JMIR Publications

ABSTRACT

Background:

Excessive screen time among school-aged children is a growing concern for child health and family routines. A previous systematic review of children aged 6 to 14 years found that excessive screen time is common in this age group, highlighting the need for feasible intervention strategies that can be implemented in daily family routines. Although many health education materials communicate the harms of excessive screen use, families often need practical support to translate risk messages into household rules, parent-child communication, alternative activities, and home environmental changes.

Objective:

This study aimed to conduct a qualitative formative evaluation of a preliminary multicomponent family-based health education package designed to reduce screen time among school-aged children and to identify refinements needed before pilot implementation.

Methods:

Semi-structured online video interviews were conducted with 10 parents or primary caregivers of school-aged children aged 6 to 12 years from October to December 2024. The package included caregiver education for parents and grandparents, child-facing materials such as a picture book and posters, home-use reminder cues, and home environment guidance through an online self-assessment tool. Participants reviewed the package components and commented on clarity, acceptability, perceived usefulness, feasibility, fit with family routines, and suggestions for refinement. Data were analyzed using directed content analysis and thematic analysis, informed by the Theoretical Framework of Acceptability and health communication material-evaluation dimensions.

Results:

Four themes were generated. First, the package was generally regarded as acceptable by the participating caregivers, but comprehension did not always translate into self-reported immediate recall during interviews. Second, concrete, scenario-based messages were described as more meaningful than abstract risk information. Third, caregivers wanted action guidance rather than additional risk information. Fourth, caregivers preferred practical, age-adapted, and home-embedded tools that could be repeatedly encountered in daily routines.

Conclusions:

The preliminary multicomponent family-based screen-time education package was generally regarded as acceptable by the participating caregivers, but refinement is needed before pilot implementation. The findings suggest that the package should move beyond general risk communication toward a family action toolkit that combines caregiver guidance, child-facing materials, concrete consequence chains, parent-child negotiation supports, replacement activity lists, and home environmental cues.