Family-based physical activity interventions

Evidence Rating  
Evidence rating: Some Evidence

Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.

Health Factors  
Date last updated

Family-based physical activity interventions attempt to change behaviors using techniques that increase family members’ support for positive changes. Interventions typically include educational sessions on health, goal-setting, problem-solving, or family behavioral management, along with reinforcement techniques (e.g., reward charts or role modeling) and physical activities. Family-based interventions may also include information about lifestyle changes such as increased healthy eating or reduced screen time1.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Increased physical activity

Potential Benefits

Our evidence rating is not based on these outcomes, but these benefits may also be possible:

  • Improved weight status

  • Improved family functioning

  • Increased parent engagement

What does the research say about effectiveness?

There is some evidence that family-based physical activity interventions modestly increase physical activity among children, especially children age 5 to 121, 2. Additional evidence is needed to confirm effects and determine which intervention components are most effective.

Some studies suggest that family and parent support can positively influence children’s weight status as part of a multi-component intervention3, 4, 5, 6, 7. A number of other studies find inconclusive effects on weight status, in some cases, due to short follow-up times8, 9, 10. Overall, studies that directly measure physical activity changes following family-based interventions (e.g., via accelerometers, pedometers, or direct observation) show slightly greater increases in physical activity than studies that use self-reported data1.

Family-based physical activity interventions may improve family functioning and parent engagement1. A Minnesota-based study suggests small but significant associations between family functioning and weight-related behaviors11. Parenting styles may also influence eating behaviors and physical activity levels12.

The most successful interventions include culturally sensitive education, parent motivation components, and efforts to accommodate time constraints such as work and school responsibilities. Interventions that combine goal-setting and reinforcement techniques can increase motivation and physical activity1. Programs that encourage other family members to change behaviors or lose weight may more effectively help overweight children lose weight than programs that assign family members a strictly supporting role13.

How could this strategy impact health disparities? This strategy is rated no impact on disparities likely.
Implementation Examples

Family-based physical activity interventions are implemented throughout the country. Programs can be implemented as independent single component programs, or combined to compliment other interventions. Examples include CARDIAC Kinder14.

Implementation Resources

OWH-Bodyworks - Office of Women's Health (OWH). Bodyworks: A toolkit for healthy girls & strong women. Washington, D.C.: Office of Women's Health (OWH), U.S. Department of Health and Human Services (U.S. DHHS); 2009.

Active Bodies, Active Minds - Washington Active Bodies Active Minds. Screen-time reduction information and resources for people who care for preschool-aged children.


* Journal subscription may be required for access.

1 CG-Physical activity - The Guide to Community Preventive Services (The Community Guide). Physical activity.

2 Cochrane-Waters 2011 - Waters E, de Silva-Sanigorski A, Burford BJ, et al. Interventions for preventing obesity in children. Cochrane Database of Systematic Reviews. 2011;(12):CD001871.

3 Campbell 2007 - Campbell KJ, Hesketh KD. Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years: A systematic review of the literature. Obesity. 2007;8(4):327-38.

4 Katz 2008 - Katz D, O’Connell M, Njike V, Yeh M-C, Nawaz H. Strategies for the prevention and control of obesity in the school setting: Systematic review and meta-analysis. International Journal of Obesity. 2008;32(12):1780-9.

5 Nixon 2012 - Nixon CA, Moore HJ, Douthwaite W, et al. Identifying effective behavioural models and behaviour change strategies underpinning preschool- and school-based obesity prevention interventions aimed at 4-6-year-olds: A systematic review. Obesity Reviews. 2012;13(Suppl 1):106-17.

6 Kitzman-Ulrich 2010 - Kitzman-Ulrich H, Wilson DK, St. George SM, et al. The integration of a family systems approach for understanding youth obesity, physical activity, and dietary programs. Clinical Child and Family Psychology Review. 2010;13(3):231–53.

7 Niemeier 2012 - Niemeier BS, Hektner JM, Enger KB. Parent participation in weight-related health interventions for children and adolescents: A systematic review and meta-analysis. Preventive Medicine. 2012;55(1):3–13.

8 OConnor 2009 - O’Connor TM, Jago R, Baranowski T. Engaging parents to increase youth physical activity: A systematic review. American Journal of Preventive Medicine. 2009;37(2):141-9.

9 van Sluijs 2011 - van Sluijs EMF, Kriemler S, McMinn AM. The effect of community and family interventions on young people’s physical activity levels: A review of reviews and updated systematic review. British Journal of Sports Medicine. 2011;45(11):914-22.

10 Knowlden 2012 - Knowlden AP, Sharma M. Systematic review of family and home-based interventions targeting paediatric overweight and obesity. Obesity Reviews. 2012;13(6):499-508.

11 Berge 2013 - Berge JM, Wall M, Larson N, Loth KA, Neumark-Sztainer D. Family functioning: Associations with weight status, eating behaviors, and physical activity in adolescents. Journal of Adolescent Health. 2013;52(3):351–7.

12 Sleddens 2011 - Sleddens EFC, Gerards SMP, Thijs C, de Vries NK, Kremers SPJ. General parenting, childhood overweight and obesity-inducing behaviors: A review. International Journal of Pediatric Obesity. 2011;6(2Part2):e12–27.

13 Barr-Anderson 2013 - Barr-Anderson DJ, Adams-Wynn AW, DiSantis KI, Kumanyika S. Family-focused physical activity, diet and obesity interventions in African-American girls: A systematic review. Obesity Reviews. 2013;14(1):29–51.

14 RTIPs-CARDIAC Kinder - Research-Tested Intervention Programs (RTIPs). CARDIAC kinder.