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Modifying media content for preschool children: a randomized controlled trial.

ABSTRACT: Although previous studies have revealed that preschool-aged children imitate both aggression and prosocial behaviors on screen, there have been few population-based studies designed to reduce aggression in preschool-aged children by modifying what they watch.We devised a media diet intervention wherein parents were assisted in substituting high quality prosocial and educational programming for aggression-laden programming without trying to reduce total screen time. We conducted a randomized controlled trial of 565 parents of preschool-aged children ages 3 to 5 years recruited from community pediatric practices. Outcomes were derived from the Social Competence and Behavior Evaluation at 6 and 12 months.At 6 months, the overall mean Social Competence and Behavior Evaluation score was 2.11 points better (95% confidence interval [CI]: 0.78-3.44) in the intervention group as compared with the controls, and similar effects were observed for the externalizing subscale (0.68 [95% CI: 0.06-1.30]) and the social competence subscale (1.04 [95% CI: 0.34-1.74]). The effect for the internalizing subscale was in a positive direction but was not statistically significant (0.42 [95% CI: -0.14 to 0.99]). Although the effect sizes did not noticeably decay at 12 months, the effect on the externalizing subscale was no longer statistically significant (P = .05). In a stratified analysis of the effect on the overall scores, low-income boys appeared to derive the greatest benefit (6.48 [95% CI: 1.60-11.37]).An intervention to reduce exposure to screen violence and increase exposure to prosocial programming can positively impact child behavior.

SUBMITTER: Christakis DA

PROVIDER: S-EPMC3581844 | biostudies-literature | 2013 Mar

REPOSITORIES: biostudies-literature

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Modifying media content for preschool children: a randomized controlled trial.

Christakis Dimitri A DA Garrison Michelle M MM Herrenkohl Todd T Haggerty Kevin K Rivara Frederick P FP Zhou Chuan C Liekweg Kimberly K

Pediatrics 20130218 3

<h4>Background</h4>Although previous studies have revealed that preschool-aged children imitate both aggression and prosocial behaviors on screen, there have been few population-based studies designed to reduce aggression in preschool-aged children by modifying what they watch.<h4>Methods</h4>We devised a media diet intervention wherein parents were assisted in substituting high quality prosocial and educational programming for aggression-laden programming without trying to reduce total screen t ...[more]

PMID: 23420911

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Project description:BackgroundThe promotion of a healthy lifestyle among preschool children is essential for establishing their future habits. Evidence indicates that the incorporation of philosophical thinking-encompassing critical, creative, and compassionate thought-can significantly contribute to children's cognitive and moral growth, thereby positively affecting their health-related decisions. This research evaluated the effects of imparting healthy lifestyle practices through philosophical thinking to preschool children.MethodsThis randomized controlled trial involved 120 preschoolers, who were randomly assigned to intervention groups for children, parents, and a control group. Educational sessions were conducted in the intervention groups of preschool children and parents using various educational tools such as films, narratives, and games. Data analysis was performed using SPSS and JAMOVI software.ResultsThe present study provides evidence that instruction in healthy lifestyle behaviors grounded in philosophical thinking significantly enhances the healthy lifestyle practices of preschool children and their parents. The statistical analyses indicate that the improvements achieved are statistically significant, with both children and parents demonstrating enhancements in healthy lifestyle behavior scores two and four months following the intervention. While the effect sizes may be relatively small, the significance of the results underscores the potential for philosophical thinking interventions to foster positive behavior changes over time.ConclusionsThis research showed that teaching healthy lifestyle practices through philosophical thinking improved healthy behaviors in preschool-aged children. The results were more pronounced in children than in their parents. Future studies should focus on longer interventions and explore the effects across different age groups.Trial registrationThe international trial code is IRCT20230703058651N1 (date of registration 03/07/2023).

Project description:ObjectiveLiving in poverty increases exposure to adversities that undermine healthy development, impeding growth in the social-emotional and language skills that support adaptive coping and promote mental health. Evidence-based programs have the potential to improve current preschool practice and strengthen these early skills, potentially reducing risk for later psychopathology. The authors tested the hypothesis that an enrichment program in preschool would be associated with reduced levels of psychopathology symptoms at the transition from middle to secondary school.MethodsThe Head Start REDI (Research-Based, Developmentally Informed) intervention was used to enrich preschool classrooms serving children from low-income families with an evidence-based social-emotional learning (SEL) program and a coordinated interactive reading program. Centers were randomly assigned to the intervention or usual practice, and 356 4-year-olds (58% White, 25% Black, 17% Latino; 54% female) were followed into early adolescence. Hierarchical linear models were used to evaluate intervention effects on teacher-rated psychopathology symptoms using the Strengths and Difficulties Questionnaire in grade 7 (ages 12-13) and grade 9 (ages 14-15), 8-10 years after the end of the intervention.ResultsStatistically significant intervention-related reductions were observed in conduct problems and emotional symptoms in the intervention group. In addition, the proportion of youths with clinically significant levels of conduct problems, emotional symptoms, and peer problems was reduced in the intervention group, with rates one-third of those in the control group.ConclusionsThe study findings indicate that enriching preschool programs serving at-risk children with a relatively inexpensive evidence-based SEL program with interactive reading substantially improved the later benefits for adolescent emotional and behavioral health. This kind of SEL enrichment represents an approach that can leverage public investments in preschool programs to enhance public health.

Project description:BackgroundMarine resources including fatty fish are important sources of n-3 long chain polyunsaturated fatty acids (n-3 LC-PUFAs), which are important for brain development. To our knowledge, this is the first randomized controlled trial (RCT) investigating the impact of fatty fish on cognition in preschool children. The purpose of the trial was to investigate whether an increased intake of fatty fish compared to meat improves cognitive function in children 4-6 years old.MethodsThe children (n = 232) in this two-armed RCT, Fish Intervention Studies-KIDS (FINS-KIDS) were recruited from 13 kindergartens in Bergen, Norway. They were randomly assigned to lunch meals with fatty fish (herring/mackerel) or meat (chicken/lamb/beef) three times a week for 16 weeks. The fish and meat were weighed before and after the meals to record the exact consumption (dietary compliance). The primary outcome was cognitive function measured by the Wechsler Preschool and Primary Scale of Intelligence, 3rd edition (WPPSI-III) and fine-motor coordination measured by the 9-Hole Peg Test (9-HPT) at pre- and post-intervention. Biological samples (blood, urine, hair), and questionnaires to the caregivers were included at both time points. Linear mixed effect models with a random intercept for kindergarten were used to analyze changes from pre- to post-intervention in the primary outcome variables.ResultsThere were 218 children included in the trial (105 in the fish, and 113 in the meat group). The children consumed a mean (standard deviation) of 2070 (978) g fish or 2675 (850) g meat from the study meals (p < 0.0001). The fish group had a significant increase of red blood cell n-3 LC-PUFAs. The intervention had no effect on the WPPSI-III scores (mean change total raw score; fish group 17.7, 95% confidence interval (CI) 14.8-20.7 vs meat group 17.8, 95% CI 15.0-20.6, p = 0.97) in the main analyses. In the sub-analyses, adjusting for dietary compliance, the fish group showed a higher improvement on total raw score (20.4, 95% CI 17.5-23.3) compared to the meat group (15.2, 95% CI 12.4-18.0, p = 0.0060); docosahexaenoic acid mediated this effect.ConclusionsThere was no beneficial effect of fatty fish compared to meat on cognitive functioning in the preschool children. When considering dietary compliance, we found a beneficial effect of fatty fish on cognitive scores.Trial registrationClinicalTrials.gov, NCT02331667 December 17, 2014.

Project description:BackgroundElectronic health (eHealth) obesity programs offer benefits to traditionally delivered programs and have shown promise in improving obesity-related behaviors in children.ObjectiveThis study aimed to assess the efficacy of a parent-focused, internet-based healthy lifestyle program for preschool-aged children, who are overweight or at or above the fiftieth percentile for body mass index (BMI) for their age and sex, on child BMI, obesity-related behaviors, parent modeling, and parent self-efficacy.MethodsThe Time2bHealthy randomized controlled trial was conducted in Australia, during 2016 to 2017. Participants were recruited both online and through more traditional means within the community. Parent or carer, and child (aged 2-5 years) dyads were randomized into an intervention or comparison group. Intervention participants received an 11-week internet-based healthy lifestyle program, underpinned by social cognitive theory, followed by fortnightly emails for 3 months thereafter. Intervention participants set goals and received individual feedback from a dietitian. They were also encouraged to access and contribute to a closed Facebook group to communicate with other participants and the dietitian. Comparison participants received email communication only. Objectively measured child BMI was the primary outcome. Secondary outcomes included objectively measured physical activity, parent-measured and objectively measured sleep habits, and parent-reported dietary intake, screen time, child feeding, parent modeling, and parent self-efficacy. All data were collected at face-to-face appointments at baseline, 3 months, and 6 months by blinded data collectors. Randomization was conducted using a computerized random number generator post baseline data collection.ResultsA total of 86 dyads were recruited, with 42 randomized to the intervention group and 44 to the comparison group. Moreover, 78 dyads attended the 3- and 6-month follow-ups, with 7 lost to follow-up and 1 withdrawing. Mean child age was 3.46 years and 91% (78/86) were in the healthy weight range. Overall, 69% (29/42) of participants completed at least 5 of the 6 modules. Intention-to-treat analyses found no significant outcomes for change in BMI between groups. Compared with children in the comparison group, those in the intervention group showed a reduced frequency of discretionary food intake (estimate -1.36, 95% CI -2.27 to -0.45; P=.004), and parents showed improvement in child feeding pressure to eat practices (-0.30, 95% CI 0.06 to -0.00; P=.048) and nutrition self-efficacy (0.43, 95% CI 0.10 to 0.76; P=.01). No significant time by group interaction was found for other outcomes.ConclusionsThe trial demonstrated that a parent-focused eHealth childhood obesity prevention program can provide support to improve dietary-related practices and self-efficacy but was not successful in reducing BMI. The target sample size was not achieved, which would have affected statistical power.Trial registrationAustralian New Zealand Clinical Trials Registry ANZCTR12616000119493; https://www.anzctr.org.au/ Trial/Registration/TrialReview.aspx?id=370030 (Archived by WebCite at http://www.webcitation.org/74Se4S7ZZ).

Project description:BackgroundAntibiotics are frequently used to treat wheezing children. Macrolides may be effective in treating bronchiolitis and asthma.MethodWe completed a prospective, double-blinded, randomized placebo-control trial of azithromycin among pre-school children (12 to 60 months of age) presenting to the emergency department with wheeze. Patients were randomized to receive either five days of azithromycin or placebo. Primary outcome was time to resolution of respiratory symptoms after treatment initiation. Secondary outcomes included the number of days children used a Short-Acting Beta-Agonists during the 21 day follow-up and time to disease exacerbation during the following six months (unscheduled health care visit or treatment with an oral corticosteroid for acute respiratory symptoms).ResultsOf the 300 wheezing children recruited, 222 and 169 were analyzed for the primary and secondary outcomes, respectively. The treatment groups had similar demographics and clinical parameters at baseline. Median time to resolution of respiratory symptoms was four days for both treatment arms (interquartile range (IQR) 3,6; p = 0.28). Median number of days of Short-Acting Beta-Agonist use among those who received azithromycin was four and a half days (IQR 2, 7) and five days (IQR 2, 9; p = 0.22) among those who received placebo. Participants who received azithromycin had a 0.91 hazard ratio for time to six-month exacerbation compared to placebo (95% CI 0.61, 1.36, p = 0.65). A pre-determined subgroup analysis showed no differences in outcomes for children with their first or repeat episode of wheezing. There was no significant difference in the proportion of participants experiencing an adverse event.ConclusionAzithromycin neither reduced duration of respiratory symptoms nor time to respiratory exacerbation in the following six months after treatment among wheezing preschool children presenting to an emergency department. There was no significant effect among children with either first-time or prior wheezing.

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Modifying media content for preschool children: a randomized controlled trial.

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Modifying media content for preschool children: a randomized controlled trial.

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