TY  - JOUR
AU  - Li, Yun
AU  - Xiao, Qiuli
AU  - Chen, Min
AU  - Jiang, Chunhua
AU  - Kang, Shurong
AU  - Zhang, Ying
AU  - Huang, Jun
AU  - Yang, Yulin
AU  - Li, Mu
AU  - Jiang, Hong
PY  - 2024
DA  - 2024/7/4
TI  - Improving Parental Health Literacy in Primary Caregivers of 0- to 3-Year-Old Children Through a WeChat Official Account: Cluster Randomized Controlled Trial
JO  - JMIR Public Health Surveill
SP  - e54623
VL  - 10
KW  - health literacy
KW  - WeChat
KW  - cluster randomized controlled trial
KW  - RCT
KW  - randomized
KW  - controlled trial
KW  - controlled trials
KW  - parental
KW  - parenting
KW  - parents
KW  - parent
KW  - China
KW  - Chinese
KW  - mHealth
KW  - mobile health
KW  - app
KW  - apps
KW  - applications
KW  - pediatric
KW  - pediatrics
KW  - paediatric
KW  - paediatrics
KW  - infant
KW  - infants
KW  - infancy
KW  - baby
KW  - babies
KW  - neonate
KW  - neonates
KW  - neonatal
KW  - newborn
KW  - newborns
KW  - toddler
KW  - toddlers
AB  - Background: Parental health literacy is important to children’s health and development, especially in the first 3 years. However, few studies have explored effective intervention strategies to improve parental literacy. Objective: This study aimed to determine the effects of a WeChat official account (WOA)–based intervention on parental health literacy of primary caregivers of children aged 0-3 years. Methods: This cluster randomized controlled trial enrolled 1332 caregiver-child dyads from all 13 community health centers (CHCs) in Minhang District, Shanghai, China, between April 2020 and April 2021. Participants in intervention CHCs received purposefully designed videos via a WOA, which automatically recorded the times of watching for each participant, supplemented with reading materials from other trusted web-based sources. The contents of the videos were constructed in accordance with the comprehensive parental health literacy model of WHO (World Health Organization)/Europe (WHO/Europe). Participants in control CHCs received printed materials similar to the intervention group. All the participants were followed up for 9 months. Both groups could access routine child health services as usual during follow-up. The primary outcome was parental health literacy measured by a validated instrument, the Chinese Parental Health Literacy Questionnaire (CPHLQ) of children aged 0-3 years. Secondary outcomes included parenting behaviors and children’s health outcomes. We used the generalized linear mixed model (GLMM) for data analyses and performed different subgroup analyses. The β coefficient, risk ratio (RR), and their 95% CI were used to assess the intervention’s effect. Results: After the 9-month intervention, 69.4% (518/746) of caregivers had watched at least 1 video. Participants in the intervention group had higher CPHLQ total scores (β=2.51, 95% CI 0.12-4.91) and higher psychological scores (β=1.63, 95% CI 0.16-3.10) than those in the control group. The intervention group also reported a higher rate of exclusive breastfeeding (EBF) at 6 months (38.9% vs 23.44%; RR 1.90, 95% CI 1.07-3.38) and a higher awareness rate of vitamin D supplementation for infants younger than 6 months (76.7% vs 70.5%; RR 1.39, 95% CI 1.06-1.82). No significant effects were detected for the physical score on the CPHLQ, breastfeeding rate, routine checkup rate, and children’s health outcomes. Furthermore, despite slight subgroup differences in the intervention’s effects on the total CPHLQ score and EBF rate, no interaction effect was observed between these subgroup factors and intervention factors. Conclusions: Using a WHO literacy model–based health intervention through a WOA has the potential of improving parental health literacy and EBF rates at 6 months. However, innovative strategies and evidence-based content are required to engage more participants and achieve better intervention outcomes. Trial Registration: Chinese Clinical Trial Registry ChiCTR2000031711; https://www.chictr.org.cn/showproj.aspx?proj=51740 
SN  - 2369-2960
UR  - https://publichealth.jmir.org/2024/1/e54623
UR  - https://doi.org/10.2196/54623
DO  - 10.2196/54623
ID  - info:doi/10.2196/54623
ER  -