Family Matters

family matters

Family Matters seeks to identify how familial factors of racially/ethnically and socioeconomically diverse children act as risk or protective factors for predicting childhood obesity.

A two-phased, mixed-methods approach is being used.

  • Phase I includes in-home observation of diverse families. Results from these observations will be used to inform the development of a culturally-appropriate survey for Phase II.
  • The Phase II survey will be administered at two time points to a diverse sample of caregivers of children ages 5 to 7.
  • View theoretical model and timeline.

This comprehensive evaluation of the home environment will identify potential factors that increase childhood obesity risk in order to create culturally-tailored interventions that will be effective in reducing childhood obesity disparities across diverse groups.

Expand all

Study Details


  • 5- to 7-year-old children and their families were recruited from primary care clinics in the Twin Cities
  • For Phase I, home visits were conducted with 150 families (25 per race/ethnicity: African American, American Indian, Latino, Hmong, Somali, and Caucasian)
  • 1,200 families (200 per race/ethnicity) are being recruited for Phase II to complete a longitudinal survey


Phase I

  • Family members played a “Family Matters” game developed by the research study to measure family interactions
  • Parent completed multiple ecological momentary assessment (EMA) mini-surveys for eight days on a study-provided iPad. Surveys asked about parent's stress level, feeding practices, modeling, etc.
  • Parent and child provided eight days of accelerometry (physical activity) data
  • Collected height and weight data on all family members living in the home
  • Home food inventories
  • Three, 24-hour dietary recalls of 5- to 7-year-old target child
  • Parent completed a qualitative interview regarding family meals, physical activity, and weight talk
  • Parent completed a quantitative survey

See our home visit visual for more information about in-home observation activities

Phase II

  • Parents of 5- to 7-year-olds will complete a longitudinal survey at two time points (baseline and 18 months), measuring parent feeding practices, physical activity, child eating behavior, family dynamics, etc.
  • An up-to-date height and weight will be gathered from primary care clinics for the 5- to 7-year-old child
  • Parents will have the option of completing an additional EMA study. Participants will get three mini-surveys per day on their smartphone. Surveys will measure constructs such as parent stress, family meals, picky eating, etc.



Hazzard, V. M., Loth, K. A., Fertig, A. R., Trofholz, A. C., de Brito, J. N., Doering, A. C., & Berge, J. M. (2023). Household food insecurity is associated with greater prevalence and 18-month incidence of a range of disordered eating behaviors in a racially and ethnically diverse sample of parents. Eating Behaviors, 49, 101728.

Buchanan, G. J., Tate, A. D., Barnes, A., Trofholz, A. C., & Berge, J. M. (2023). Potential Points of Intervention to Minimize the Impact of Parents' Adverse Childhood Experiences on Child Mental Health. Journal of Developmental & Behavioral Pediatrics, 44(1), e24-e31.

Daragan, C., Tate, A. D., Trofholz, A. C., & Berge, J. M. (2023). Exploration of parent-reported family meal dinner characteristics to inform a definition of family meals. Appetite, 184, 106480.

Berge, J. M., Tate, A., Trofholz, A., & Kunin-Batson, A. (2023). Intergenerational pathways between parental experiences of adverse childhood experiences (ACEs) and child weight: implications for intervention. The Journal of the American Board of Family Medicine, 36(1), 39-50.


Agarwal, S., Fertig, A. R., Trofholz, A. C., Tate, A. D., Robinson, J., & Berge, J. M. (2022). Exploring the associations between neighbourhood food environment, household food insecurity and child weight-related outcomes in socio-economically and racially/ethnically diverse families. Public Health Nutrition, 25(12), 3538-3547.

Berge, J. M., Trofholz, A., Jacobs, N., & Tate, A. (2022). A Mixed-Methods Description of the Home Physical Activity Environments of Racially/Ethnically Diverse and Immigrant/Refugee Children. Global Pediatric Health, 9, 2333794X221133020.

Fertig, A. R., de Brito, J. N., Trofholz, A. C., & Berge, J. M. (2022). Maternal employment and child weight-related health. Social Science & Medicine, 310, 115303.

Trofholz, A. C., Tate, A., Telke, S., Loth, K. A., Buchanan, G. J., & Berge, J. M. (2022). Associations Between Weight Talk and Biopsychosocial Outcomes in Children from Racially/Ethnically Diverse Households. Journal of Child and Family Studies, 1-13.

Prokosch, C., Fertig, A. R., Ojebuoboh, A. R., Trofholz, A. C., Baird, M., Young, M., ... & Berge, J. M. (2022). Exploring associations between social determinants of health and mental health outcomes in families from socioeconomically and racially and ethnically diverse households. Preventive Medicine, 107150.

de Brito, J. N., Loth, K. A., Fertig, A., Trofholz, A. C., Tate, A., & Berge, J. M. (2022). Participant characteristics and dietary correlates of SNAP and other assistance programs among families with children from racially and ethnically diverse households. Appetite, 174, 106015.

Othman, S. I., Fertig, A., Trofholz, A., & Berge, J. M. (2022). How time in the US and race/ethnicity shape food parenting practices and child diet quality. Appetite, 171, 105870.


Trofholz, A., Tate, A., Janowiec, M., Fertig, A., Loth, K., de Brito, J. N., & Berge, J. (2021). Ecological Momentary Assessment of Weight-Related Behaviors in the Home Environment of Children From Low-Income and Racially and Ethnically Diverse Households: Development and Usability Study. JMIR Research Protocols, 10(12), e30525.

Buchanan, G. J., Tate, A. D., Loth, K. A., Trofholz, A. C., & Berge, J.M. (2021). CHAOS in the home environment and child weight-related outcomes. The Journal of the American Board of Family Medicine, 34(6), 1163-1173.

Fertig, A. R., Trofholz, A. C., Loth, K., Tate, A. D., Miner, M., Neumark-Sztainer, D., ... & Berge, J. M. (2021). Kitchen Adequacy and Child Diet Quality in a Racially/Ethnically Diverse Sample. Ecology of Food and Nutrition, 1-9.

Berge, J. M., Cheatom, O., Fertig, A. R., Tate, A., Trofholz, A., Brito, J. N., & Shippee, N. (2021). Examining the Relationship Between Parental Stress and Girls’ and Boys’ Physical Activity Among Racially/Ethnically Diverse and Immigrant/Refugee Populations. Pediatric Exercise Science, 1(aop), 1-6.

Loth, K. A., Mohamed, N., Trofholz, A., Tate, A., & Berge, J. M. (2021). Associations between parental perception of-and concern about-child weight and use of specific food-related parenting practices. Appetite, 160, 105068.


Tate, A., Telke, S., Trofholz, A., Miner, M., & Berge, J. M. (2020). Stressed Out! Examining family meal decisions in response to daily stressors via ecological momentary assessment in a racially/ethnically diverse population. Preventive medicine reports, 20, 101251

Berge, J. M., Trofholz, A., Danner, C., Brandenburg, D., Pusalavidyasagar, S., & Loth, K. (2020). Weight-and health-focused conversations in racially/ethnically diverse households with and without a child with overweight/obesity. Stigma and Health.

Trofholz, A. C., Tate, A., Keithahn, H., de Brito, J. N., Loth, K., Fertig, A., & Berge, J. M. (2020). Family meal characteristics in racially/ethnically diverse and immigrant/refugee households by household food security status: A mixed methods study. Appetite, 157, 105000.

Berge, J. M., Mountain, S., Telke, S., Trofholz, A., Lingras, K., Dwivedi, R., & Zak-Hunter, L. (2020). Stressful life events and associations with child and family emotional and behavioral well-being in diverse immigrant and refugee populations. Families, Systems, & Health.

Loth, K. A., Fertig, A., Trofholz, A., Harnack, L., Crosby, R., Neumark-Sztainer, D., & Berge, J. M. (2020). Concordance of children’s intake of selected food groups as reported by parents via 24-h dietary recall and ecological momentary assessment. Public health nutrition, 1-12.

Berge, J. M., Fertig, A. R., Trofholz, A., Neumark-Sztainer, D., Rogers, E., & Loth, K. (2020). Associations between parental stress, parent feeding practices, and child eating behaviors within the context of food insecurity. Preventive medicine reports, 19.

Wirthlin, R., Linde, J. A., Trofholz, A., Tate, A., Loth, K., & Berge, J. M. (2020). Associations between parent and child physical activity and eating behaviours in a diverse sample: an ecological momentary assessment study. Public health nutrition, 1-9.

Trofholz, A., Richardson, K., Mohamed, N., Vang, C., & Berge, J. M. (2020). How a Racially/Ethnically Diverse and Immigrant Sample Qualitatively Describes the Role of Traditional and Non-traditional Foods in Feeding Their Children. Journal of Immigrant and Minority Health, 1-8.

de Brito, J. N., Loth, K. A., Tate, A., & Berge, J.M. (2020). Associations Between Parent Self-Reported and Accelerometer-Measured Physical Activity and Sedentary Time in Children: Ecological Momentary Assessment Study. JMIR mHealth and uHealth, 8(5), e15458.

Loth, K. A., Tate, A. D., Trofholz, A., Fisher, J. O., Miller, L., Neumark-Sztainer, D., & Berge, J. M. (2020). Ecological momentary assessment of the snacking environments of children from racially/ethnically diverse households. Appetite, 145, 104497.


Loth, K. A., Tate, A., Trofholz, A., Fisher, J. O., Neumark-Sztainer, D., & Berge, J. M. (2019). The Contribution of Snacking to Overall Diet Intake among an Ethnically and Racially Diverse Population of Boys and Girls. Journal of the Academy of Nutrition and Dietetics. 

Berge, J. M., Beebe, M., Smith, M. C. M., Tate, A., Trofholz, A., & Loth, K. (2019). Ecological Momentary Assessment of the Breakfast, Lunch, and Dinner Family Meal Environment in Racially/Ethnically Diverse and Immigrant Households. Journal of nutrition education and behavior.

Berge, J. M., Telke, S., Tate, A., & Trofholz, A. (2019). Utilizing a Board Game to Measure Family/Parenting Factors and Childhood Obesity Risk. Journal of nutrition education and behavior.

Fertig, A. R., Loth, K. A., Trofholz, A. C., Tate, A. D., Miner, M., Neumark-Sztainer, D., & Berge, J. M. (2019). Compared to Pre-prepared Meals, Fully and Partly Home-Cooked Meals in Diverse Families with Young Children Are More Likely to Include Nutritious Ingredients. Journal of the Academy of Nutrition and Dietetics.

Jennings, K. M., Loth, K. A., Tate, A. D., Miner, M. H., & Berge, J. M. (2019). Application of latent profile analysis to define subgroups of parenting styles and food parenting practices. Appetite.

Trofholz, A. C., Tate, A., Loth, K., Neumark-Sztainer, D., & Berge, J. M. (2019). Watching Television while Eating: Associations with Dietary Intake and Weight Status among a Diverse Sample of Young Children. Journal of the Academy of Nutrition and Dietetics.

Trofholz, A. C., Telke, S., Loth, K., Tate, A., & Berge, J. M. (2019). Examining Predictors of Watching Television During Family Meals in a Diverse Sample. Journal of nutrition education and behavior, 51(9), 1113-1120.


Berge, J. M., Fertig, A., Tate, A., Trofholz, A., & Neumark-Sztainer, D. (2018). Who is meeting the Healthy People 2020 objectives?: Comparisons between racially/ethnically diverse and immigrant children and adults. Families, systems & health: the journal of collaborative family healthcare36(4), 451-470.

Berge, J. M., Tate, A., Trofholz, A., Fertig, A., Crow, S., Neumark-Sztainer, D., & Miner, M. (2018). Examining within-and across-day relationships between transient and chronic stress and parent food-related parenting practices in a racially/ethnically diverse and immigrant population. International Journal of Behavioral Nutrition and Physical Activity15(1), 7.

Berge, J. M., Tate, A., Trofholz, A., Loth, K., Miner, M., Crow, S., & Neumark-Sztainer, D. (2018). Examining variability in parent feeding practices within a low-income, racially/ethnically diverse, and immigrant population using ecological momentary assessment. Appetite127, 110-118.

Trofholz, A. C., Thao, M. S., Donley, M., Smith, M., Isaac, H., & Berge, J. M. (2018). Family meals then and now: A qualitative investigation of intergenerational transmission of family meal practices in a racially/ethnically diverse and immigrant population. Appetite121, 163-172.

Trofholz, A., Tate, A., Fulkerson, J. A., Hearst, M. O., Neumark-Sztainer, D., & Berge, J. M. (2018). Description of the home food environment in Black, White, Hmong, Latino, Native American and Somali homes with 5–7-year-old children. Public health nutrition, 1-12.


Berge, J. M., Tate, A., Trofholz, A., Fertig, A. R., Miner, M., Crow, S., & Neumark-Sztainer, D. (2017). Momentary Parental Stress and Food-Related Parenting Practices. Pediatrics140(6), e20172295.

Berge, J. M., Trofholz, A., Tate, A. D., Beebe, M., Fertig, A., Miner, M. H., ... & Neumark-Sztainer, D. (2017). Examining unanswered questions about the home environment and childhood obesity disparities using an incremental, mixed-methods, longitudinal study design: The Family Matters study. Contemporary Clinical Trials62, 61-76.


Ochoa, A., & Berge, J. M. (2016). Home Environmental Influences on Childhood Obesity in the Latino Population: A Decade Review of Literature. Journal of Immigrant and Minority Health, 1-18.


Study team