Theoretically based behavioral interventions provide the most evidence for successful change; however, several issues should be considered when applying these interventions. For example, school-based obesity prevention programs can be used to teach children how to adopt healthy lifestyle behaviors from an early age. Ecological systems theory provides a framework to design, implement, and evaluate school-based obesity prevention programs. An ecological framework emphasizes that the characteristics within and between systems place children at risk for obesity. Although this developmental process is considered to occur continuously and simultaneously, in practice, we tend to consider the relationships to be unidirectional. Using a positive behavioral momentum approach in practice may assist in addressing these complexities.
Keywords: bidirectional relationships; childhood obesity; ecological models; systems theory; unidirectional relationships.