Reducing screen-time and unhealthy snacking in 9-11 year old children: the Kids FIRST pilot randomised controlled trial

Background
Many young people form unhealthy behavioural habits, such as low intake of fruit and vegetables, high intake of energy-dense snack foods, and excessive sedentary screen-based behaviours. However, there is a shortage of parent-and home-focused interventions to change multiple health behaviours in children.
Methods
Kids FIRST was a 12-week, home- and school-based pilot randomised controlled trial to reduce screen-time and unhealthy snacking with assessments at pre- (baseline) and post-intervention. Four UK schools were randomised to control or one of three interventions targeting reductions in (1) screen-time and unhealthy snacking (ST+Sn), (2) screen-time (ST only), (3) unhealthy snacking (Sn only), and parents with children aged 9-11 years were recruited via schools. Intervention group parents received four online ‘sessions’ and four packages of resources tailored to each group. Children received four 30-minute lessons during school time. Children and parents reported their own screen-time behaviours, children reported their own snacking behaviours. Descriptive analyses were undertaken using principles of intention to treat.
Results
Initial feasibility was shown in that this study successfully recruited schools and families into all four study arms and retained them over a period of 13 weeks (retention rate ≥74%). Seventy-five children and 64 parents provided full baseline questionnaire data. Reductions in children’s school day and weekend day TV/DVD viewing and computer game use were found in the ST+Sn and ST groups, while self-reported smartphone use increased in these groups. Similar results were found for parents’ TV/DVD, computer and smartphone use in these groups. Little to no changes were found in reports of the dietary variables assessed in any intervention group for children or parents.
Conclusions
These preliminary findings show some promise for the Kids FIRST intervention. Based on these findings, a future full trial should recruit a more diverse sample of families and optimise the intervention and intervention resources to more fully engage parents with the dietary-based components of the intervention programme, where fewer changes were seen. Although most parents reporting receiving the intervention resources, further development work is required to achieve higher levels of engagement. This might include greater parent and child engagement work early in the development of the project.
Trial Registration: retrospectively registered in June 2019 with ClinicalTrials.gov (number NCT03993652)