Abstract
BackgroundThe development of healthy food portion sizes among families is deemed critical to childhood weight management; yet little is known about the interacting factors influencing parents’ portion control behaviours. This study aimed to use two synergistic theoretical models of behaviour: the COM-B model (Capability, Opportunity, Motivation – Behaviour) and Theoretical Domains Framework (TDF) to identify a broad spectrum of theoretically derived influences on parents’ portion control behaviours including examination of affective and habitual influences often excluded from prevailing theories of behaviour change.MethodsSix focus groups exploring family weight management comprised of one with caseworkers (n = 4), four with parents of overweight children (n = 14) and one with parents of healthy weight children (n = 8). A thematic analysis was performed across the dataset where the TDF/COM-B were used as coding frameworks.ResultsTo achieve the target behaviour, the behavioural analysis revealed the need for eliciting change in all three COM-B domains and nine associated TDF domains. Findings suggest parents’ internal processes such as their emotional responses, habits and beliefs, along with social influences from partners and grandparents, and environmental influences relating to items such as household objects, interact to influence portion size behaviours within the home environment.ConclusionThis is the first study underpinned by COM-B/TDF frameworks applied to childhood weight management and provides new targets for intervention development and the opportunity for future research to explore the mediating and moderating effects of these variables on one another.
Highlights
The development of healthy food portion sizes among families is deemed critical to childhood weight management; yet little is known about the interacting factors influencing parents’ portion control behaviours
Theory is helpful in understanding behaviours as a first step in intervention development [7] and there are Curtis et al BMC Public Health (2017) 17:716 a number of theoretical frameworks that can be applied to childhood weight management
These theoretical shortcomings have led to a response for the need for an overarching holistic theoretical framework where experts in areas of health psychology, theory and health services have identified 128 initial theoretical constructs drawn from 33 psychological theories [13]
Summary
The development of healthy food portion sizes among families is deemed critical to childhood weight management; yet little is known about the interacting factors influencing parents’ portion control behaviours. Parents exert strong influences on children’s weight status through an array of mediators including: availability of Theory is helpful in understanding behaviours as a first step in intervention development [7] and there are Curtis et al BMC Public Health (2017) 17:716 a number of theoretical frameworks that can be applied to childhood weight management. Prevailing health behaviour change theories in Health Psychology comprise social cognitive theories which rely heavily on individual reflective cognitive processes and largely ignore automatic processes comprising of emotional variables, impulses, habits, associative learning and self-control [9] They primarily focus on intra-individual factors as opposed to wider social and environmental factors [10], they can only weakly address the parent-child dyad and the environmental system processes where interactions among family members impact on parents’ behaviours [5]. The TDF is designed to be ‘an inclusive, rather than selective, approach to exploratory research in the field of implementation’ [14]
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