Background: Family-based interventions have been suggested as an effective way to help overweight or obese children change their health behaviors, and communities are working together to develop cost-effective programs. Unfortunately, attendance to family-based interventions is limited, and few studies have evaluated reasons for dropout. Therefore, the purpose of this case study was to explore the factors related to families' level of participation and overall satisfaction to guide future design in a family-based community intervention. Methods: Purposeful sampling was used for a qualitative case study to recruit 9 families (parent and child dyads) who had completed at least 1 of 12 sessions of a family-based community intervention. Children were between the ages of 6 and 18 years old and in the 85th percentile or above. Immersion crystallization was used to explore themes found in the data. Results: Families appeared to be aware of the need to change their health behaviors and felt they had knowledge about healthy lifestyles before they entered the program. Families who did not complete the intervention reported transportation as their major barrier. Families that completed the intervention had active external support and made more changes together as a family. Overall, families appeared to enjoy the program and wanted to return. Conclusion: Health promotion professionals may consider designing future family-based community interventions to help participants avoid barriers, such as transportation. Additionally, a focus on encouraging families to actively support their family members may help to assure families finish programs and make more changes to their health behaviors together.