“It's like Big Mama's house.”: Understanding the importance of extended family networks in addressing childhood obesity among urban African American children

Background: Childhood obesity is a public health problem with significant long-term implications and racial/ethnic disparities. Traditionally, African-American extended family members play a key role in child socialization, and research suggests that grandparents, in general, may influence children's weight-related behaviors. There is, however, a need for additional research exploring how urban African-American children's relationships with extended family members may influence children's weight-related behaviors. The purpose of this study is to explore how extended family members interact with children and how extended family members differ from primary caregivers in the mechanisms they use to socialize children to adopt dietary and physical activity norms. Methods: In-depth, semi-structured interviews were conducted to elicit information regarding general neighborhood and household factors influencing children's dietary and physical activity practices, and familial and cultural norms related to those practices, as well as differences in how primary caregivers and extended family members socialize children to adopt related norms. Findings: The study included 8 family units (child, primary caregiver, and extended family member). The children were 6 to 11 years old, and five of the children were male. With the exception of one family unit, all of the primary caregivers were the biological mothers of the children. The data suggest that: 1) primary caregivers and extended family members differ in their influences on children's weight-related behaviors; 2) the operationalization of family-based collectivism may influence those differences; and 3) the inclusion of extended family networks may improve the effectiveness of obesity interventions for African-American children.