Abstract
BackgroundParticipation in electronic media use among 2–3 year olds is high and associated with adverse health and developmental outcomes. This study sought to test the feasibility and potential efficacy of a family-based program to decrease electronic media (EM) use in 2–3-year-old children.MethodsFamily@play was a six-session pilot randomised controlled trial delivered to parents of 2–3 year-old children from August to September 2012 in a community environment in the Illawarra region of New South Wales, Australia. Development of program content was guided by Social Cognitive and Family Systems Theories. The primary outcome was children’s electronic media use. Secondary outcomes included children’s time in sitting, standing and stepping. Data collectors were blinded to group allocation. Parents completed comprehensive process evaluation measures and participated in focus group discussions following completion of the program. Regression analyses were undertaken and effect sizes calculated using principles of intention to treat.ResultsTwenty-two participants (n = 12 intervention; n = 10 control) provided complete baseline data; complete data from 16 participants (n = 6 intervention; n = 10 control) were available post-intervention. Process evaluation results were high, showing the acceptability of the program. Compared with children in the control group, there were greater decreases in total EM use among children in the intervention group (adjusted difference [95 % CI] = −31.2 mins/day [−71.0–8.6] Cohen’s d = 0.70). Differences for other outcomes were in the hypothesised direction and ranged from small for postural (sitting, standing, stepping) outcomes to moderate to large for individual electronic media (e.g. TV viewing, DVD/video viewing).ConclusionsThis is the first family-based study to engage families of 2–3 year old children outside the United States and target multiple EM behaviours. Family@play was shown to be a feasible and acceptable intervention to deliver to families of 2–3 year old children. Potential efficacy is evident from moderate to large effect sizes. A larger trial is warranted to test the efficacy of the program.Trial registrationAustralian New Zealand Clinical Trials Registry (ACTRN12612000470897).
Highlights
Participation in electronic media use among 2–3 year olds is high and associated with adverse health and developmental outcomes
Recruitment occurred through local community groups, such as playgroups, early childhood classes and childcare centres, where families with young children were likely to attend, and with a University-wide email invitation
The results show that Family@play was feasible, acceptable and potentially efficacious in reducing children’s electronic media use
Summary
Participation in electronic media use among 2–3 year olds is high and associated with adverse health and developmental outcomes. Young children spend up to 85 % of their day being sedentary [10,11,12]; that is, participating in behaviours in a sitting or lying posture while expending low levels of energy [13] Such behaviours have been independently associated with adverse health outcomes even in children [14] and co-exist with multiple other unhealthy behaviours including poor dietary behaviours [15]. Such high levels of EM use and sedentary behaviours during early childhood are alarming as it is acknowledged that this period is foundational in the development of health behaviours such as these [16]. That by two years of age, these behaviours may already be established, high in prevalence, and stable
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