Evaluation of a Technology-Based Parent Education Tool on Nutrition and Physical Activity of Preschool Children

Background: Childhood obesity has become an epidemic in America, affecting millions of children from early childhood to adolescence. Childhood obesity rates have tripled in the last three decades (CDC, 2016b). Additionally, the obesity epidemic is reaching our nation’s youngest children; it was recently reported that over 20% of 2- to 5-year-old children are overweight or obese (American Academy of Pediatrics [AAP], 2018). Arizona has the fourth highest childhood obesity rate in the nation, hence childhood obesity is a top health concern for this state (Alliance for a Healthier Generation, 2016). Obesity can lead to several adverse health outcomes, including high blood pressure, high cholesterol, cardiovascular disease, type 2 diabetes, and joint disorders. Poor nutrition and physical inactivity are highly correlated with obesity. Nutrition and physical activity promotion among children in clinic settings typically focuses on patient and parent education using verbal advice and written handouts. Current evidence shows that this has proven to be ineffective, as childhood obesity across all children continues to be alarmingly high (CDC, 2016b). Based on this evidence, there is a need for innovative educational methods, such as interactive technology, focused on healthy nutrition and physical activity to decrease current childhood obesity rates. Purpose: The purpose of this DNP project was to improve parent education about healthy nutrition and physical activity among preschool children in southwest Arizona by evaluating an interactive technology-based education tool for use as a preventive approach for childhood obesity. The aim of this project was to determine if parents of preschoolers found an interactive technology-based education tool understandable and actionable. Methods: A pilot study was conducted in which southwest Arizona parents of preschool aged children used the Patient Education Materials Assessment Tool for Audio/Visual (PEMAT-A/V) to evaluate the understandability and actionability of the interactive technology-based education tool, “Healthy Active Living for Families” (HALF) developed by the AAP (2017) (Shoemaker, Wolf, & Brach, 2013). An iPad was used to deliver the educational presentation to parents on healthy nutrition, appropriate physical activity, and healthy living information for preschool aged children. PEMAT-A/V questionnaires were scored and entered into IBM SPSS to determine mean understandability and actionability percent scores. Results: For this study, a PEMAT score of 70% for both understandability and actionability was used as the cutoff for acceptable scores, thus a 70% score or lower is considered lacking understandability and actionability. All parents except one scored the interactive educational presentation above 70% for understandability. The overall mean understandability score was 91% with a standard deviation of 12. Actionability was scored above 70% by eight parents and below 70% by two parents. The overall mean actionability percent score was 86% with a standard deviation of 25. Conclusion: Based on the high PEMAT scores it was found that an iPad delivered interactive educational tool on healthy living was found to be highly understandable and actionable by southwest Arizona parents of preschool children thus it is a useful innovative method of education that can potentially be utilized as a preventive approach to childhood obesity