4. Discussion
unintentional injuries
The present study aimed to explore the mechanisms underlying the effect of online-social-media-based parental health-education interventions for improving children's health status and parents' associated knowledge and skills. To perform this exploration, SNA was applied. Comparing the outcomes for the intervention group with those for the control group provided the following main results:Regarding hypothesis HRegarding hypothesis HRegarding hypothesis HFrom the perspective of the intervention platform and tools, the present study used WeChat as the intervention platform. WeChat is not only free, but is also used widely in China to communicate with others one-to-one or in groups. In addition, this application can help people search for specific information. WeChat has similar functions to Facebook and Twitter, which are widely used in Western countries such as America; this is notable because these social-network systems have been found to potentially be effective for providing health education and for sharing information with others (From the perspective of SNA, some studies of community-based interventions have found that the intervention information can be diffused through social interactions, such as active and voluntary communication with other group members; this is similar to the observations of the present study (The health education conducted in this study was in an mHealth format, and the strengths of this health-education program and study were as follows:First, this health-education program could shorten social distance. Social distance, one of the components of psychological distance (Second, health education could save community childcare doctors time. Through expert interviews, the community childcare doctor stated that the health education allowed more parents to acquire childcare knowledge and improve their knowledge and skills relating to preventing children from acquiring injuries. Concurrently, the intervention also encouraged parents to answer other parents' questions, leaving the community childcare doctor to merely judge whether the parents' answers were correct and sufficiently detailed.Third, the WeChat-group-based parental-health-education intervention imitated real-world communication, lending it a certain sense of realness.Fourth, this is the first study to explore the mechanism of an online-social-network-based parental-health education intervention designed to reduce the incidence of unintentional injuries among children, and it was found that such an intervention can enhance parents' knowledge, attitudes, and behaviors in this regard.In contrast, the study also had some limitations:First, the study featured social desirability bias. This study was conducted in Shanghai, China, where parents generally have a higher level of education (Second, because the health-education platform was online social media, to access the health-education platform a certain level of regional economic development was necessary.Third, to assess the mechanisms of health education and their effectiveness, two groups were established, a WeChat group containing parents only and a WeChat group that featured parents and a community childcare doctor. However, the parents-only WeChat group still provided a low level of health education. The reason we did not create a blank control is that it is difficult to confirm parents' issues and questions when examining off-line health education.The interaction of the intervention group was closer than that of the control group, which may indicate that the effectiveness of the health education originates from communication between parents and/or from communication between parents and the community childcare doctor. In short, although SNA is seldom used to analyze the mechanism of unintentional-injury prevention, the present study obtains the same conclusions as similar previous studies (