Objective: The purpose of this study was to examine the associations among community characteristics, family economic adversity, parents' health beliefs, and parents' and children's health using cross-level mediation analyses.
Methods: Survey data were collected from a nationally representative sample of 1,337 families with children between 3 and 6 years nested within 45 Trinidad and Tobago community clusters.
Results: At the individual level, parents' health belief of internality was a significant mediator between family economic adversity, adult health, and children's health. In the cross-level mediation analyses, health belief of internality was a significant mediator between community health problems and children's health. There were between-community variations in the relationship between adult health, health belief of powerful others, and children's health.
Conclusions: There is strong evidence of the role of community and family influences on children's health. Findings indicate the need to use a multilevel analytical approach in studies of children's health.
Keywords: Trinidad and Tobago; child health; community characteristics; economic adversity; parental health and beliefs.