Nutrition and physical activity practices of low-income urban families with young children: Negotiating a balance in resource poor environments

School-based projects targeting nutritional and physical activity (PA) behaviors and environments have demonstrated modest results. Targeting a single, bounded context and seeking linear, simple relations are being recognized as inadequate for explaining and developing interventions for the complex phenomena of children's health. The goal of this research is to gain a broad understanding of how low-income urban families with elementary-age children negotiate and organize their food and PA practices across the levels of home, school, and community. Working with 15 families we collected data through in-depth interviews, informal conversations and home observations, neighborhood walking tours, and photovoice interviews. Data were analyzed through an iterative grounded theory process. Several themes emerged, including: · Families have extensive knowledge about issues related to PA and nutrition and utilize an array of strategies to keep their families healthy; · Translating knowledge into practice is severely constrained by resource poor environments (e.g. inadequate affordable housing, limited access to transportation, few or no neighborhood grocery stores, unsafe streets); · Caregivers' chronic stress prevents them from accessing scarce neighborhood assets; · Schools serve as both sources of support and frustration; · Families often “live on the edge” as they work toward sustaining the health of their families.

Our findings indicate that education programs alone are insufficient. This research moves beyond individual change models and deficit views of families to provide insights into how to build on familial, organizational, and community supports and facilitators to family nutrition and physical activity practices.