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Effectiveness of a Parent-Based eHealth Intervention on Physical Activity, Dietary Behaviors, and Sleep in
Zhou Peng1, Li Ming Wen2, Patrick W C Lau1,3
1Department of Sports and Health Sciences, Academy of Wellness and Human Development, Hong Kong Baptist University, Hong Kong, China (Hong Kong).
Insights
This study shows that parent-based eHealth interventions delivered via social media can improve preschoolers' physical activity, sleep, and reduce screen time. These findings support using technology to promote healthy lifestyles in young children.
Area of Science:
- Pediatrics
- Public Health
- Digital Health
Background:
- Increasing rates of physical inactivity, poor diet, and sleep disturbances in preschoolers.
- Parents are key to establishing healthy habits, but face-to-face interventions have limitations.
- eHealth interventions offer a scalable solution, but existing ones have design flaws and limited generalizability.
Purpose of the Study:
- To evaluate the effectiveness of a parent-based eHealth intervention for promoting physical activity, healthy eating, and sleep in Chinese preschoolers.
- To address the limitations of current eHealth interventions by offering a comprehensive, multi-behavioral approach.
Main Methods:
- A 12-week single-blinded randomized controlled trial with 237 parent-child dyads in China.
- Intervention group received 12 weekly interactive social media modules on physical activity, diet, and sleep.
- Control group received weekly electronic pamphlets; outcomes assessed via accelerometers and parent questionnaires.
Main Results:
- The eHealth intervention significantly increased light and vigorous physical activity in preschoolers.
- Improvements were observed in sleep latency and sleep efficiency.
- Parent-reported screen time decreased significantly on both weekdays and weekends.
Conclusions:
- Parent-based eHealth interventions delivered via social media are effective in improving preschoolers' physical activity, sleep, and reducing screen time.
- Findings suggest a viable strategy to combat unhealthy lifestyles in young children.
- Further research should explore leveraging technology for broader regional application.
Background:
The prevalence of physical inactivity, unhealthy diet, and sleep disturbance among preschoolers is increasing dramatically. Parents play a crucial role in fostering their children's physical activity (PA), dietary behaviors, and sleep habits. Face-to-face interventions have barriers such as time commitment, making eHealth options appealing. However, current parent-based eHealth interventions have limitations in design (eg, focus on a single outcome, imbalanced content, and sequence), and their results cannot be generalized to other regions.
Objective:
This study aims to assess the effectiveness of parent-based eHealth interventions targeting PA, dietary behaviors, and sleep in preschoolers in China.
Methods:
This single-blinded randomized controlled trial with 2 parallel arms comprised a 12-week intervention followed by a 12-week follow-up, conducted from September 2023 to June 2024 in China. The intervention, grounded in social cognitive theory, included 12 interactive modules on PA (n=4), dietary behaviors (n=4), and sleep (n=4), each delivered weekly via social media. Each module consisted of videos, evidence-based information, parent interaction, goal setting, and feedback. The control group received a weekly electronic pamphlet via WeChat without interactive components. Preschoolers' PA, sleep duration, and sleep quality were assessed using the wGT3X-BT ActiGraph, while dietary behaviors, sleep problems, and screen time were reported by parents through paper-based questionnaires. Generalized estimating equations, adjusting for demographic covariates, were used to examine the effects of the parent-based eHealth intervention on preschoolers' outcomes.
Results:
A total of 237 eligible parent-child dyads were randomly assigned to the intervention group (n=120, mean age 4.51 years, SD 0.72 years; n=67, 55.8%, boys) or the control group (n=117, mean age 4.31 years, SD 0.70 years; n=69, 59%, boys). At baseline, 237 parents completed questionnaires, and 196 preschoolers provided valid ActiGraph data. At posttest, 181 parents completed questionnaires, and 166 preschoolers provided valid ActiGraph data (intervention, n=90; control, n=91). At follow-up, 181 parents again completed questionnaires, and 170 preschoolers provided valid ActiGraph data (intervention, n=90; control, n=91). Educating parents about healthy lifestyles through social media had a positive impact on preschoolers' light PA (vs control: adjusted mean difference -151.61 minutes/7 days, 95% CI -418.18 to -96.67, P=.002, Cohen d=0.28), vigorous PA (vs control: adjusted mean difference 138.47 minutes/7 days, 95% CI 117.61-183.10, P=.03, Cohen d=0.23), sleep latency (vs control: adjusted mean difference -21.04 minutes/day, 95% CI -16.07 to -6.00, P=.005, Cohen d=0.78), sleep efficiency (vs control: adjusted mean difference 4.61%, 95% CI 4.29-9.72, P<.001, Cohen d=0.34), and screen time (vs control: on weekdays, adjusted mean difference -16.42 minutes/weekday, 95% CI -30.83 to -2.01, P=.01, Cohen d=0.25; on weekends, adjusted mean difference -73.88 minutes/weekend day, 95% CI -98.48 to -49.28, P<.001, Cohen d=.46).
Conclusions:
The findings may help address unhealthy lifestyles commonly observed in young children. Further efforts are needed to leverage cutting-edge technological advancements to support families in creating healthy living environments for children across broader regions.
Trial Registration:
ClinicalTrials.gov NCT06025019; https://clinicaltrials.gov/ct2/show/NCT06025019.
International Registered Report Identifier (Irrid):
RR2-10.2196/58344.
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