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A peer-to-peer live-streaming intervention for children during COVID-19 homeschooling to promote physical activity and reduce anxiety and eye strain: Cluster randomized controlled trial

Date

2021

Authors

Zheng, Yingfeng
Wang, Wei
Zhong, Yuxin
Wu, Fengchun
Zhu, Zhuoting
Tham, Yih-Chung
Lamoureux, Ecosse
Xiao, Liang
Zhu, Erta
Liu, Haoning

Journal Title

Journal ISSN

Volume Title

Publisher

Journal of medical Internet Research

Abstract

Background: The COVID-19 pandemic has led to worldwide school closures, with millions of children 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 aimed at promoting physical activity could reduce children's anxiety and digital eye strain while undergoing prolonged homeschooling during the COVID-19 pandemic. Methods: In this cluster randomized controlled trial, homeschooled grade 7 students at 12 middle schools in southern China were recruited through local schools and randomly assigned by the school to receive (1:1 allocation): (1) health education information promoting exercise and ocular relaxation, and access to a digital behavior change intervention, with live streaming and peer sharing of promoted activities (intervention), or (2) health education information only (control). The primary outcome was change in self-reported anxiety score. Secondary outcomes included change in self-reported eye strain and sleep quality. Results: On March 16, 2020, 1009 children were evaluated, and 954 (94.5%) eligible children of consenting families were included in the intention-to-treat analysis. Children in the intervention (n=485, 6 schools) and control (n=469, 6 schools) groups were aged 13.5 (SD 0.5) years, and 52.3% (n=499) were male. The assigned interventions were completed by 896 children (intervention: n=467, 96.3%; control: n=429, 91.5%). The 2-week change in square-root-transformed self-reported anxiety scores was greater in the intervention (-0.23, 95% CI -0.27 to -0.20) vs control group (0.12, 95% CI 0.09-0.16; unadjusted difference -0.36, 95% CI -0.63 to -0.08; P=.02). There was a significant reduction in square-root-transformed eye strain in the intervention group (-0.08, 95% CI -0.10 to 0.06) compared to controls (0.07, 95% CI 0.05-0.09; difference -0.15, 95% CI -0.26 to -0.03; P=.02). Change in sleep quality was similar between the two groups. Conclusions: This digital behavior change intervention reduced children's anxiety and eye strain during COVID-19-associated online schooling.

Description

Keywords

homeschooling, children, anxiety, digital eye strain, peer to peer, live streaming, digital health, intervention, health information, physical activity, COVID-19, online learning, behavior, app, mobile phone

Citation

Source

Journal of Medical Internet Research

Type

Journal article

Book Title

Entity type

Access Statement

Open Access

License Rights

Creative Commons Attribution License

DOI

10.2196/24316

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