Effect of an Occupation-Focused Family Intervention on Change in Parents’ Time Use and Children’s Body Mass Index Kristina Orban, Lena-Karin Erlandsson, Anna-Karin Edberg, Jenny O ¨ nnerfa ¨lt, Kristina Thorngren-Jerneck MeSH TERMS  body mass index  family health  health promotion  life style  pediatric obesity Kristina Orban, PhD, Reg OT, is Assistant Professor, Department of Health Sciences, Faculty of Medicine, Lund University, PO Box 157, S-221 00 Lund, Sweden; kristina. orban@med.lu.se Lena-Karin Erlandsson, PhD, Reg OT, is Associate Professor, Department of Health Sciences, Lund University, Lund, Sweden. Anna-Karin Edberg, PhD, RN, is Professor, School of Health and Society, Kristianstad University, Kristianstad, Sweden. Jenny O ¨ nnerfa ¨lt, MD, is Doctoral Student, Department of Pediatrics, Clinical Sciences, Lund University, and Va ˚rdalinstitutet, Swedish Institute for Health Sciences, Lund, Sweden. Kristina Thorngren-Jerneck, MD, PhD, is Chief Physician, Department of Pediatrics, Clinical Sciences, Lund University, Lund, Sweden . OBJECTIVE. This study explored factors related to changes in the time parents spent with their children with obesity and associated decreases in children’s body mass index (BMI) z-scores after an occupation-focused intervention. METHOD. Parents participated in a 1-yr occupation-focused intervention to promote healthy family life- styles. Data on 40 parents of 22 children with obesity ages 4–6 yr were collected before and after intervention and analyzed using linear and multiple regression methods. RESULTS. Parents increased time spent with their children by an average of 91 min/day. Parents’ finances, perceived satisfaction in daily occupations, low BMI, and mastery at inclusion were associated with increased time spent with their children. Mothers’ subjective health and high mastery and fathers’ perceived occupational value and education explained 67% of the variance in children’s BMI z-scores. CONCLUSION. The results indicate important factors to consider in developing interventions that facilitate occupational engagement and health among children with obesity and their families. Orban, K., Erlandsson, L.-K., Edberg, A.-K., O ¨ nnerfa ¨lt, J., & Thorngren-Jerneck, K. (2014). Effect of an occupation-focused family intervention on change in parents’ time use and children’s body mass index. American Journal of Occupational Therapy, 68, e217–e226. http://dx.doi.org/10.5014/ajot.2014.010405 T he prevalence of obesity has escalated worldwide, and the World Health Organization (WHO; 2012) has noted that overweight or obesity is a major risk factor for several chronic diseases. Multiple factors are associated with in- creasing rates of childhood obesity (Brown, Kelly, & Summerbell, 2007), in- cluding low levels of activity and high levels of sedentary behavior (Telama, 2009) and parents’ weight (Davison & Birch, 2001) and socioeconomic status (Lissner, Johansson, Qvist, Ro ¨ssner, & Wolk, 2000). Obesity is preventable (WHO, 2012), and contemporary research has found family-based lifestyle interventions to be useful in preventing and treating childhood obesity (Golley, Magarey, Baur, Steinbeck, & Daniels, 2007; Oude Luttikhuis et al., 2009; Reinehr, Kleber, Lass, & Toschke, 2010; Wilfley et al., 2007). Health care practitioners agree that it is necessary to assess family lifestyles and support parents in establishing healthier family lifestyles (e.g., Ayoob, 2011). However, only a few examples of effective intervention strategies with this focus have been published (see Berge & Everts, 2011). The establishment of healthy family lifestyles is most likely based on many factors (Golan, 2006), including supportive environments and communities that encourage families to make healthier choices about food and regular physical activity. From a public health perspective, outreach to parents, who are the principal enactors of change in childhood obesity, has been recommended as an effective approach to help them establish proactive strategies early in their children’s lives (Nader et al., 2012). The American Journal of Occupational Therapy e217