Healthy Homes/Healthy Families

Overview

Healthy Homes/Healthy Families (HH/HF) was the EPRC’s original core research, funded by the CDC and guided by a Community Advisory Board in southwest Georgia. It is an evidenced-based environmental change program, designed to support healthier eating by improving the home food environment. Coaches work directly with families to identify practical changes that improve both the social and physical aspects of the home. Through practical tools, coaching, and tailored support, the program helps families make realistic changes that create a home environment that supports healthy eating habits.

Why Healthy Homes/Healthy Families Matters

The home environment plays a critical role in shaping eating and physical activity behaviors. Many families face barriers to maintaining healthy habits, including limited access to healthy foods and competing daily demands.

By focusing on small, manageable changes within the home, Healthy Homes/Healthy Families helps families:

Improve diet quality
Reduce daily calorie intake
Increase availability of healthy foods at home
Decrease reliance on meals prepared outside the home

These changes can lead to meaningful improvements in overall health and well-being.

Program & Materials

The Healthy Homes/Healthy Families program includes a combination of coaching calls, text messages, and supportive materials delivered over a structured period. Coaches work one-on-one with participants to identify small, achievable changes—such as improving food choices in the home or creating opportunities for physical activity—and provide ongoing guidance and encouragement.

During coaching sessions, participants learn practical strategies to improve their home food environment, such as reducing access to less healthy foods, increasing availability of fruits and vegetables, and building routines that support healthier eating. Coaches also help participants solve barriers and reinforce progress over time.

The program has several key components:

A healthy action checklist that lists eight easy changes to make to the home.
A tailored home environment that points out positive aspects of the home food environment and areas for improvement.
A family contract for implementing at least three healthy actions.

The current version of the program takes three months to deliver and involves six coaching sessions and six text messages. It can be delivered in-person, by telephone or remotely. While not designed for group delivery, it may also work in a group setting. The tailored home food environment profile is based on answers to a web-based survey and is generated automatically upon completion of the survey.

Research

Healthy Homes/Healthy Families has been tested through multiple research studies, including randomized controlled trials and pilot programs conducted in partnership with healthcare systems and community organizations. The first Healthy Homes/Healthy Families randomized controlled trial was conducted in partnership with three federally qualified health centers in southwest Georgia. The five-month intervention included three home visits, four coaching calls, and four mailings of supportive materials, providing families with multiple opportunities for guidance and reinforcement.

We then completed an NCI-funded pilot and feasibility trial to adapt this intervention for telephone-based delivery with 2-1-1 clients in partnership with United Way of Greater Atlanta 2-1-1. Building on this work, additional CDC funding expanded the program across four United Way 2-1-1 agencies in Albany, Macon, Columbus, and Atlanta. The 12-week adapted intervention included six coaching calls and six text messages delivered on alternating weeks, maintaining a consistent level of support while allowing flexibility for participants. This streamlined approach focuses on nutrition-related behaviors while maintaining the program’s core emphasis on creating a healthier home environment.

We also conducted and evaluated a small grants program to explore how Healthy Homes/Healthy Families could be implemented in a variety of community settings. Seven organizations received funding to deliver the program over 12 to 15 months. Many adapted the model to better fit their communities, including shifting from telephone-based coaching to group or hybrid formats and adding new components such as cooking classes.

Findings

Participants in the program experienced meaningful improvements in their home food and activity environments, along with positive changes in food-related behaviors. Findings included improved diet quality, reduced daily calorie intake, and decreases in self-reported weight. Additional results showed increases in Healthy Eating Index scores, healthier household food inventories, and fewer meals obtained outside the home.

In the recent multi-site study across 2-1-1 agencies in Albany, Macon, Columbus, and Atlanta, participants in the program showed greater improvements in diet quality compared to a control group nine months after enrollment. The program was also found to be cost-effective.
Through these efforts, families showed improvements in key areas of the home food environment, including increased availability of fruits and vegetables, changes in food placement, and healthier food preparation practices.

Key Publications

Kegler MC, Bundy ŁT, Hartman T, Owolabi S, Haardörfer R. Promoting healthier home food environments through 2-1-1: a pilot and feasibility study. Fam Community Health. 2020 Oct/Dec;43(4):276-286.
Kegler MC, Haardörfer R, Alcantara IC, Gazmararian JA, Veluswamy JK, Hodge TL, Addison AR, Hotz JA. Impact of improving home environments on energy intake and physical activity: A randomized controlled trial. Am J Public Health. 2016 Jan;106(1):143-52.
Kegler MC, Alcantara I, Veluswamy JK, Haardörfer R, Hotz JA, Glanz K. Results from an intervention to improve rural home food and physical activity environments. Prog Community Health Partnersh. 2012 6(3):265-77.

Contact

For more information about Healthy Homes Healthy Families, please contact: Shadé Owolabi at shade.o.owolabi@emory.edu