Optimising 24-Hour movement behaviours in preschoolers through parenting practices: an evidence-based intervention study.

BACKGROUND: Establishing healthy 24-hour movement behaviours early in life is crucial for long-term health. However, few preschoolers comply with the 24-hour movement behaviour guidelines. Given the pivotal role of parents in shaping children's health habits, interventions targeting parenting practices may optimise these behaviours in preschoolers. This study evaluates the effectiveness of the 'Move ARound And Get Active' (MARGA) intervention in improving preschoolers' 24-hour movement behaviour composition, guideline compliance, and parents' parenting practices. METHODS: A two-armed, non-equivalent pretest-post-test control group design was conducted in Belgium. The MARGA intervention, co-created with parents, incorporated seven interactive sessions over 11 weeks, focussing on parenting practices conceptualised within the Self-Determination Theory and behaviour change methods such as planning and goal setting. Participants included preschoolers (2.5-6 years) and one parent per child (n = 141; 49 intervention, 92 control). The primary outcomes were changes in preschoolers' 24-hour movement behaviour composition and guideline compliance measured using accelerometers and proxy-reported diary. Secondary outcomes included changes in proxy-reported parents' parenting practices. Both intention-to-treat (ITT) and per-protocol (PP) analyses were performed. In addition, intervention implementation was investigated. RESULTS: The intervention showed no significant impact on the overall 24-hour movement behaviour composition, nor on 24 h-movement behaviour guideline compliance. However, favourable intervention effects were observed for screen time guideline compliance (ITT: d = 1.5, p = 0.04, PP: d = 8.6, p = < 0.001) and combinations of screen time and physical activity (ITT: d = 1.2, p = 0.05, PP: d = 1.7, p = 0.04) or sleep (PP: d = 1.7, p = 0.05) guideline compliance. Parenting practices also improved in parents from the intervention condition compared to parents from the control condition, including setting screen time rules (ITT: d = 0.79, p = 0.01, PP: d = 1.1, p = 0.001), providing choices within sleep routines (ITT: d = 0.63, p = 0.04, PP: d = 0.68, p = 0.05), parent and preschooler performing physical activity together (PP: d = 0.76, p = 0.03) and explaining screen time rules (PP: d = 0.68, p = 0.05). Implementation scores indicated moderate engagement, with attendance rates averaging 49.7%. CONCLUSIONS: The intervention showed modest improvements in preschoolers' 24-hour movement behaviours and parenting practices. Extended follow-up observations might be required to capture changes in preschoolers' 24-hour movement behaviours, especially considering that the intervention targets preschoolers indirectly by first aiming to influence parents' parenting practices. TRIAL REGISTRATION: ClinicalTrials.gov (ID NCT06171191).