State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China.
J Med Internet Res. 2021 Apr 30;23(4):e24316. doi: 10.2196/24316.
The COVID-19 pandemic has led to worldwide school closures, with millions of children confined to online learning at home. As a result, children may be susceptible to anxiety and digital eye strain, highlighting a need for population interventions.
The objective of our study was to investigate whether a digital behavior change intervention aimed at promoting physical activity could reduce children's anxiety and digital eye strain while undergoing prolonged homeschooling during the COVID-19 pandemic.
In this cluster randomized controlled trial, homeschooled grade 7 students at 12 middle schools in southern China were recruited through local schools and randomly assigned by the school to receive (1:1 allocation): (1) health education information promoting exercise and ocular relaxation, and access to a digital behavior change intervention, with live streaming and peer sharing of promoted activities (intervention), or (2) health education information only (control). The primary outcome was change in self-reported anxiety score. Secondary outcomes included change in self-reported eye strain and sleep quality.
On March 16, 2020, 1009 children were evaluated, and 954 (94.5%) eligible children of consenting families were included in the intention-to-treat analysis. Children in the intervention (n=485, 6 schools) and control (n=469, 6 schools) groups were aged 13.5 (SD 0.5) years, and 52.3% (n=499) were male. The assigned interventions were completed by 896 children (intervention: n=467, 96.3%; control: n=429, 91.5%). The 2-week change in square-root-transformed self-reported anxiety scores was greater in the intervention (-0.23, 95% CI -0.27 to -0.20) vs control group (0.12, 95% CI 0.09-0.16; unadjusted difference -0.36, 95% CI -0.63 to -0.08; P=.02). There was a significant reduction in square-root-transformed eye strain in the intervention group (-0.08, 95% CI -0.10 to 0.06) compared to controls (0.07, 95% CI 0.05-0.09; difference -0.15, 95% CI -0.26 to -0.03; P=.02). Change in sleep quality was similar between the two groups.
This digital behavior change intervention reduced children's anxiety and eye strain during COVID-19-associated online schooling.
ClinicalTrials.gov NCT04309097; http://clinicaltrials.gov/ct2/show/NCT04309097.
COVID-19 大流行导致全球范围内的学校关闭，数以百万计的儿童只能在家中接受在线学习。因此，儿童可能容易出现焦虑和数字眼疲劳，这凸显了需要进行人群干预。
我们的研究目的是调查一项旨在促进体育活动的数字行为改变干预措施是否可以减少儿童在 COVID-19 大流行期间长时间在家接受 homeschooling 时的焦虑和数字眼疲劳。
在这项整群随机对照试验中，通过当地学校招募了 12 所中国南方中学的 7 年级 homeschooled 学生，并按学校随机分配（1:1 分配）：（1）健康教育信息，促进运动和眼部放松，并可以访问数字行为改变干预措施，包括直播和同龄人的活动分享（干预组），或（2）健康教育信息（对照组）。主要结局是自我报告的焦虑评分变化。次要结局包括自我报告的眼疲劳和睡眠质量变化。
2020 年 3 月 16 日，评估了 1009 名儿童，其中 954 名（94.5%）同意参加家庭的合格儿童被纳入意向治疗分析。干预组（n=485，6 所学校）和对照组（n=469，6 所学校）的儿童年龄为 13.5（SD 0.5）岁，其中 52.3%（n=499）为男性。完成了分配的干预措施的儿童有 896 名（干预组：n=467，96.3%；对照组：n=429，91.5%）。干预组（-0.23，95%CI-0.27 至-0.20）与对照组（0.12，95%CI0.09 至 0.16）相比，2 周内自我报告的焦虑评分的平方根变化更大（未调整差异-0.36，95%CI-0.63 至-0.08；P=.02）。与对照组相比，干预组的眼疲劳平方根变化明显降低（-0.08，95%CI-0.10 至 0.06）（差异-0.15，95%CI-0.26 至-0.03；P=.02）。两组之间的睡眠质量变化相似。
在 COVID-19 相关的在线学校教育期间，这种数字行为改变干预措施降低了儿童的焦虑和眼疲劳。
ClinicalTrials.gov NCT04309097；http://clinicaltrials.gov/ct2/show/NCT04309097。
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