# Archetypes of Family Health Climates for Nutrition and Physical Activity Among Families in Singapore: A Cross-Sectional Study

## TL;DR

The study identifies four distinct family health climate types in Singapore, showing how socioeconomic and family factors influence nutrition and physical activity behaviors.

## Contribution

The novel contribution is the identification of four family health climate archetypes linked to lifestyle behaviors and socioeconomic factors.

## Key findings

- Four family health climate archetypes were identified based on physical activity and nutrition behaviors.
- Socioeconomic and family structure factors influence how families support healthy behaviors.
- Tailored interventions are needed for different family types to promote health.

## Abstract

What are the main findings?
Four family health climate archetypes were identified, reflecting differences in routines, resources and engagement in healthy behavioursSocioeconomic and family structure factors shape how families support physical activity and nutrition

Four family health climate archetypes were identified, reflecting differences in routines, resources and engagement in healthy behaviours

Socioeconomic and family structure factors shape how families support physical activity and nutrition

What are the implications of the main findings?
Interventions should be tailored to the needs and contexts of different family types.Family-based strategies should be supported by the broader community, and policy efforts should support family-based strategies

Interventions should be tailored to the needs and contexts of different family types.

Family-based strategies should be supported by the broader community, and policy efforts should support family-based strategies

Background: Poor lifestyle choices contribute significantly to non-communicable chronic diseases. Given the family’s influence on health behaviours, this study aimed to identify distinct family archetypes based on family health climates for physical activity and nutrition to inform targeted family-based health promotion strategies. Methods: Two hundred family dyads (≥15 years old, cohabiting) in Singapore completed a survey assessing family health climates (physical activity and nutrition), together with individual behaviours, and family lifestyle behaviours. Based on family health climate scores, K-means clustering identified family archetypes. Random Forest analysis determined key contributing constructs to the clusters. Chi-square and ANOVA tests compared socio-demographics, family and individual behaviours, and sleep quality across archetypes. Results: Four family health climate archetypes were identified: Survivors (16%) had poor health climate scores for both physical activity and nutrition, lower socioeconomic status, infrequent family meals, and poorer diet and sleep quality. Nourished Sedentary (16%) had a poor climate for physical activity but a positive climate for nutrition, higher socioeconomic status, frequent family meals, and limited physical activity. Satisficers (41%) had moderate health climates for both, with average socioeconomic status and engagement in healthy behaviours. Flourishers (27%) had positive health climates for both higher socioeconomic status, frequent family meals, healthy food choices, and greater physical activity engagement. Conclusions: The identification of four distinct family health climate archetypes demonstrates that health-related behaviours cluster at the family level rather than solely at the individual level. These findings underscore the importance of targeting family systems in health promotion and support the development of tailored, family-specific strategies.