Comparison with previous work
SECONDARY, STILL
To date, there are no other app-based interventions targeting healthy lifestyle behaviors in preschool-aged children offered through child health care. However, a few web-based eHealth interventions have been conducted, that were also linked to a child/youth health care setting. Van Grieken et alWe also observed a statistically significant effect on screen time. This effect was possibly driven by screen time during weekdays, where an effect size of almost 8 min per day less screen time was observed. Interestingly, this effect is comparable to the long-term follow-up results of the INFANT trial: a more traditional and resource-intense face-to-face intervention delivered by dietitians in 2-h sessions every three months to first time parents of infants aged 4 months [Interestingly, parents in the intervention group reported a higher PSE for promoting healthy diet and physical activity behaviors at follow-up. As parents are key players in promoting healthy lifestyle behaviors for this age group, we believe that this was a meaningful finding. Our results are also in accordance with Möhler et alWe did not observe any intervention effect on children’s BMI z-score, however, this was not expected as it may take longer than six months to observe changes in children’s body weight. Furthermore, the intervention was primarily aimed at promoting healthy lifestyle behaviors and therefore included children from all BMI-categories, with the majority classified as having normal weight. Due to the above-mentioned reasons, BMI was also defined as our secondary outcome a priori. Still, the positive intervention effects on dietary and screen time behaviors and PSE, could lead to potential positive effects on BMI later on in childhood. Our null finding for BMI is also in line with the results of Derwig et al