CHAOS in the home environment and child weight-related outcomes

Gretchen J.R. Buchanan, Allan D. Tate, Katie A. Loth, Amanda C. Trofholz, Jerica M. Berge

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Introduction: Biopsychosocial approaches to health care are critical to addressing childhood obesity. This study aimed to examine how multiple indicators of the home environment related to child weight-related outcomes. We hypothesized that families with home environments of higher chaos and stress, and lower quality parent-child interactions, would have children with a higher body mass index (BMI), less healthy dietary intake, and less healthy eating behaviors. Methods: Data were drawn from the cross-sectional Phase I of the Family Matters study. Participants were 150 racially/ethnically diverse families with a child between 5 to 7 (mean, 6.4) years old. We used a latent profile analysis approach. A 4-class solution fit the data well, and we used predicted class posterior probabilities to assign families to classes. We then regressed the results onto the distal outcomes of child BMI, healthy dietary intake, and healthy eating behaviors. Results: Families were classified as Collaborative-Chill (n = 38), Busy Bees (n = 37), Engaged (n = 61), and Inconsistent-Distant (n = 14). Collaborative-Chill was used as the reference class. Inconsistent-Distant families had children with higher BMI (P < .001) that were more food responsive (P < .001). Busy Bees families had children who were more food responsive (P = .04) and more satiety responsive (P = .02). Engaged families had children who were marginally more food responsive (P = .06). Conclusion: Household chaos, parent stress, and parent-child interactions are important components of the home environment implicated in children’s weight-related outcomes. Health care providers should consider these indicators with child patients who struggle with obesity.

Original languageEnglish (US)
Pages (from-to)1163-1173
Number of pages11
JournalJournal of the American Board of Family Medicine
Issue number4
StatePublished - Nov 2021

Bibliographical note

Funding Information:
Funding: This research was supported by the National Heart, Lung, and Blood Institute (Grant No. R01HL126171 to Primary Investigator: Jerica M. Berge). Additionally, GJRB was supported by the National Institutes of Health’s National Center for Advancing Translational Sciences grants TL1R002493 and UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of

Publisher Copyright:
© 2021 American Board of Family Medicine. All rights reserved.


  • Behavioral sciences
  • Body Mass Index
  • Caregivers
  • Child health
  • Counseling
  • Cross-sectional studies
  • Eating habits
  • Family health
  • Parent-child relations
  • Pediatric obesity
  • Primary health care


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