Abstract
BackgroundSocial media may be an effective medium by which parents could be trained to promote healthy eating behaviour and physical activity for their children. This trial evaluates the effectiveness of a family-based intervention using social media in combination with face-to-face sessions - the REDUCE (REorganise Diet, Unnecessary sCreen time and Exercise) programme - on adiposity of Malay children.MethodsFive primary schools in an urban area in Selangor, Malaysia participated in this two-arm randomized controlled field trial. Participants were parents (n = 134) and their primary school-going children 8–11 years of age who were either overweight or obese. These parent-child dyads were randomly allocated to intervention and wait-list control groups and were blinded to group assignment. The intervention was a four-week training programme using two face-to-face sessions and two Facebook sessions followed by weekly booster sessions over a three-month period using WhatsApp. The primary outcome was body mass index (BMI) z-score. Height, body weight, waist circumference and percentage of body fat were measured by blinded assessors. Data were collected at baseline (T1), immediately post-training (T2) and at three- (T3) and six-month post training (T4) and were analysed using generalized linear mixed modelling adjusted for covariates to estimate the intervention effects. Subgroup analysis was conducted for overweight and obese children.ResultsNinety-one percent of parents completed the study, 64 in intervention group and 58 in wait-list group. At the sixth month post-training, BMI z-scores were significantly reduced in the intervention group compared to the wait-list group, for the all children (overweight and obese children) and within the obese subgroup ((F(6, 517) = 2.817, p = 0.010) and (F(6, 297) = 6.072, p < 0.001) respectively. For waist circumference percentile and body fat percentage, the intervention group experienced a significant reduction compared to the wait-list group, within the obese subgroup ((F(6, 297) = 3.998, p = 0.001) and within the overweight subgroup (F(6, 201) = 2.526, p = 0.022).ConclusionsThe four-month REDUCE intervention programme was effective in reducing childhood adiposity. Further research using this approach needs to be conducted including cost-effectiveness studies before implementing it in a child obesity prevention programme.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12617000844347 (7 June 2017 retrospectively registered). National Medical Research Register, Ministry of Health Malaysia: NMRR-14-685-21,874 (July 2014).
Highlights
Social media may be an effective medium by which parents could be trained to promote healthy eating behaviour and physical activity for their children
The aim of this study is to evaluate the effectiveness of using social media and face-to-face sessions in a family-based intervention on the primary outcome of body mass index (BMI) z-score and secondary outcomes of waist circumference percentile and percentage total body fat
There was no significant difference between parents who remained in the study and parents who dropped out in terms of sociodemographic characteristics, parental BMI and the anthropometric measurements of their children
Summary
Social media may be an effective medium by which parents could be trained to promote healthy eating behaviour and physical activity for their children. This trial evaluates the effectiveness of a family-based intervention using social media in combination with face-to-face sessions - the REDUCE (REorganise Diet, Unnecessary sCreen time and Exercise) programme - on adiposity of Malay children. The prevalence of overweight and obesity among children 5 to 19 years of age was reported to have experienced a tenfold increase worldwide from 11 million in 1975 to 124 million in 2016 [1]. Some ethnic groups are more affected by obesity and in Malaysia, the Chinese have the highest prevalence of obesity (13.0%), followed by Indians (12.6%) and Malays (11.8%). Healthy lifestyle programmes that are socio-culturally customized may be more effective [7] and this intervention programme was tailored to the Malay ethnicity
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