ABSTRACT

Introduction

Mobile apps (i.e. mHealth) provide unprecedented opportunity for widespread dissemination of health behavior programs. However, for programs directed towards young children, parental engagement may explain differing results of mHealth programs. Within the context of an app-based fundamental motor skill (FMS) intervention that improved children’s motor skills (PLAY), this paper examines parents’ fidelity to the intervention and the extent to which fidelity was related to children’s motor skill improvements.

Methods

In the PLAY trial, 72 children aged 3–5 years were randomized for their parents to access a Motor Skills app or Free Play app for a 12-week intervention. The Motor Skills app contained lessons, videos, and activity breaks totaling 1 h/week of directed FMS instruction by the parent to the child over a 12-week period. The Free Play app was similar in appearance and format but focused on unstructured physical activity. Children’s FMS were evaluated with the Test of Gross Motor Development (TGMD-3) at baseline, 12-weeks, and 24-week follow-up. Implementation fidelity data included dosage completed (activity breaks completed), parental engagement (duration of video views), and quality of intervention delivery (feasibility and acceptability). Dosage and engagement were dichotomized within the Motor Skills condition into high vs. low. Linear mixed effects models were used to examine the association of dosage completed and parental engagement with changes in children’s FMS both within and between conditions. The level of significance was set at 0.05 for all analyses.

Results

Children completed 70% (8.4 of 12 h) of the prescribed activity breaks based on parental report in the Motor Skills condition and 87% (10.4 of 12 h) in the Free Play condition (not significantly different). Parental engagement based on video viewing duration for the Motor Skills condition was on average 8.0 ± 8.6 of the 9.8 available minutes and for the Free Play condition was 5.0 ± 5.5 of the available 18 min, with no significant difference between conditions. Parents rated high acceptability and usability for both apps. Children in the Motor Skills condition improved their FMS more than children in the Free Play condition regardless of whether they were classified as receiving high or low dosage or high or low parental engagement.

Conclusion

Parents and children consistently engaged with a 12-week Motor Skills app intervention, and the salience of FMS improvements did not differ by the level of parent fidelity or engagement with the mHealth app. The intervention potency, parental engagement, and dosage completed were sufficient to produce the desired child motor skills improvements.

中文翻译：

---

幼儿移动健康运动技能干预中家长的参与和实施保真度

摘要

介绍

移动应用程序（即移动医疗）为健康行为计划的广泛传播提供了前所未有的机会。然而，对于针对幼儿的计划，家长的参与可能可以解释移动医疗计划的不同结果。在基于应用程序的基本运动技能（FMS）干预提高儿童运动技能（PLAY）的背景下，本文研究了父母对干预的忠诚度以及忠诚度与儿童运动技能提高的相关程度。

方法

在 PLAY 试验中，72 名 3-5 岁的儿童被随机分配给他们的父母使用 Motor Skills 应用程序或 Free Play 应用程序进行为期 12 周的干预。运动技能应用程序包含课程、视频和活动休息时间，在 12 周内由家长向孩子提供每周总计 1 小时的 FMS 指导。Free Play 应用程序的外观和格式类似，但侧重于非结构化的身体活动。在基线、12 周和 24 周随访时通过粗大运动发育测试 (TGMD-3) 评估儿童的 FMS。实施保真度数据包括完成的剂量（完成的活动休息）、家长参与度（视频观看的持续时间）和干预实施的质量（可行性和可接受性）。在运动技能条件下，剂量和参与度分为高与低。使用线性混合效应模型来检查完成剂量和家长参与与儿童 FMS 在条件内和条件之间的变化之间的关系。所有分析的显着性水平均设为 0.05。

结果

根据家长报告，儿童在运动技能条件下完成了 70%（12 小时中的 8.4 小时）规定的活动休息时间，在自由玩耍条件下完成了 87%（12 小时中的 10.4 小时）（无显着差异）。基于视频观看持续时间的家长参与度，在运动技能条件下，平均为 9.8 分钟可用分钟的 8.0 ± 8.6，在免费游戏条件下，平均为可用分钟 18 分钟的 5.0 ± 5.5，两种条件之间没有显着差异。家长对这两款应用程序的接受度和可用性评价很高。运动技能条件下的儿童​​比自由玩耍条件下的儿童​​改善了更多的 FMS，无论他们被归类为接受高剂量还是低剂量，或者父母参与度高还是低。

结论

家长和孩子持续参与为期 12 周的运动技能应用程序干预，并且 FMS 改进的显着性并不因家长忠诚度或对移动医疗应用程序的参与程度而有所不同。干预效力、家长参与和完成的剂量足以产生所需的儿童运动技能改善。