Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Sep 25, 2020
Date Accepted: Apr 14, 2021
Date Submitted to PubMed: Apr 21, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A peer-to-peer live streaming intervention aimed at promoting physical activity reduces anxiety and eye strain among children during COVID-19 home schooling: a cluster randomized controlled trial
ABSTRACT
Background:
The COVID-19 pandemic has led to global school closures, and millions of children are 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.
Objective:
The objective of our study was to investigate whether a digital behavior change intervention could reduce children's anxiety and digital eye strain while undergoing prolonged home schooling during the COVID-19 pandemic.
Methods:
In this cluster-randomized trial, home-schooled grade-7 students at 12 middle schools in southern China were recruited through local schools, and randomly assigned by school (1: 1) to receive: health education information promoting exercise and ocular relaxation, and access to the digital behavior change intervention, allowing live stream and peer-sharing of promoted activities (Intervention) or health education information only (Control). Primary outcome was change in self-reported anxiety score. Secondary outcomes included change in self-reported eye strain and sleep quality.
Results:
On 16 March 2020, 1009 children were evaluated, of whom 954 (94.5%) eligible children of consenting families were included in intention-to-treat analysis. Children in the Intervention (n=485, 6 schools) and Control (n=469, 6 schools) groups were aged 13·5 ± 0·5 years and 52·3% were boys. Assigned interventions were completed by 896 children (Intervention: 96.3%, Control: 91.5%). The 2-week change in square root-transformed self-reported anxiety scores was greater in the Intervention (-0·23 [95% confidence interval (CI): -0·27, -0·20]) vs Control group (0·12 [95%CI: 0·09, 0·16]; unadjusted difference -0·36, [95% CI: -0·63, -0·08]; p=0·017). There was a significant reduction in square root-transformed eye strain in the intervention group (-0·08 [95%CI: -0·10, 0·06]) compared to controls (0·07 [95%CI: 0·05, 0·09]; difference -0·15 [95%CI: -0·26, -0·03]; p=0·015). Change in sleep quality was similar between groups.
Conclusions:
This digital behavior change intervention reduced children’s anxiety and eye strain during COVID-associated online schooling. Clinical Trial: ClinicalTrials.gov, NCT04309097.
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