Strengths and Limitations
This is one of the pioneer studies that provided strong evidence of the effectiveness of a digitally delivered screen time reduction intervention for parents of preschool children. Furthermore, the intervention also measured self-efficacy as a principal construct of the SCT, thus affirming its use in screen time studies. Low attrition rates indicated strong interest among participants in the reduction of screen time among their children. Furthermore, the use of whiteboard animation videos for health education resonates with young mothers who were mainly millennials, that is, Generation Z. Moreover, the remote method of delivery allowed mothers to conveniently access the intervention at a time and place suitable for them.Nevertheless, this study has few limitations. First, the findings need to be interpreted with caution owing to the limited generalizability. Although the use of screen media diaries helped to minimize recall bias, self-reporting by mothers could have been influenced by social desirability related to underreporting their child’s screen time and overembellishing their parenting capabilities, thus raising issues about the fidelity of the outcomes. Second, owing to the remote method of health education delivery, the lack of physical interaction could have resulted in poor interpersonal relationship between the researcher and the participants, indirectly affecting the strength of the outcomes. Furthermore, we were unable to measure the exact amount of physical activity because outdoor activities were not possible during the pandemic. In addition, data collection for both postintervention time points was also subjected to different conditions as compared with that at the baseline owing to the closure of schools during MCO. During the baseline period and 1-month data collection period, children were undergoing web-based school sessions for 1 hour per day, thus leading to long period of participation in screen-based activities at home. However, during the 3-month postintervention data collection period, physical lessons had resumed for all schools, leaving the children with less time to spend on screen-based activities. Finally, we were unable to explicitly verify whether all mothers watched the given videos, as the number of views could have represented repeated viewing from the same participants.