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Flynn RJ, Pringle A, Roscoe CMP. Multistakeholder Perspectives on the Determinants of Family Fundamental Movement Skills Practice: A Qualitative Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1066. [PMID: 39334599 PMCID: PMC11429575 DOI: 10.3390/children11091066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 08/24/2024] [Accepted: 08/28/2024] [Indexed: 09/30/2024]
Abstract
BACKGROUND Childhood obesity is a significant public health crisis that is exposing children to associated morbidities and premature mortality. However, parents can positively influence physical activity trajectories and improve health outcomes by nurturing fundamental movement skills (FMS) in children. This is the first study to explore the determinants of family FMS practice via a systematic synthesis of qualitative evidence. METHODS Keyword searches were completed in SPORTDiscus, PubMed, Scopus, Web of Science, and Embase. Studies that offered perspectives relating to influences on the FMS of 2-6-year-old children in the family context via qualitative approaches, including visual methodologies that provided an important voice to children, were included. A thematic analysis was used to establish key themes. RESULTS The emergent themes included parent knowledge and beliefs, self-efficacy of parents to teach, and the home environment. Parents often undervalued FMS and lacked the self-efficacy to teach due to poor understanding, conflicting priorities, and multifaceted societal influences. Children preferred autonomous play and socialisation but were negatively influenced by technology and restrictive household rules. CONCLUSIONS Greater knowledge exchange between stakeholders is necessary to empower parents and enhance FMS application at home. More community initiatives could facilitate greater access to outdoor spaces, facilities, and equipment, which may improve family engagement with FMS.
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Affiliation(s)
- Robert J Flynn
- Clinical Exercise and Rehabilitation Research Centre, School of Sport and Exercise Sciences, University of Derby, Kedleston Road, Derby DE22 1GB, UK
| | - Andy Pringle
- Clinical Exercise and Rehabilitation Research Centre, School of Sport and Exercise Sciences, University of Derby, Kedleston Road, Derby DE22 1GB, UK
| | - Clare M P Roscoe
- Clinical Exercise and Rehabilitation Research Centre, School of Sport and Exercise Sciences, University of Derby, Kedleston Road, Derby DE22 1GB, UK
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Kerimaa H, Hakala M, Haapea M, Serlo W, Pölkki T. The preparation of children for day surgery from the parent's viewpoint: A mixed methods study. Nurs Open 2024; 11:e2121. [PMID: 38436537 PMCID: PMC10910610 DOI: 10.1002/nop2.2121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 01/13/2024] [Accepted: 02/07/2024] [Indexed: 03/05/2024] Open
Abstract
AIM The purpose of the study was to describe the preparation of children for day surgery from the parent's viewpoint. DESIGN Empirical Research Mixed Method. METHODS The research applied a mixed-methods study design. The study was conducted at the Paediatric Day Surgical Department of one REDACTED between 2018 and 2020 at the same time as an associated randomised controlled conduct trial. Parents of 41 children (ages 2-6 years) completed measures assessing their preparation for day surgery and satisfaction with the procedure. Semi-structured interviews were conducted with 15 parents to better understand their experiences. RESULTS According to the results, most of the parents (95%) told their children about the upcoming day surgery procedure. The child was prepared for the surgery with cognitive and sensory information, and the preparation usually started at home well before the surgery. The parents' experiences with the most critical aspects of preparing their child included three main categories: (1) usability of the preparation method; (2) content and timing of the preparation method and (3) consideration of the family perspective.
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Affiliation(s)
- Heli Kerimaa
- Research Unit of Health Sciences and TechnologyUniversity of OuluOuluFinland
- Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland
| | - Mervi Hakala
- Research Unit of Health Sciences and TechnologyUniversity of OuluOuluFinland
- Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland
- Oulu University HospitalOuluFinland
| | - Marianne Haapea
- Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland
- Research Service UnitOulu University HospitalOuluFinland
| | | | - Tarja Pölkki
- Research Unit of Health Sciences and TechnologyUniversity of OuluOuluFinland
- Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland
- Oulu University HospitalOuluFinland
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Jiang S, Ng JYY, Chong KH, Peng B, Ha AS. Effects of eHealth Interventions on 24-Hour Movement Behaviors Among Preschoolers: Systematic Review and Meta-Analysis. J Med Internet Res 2024; 26:e52905. [PMID: 38381514 PMCID: PMC10918543 DOI: 10.2196/52905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/04/2023] [Accepted: 01/18/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND The high prevalence of unhealthy movement behaviors among young children remains a global public health issue. eHealth is considered a cost-effective approach that holds great promise for enhancing health and related behaviors. However, previous research on eHealth interventions aimed at promoting behavior change has primarily focused on adolescents and adults, leaving a limited body of evidence specifically pertaining to preschoolers. OBJECTIVE This review aims to examine the effectiveness of eHealth interventions in promoting 24-hour movement behaviors, specifically focusing on improving physical activity (PA) and sleep duration and reducing sedentary behavior among preschoolers. In addition, we assessed the moderating effects of various study characteristics on intervention effectiveness. METHODS We searched 6 electronic databases (PubMed, Ovid, SPORTDiscus, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials) for experimental studies with a randomization procedure that examined the effectiveness of eHealth interventions on 24-hour movement behaviors among preschoolers aged 2 to 6 years in February 2023. The study outcomes included PA, sleep duration, and sedentary time. A meta-analysis was conducted to assess the pooled effect using a random-effects model, and subgroup analyses were conducted to explore the potential effects of moderating factors such as intervention duration, intervention type, and risk of bias (ROB). The included studies underwent a rigorous ROB assessment using the Cochrane ROB tool. Moreover, the certainty of evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) assessment. RESULTS Of the 7191 identified records, 19 (0.26%) were included in the systematic review. The meta-analysis comprised a sample of 2971 preschoolers, which was derived from 13 included studies. Compared with the control group, eHealth interventions significantly increased moderate to vigorous PA (Hedges g=0.16, 95% CI 0.03-0.30; P=.02) and total PA (Hedges g=0.37, 95% CI 0.02-0.72; P=.04). In addition, eHealth interventions significantly reduced sedentary time (Hedges g=-0.15, 95% CI -0.27 to -0.02; P=.02) and increased sleep duration (Hedges g=0.47, 95% CI 0.18-0.75; P=.002) immediately after the intervention. However, no significant moderating effects were observed for any of the variables assessed (P>.05). The quality of evidence was rated as "moderate" for moderate to vigorous intensity PA and sedentary time outcomes and "low" for sleep outcomes. CONCLUSIONS eHealth interventions may be a promising strategy to increase PA, improve sleep, and reduce sedentary time among preschoolers. To effectively promote healthy behaviors in early childhood, it is imperative for future studies to prioritize the development of rigorous comparative trials with larger sample sizes. In addition, researchers should thoroughly examine the effects of potential moderators. There is also a pressing need to comprehensively explore the long-term effects resulting from these interventions. TRIAL REGISTRATION PROSPERO CRD42022365003; http://tinyurl.com/3nnfdwh3.
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Affiliation(s)
- Shan Jiang
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Johan Y Y Ng
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Kar Hau Chong
- School of Health and Society and Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Bo Peng
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Amy S Ha
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
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Kerimaa H, Hakala M, Haapea M, Vähänikkilä H, Serlo W, He HG, Pölkki T. Effectiveness of a Mobile App Intervention for Preparing Preschool Children and Parents for Day Surgery: Randomized Controlled Trial. J Med Internet Res 2023; 25:e46989. [PMID: 37773624 PMCID: PMC10576237 DOI: 10.2196/46989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/31/2023] [Accepted: 07/31/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Day surgery allows families to return home quickly. Only a few approaches to preparing for day surgery have demonstrated how digital solutions can support families and children. OBJECTIVE This study aims to evaluate the effectiveness of a mobile app intervention on preschool children's fear and pain and parents' anxiety and stress in preparing children for day surgery. METHODS This study was conducted at the Pediatric Day Surgical Department of a university hospital in Finland between 2018 and 2020. Parents of children (aged 2-6 y) who were in a queue for elective day surgery were randomized into the intervention group (IG; n=36) and control group (CG; n=34). The CG received routine preparations, whereas the IG was prepared using a mobile app. Parents' and children's outcomes were measured using validated scales at 4 different points: at home (T1 and T4) and at the hospital (T2 and T3) before and after surgery. Group differences were analyzed using statistical methods suitable for the material. RESULTS Before surgery, parents in both groups experienced mild anxiety, which decreased after surgery. Parental anxiety did not differ between groups preoperatively (P=.78) or postoperatively (P=.63). Both groups had less anxiety at home after surgery compared with before. The IG showed a significant decrease (P=.003); the CG also improved (P=.002). Preoperatively at home, most parents in both groups experienced no stress or mild stress (P=.61). Preoperatively at the hospital, parents in both groups experienced mild stress; however, parents in the IG experienced more stress during this phase (P=.02). Parents in the IG experienced significantly less stress postoperatively than those in the CG (P=.05). Both groups showed decreased stress levels from before to after surgery (IG: P=.003; CG: P=.004) within each group. There were no significant differences in children's pain levels between the groups and measurement points. This was observed before surgery at home (P=.25), before surgery at the hospital (P=.98), and after surgery at the hospital (P=.72). Children's fear decreased more in the IG (P=.006) than in the CG (P=.44) comparing the phases before and after surgery at home. Fear did not differ between the IG and CG preoperatively at home (P=.20) or at the hospital (P=.59) or postoperatively at the hospital (P=.62) or at home (P=.81). CONCLUSIONS The mobile app intervention did not reduce anxiety or pain. However, it was observed that parents in the IG experienced substantially heightened stress levels before surgery at the hospital, which decreased significantly after surgery at home. In addition, fear levels in children in the IG decreased over time, whereas no significant change was observed in the CG. These results are important for developing health care service chains and providing families with innovative and customer-oriented preparation methods. TRIAL REGISTRATION ClinicalTrials.gov NCT03774303; https://classic.clinicaltrials.gov/ct2/show/NCT03774303.
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Affiliation(s)
- Heli Kerimaa
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
| | - Mervi Hakala
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Oulu University Hospital, Oulu, Finland
| | - Marianne Haapea
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Service Unit, Oulu University Hospital, Oulu, Finland
| | - Hannu Vähänikkilä
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Willy Serlo
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Division of Pediatric Surgery, Oulu University Hospital, Oulu, Finland, Oulu, Finland
- Oulu University Unit of Clinical Medicine, University of Oulu, Oulu, Finland
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
| | - Tarja Pölkki
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Oulu University Hospital, Oulu, Finland
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Graybeal AJ, Brandner CF, Tinsley GM. Evaluation of automated anthropometrics produced by smartphone-based machine learning: a comparison with traditional anthropometric assessments. Br J Nutr 2023; 130:1077-1087. [PMID: 36632007 PMCID: PMC10442791 DOI: 10.1017/s0007114523000090] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/10/2022] [Accepted: 01/03/2023] [Indexed: 01/13/2023]
Abstract
Automated visual anthropometrics produced by mobile applications are accessible and cost effective with the potential to assess clinically relevant anthropometrics without a trained technician present. Thus, the aim of this study was to evaluate the precision and agreement of smartphone-based automated anthropometrics against reference tape measurements. Waist and hip circumference (WC; HC), waist:hip ratio (WHR) and waist:height ratio (W:HT) were collected from 115 participants (69 F) using a tape measure and two smartphone applications (MeThreeSixty®, myBVI®) across multiple smartphone types. Precision metrics were used to assess test-retest precision of the automated measures. Agreement between the circumferences produced by each mobile application and the reference were assessed using equivalence testing and other validity metrics. All mobile applications across smartphone types produced reliable estimates for each variable with intraclass correlation coefficients ≥ 0·93 (all P < 0·001) and root mean square coefficient of variation between 0·5 and 2·5 %. Precision error for WC and HC was between 0·5 and 1·9 cm. WC, HC, and W:HT estimates produced by each mobile application demonstrated equivalence with the reference tape measurements using 5 % equivalence regions. Mean differences via paired t-tests were significant for all variables across each mobile application (all P < 0·050) showing slight underestimation for WC and slight overestimation for HC which resulted in a lack of equivalence for WHR compared with the reference tape measure. Overall, the results of our study support the use of WC and HC estimates produced from automated mobile applications, but also demonstrates the importance of accurate automation for WC and HC estimates given their influence on other anthropometric assessments and clinical health markers.
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Affiliation(s)
- Austin J. Graybeal
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS39406, USA
| | - Caleb F. Brandner
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS39406, USA
| | - Grant M. Tinsley
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX79409, USA
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Visier-Alfonso ME, Sánchez-López M, Rodríguez-Martín B, Ruiz-Hermosa A, Bartolomé-Gutiérrez R, Sequí-Domínguez I, Martínez-Vizcaíno V. Parents' Perceptions of Children's and Adolescents' Use of Electronic Devices to Promote Physical Activity: Systematic Review of Qualitative Evidence. JMIR Mhealth Uhealth 2023; 11:e44753. [PMID: 37471127 PMCID: PMC10401398 DOI: 10.2196/44753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/17/2023] [Accepted: 06/09/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND The use of physical activity (PA) electronic devices offers a unique opportunity to engage children and adolescents in PA. For this age group (2-17 years), parents play a key role in promoting healthy lifestyles and regulating the use of electronic devices. Therefore, parents' perceptions of the use of electronic devices for PA in children and adolescents are critical for efficient intervention. OBJECTIVE The aim of this qualitative systematic review was to improve the understanding of parents' perceptions of the use of electronic devices for PA in children and adolescents. METHODS A systematic search of electronic databases (Medline/PubMed, SPORTDiscus, Web of Science, Scopus, OpenGrey, and Deep Blue) was conducted. Studies from inception (2010) to May 2022 were identified. Qualitative studies on the perceptions of healthy children's and adolescents' (aged 2-17 years) parents regarding PA interventions performed on electronic devices were included according to the Cochrane Qualitative and Implementation Methods Group Guidance Series and the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used for methodological validity. RESULTS In total, 18 studies with 410 parents, mostly mothers, were included. Parents' perceptions were grouped into 4 categories: usefulness, advantages, general perceptions (electronic devices for health promotion, preferences for real-life PA, and concerns), and acceptability (barriers and facilitators) of electronic devices for PA. Parents perceived electronic devices as useful for increasing PA, learning new skills, and increasing motivation for PA and valued those devices that promoted socialization and family and peer bonding. In terms of general perceptions, parents had positive attitudes toward PA electronic devices; however, they preferred outdoor and real-life PA, especially for preschoolers and children. Concerns, such as physical and psychological harm, addiction, conflicts, and compliance difficulties, were found. Facilitators were identified as ease of use, appropriate feedback, promotion of socialization, and motivational strategies, such as rewards, challenges, and attractiveness. Barriers, such as discomfort, price, and difficulties in using or understanding electronic devices, were also identified. For older children and adolescents, parents were more concerned about high levels of screen time and setting limits on electronic devices and therefore preferred PA electronic devices rather than traditional ones. CONCLUSIONS Overall, the participants had positive attitudes toward electronic devices for PA and perceived them as an effective way to promote PA in children and adolescents. They also perceived several benefits of using electronic devices, such as health promotion, increased awareness and motivation, and socialization, as well as barriers, facilitators, and age differences. The results of this study could provide researchers with insights into designing more effective, age-appropriate PA electronic devices for children and adolescents and improving adherence to their use. TRIAL REGISTRATION PROSPERO CRD42021292340; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=292340.
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Affiliation(s)
| | | | - Beatriz Rodríguez-Martín
- Faculty of Occupational Therapy, Logopedia and Nursing, University of Castilla-La Mancha, Toledo, Talavera de la Reina, Spain
| | - Abel Ruiz-Hermosa
- Department of Didactics of Musical, Plastic and Body Expression, Faculty of Sports and Sciences, University of Extremadura, Cáceres, Spain
| | | | | | - Vicente Martínez-Vizcaíno
- Faculty of Nursing, University of Castilla-La Mancha, Cuenca, Spain
- Health and Social Research Center, University of Castilla-La Mancha, Cuenca, Spain
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Flynn RJ, Pringle A, Roscoe CMP. Direct Parent Engagement to Improve Fundamental Movement Skills in Children: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1247. [PMID: 37508744 PMCID: PMC10378247 DOI: 10.3390/children10071247] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023]
Abstract
Fundamental movement skills (FMS) are basic movements in children that represent the building blocks for more complex motor skill development and act as a prerequisite for enduring sport and physical activity (PA) engagement and positive health-related behaviours. The FMS proficiency is currently inadequate worldwide, and consequently there are alarming levels of inactivity and childhood obesity. However, parents are role models to their children and possess the power to influence their PA behaviour. This review investigated if parent-focused interventions could improve FMS in 2-7-year-old children and evaluated which setting and method of parent engagement was most impactful. Keyword searches were conducted via Scopus, Web of Science, SPORTDiscus, PubMed, Science Direct, and Google Scholar. Only nine articles met the inclusion criteria. No research originated from the United Kingdom, highlighting the urgent need for further FMS interventions involving parents. The FMS improved in all nine studies, with significant changes in seven of the articles (p < 0.05). Parent-child co-activity, the education and empowerment of parents, and the provision of clear FMS guidance, messaging, and structure can positively influence children's FMS. Recently, smartphone apps have increased the feasibility and accessibility of FMS practice at home and may be integral to future interventions. Further research with direct parental involvement is clearly warranted.
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Affiliation(s)
- Robert J Flynn
- Department of Sport and Exercise Science, Clinical Exercise and Rehabilitation Research Centre, University of Derby, Kedleston Road, Derby DE22 1GB, UK
| | - Andy Pringle
- Department of Sport and Exercise Science, Clinical Exercise and Rehabilitation Research Centre, University of Derby, Kedleston Road, Derby DE22 1GB, UK
| | - Clare M P Roscoe
- Department of Sport and Exercise Science, Clinical Exercise and Rehabilitation Research Centre, University of Derby, Kedleston Road, Derby DE22 1GB, UK
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Schwarz A, Winkens LHH, de Vet E, Ossendrijver D, Bouwsema K, Simons M. Design Features Associated With Engagement in Mobile Health Physical Activity Interventions Among Youth: Systematic Review of Qualitative and Quantitative Studies. JMIR Mhealth Uhealth 2023; 11:e40898. [PMID: 36877551 PMCID: PMC10028523 DOI: 10.2196/40898] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/02/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Globally, 81% of youth do not meet the physical activity (PA) guidelines. Youth of families with a low socioeconomic position are less likely to meet the recommended PA guidelines. Mobile health (mHealth) interventions are preferred by youth over traditional in-person approaches and are in line with their media preferences. Despite the promise of mHealth interventions in promoting PA, a common challenge is to engage users in the long term or effectively. Earlier reviews highlighted the association of different design features (eg, notifications and rewards) with engagement among adults. However, little is known about which design features are important for increasing engagement among youth. OBJECTIVE To inform the design process of future mHealth tools, it is important to investigate the design features that can yield effective user engagement. This systematic review aimed to identify which design features are associated with engagement in mHealth PA interventions among youth who were aged between 4 and 18 years. METHODS A systematic search was conducted in EBSCOhost (MEDLINE, APA PsycINFO, and Psychology & Behavioral Sciences Collection) and Scopus. Qualitative and quantitative studies were included if they documented design features associated with engagement. Design features and related behavior change techniques and engagement measures were extracted. Study quality was assessed according to the Mixed Method Assessment Tool, and one-third of all screening and data extraction were double coded by a second reviewer. RESULTS Studies (n=21) showed that various features were associated with engagement, such as a clear interface, rewards, multiplayer game mode, social interaction, variety of challenges with personalized difficulty level, self-monitoring, and variety of customization options among others, including self-set goals, personalized feedback, progress, and a narrative. In contrast, various features need to be carefully considered while designing mHealth PA interventions, such as sounds, competition, instructions, notifications, virtual maps, or self-monitoring, facilitated by manual input. In addition, technical functionality can be considered as a prerequisite for engagement. Research addressing youth from low socioeconomic position families is very limited with regard to engagement in mHealth apps. CONCLUSIONS Mismatches between different design features in terms of target group, study design, and content translation from behavior change techniques to design features are highlighted and set up in a design guideline and future research agenda. TRIAL REGISTRATION PROSPERO CRD42021254989; https://tinyurl.com/5n6ppz24.
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Affiliation(s)
- Ayla Schwarz
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Wageningen, Netherlands
| | - Laura H H Winkens
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Wageningen, Netherlands
| | - Emely de Vet
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Wageningen, Netherlands
| | - Dian Ossendrijver
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Wageningen, Netherlands
| | - Kirsten Bouwsema
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Wageningen, Netherlands
| | - Monique Simons
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Wageningen, Netherlands
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Reyes LI, Johnson SL, Chamberlin B, Bellows LL. Engaging Preschoolers in Food Tasting and Movement Activities Using Mobile Applications. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:77-80. [PMID: 36151001 DOI: 10.1016/j.jneb.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Ligia I Reyes
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Susan L Johnson
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Barbara Chamberlin
- Innovative Media Research and Extension, New Mexico State University, Las Cruces, NM
| | - Laura L Bellows
- Division of Nutritional Sciences, Cornell University, Ithaca, NY; Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
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Mallawaarachchi SR, Hooley M, Sutherland-Smith W, Horwood S. "You're damned if you do, you're damned if you don't": a qualitative exploration of parent motives for provision of mobile screen devices in early childhood. BMC Public Health 2022; 22:2011. [PMID: 36324121 PMCID: PMC9629764 DOI: 10.1186/s12889-022-14459-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Exploring parental motives for providing smartphones and tablets to young children is important to better understand ways to optimise healthy use of mobile screens in early childhood. To date, no study has qualitatively examined the factors underpinning parental motives of providing mobile screens to young children, using a theoretically driven approach. METHODS We conducted 45 in-depth, semi structured online interviews with primary caregivers of toddlers and pre-schoolers from diverse family backgrounds who participated in a large online survey in Australia. Themes were generated from the transcribed interviews using template thematic analysis. The coding was completed deductively using the Theory of Planned Behaviour (TPB) and data-driven induction. RESULTS Participants consistently reported a spectrum of attitudes, subjective norms and perceived behavioural control aspects which drove their decision to provide or not provide a mobile screen device to their child. Five main descriptive themes were generated, guided by the TPB: (1) Convenience, connection, and non-traditional learning experience; (2) Negative behavioural consequences and potential activity displacement through mobile screens; (3) Influences of society and resources; (4) Managing and achieving a balance; (5) External challenges. CONCLUSIONS Overall, the findings demonstrated that parents experienced cognitive dissonance between their attitudes and behaviour, primarily from perceived behavioural control and subjective norms negating the influence of attitudes on their motives to provide a device. These insights offer important avenues for public health messaging and resources to better involve and support parents in decision-making relating to mobile screens in everyday lives of young children.
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Affiliation(s)
| | | | - Wendy Sutherland-Smith
- Centre for Research in Assessment and Digital Learning (CRADLE), Deakin University, Burwood, Australia
| | - Sharon Horwood
- School of Psychology, Deakin University, Burwood, Australia
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Staiano AE, Newton RL, Beyl RA, Kracht CL, Hendrick CA, Viverito M, Webster EK. mHealth Intervention for Motor Skills: A Randomized Controlled Trial. Pediatrics 2022; 149:e2021053362. [PMID: 35415743 PMCID: PMC9648112 DOI: 10.1542/peds.2021-053362] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Children's motor skills are a critical foundation for physical activity. The objective was to determine the effectiveness and feasibility of a mobile app-based intervention delivered to parents to improve preschoolers' motor skills. METHODS This randomized controlled trial randomly assigned children to : (1) Motor Skills, including instructional lessons, peer modeling videos, behavioral scaffolding, and structured activities or 2) Free Play. Both groups received a 12-week app-based intervention informed by social cognitive theory to deliver 12 hours (12-minutes per day, 5× per week) of instruction. The children were aged 3 to 5 y; parents and children had no mobility impairments. The primary outcome variables were children's motor skills percentile score assessed with the Test of Gross Motor Development, third edition (TGMD-3) at baseline, end-of-intervention (week 12), and follow-up (week 24); and feasibility and acceptability. RESULTS Seventy-two children (4.0 ± 0.8 y) participated. Between baseline and week 12, children in the Motor Skills condition significantly improved total TGMD-3 percentile (+13.7 Motor Skills vs -5.3 Free Play, P < .01), locomotor skills percentile (+15.5 Motor Skills vs -4.8 Free Play, P < .01), and ball skills percentile (+8.3 Motor Skills vs -7.3 Free Play, P < .01) compared with children in the comparator group. Significant differences were sustained at follow-up (week 24). Adherence did not significantly differ between conditions (71% for Motor Skills; 87% for Free Play). Parents in both arms reported high scores on satisfaction, helpfulness, and ease of use. CONCLUSIONS Clinicians and educators may encourage parents to enhance their child's motor skills through structured at-home programs.
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Affiliation(s)
| | | | - Robbie A. Beyl
- Pennington Biomedical Research Center, Baton Rouge,
Louisiana
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12
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Swindle T, Poosala AB, Zeng N, Børsheim E, Andres A, Bellows LL. Digital Intervention Strategies for Increasing Physical Activity Among Preschoolers: Systematic Review. J Med Internet Res 2022; 24:e28230. [PMID: 35014962 PMCID: PMC8790686 DOI: 10.2196/28230] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/27/2021] [Accepted: 10/05/2021] [Indexed: 01/11/2023] Open
Abstract
Background Digital interventions are increasingly used to improve health behaviors. Improved access and lower costs (relative to in-person interventions) make such interventions appealing. Specifically, digital platforms may be a promising approach for increasing physical activity (PA) in young children. Objective The goal of this systematic review was three-pronged: (1) to determine the quality of studies using digital PA intervention strategies with preschool-aged children (ie, 3 to 5 years old); (2) to assess the efficacy of digital interventions and approaches designed to improve PA in preschool-aged children; and (3) to examine theoretical application and implementation outcomes with current approaches to digital PA interventions. Methods This review identified and summarized studies on digitally supported interventions for promoting PA in preschool-aged children. We generated 3 lists of relevant search terms that included technology-related terms, PA-related terms, and weight-related terms. The search included Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, and Daily, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. Study selection was led by a single author and verified by a second; the same 2 authors assessed study quality using a standardized tool, and 3 authors completed data extraction on PA outcomes, theory application, and implementation outcomes. Results In total, 601 studies were identified; 8 met the inclusion criteria. For study quality, only 2 studies received an overall rating of strong quality and low risk of bias. All but 1 study had a small sample size (<100). Positive and significant changes in child PA outcomes were reported in only 2 studies with weak overall quality, both of which used child-directed approaches. In total, 5 studies applied a behavioral theory for designing the intervention; no patterns of effectiveness were identified based on the application of theory. Finally, no studies reported on the implementation outcomes of adoption, cost, penetration, or sustainability; 1 study did not assess any implementation outcomes, and no single study reported on more than 2 implementation outcomes. Studies measured the implementation outcome of acceptability most frequently (n=4), and researchers assessed fidelity in 3 studies. Conclusions The interventions with a significant effect on PA used child-centered activities; parent-directed digital interventions alone were ineffective for improving PA. Future research with rigorous designs, monitoring of implementation outcomes, and testing of the contributions of digital components will advance understanding of the effectiveness of digital interventions for increasing PA in children.
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Affiliation(s)
- Taren Swindle
- Department of Pediatrics, University of Arkansas Medical Sciences, Little Rock, AR, United States
| | | | - Nan Zeng
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, United States
| | - Elisabet Børsheim
- Department of Pediatrics, University of Arkansas Medical Sciences, Little Rock, AR, United States.,Arkansas Children's Nutrition Center, Little Rock, AR, United States.,Arkansas Children's Research Institute, Little Rock, AR, United States
| | - Aline Andres
- Department of Pediatrics, University of Arkansas Medical Sciences, Little Rock, AR, United States.,Arkansas Children's Nutrition Center, Little Rock, AR, United States.,Arkansas Children's Research Institute, Little Rock, AR, United States
| | - Laura L Bellows
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
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Forseth B, Ortega A, Hibbing PR, Moon M, Steel C, Singh M, Kollu A, Miller B, Miller M, Staggs V, Calvert H, Davis AM, Carlson J. Adding Family Digital Supports to Classroom-Based Physical Activity Interventions to Target In- and Out-of-School Activity: An Evaluation of the Stay Active Intervention during the COVID-19 Pandemic. JOURNAL OF HEALTHY EATING AND ACTIVE LIVING 2021; 1:226-240. [PMID: 37771566 PMCID: PMC10522008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
Remotely delivered interventions are promising for reaching large numbers of people, though few have targeted multiple levels of influence such as schools and families. This study evaluated two versions (arms) of a remotely delivered classroom-based physical activity (CBPA) intervention. One arm solely included remote CBPA; the other included remote CBPA and mobile health (mHealth) family supports. Six schools were randomized to CBPA or CBPA+Family. Both arms were remotely delivered for seven weeks. CBPA+Family added behavior change tools delivered via text messages and newsletters to caregiver/child dyads. Garmin devices measured moderate-to-vigorous activity (MVPA) in both arms and were used for goal setting/monitoring in the CBPA+Family arm (integrated with the text messages). Caregivers completed surveys evaluating intervention acceptability. 53 participants (CBPA n=35; CBPA+Family n=18; 9.7±0.7 years) were included. Increases in MVPA were similar between arms, showing a pre-post effect of the CBPA but no additional effect of family supports. MVPA was low at baseline and during the first 3 weeks (CBPA 7.5±3.1 minutes/day; CBPA+Family 7.9±2.7 minutes/day) and increased by Weeks 6-8 (CBPA 56.8±34.2 minutes/day; CBPA+Family 49.2±18.7 minutes/day). Approximately 90% of caregivers reported high satisfaction with the added family support content. CBPA+Family participants wore the Garmin later into the study period. Remote delivery of CBPA appears feasible and effective for supporting increases in children's MVPA. Adding family supports to school-based interventions appears acceptable and may support engagement, demonstrating promise for more multilevel/multi-setting interventions, though the multilevel intervention was not more effective than the single-level intervention in increasing children's MVPA.
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Affiliation(s)
- Bethany Forseth
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
- Department of Pediatrics, University of Kansas Medical Center, USA
| | - Adrian Ortega
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Paul R Hibbing
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Mallory Moon
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Chelsea Steel
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Mehar Singh
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Avinash Kollu
- Research Informatics, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Bryce Miller
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Maurice Miller
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Vincent Staggs
- Biostatistics & Epidemiology, Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO, USA
- School of Medicine, University of Missouri-Kansas City, USA
| | | | - Ann M Davis
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
- Department of Pediatrics, University of Kansas Medical Center, USA
| | - Jordan Carlson
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
- School of Medicine, University of Missouri-Kansas City, USA
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Papadakis S, Alexandraki F, Zaranis N. Mobile device use among preschool-aged children in Greece. EDUCATION AND INFORMATION TECHNOLOGIES 2021; 27:2717-2750. [PMID: 34483704 PMCID: PMC8406380 DOI: 10.1007/s10639-021-10718-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/16/2021] [Indexed: 02/05/2023]
Abstract
In the last decade, interactive touchscreen devices have become ubiquitous in young children, and toddlers first experience touchscreen technology before two. Although parents have a vital role in developing the home environment as a stimulus for development, they also have conflicting views on the appropriateness of using apps to deliver educational content for assorted reasons. The purpose of the study was to reveal various aspects of children's smart mobile use at home, such as the frequency of mobile device usage, preferred app types, and parent beliefs and strategies. Three hundred twenty-five parents of kindergarten children took part in this study. The present study revealed that parents seek to support their children's learning at home via mobile devices. Furthermore, parents lack knowledge about app developmentally appropriateness and need further guidance. We expect the findings to serve as a reference for researchers to better information for parents and create apps with real educational value for children.
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Affiliation(s)
- Stamatios Papadakis
- Department of Preschool Education, School of Education, University of Crete, Rethymnon, Greece
| | - Foteini Alexandraki
- Department of Preschool Education, School of Education, University of Crete, Rethymnon, Greece
| | - Nikolaos Zaranis
- Department of Preschool Education, School of Education, University of Crete, Rethymnon, Greece
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Vaiopoulou J, Papadakis S, Sifaki E, Stamovlasis D, Kalogiannakis M. Parents' Perceptions of Educational Apps Use for Kindergarten Children: Development and Validation of a New Instrument (PEAU-p) and Exploration of Parents' Profiles. Behav Sci (Basel) 2021; 11:82. [PMID: 34071894 PMCID: PMC8227413 DOI: 10.3390/bs11060082] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/13/2021] [Accepted: 05/17/2021] [Indexed: 02/05/2023] Open
Abstract
Contemporary mobile technologies offer tablets and smartphones that elicit young children's active participation in various educational apps, dramatically transforming playing, learning, and communication. Even the most knowledgeable users face difficulties in deciding about the value and appropriateness of the so-called educational apps because of many factors that should be considered. Their importance for children's attitudes is affected by the perceived positive and negative aspects, which vary across a multiplicity of criteria. Filling the gap in the relevant literature, a new instrument, named PEAU-p (Perceptions about Educational Apps Use-parents), was developed and validated in the present study designed to measure parents' perception of educational apps for kindergarten pupils. Data (N = 435) were collected via online procedures, and the psychometric properties of PEAU-p were studied via exploratory and confirmatory methods. Principal Components Analysis extracted six factors, namely Usability, Enjoyment, Involvement, Learning, Worries, and Values, which explained 72.42% of the total variance. Subsequently, by implementing Latent Class Analysis based on the above factors, four Clusters (i.e., parents' Profiles) were extracted corresponding to their perceptions and attitudes towards the educational apps used for kindergarten pupils. Those were named as 'mild attitude', 'negative attitude', 'positive attitude', and 'indifferent attitude'. This categorization, besides the statistical support, is fully interpretable, and the profiles were associated with certain covariates, such as age, the number of children, knowledge on new technologies, or distal outcomes, e.g., the frequency of using apps, the general position towards apps or their intention to recommend apps use. The findings are discussed within the current research field, investigating the influential role parents play in young children's media selection and use.
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Affiliation(s)
- Julie Vaiopoulou
- Department of Education, University of Nicosia, 2417 Nicosia, Cyprus;
| | - Stamatios Papadakis
- Department of Preschool Education, Faculty of Education, University of Crete, 74100 Crete, Greece;
| | - Eirini Sifaki
- Department of Cultural Organisations Management, Hellenic Open University, 26222 Patras, Greece;
| | - Dimitrios Stamovlasis
- Department of Philosophy and Education, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Michail Kalogiannakis
- Department of Preschool Education, Faculty of Education, University of Crete, 74100 Crete, Greece;
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Williamson AA, Gould R, Leichman ES, Walters RM, Mindell JA. Socioeconomic disadvantage and sleep in early childhood: Real-world data from a mobile health application. Sleep Health 2021; 7:143-152. [PMID: 33678602 DOI: 10.1016/j.sleh.2021.01.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 01/05/2021] [Accepted: 01/12/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To examine whether increased socioeconomic disadvantage, indexed using a measure of community distress, was associated with variation in caregiver-reported early childhood sleep patterns and problems in a large US sample using a mobile health application (app). DESIGN Cross-sectional. SETTING Data were collected using the free, publicly available Johnson's Bedtime© baby sleep app. PARTICIPANTS A total of 14,980 caregivers (85.1% mothers) of children ages 6-35.9 months (M = 13.88 months; 52.6% boys) participated in this study. MEASURES Caregivers reported on child sleep using the Brief Infant Sleep Questionnaire-Revised. Socioeconomic disadvantage was indexed by zip code using the Distressed Communities Index (DCI), which combines seven US census indicators of socioeconomic disadvantage. DCI scores range from prosperous (lowest quintile) to distressed (highest quintile). RESULTS Socioeconomic disadvantage was significantly associated with later bedtimes, longer sleep onset latency, and shorter nighttime and 24-hour (total) sleep duration, with children living in distressed communities showing the poorest sleep. However, caregivers living in distressed communities reported a significantly lower prevalence of overall child sleep problems (43% vs 58% in prosperous communities), and more confidence in managing child sleep (42% vs 34% in prosperous communities). CONCLUSIONS Children living in the most distressed communities have the poorest reported sleep patterns and bedtime behaviors; however, their caregivers are less likely to report problematic child sleep. These findings highlight the need for community-level sleep health promotion interventions, as well as further investigation of caregiver perceptions about child sleep and sleep health promotion among families living in socioeconomically disadvantaged contexts.
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Affiliation(s)
- Ariel A Williamson
- Sleep Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
| | - Russell Gould
- Johnson & Johnson Consumer Health, Skillman, New Jersey, USA
| | - Erin S Leichman
- Department of Psychology, Saint Joseph's University, Philadelphia, Pennsylvania, USA
| | | | - Jodi A Mindell
- Sleep Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Psychology, Saint Joseph's University, Philadelphia, Pennsylvania, USA
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McCloskey ML, Johnson SL, Bekelman TA, Martin CK, Bellows LL. Beyond Nutrient Intake: Use of Digital Food Photography Methodology to Examine Family Dinnertime. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:547-555.e1. [PMID: 30826162 PMCID: PMC6511478 DOI: 10.1016/j.jneb.2019.01.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 01/03/2019] [Accepted: 01/23/2019] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To explore the feasibility of using an image-based food photography methodology (Remote Food Photography Method) in a rural, low-resource audience and use the photos to examine the context of family dinner. DESIGN Parents used the SmartIntake app on study-issued tablets to take before and after photos of their and their child's dinner for about 7 nights and participated in a mini-focus group to discuss their experience with the Remote Food Photography Method. SETTING Six Head Start/preschool centers in rural Colorado. PARTICIPANTS Mother-child dyads (n = 31). VARIABLES MEASURED Number and quality of photos received, participant feedback, meal timing, concordance, location, preparation, and quality. ANALYSIS The researchers assessed feasibility via practicality (percent photos received) and acceptability (general inductive approach used to analyze mini-focus group transcripts for participant feedback); time stamps, meal quality, and food preparation scales were used to analyze dinner photos. RESULTS The majority of photographs (738 of 864) were received. Participants reacted favorably to the methodology; for some, it led to greater self-reflection about mealtime. Mother-child dyads usually ate dinner at the same time and often ate the same food. Children were frequently served protein and refined grains and were rarely served whole grains or fruit. Many families relied on convenience foods. CONCLUSIONS AND IMPLICATIONS Digital food photography was feasible in this audience. Photos yielded a holistic picture of family dinnertime: meal timing, location, concordance in parent-child meals, level of preparation, and meal quality.
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Affiliation(s)
- Morgan L McCloskey
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Susan L Johnson
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Traci A Bekelman
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | | | - Laura L Bellows
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
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Chung A, Wallace B, Stanton-Koko M, Seixas A, Jean-Louis G. Feasibility and Acceptability of a Culturally Tailored Website to Increase Fruit and Vegetable Intake and Physical Activity Levels in African American Mother-Child Dyads: Observational Study. JMIR Pediatr Parent 2019; 2:e12501. [PMID: 31518320 PMCID: PMC6715398 DOI: 10.2196/12501] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 12/31/2018] [Accepted: 12/31/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND African American youth (aged 8-14 years) do not adhere to national dietary and physical activity guidelines. Nonadherence to these recommendations contributes to disproportionate rates of obesity compared with their white counterparts. Culturally tailored electronic health (eHealth) solutions are needed to communicate nutrition and physical activity messages that resonate with this target population. OBJECTIVE This study aimed to identify the impact of exposure to a website hosting culturally tailored cartoons to inspire fruit and vegetable uptake and physical activity levels in African American mother-child dyads. METHODS Statistical analysis included paired sample t tests to evaluate knowledge gains, self-efficacy, and readiness to change. Adapted items from Prochaska's Stages of Change toward the following 4 behaviors were assessed with pre- and posttest surveys: (1) fruit and vegetable selection on my plate, (2) meal preparation, (3) fruit and vegetable selection outside of home, and (4) physical activity. Open-ended comments on videos from mother-child dyads were used to determine user acceptance. Observations of repeated responses during content analysis informed coding and development of key themes. RESULTS A final sample size of 93 mother-child dyads completed the study. Mothers reported significant improvement from precontemplation or contemplation stages to preparation or action stages for (1) fruit and vegetable selection on her plate (P=.03), (2) meal preparation for her family (P=.01), (3) fruit and vegetable selection outside the home (P<.001), and (4) physical activity (P<.001). Significant improvements were found in knowledge, stage of change, and self-efficacy for the 4 target behaviors of interest (P<.001). Children's open-ended commentary reported vicarious learning and positive character identification with brown-skinned cartoons exhibiting healthful food and exercise behaviors. Mothers commented on the lack of accessible produce in their neighborhoods not depicted in the cartoon videos. CONCLUSIONS Culturally adapted cartoons that incorporate tailored preferences by African American families, such as race or demography, may help increase adherence to target health behaviors when developing eHealth behavior solutions.
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Affiliation(s)
- Alicia Chung
- New York University School of Medicine, New York, NY, United States
| | - Barbara Wallace
- Teachers College, Columbia University, New York, NY, United States
| | | | - Azizi Seixas
- New York University School of Medicine, New York, NY, United States
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