Researchers in China tested whether a special program could help families support their children in developing healthier eating and exercise habits. They worked with 396 elementary school students over one school year, comparing a group that received the program with a group that didn’t. The results showed that when families—including parents and grandparents—became more involved and supportive, children naturally started eating better and spending less time on screens. This suggests that programs focused on getting the whole family involved might be more effective at fighting childhood obesity than programs that only target kids.

The Quick Take

  • What they studied: Whether a family-focused program could help kids develop healthier eating habits and more physical activity, and whether family support was the key reason the program worked
  • Who participated: 396 elementary school students (ages approximately 6-12) from eight schools in Changzhi City, China. Half received the special intervention program while the other half continued with their normal routine.
  • Key finding: Children whose families received the intervention program had significantly higher family support (2.5 times more likely to have strong family support). This increased family support was directly connected to improvements in what kids ate and how much screen time they used.
  • What it means for you: If you’re a parent or grandparent trying to help a child develop healthier habits, being actively involved and supportive appears to be one of the most important factors. Programs that teach the whole family together may work better than programs that only focus on the child.

The Research Details

This was a cluster-randomized controlled trial, which is one of the strongest types of research studies. Researchers randomly assigned eight elementary schools to either receive a comprehensive intervention program or continue with their normal activities. The intervention group received a special program designed to help families support children’s healthy eating and physical activity over the course of one school year (2018-2019).

The researchers collected information from children and families using questionnaires about eating habits, physical activity levels, and how much support family members provided. They used advanced statistical methods to analyze the data and understand not just whether the program worked, but also how it worked—specifically, whether increased family support was the reason children’s behaviors improved.

This design is particularly strong because it randomly assigned schools rather than individual children, which helps prevent bias and makes the results more reliable.

Understanding how a program actually works is just as important as knowing whether it works. By examining family support as a ‘mediator,’ researchers could identify the specific mechanism—the family involvement—that led to better outcomes. This helps future programs focus on what actually matters and makes them more effective.

This study has several strengths: it used random assignment (reducing bias), included a control group for comparison, involved a reasonable number of participants (396 students), and was published in a peer-reviewed journal (PLOS ONE). The study was conducted over a full academic year, allowing time to see real changes. However, the study was conducted in China, so results may vary in different cultures and settings. The study also relied on questionnaires, which depend on people accurately reporting their own behaviors.

What the Results Show

After one school year, children in the intervention group had families that were significantly more supportive of healthy behaviors. Overall, the intervention group was 2.5 times more likely to have high family support compared to the control group. This increase came from all family members: fathers were about 1.9 times more supportive, mothers were about 3.6 times more supportive, and grandmothers were about 1.3 times more supportive.

Most importantly, the increased family support directly led to improvements in children’s eating habits and reduced screen time. The analysis showed that family support was a ‘partial mediator,’ meaning it explained some (but not all) of why the intervention worked. In other words, when families became more involved and supportive, children naturally made healthier choices about food and screen time.

The fact that mothers showed the largest increase in support (3.6 times) suggests that mothers may play a particularly important role in supporting children’s healthy behaviors, though all family members contributed to the positive changes.

The study found that different family members contributed to the improvements in different ways. Mothers showed the strongest increase in supportive behaviors, followed by fathers and then grandmothers. This suggests that comprehensive family programs should engage all household members, not just parents. The findings also indicate that family support was particularly effective at changing eating behaviors and screen time habits, which are two of the most important factors in childhood weight management.

This research builds on existing knowledge that family involvement is crucial for children’s health. Previous studies have shown that family support matters, but this study goes further by showing exactly how family support works—as the mechanism that connects an intervention program to actual behavior changes in children. The findings align with other research suggesting that obesity prevention programs are more effective when they involve the whole family rather than focusing only on the child.

The study was conducted in one city in China, so the results may not apply to all cultures or countries with different family structures and values. The study relied on self-reported information from questionnaires, which means people might not always accurately remember or report their behaviors. The study only lasted one school year, so we don’t know if the benefits continue over longer periods. Additionally, the study measured family support as a ‘partial mediator,’ meaning other factors beyond family support also contributed to the improvements, though the study didn’t identify what those other factors were.

The Bottom Line

If you’re working to help children develop healthier eating and exercise habits, actively involve the entire family in the process. This means parents, grandparents, and other caregivers should all understand the goals and work together to support the child. Programs that teach families together appear to be more effective than programs that only target children. Confidence level: Moderate to High (based on a well-designed study, though conducted in a specific geographic and cultural setting).

Parents, grandparents, teachers, school administrators, and public health professionals working on childhood obesity prevention should pay attention to these findings. This is particularly relevant for families with children who are overweight or at risk of becoming overweight. Healthcare providers recommending lifestyle changes to families should consider emphasizing the importance of whole-family involvement. These findings may be most applicable to families in similar cultural settings, though the general principle of family involvement likely applies broadly.

Based on this study, meaningful changes in children’s eating habits and screen time can be observed within one school year (approximately 9-10 months) when family support is actively increased. However, maintaining these changes likely requires ongoing family involvement and support over the long term.

Want to Apply This Research?

  • Track weekly ‘family support moments’—count how many times each family member (parent, grandparent, etc.) actively encourages or participates in healthy eating or physical activity with the child. Aim for at least 3-5 supportive interactions per family member per week.
  • Use the app to set up family challenges where multiple household members commit to one healthy behavior together (like a 20-minute family walk or trying a new healthy recipe). Have family members check in on the app to show they participated, creating accountability and visible support.
  • Create a monthly family support score in the app that tracks engagement from different family members. Monitor changes in the child’s eating habits and screen time monthly, and correlate these with increases in family support scores to show users the connection between family involvement and behavior change.

This research suggests that family involvement may help children develop healthier eating and exercise habits, but it should not replace professional medical advice. If you have concerns about a child’s weight or health, consult with a pediatrician or healthcare provider. This study was conducted in China and results may vary in different populations and settings. Individual results will vary based on many factors including genetics, overall health, and consistency of effort. Always consult with healthcare professionals before making significant changes to a child’s diet or exercise routine.