Background: Preschoolers’ lifestyles have become physically inactive and sedentary, their eating habits have become unhealthy, and their sleep routines have become increasingly disturbed. Parent-based interventions have shown promise to improve physical activity (PA), improve dietary behavior (DB), and reduce sleep problems among preschoolers. However, because of the recognized obstacles of face-to-face approaches (eg, travel costs and time commitment), easy access and lower costs make eHealth interventions appealing. Previous studies that examined the effectiveness of parent-based eHealth for preschoolers’ PA, DB, and sleep have either emphasized 1 variable or failed to balance PA, DB, and sleep modules and consider the intervention sequence during the intervention period. There is an acknowledged gap in parent-based eHealth interventions that target preschoolers raised in Chinese cultural contexts. Objective: This study aims to investigate the effectiveness of a parent-based eHealth intervention for PA, DB, and sleep problems among Chinese preschoolers. Methods: This 2-arm, parallel, randomized controlled trial comprises a 12-week intervention with a 12-week follow-up. A total of 206 parent-child dyads will be randomized to either an eHealth intervention group or a control group. Participants allocated to the eHealth intervention group will receive 12 interactive modules on PA, DB, and sleep, with each module delivered on a weekly basis to reduce the sequence effect on variable outcomes. The intervention is grounded in social cognitive theory. It will be delivered through social media, where parents can obtain valid and updated educational information, have a social rapport, and interact with other group members and facilitators. Participants in the control group will receive weekly brochures on PA, DB, and sleep recommendations from kindergarten teachers, but they will not receive any interactive components. Data will be collected at baseline, 3 months, and 6 months. The primary outcome will be preschoolers’ PA. The secondary outcomes will be preschoolers’ DB, preschoolers’ sleep duration, preschoolers’ sleep problems, parents’ PA, parenting style, and parental feeding style. Results: Parent-child dyads were recruited in September 2023. Baseline and posttest data collection occurred from October 2023 to March 2024. The follow-up data will be obtained in June 2024. The results of the study are expected to be published in 2025. Conclusions: The parent-based eHealth intervention has the potential to overcome the barriers of face-to-face interventions and will offer a novel approach for promoting a healthy lifestyle among preschoolers. If this intervention is found to be efficacious,
Background: The prevalence of physical inactivity, unhealthy diet, and sleep disturbance among preschoolers is increasing dramatically. Parents play a crucial role in fostering their children’s physical activity (PA), dietary behaviors, and sleep habits. Face-to-face interventions have barriers such as time commitment, making eHealth options appealing. However, current parent-based eHealth interventions have limitations in design (eg, focus on a single outcome, imbalanced content, and sequence), and their results cannot be generalized to other regions. Objective: This study aims to assess the effectiveness of parent-based eHealth interventions targeting PA, dietary behaviors, and sleep in preschoolers in China. Methods: This single-blinded randomized controlled trial with 2 parallel arms comprised a 12-week intervention followed by a 12-week follow-up, conducted from September 2023 to June 2024 in China. The intervention, grounded in social cognitive theory, included 12 interactive modules on PA (n=4), dietary behaviors (n=4), and sleep (n=4), each delivered weekly via social media. Each module consisted of videos, evidence-based information, parent interaction, goal setting, and feedback. The control group received a weekly electronic pamphlet via WeChat without interactive components. Preschoolers’ PA, sleep duration, and sleep quality were assessed using the wGT3X-BT ActiGraph, while dietary behaviors, sleep problems, and screen time were reported by parents through paper-based questionnaires. Generalized estimating equations, adjusting for demographic covariates, were used to examine the effects of the parent-based eHealth intervention on preschoolers’ outcomes. Results: A total of 237 eligible parent-child dyads were randomly assigned to the intervention group (n=120, mean age 4.51 years, SD 0.72 years; n=67, 55.8%, boys) or the control group (n=117, mean age 4.31 years, SD 0.70 years; n=69, 59%, boys). At baseline, 237 parents completed questionnaires, and 196 preschoolers provided valid ActiGraph data. At posttest, 181 parents completed questionnaires, and 166 preschoolers provided valid ActiGraph data (intervention, n=90; control, n=91). At follow-up, 181 parents again completed questionnaires, and 170 preschoolers provided valid ActiGraph data (intervention, n=90; control, n=91). Educating parents about healthy lifestyles through social media had a positive impact on preschoolers’ light PA (vs control: adjusted mean difference –151.61 minutes/7 days, 95% CI –418.18 to –96.67, P=.002, Cohen d=0.28), vigorous PA (vs control: adjusted mean difference 138.47 minutes/7 days, 95% CI 117.61-183.10, P=.03, Cohen d=0.23), sleep latency (vs control: adjusted mean difference –21.04 minutes/day, 95% CI –16.07 to –6.00, P=.005, Cohen d=0.78), sleep efficiency (vs control: adjusted mean difference 4.61%, 95% CI 4.29-9.72, P<.001, Cohen d=0.34), and screen time (vs control: on weekdays, adjusted mean difference –16.42 minutes/weekday, 95% CI –30.83 to –2.01, P=.01, Cohen d=0.25; on weekends, adjusted mean difference –73.88 minutes/weekend day, 95% CI –98.48 to –49.28, P<.001, Cohen d=.46). Conclusions: The findings may help address unhealthy lifestyles commonly observed in young children. Further efforts are needed to leverage cutting-edge technological advancements to support families in creating healthy living environments for children across broader regions. Trial Registration: ClinicalTrials.gov NCT06025019; https://clinicaltrials.gov/ct2/show/NCT06025019