Obesity is now a worldwide epidemic. Currently, more than 40 million children younger than 5 years are overweight and this number is projected to rise to 60 million by 2020.1 Weight status is strongly associated with the development of chronic disease, and the increased morbidity places an incredible burden on society. It is widely accepted that obesity is associated with lifestyle factors of physical activity and eating behaviors. Factors from the broader physical, social, and cultural environments, and within families, influence weight status of children.2 Many of these factors are yet to be identified, and relationships among known factors are complex and not well understood. The National Institutes of Health and the US Department of Agriculture have proposed a research agenda for social and behavioral scientists to "examine how social contexts influence health and elucidate the mechanisms through which those mechanisms operate" and to "develop ways to intervene on those factors for preventing obesity," respectively. A critical step in developing successful interventions to increase physical activity and healthy eating involves understanding how the family and community environments influence weight-regulating behaviors, the detection of barriers and facilitators of these behaviors, and the identification of the best ways to engage families and communities for comprehensive health promotion efforts.3

The articles in this issue of Family & Community Health focus on family and community influences on weight-regulating behaviors and energy balance. These studies are grounded in health behavior theory, involve some type of intervention, and focus on underserved (eg, minority, low-income, rural, immigrant) populations. The article by Arredondo et al presents a church-based pilot study with Latina mother-daughter dyads. They used mixed methods and focused on family communication and physical activity. The article by George et al involves a school-based combined pilot study examining physical health and mental health outcomes. They also used mixed methods and explored parenting style, family support, parent communication associations with fruits and vegetables, physical activity, and weight. Grow et al describe a hospital-YMCA partnership and ongoing intervention development. These authors used mixed methods, motivational interviewing, and the RE-AIM framework to develop and test preliminary intervention ideas and looked at impacts on self-efficacy and quality of life, assessed physical activity via accelerometry, collected several measures of fitness, and looked at changes in waist circumference and weight. Similarly, Weaver et al describe a family medicine-community health center partnership and formative intervention development involving parent-child dyads targeting overweight and obese children through families promoting family healthy food choices, healthy cooking, increasing physical activity, and decreasing sedentary time. Halliday et al used qualitative methods and the participatory ANGELO (Analysis Grid for Elements Linked to Obesity) framework to elicit and prioritize salient diet, activity, and weight-related intervention targets for African immigrant families in Australia. Olson and colleagues used a prospective cohort design to assign pregnant women to 1 of 2 groups on the basis of their exposure to various breast-feeding interventions in their county of residence and examined associations with mother and infant weight. Paek et al present an evaluation of an environmental intervention designed to increase healthy options in low-income, ethnically diverse neighborhood corner stores in Michigan. Their study used social marketing with FIT store logos and branding to promote increased availability of whole grains, lean protein, low-fat dairy, and fruits and vegetables.

The articles in this issue involve small pilot samples and quasi-experimental designs, reflecting their preliminary or formative research nature. These studies may not meet the traditional definition of "evidence based," for example, intervention strategies based on critical review of multiple research and evaluation studies that substantiate intervention efficacy in particular populations and circumstances; however, they do represent useful and important preliminary findings that need a platform for publication. There is something valuable to be learned from each of these studies. The studies in this issue would fall under the definitions of best experiences, best processes, as described by Green and Kreuter,4 or effective, promising, emerging, following the classification system proposed by Brownson et al.5 The "next phase" for the studies presented in this issue will be the evidence base upon which we build future interventions. In the normal progression of the empirical process, accumulated evidence-beginning with formative research that informs efficacy trials-should be translated and widely disseminated into community-based programs, thus increasing the probability of success of population-based obesity prevention and control interventions.

-Joel E. Williams, MPH, PhD, ATC

Issue Editor

Department of Public Health Sciences

Clemson University

Clemson, South Carolina

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