Family Engagement

sp-familyFamily engagement refers to the active collaboration and commitment between families and their ECE providers.  Rather than being a distinct mechanism for pursuing obesity prevention strategies, it is a critical component for implementation of policy and practice changes made through the other opportunities. It is represented on the spectrum as if it were a distinct opportunity to ensure that it is given special consideration.

Families are essential partners when it comes to promoting the health of children. They have a great deal of influence over the food and physical activity choices available to children and are primary role models for children’s behavior—especially for children younger than 5 years of age. As children increase in age, family involvement in ECE often decreases.1 Thus, it is especially important for providers to engage families of young children early and maintain relationships with them as they get older. Strong family engagement will help ensure successfully implementation of policy and practice changes to promote obesity prevention in ECE pursued through the spectrum of opportunities and can produce ripple effects with respect to improving home environments and families’ behaviors.
Engaging families to support successful implementation of improved policies and practices in ECE facilities should include a forum through which parents and other caregivers can freely and constructively express to ECE providers support for improvements and dissatisfaction with unhealthy food and beverage options, inadequate support for breastfeeding, and limited physical activity and offer ideas for improvements may help spark change in ECE providers. Researchers in North Carolina surveyed more than 500 parents of children attending ECE centers and found that most parents trusted their providers to serve healthy foods and engage their children in physical activity.2 Parents were hesitant to criticize their providers, but when prompted, they had creative suggestions for improving the quality of foods and opportunities for physical activity in their children’s centers. Families may also serve on boards or volunteer councils to offer assistance in health promotion in ECE settings.

ECE providers can help nudge families to adopt healthier practices and make environment changes in the home to support those practices by providing timely and consistent health education messages that are offered with practical suggestions that can be implemented easily in the home.3 There are many opportunities for such communication: during orientation, during teacher conferences, at children’s programs, and even when interacting around the drop-off and pick-up of children. Providers can also host special family events that center around healthy meal planning and preparation and physically active games. Additionally, providers can use innovative technological approaches through an electronic distribution system such as a family email or facility newsletter. These messages may be as simple as reminding families to provide coats and an extra set of clothes for children for cold or rainy outdoor play. Other messages may focus on changing behavior within the home, such as tips for introducing new fruits or vegetables at home or cooking quick and easy healthy meals.

Free, off-the-shelf materials are available for ECE providers to use for family engagement activities. For example, USDA offers Nibbles for Health, a resource for ECE providers and the families they serve, that focuses on nutrition for young children. Nibbles for Health includes posters and newsletters containing user-friendly, practical tips to promote healthy eating and active living. Materials are available on a CD or can be downloaded from the website. Additional family engagement resources are available at the Let’s Move! Child Care initiative website.

State Example: Missouri

Parents as Teachers is an approved home visiting model meeting the evidence-based criteria of the Maternal, Infant, Early Childhood Home Visiting (MIECHV) program. Certified parent educators implement the Parent as Teachers model emphasizing parent-child interaction, development-centered parenting, and family well-being in their work with families. The program builds resilience, social connections, and access to and use of services as well as supports social-emotional development in families and children. Parents as Teachers exists in every state, and the model is implemented through a variety of mechanisms. The federal funding for the MIECHV program within the Affordable Care Act currently supports 26 state departments of public health/maternal child health to include Parents as Teachers as part of their statewide home visitation program. States may use community health centers, Head Start programs, clinics, or a centralized intake system through MIECHV funding instead of using school districts to house home visitation services.

In Missouri (MO), the department of education funds a majority of the Parents as Teachers affiliates. Parents as Teachers was initiated as a pilot project in 1981 to demonstrate the value of high-quality parent education and family support to strengthen the skills parents need to enhance their children’s development from birth to age 3. A study of MO children4 showed that children’s participation in Parents as Teachers predicted their school readiness and third grade achievement, regardless of income level. Among low-income children who participated with high intensity in both Parents as Teachers and ECE, 82% entered kindergarten ready to learn, as compared with 64% of low-income children who had no involvement in either service.

How It Came About

Under the Early Childhood Development Act of 1984, parents’ education and family support beginning at birth became a mandatory service for all MO school districts. The governor, commissioner of education, and a state senator were key facilitators in the legislative process. A potential barrier to passage of the act was the perception by some lawmakers that the program was government interference. The Parent as Teachers model was selected as the approach to use to meet the state mandate. The Parents as Teachers National Center is located in MO and provides training and technical assistance to states throughout the country. The Center assisted the MO Department of Elementary and Secondary Education in implementing the statewide program.


In MO, the state funds the school district to train parent educators and to implement the model services. One to 40 parent educators are located in each school district to work with families with children from birth to 5 years of age and beginning during the prenatal period. Implementing the model with fidelity includes service delivery of four components:

  • Home visits—Parent educators meet with a family at least monthly during a home or personal visit, with higher frequency for families at risk, to implement a curriculum that educates on parenting skills;
  • Screening—Children are screened annually for health, hearing, vision and developmental delays;
  • Group connections—At least one monthly group connection is held to help build social connections for families; and
  • Resource networking—Parent educators partner with families by directly connecting families to services in the community.

Lessons Learned

  • Funding is critical to the success of this program as a statewide initiative.  School district budgets are tight, and the amount of state reimbursement for a visit is less than the district pays, which can be a disincentive to providing services to families. Sometimes, states and localities adapt the model based on their available funding and do not provide the complete evidence-based model. States need to be able to fund the evidenced-based model for a minimum of 2 years to meet 14 criteria for implementation found at the Parents as Teachers website to be called an affiliate.
  • States need to keep up-to-date with trends in services to families with young children, including quality and costs of services. States must see themselves as partners with implementers who keep up with research and the status of communities served to ensure the safety and well-being of children.



  1. Fox MK, Condon E, Briefel RR, Reidy KC, Deming DM. Food consumption patterns of young preschoolers: are they starting off on the right path? J Am Diet Assoc 2010;110(12 Suppl 1):S52-9.
  2. Pfannenstiehl J, Zigler E. The Parents as Teachers program: its impact on school readiness and later school achievement: a research summary. St. Louis, MO: Parents as Teachers National Center; April 2007. Available from
  3. Benjamin SE, Haines J, Ball SC, Ward DS. Improving nutrition and physical activity in child care: what parents recommend. J Am Diet Assoc 2008;108(11):1907-11.
  4. Souto-Manning M, Swick KJ.  Teachers’ beliefs about parent and family involvement: rethinking our family involvement paradigm. Early Childhood Educ J 2006;34(2):187-93.