Fostering Healthy Lifestyles: Assessing the Need and Potential Intervention Strategies for Foster Children

According to recent estimates, approximately 423,773 children in the United States are in foster care (US Department of Health and Human Services, 2011). While research has documented that childhood obesity is high in foster children, the relationship between nutrition, physical activity, weight status of foster children and the foster home environment is unclear. Furthermore, there is a gap in the literature on the capacity of the child welfare system to address obesity among this population nor practical intervention strategies.

This dissertation consists of three studies, with the following purposes: 1) assess the current foster care landscape related to the promotion of healthy eating and physical activity through questionnaire based and objective data; 2) examine legislature and training programs that focus on nutrition and physical activity as it relates to foster families; and 3) utilize the Delphi method to begin the development of a potential healthy eating and physical activity intervention for foster care through the recommendation of intervention strategies that could be integrated into the foster care system. These purposes are achieved utilizing a systems-based approach. More specifically, research was conducted through collaboration with several local agencies throughout Virginia. The findings from Study 1 suggest that obesity is prevalent among foster children and foster parents in Virginia and that there are some indications that the foster home environment is related to lifestyle behaviors and weight status, though the relationships were small. Study 2 identified face-to-face trainings targeting foster parents and children (depending on the child's age) as an important and practical method to intervene through regular trainings. Study 3 indicated that there are few federal or local policies that explicitly address physical activity, nutrition, and weight status. A number of recommendations are made for the structure, content, and process of integrating obesity prevention and treatment strategies within the foster care system.