JMIR Publications

ABSTRACT

Background:

The family environment plays a critical role in shaping children’s health behaviors, particularly during early childhood when lifestyle habits are developing. Family-based lifestyle interventions are a cornerstone of childhood obesity prevention but often yield modest effects and have several limitations, including a focus on a single caregiver (usually the mother), and insufficient attention to coparenting dynamics. Mobile health (mHealth) interventions that focus on young children, include multiple caregivers, and target coparenting practices are rare, but have the potential to amplify parenting intervention effects, leading to stronger child health outcomes.

Objective:

This protocol describes a randomized controlled trial (RCT) designed to evaluate the efficacy of the Good Start Matters mHealth Parenting Program in improving parenting and coparenting practices (primary outcomes) and child health behaviors (secondary outcomes) among 2.5-6-year-olds.

Methods:

This RCT will recruit 118 two-parent families (i.e., families with two caregivers participating in the trial) from childcare centers across British Columbia, Canada. To promote inclusivity, one-parent families (i.e., only one parent participating) will also be eligible provided that they meet the eligibility criteria, but they will not count toward the target sample size for recruitment purposes. Eligibility criteria include at least one parent having primary custody of a child aged 2.5-6 years old, both parents being fluent in English, and each caregiver owning a smartphone device. In addition, children must not have severe limitations that prevent adherence to general nutritional and 24-hour movement guidelines, nor can they be undergoing weight management treatment. After baseline data collection, families will be randomized into either the intervention group, who will receive immediate access to the app, or a waitlist control group, which will gain access to the app after the follow-up assessment, two months later. Baseline and follow-up assessments will collect data on food, physical activity, and media parenting practices, coparenting agreement, and child eating, active play, and screen time behaviors. To analyze the data while accounting for its nested structure (two parents nested within families with repeated measures over time), multilevel mixed-effects models, integrating intention-to-treat principles and imputation techniques when necessary, will be used. Sensitivity dose-response analyses will assess the extent to which differential adherence/exposure to the intervention influences the study’s outcomes.

Results:

N/A

Conclusions:

This study will provide critical insights into the potential of mHealth interventions to improve parenting and coparenting practices while promoting healthier child behaviors during early childhood. The Good Start Matters mHealth Parenting Program has the potential to strengthen the foundation of family-centered interventions and set a new standard for systemic approaches to early childhood obesity prevention. Clinical Trial: ClinicalTrials.gov (NCT05802160), Registered on March 2023.