JMIR Publications

ABSTRACT

Background:

High prevalence of unhealthy movement behaviors in young children remains a global public health issue. eHealth interventions represent a potentially valuable route to improving health indicators by increasing accessibility and reducing costs. Prior studies on interventions targeting behavior change have predominantly concentrated on adolescents and adults, with less evidence available for preschoolers.

Objective:

The purpose of this review is to examine the effectiveness and summarize the characteristics of eHealth interventions in promoting 24-hour movement behaviors (sleep, sedentary behaviour, physical activity) among preschoolers.

Methods:

We searched six electronic databases for randomized controlled trails (RCT) and quasi-experimental studies that examined the effectiveness of eHealth interventions on 24-hour movement behaviors among preschoolers aged 2-6 years. Meta-analysis was conducted to assess the pooled effect utilizing a random-effects model. Subgroup analyses were carried out to investigate the potential moderate effects of other factors (e.g., intervention duration, intervention type, and risk of bias).

Results:

Of 7691 identified records, 19 studies were included in the systematic review. The sample size for the meta-analysis is 2971 preschoolers from the included 13 studies. Compared with control group, eHealth interventions significantly increased moderate- to vigorous-intensity physical activity (MVPA, g=0.16, 95% CI 0.03 to 0.30, P=.02) and total physical activity (g=0.37, 95% CI 0.02 to 0.72, P=.04). In addition, eHealth interventions significantly reduced sedentary behaviors (SED, g=-0.15, 95% CI -0.27 to -0.02, P=.02) and increased sleep duration (g=0.47, 95% CI 0.18 to 0.75, P<.01) immediately after the intervention. The overall quality of evidence was rated as ‘moderate’ for MVPA and SED outcomes, and ‘low’ for sleep outcomes.

Conclusions:

eHealth interventions may be a promising strategy to increase PA and sleep duration and decrease SED among preschoolers. However, effects were small and only evident immediately after the intervention. Future studies need to design comparative trials of higher quality and with larger sample sizes to promote healthy 24-hour movement behaviors and sustain long-term effects for young children. Clinical Trial: This review was registered with PROSPERO (CRD42022365003).