Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong).
School of Health and Society and Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia.
J Med Internet Res. 2024 Feb 21;26:e52905. doi: 10.2196/52905.
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.
背景:儿童期不健康运动行为的高发率仍是一个全球性的公共卫生问题。电子健康(eHealth)被认为是一种具有成本效益的方法,有望改善健康和相关行为。然而,之前针对促进行为改变的 eHealth 干预措施的研究主要集中在青少年和成年人,针对学龄前儿童的证据有限。
目的:本综述旨在研究 eHealth 干预措施在促进 24 小时运动行为方面的有效性,特别是在改善学龄前儿童的身体活动(PA)和睡眠持续时间以及减少久坐行为方面。此外,我们评估了各种研究特征对干预效果的调节作用。
方法:我们于 2023 年 2 月在 6 个电子数据库(PubMed、Ovid、SPORTDiscus、Scopus、Web of Science 和 Cochrane 对照试验中心注册)中搜索了具有随机分组程序的实验研究,以评估 eHealth 干预措施对 2 至 6 岁学龄前儿童 24 小时运动行为的有效性。研究结果包括 PA、睡眠持续时间和久坐时间。使用随机效应模型进行荟萃分析评估汇总效果,进行亚组分析以探索干预持续时间、干预类型和偏倚风险(ROB)等调节因素的潜在影响。对纳入的研究使用 Cochrane ROB 工具进行了严格的 ROB 评估。此外,使用 GRADE(推荐评估、制定与评价)评估对证据的确定性进行了评估。
结果:在 7191 条记录中,有 19 条(0.26%)被纳入系统评价。荟萃分析包括了来自 13 项纳入研究的 2971 名学龄前儿童样本。与对照组相比,eHealth 干预措施显著增加了中度到剧烈强度的 PA(Hedges g=0.16,95%置信区间 0.03-0.30;P=.02)和总 PA(Hedges g=0.37,95%置信区间 0.02-0.72;P=.04)。此外,eHealth 干预措施还显著减少了久坐时间(Hedges g=-0.15,95%置信区间-0.27 至-0.02;P=.02)并增加了睡眠持续时间(Hedges g=0.47,95%置信区间 0.18-0.75;P=.002)。然而,未观察到任何变量的显著调节作用(P>.05)。对中度至剧烈强度 PA 和久坐时间结局的证据质量评为“中度”,对睡眠结局的证据质量评为“低”。
结论:eHealth 干预措施可能是一种增加学龄前儿童 PA、改善睡眠和减少久坐时间的有前途的策略。为了在儿童早期有效促进健康行为,未来的研究必须优先制定具有更大样本量的严格比较试验。此外,研究人员应仔细研究潜在调节因素的影响。还迫切需要全面探讨这些干预措施的长期效果。
试验注册:PROSPERO CRD42022365003;http://tinyurl.com/3nnfdwh3。
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