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A Home-Based Intervention to Improve Adherence to the 24-Hour Movement Guidelines in Young Children: Protocol for a
Chelsea L Kracht1, Jerica M Berge2, Monique LeBlanc3
1Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States.
Insights
A new mobile health intervention aims to improve physical activity, screen time, and sleep in preschoolers. This study will assess the app
Area of Science:
- Pediatric Health
- Behavioral Science
- Digital Health
Background:
- Only 10% of preschoolers (3-4 years) meet all three 24-hour Movement Guidelines.
- These guidelines encompass physical activity, sedentary screen time, and adequate sleep.
- A significant gap exists in promoting healthy movement behaviors in early childhood.
Purpose of the Study:
- To evaluate a 12-week mobile health (mHealth) home-based intervention.
- The intervention targets preschoolers meeting zero or one guideline.
- The study assesses effectiveness and feasibility of improving 24-hour movement behaviors.
Main Methods:
- A 12-week randomized controlled trial with a wait-list control group.
- 80 families (40 per arm) will participate.
- Intervention content informed by preliminary studies and behavior change theories (transfer theory, multi-process action control framework).
- Primary outcomes: device-based and parent-report measures of 24-hour movement behaviors.
- Secondary outcome: app feasibility and acceptability.
- Exploratory outcomes: cognitive/motor skills, home environment, behavioral control.
Main Results:
- The study is a 2-phase project, with preliminary studies concluding in December 2023.
- IRB approval obtained April 2024; funding began May 2024.
- Registered on ClinicalTrials.gov (October 2024), first participant enrolled January 2025.
- As of October 2025, 39 families enrolled; trial completion anticipated late 2026.
Conclusions:
- This research tests a novel mobile app intervention for improving preschooler movement behaviors at home.
- Findings will inform future interventions and understanding of improving multiple health behaviors.
- The study aims to ultimately enhance preschoolers' overall health outcomes.
Background:
One in 10 preschoolers (aged 3-4 y) meet the three 24-hour Movement Guidelines, that is, (1) physical activity, (2) sedentary screen time, and (3) sleep.
Objective:
The overarching aim of this study is to evaluate the effectiveness and feasibility of a 12-week mobile health home-based intervention on 24-hour movement behaviors in preschoolers who meet few guidelines (zero or 1 guideline).
Methods:
We will conduct a 12-week randomized controlled trial with a wait-list control in 80 families (40 per arm). Preliminary studies in this population informed intervention app content, features, and app development. Behavior change theories, including transfer theory and the multi-process action control framework, helped inform content presentation and topics. Primary outcomes include device-based and parent-report measures of 24-hour movement behaviors, and the secondary outcome is the feasibility and acceptability of the app. Exploratory outcomes include preschoolers' cognitive and motor skills, changes within the home environment, and behavioral control processes.
Results:
This 2-phase study (K99/R00) received initial funding in March 2022, and preliminary studies were concluded in December 2023. The main grant received institutional review board approval in April 2024, and the grant funding began in May 2024. The study was registered in Clinical Trials in October 2024 and enrolled its first participant in January 2025. As of October 2025, the study has enrolled 39 families. We anticipate the trial will be completed in late 2026.
Conclusions:
This research is designed to test a novel approach to improve all three 24-hour movement behaviors in preschoolers in home settings by using a mobile app. Results from this study will have implications for future 24-hour movement interventions, our understanding of improving all 3 behaviors, and ultimately, improvements in preschoolers' health.
Trial Registration:
Clinicaltrials.gov NCT06667661; https://clinicaltrials.gov/study/NCT06667661.
International Registered Report Identifier (Irrid):
DERR1-10.2196/75621.
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