Abstract

BackgroundChildhood obesity is still a major health problem in many countries, including Sweden. Childhood obesity and obesity-related behaviours in childhood, such as low physical activity and unhealthy eating habits, tend to track into adulthood, which highlights the need for early prevention. Our aims are to evaluate whether a parent-oriented mobile health app (the MINISTOP 2.0 app) integrated into primary child health care can improve diet and physical activity behaviours and reduce the prevalence of overweight and obesity in preschool-aged children as well as to evaluate the implementation among child health care nurses and parents.MethodsThis trial uses a hybrid type 1 effectiveness-implementation design. Families (n = 500) who attend a routine visit to one of 15–20 primary child health care centres throughout Sweden, when their child is 2.5 years, are offered participation in a randomised controlled trial (effectiveness evaluation). After acceptance, families will be randomised (1:1) to control or intervention groups. The intervention group receives a 6-month parent-oriented smartphone intervention aimed at improving the dietary and activity behaviours of their child (the MINISTOP 2.0 app) and the control group receives routine child health care. Dietary habits, physical activity and screen time (primary outcomes), body weight and height in children, and parental self-efficacy (secondary outcomes) are measured at baseline and at 6 months post randomisation. Implementation outcomes (i.e. perceived acceptability, appropriateness, and feasibility) of the intervention will be assessed among primary child health care nurses and parents in the trial through questionnaires and qualitative interviews.DiscussionThis trial will evaluate whether the MINISTOP 2.0 app can be used in primary child health care to improve diet and physical activity behaviours, and prevent overweight and obesity, in preschool-aged children. If effectiveness is proven, and the MINISTOP 2.0 app is considered acceptable, appropriate and feasible, it can be implemented nationally as part of the preventive strategies to combat childhood obesity provided by routine child health care.Trial registrationThe trial was registered at the Clinicaltrials.gov register platform (ID NCT04147039) on 31 October 2019.

Highlights

  • Childhood obesity is still a major health problem in many countries, including Sweden

  • Henriksson et al BMC Public Health (2020) 20:1756 (Continued from previous page) parents in the trial through questionnaires and qualitative interviews. This trial will evaluate whether the MINISTOP 2.0 app can be used in primary child health care to improve diet and physical activity behaviours, and prevent overweight and obesity, in preschool-aged children

  • The MINISTOP 2.0 app is considered acceptable, appropriate and feasible, it can be implemented nationally as part of the preventive strategies to combat childhood obesity provided by routine child health care

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Summary

Methods

Setting and study design The trial is based on a hybrid type 1 study design which combines an effectiveness study with an implementation study [32]. Participants in the intervention group are given access to the MINISTOP 2.0 app for 6 months, in addition to standard care, while those in the control group only receive age-appropriate information about healthy food and physical activity that currently is provided by routine child health care. The nurse again measures the child’s weight and height and the parents complete the same questionnaire about the child’s food, physical activity, screen time, fitness and dental health behaviours At this visit, the control group will be offered access to the MINISTOP 2.0 app. Implementation evaluation Implementation will be investigated in terms of perceived acceptability, appropriateness, and feasibility concerning the MINISTOP 2.0 app among primary child health care nurses and parents of the children participating in the randomised controlled trial

Discussion
Background
Participants and data collection
Findings
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