur both in and outside the home environment. A positive perception of this climate indicates that these health behaviors are intrinsic in daily motivations and actions.…”

“…A positive perception of this climate indicates that these health behaviors are intrinsic in daily motivations and actions. 25 Studies typically assessing FHC and health behaviors use inclusive psychosocial measures consistent with the concept, such as spouse or family social support for health behaviors, but not as an intuitive measure of health climate that captures relationships, attitudes, and behaviors in the home and family environment. 26–29 …”

Stress: Personal Matter or Family Affair? Intra- And Inter-Individual Relationships Between Stress, Physical Activity, Sedentary Behavior, and Nutrition

“…Including individual and family-level mediators and moderators, such as individual habits and attitudes, and the Family Health Climate (Niermann, Krapf, Renner, Reiner, & Woll, 2014), would be beneficial to further investigate with this new perspective of linking perceived stress with family environment and the health behavior of other family members.…”

“…More insight into the interaction between individuals and their shared environment is important for the development of intervention programs. Above all, interventions that aim to improve the health behavior of children and adolescents should integrate the family, and should aim to improve family-level variables such as the Family Health Climate (Niermann et al, 2014).…”

Study Protocol for the Evaluation of “SuperFIT”, a Multicomponent Nutrition and Physical Activity Intervention Approach for Preschools and Families

“…All parents will be asked to fill out a questionnaire on demographics and other background variables. The parents of children in the family component will be additionally asked to fill out a questionnaire on nutritional and PA-related practices (Preschooler Physical Activity Parenting Practices questionnaire (PPAPP) [65], and Comprehensive Feeding Practices Questionnaire (CFPQ) [66]), family health climate (Family Health Climate Scale [67]), and physical home environment, based on the Environment and Policy Assessment and Observation-Self Report (EPAO_SR) [68]).…”