Digital Intervention Strategies for Increasing Physical Activity Among Preschoolers: Systematic Review

Abstract

Background Digital interventions are increasingly used to improve health behaviors. Improved access and lower costs (relative to in-person interventions) make such interventions appealing. Specifically, digital platforms may be a promising approach for increasing physical activity (PA) in young children. Objective The goal of this systematic review was three-pronged: (1) to determine the quality of studies using digital PA intervention strategies with preschool-aged children (ie, 3 to 5 years old); (2) to assess the efficacy of digital interventions and approaches designed to improve PA in preschool-aged children; and (3) to examine theoretical application and implementation outcomes with current approaches to digital PA interventions. Methods This review identified and summarized studies on digitally supported interventions for promoting PA in preschool-aged children. We generated 3 lists of relevant search terms that included technology-related terms, PA-related terms, and weight-related terms. The search included Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, and Daily, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. Study selection was led by a single author and verified by a second; the same 2 authors assessed study quality using a standardized tool, and 3 authors completed data extraction on PA outcomes, theory application, and implementation outcomes. Results In total, 601 studies were identified; 8 met the inclusion criteria. For study quality, only 2 studies received an overall rating of strong quality and low risk of bias. All but 1 study had a small sample size (<100). Positive and significant changes in child PA outcomes were reported in only 2 studies with weak overall quality, both of which used child-directed approaches. In total, 5 studies applied a behavioral theory for designing the intervention; no patterns of effectiveness were identified based on the application of theory. Finally, no studies reported on the implementation outcomes of adoption, cost, penetration, or sustainability; 1 study did not assess any implementation outcomes, and no single study reported on more than 2 implementation outcomes. Studies measured the implementation outcome of acceptability most frequently (n=4), and researchers assessed fidelity in 3 studies. Conclusions The interventions with a significant effect on PA used child-centered activities; parent-directed digital interventions alone were ineffective for improving PA. Future research with rigorous designs, monitoring of implementation outcomes, and testing of the contributions of digital components will advance understanding of the effectiveness of digital interventions for increasing PA in children.

Effective management of sedentary behavior among Indian university students: An empirical exploration into health-related behavior

“…[ 44 45 ] Technological interventions have demonstrated their potential in promoting physical activity and well-being across clinical populations and mixed populations. [ 46 47 48 49 50 51 52 53 ] These interventions have shown promise in addressing a spectrum of health conditions, such as diabetes, cardiovascular diseases, and mental health disorders, by facilitating behavior change and encouraging active lifestyles.…”

“…An increase in remote studies, which were conducted to implement management strategies for sedentary behavior, was observed. [ 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 ] Given the notable rise in sedentary behaviors and the increasing prevalence of obesity,[ 71 ] there is a compelling need for research on interventions that promote active and healthier lifestyles. Continual research is warranted to regularly update the data pertaining to the physical activity levels of school-age children, adolescents, and adults, as well as their respective sedentary behaviors.…”

Direct Parent Engagement to Improve Fundamental Movement Skills in Children: A Systematic Review

“…Mobile devices are now integral to everyday family routines, and parents are generally supportive of their use as a tool for behavioural management, including FMS delivery [96]. Consequently, digital PA interventions are an increasingly appealing method as they may improve the access and practicality for parents and are low in cost compared to in-person interventions [97]. Both digital studies included reported high levels of engagement that may have contributed to the improvement in FMS, possibly because the families found the apps to be fun and engaging, user friendly, and flexible to allow convenient access from the comfort of the home [77].…”

An Intervention Pattern of Family Parent-Child Physical Activity Based on a Smartphone App for Preschool Children during COVID-19

“…This study explored the feasibility and effectiveness of an online platform-based PA intervention model for preschool children's families during the COVID-19 epidemic. In the case of school suspension during the epidemic period, the content of family sports activities suitable for the physical [22]. The main reason for this result was that the parents played only a supervisory role in the interventions included in the analysis and did not participate in the practice with their children through the same intervention.…”

“…A recently published review analyzed nearly 6 years of research published on digital intervention strategies to improve PA in preschoolers. It found that implementing child-centered digital PA interventions in kindergartens significantly improved physical activity in preschoolers, but implementing digital PA interventions monitored only by parents was not effective in improving PA levels in preschoolers [ 22 ]. The main reason for this result was that the parents played only a supervisory role in the interventions included in the analysis and did not participate in the practice with their children through the same intervention.…”