An Online Resource for Monitoring 24-Hour Activity in Children and Adolescents: Observational Analysis

Abstract

Background: The Singapore integrated 24-hour activity guide for children and adolescents was introduced to promote healthy lifestyle behaviors, including physical activity, sedentary behavior, sleep, and diet, to enhance metabolic health and prevent noncommunicable diseases. To support the dissemination and implementation of these recommendations, a user-friendly online resource was created to help children and adolescents adopt these behaviors in Singapore.

Objective: This study aimed to assess the acceptability of the online resource in the adoption of healthier lifestyle behaviors, and the change in the users' behaviors with the use of this online resource.

Methods: Participants aged 7-17 years were required to log their activity levels of the past 7 days at the beginning and at the end of a 3-month period using the browser-based online resource, including information on the duration and frequency of moderate- to vigorous-intensity physical activity (MVPA), length of sedentary behavior, duration and regularity of sleep, and food portions. User satisfaction, on the length, ease of use, and relevance of the online resource, was also recorded using a 10-point Likert scale. Descriptive statistics and statistical analyses, including the Wilcoxon signed rank test and McNemar test, were carried out at baseline and at the end of 3 months.

Results: A total of 46 participants were included for analysis. For physical activity, the number of days of MVPA increased from a median of 3 (IQR 2-5) days to 4 (IQR 2-5) days (P=.01). For sedentary behavior, the median daily average screen time decreased from 106 (IQR 60-142.5) minutes to 90 (IQR 60-185) minutes. For sleep, 10% (5/46) more participants met the recommended duration, and the number of days with regular sleep increased from a median of 6 (IQR 5-7) days to 7 (IQR 5-7) days (P=.03). For diet, there was a decrease in the portion of carbohydrates consumed from a median of 42% (IQR 30-50) to 40% (IQR 30-48.5; P=.03), and the number of days of water and unsweetened beverage consumption remained stable at a median of 5 days but with a higher IQR of 4-7 days (P=.04). About 90% (39-41/46) of the participants reported that the online resource was relevant and easy to use, and the rating for user satisfaction remained favorable at a median of 8 with a higher IQR of 7-9 (P=.005).

Conclusions: The findings support the development of a dedicated online resource to assist the implementation of healthy lifestyle behaviors based on the Singapore integrated 24-hour activity guide for children and adolescents. This resource received favorable ratings and its use showed the adoption of healthier behaviors, including increased physical activity and sleep, as well as decreased sedentary time and carbohydrate consumption, at the end of a 3-month period.

Keywords: 24-hour activity; adolescent; child; diet; online; physical activity; sedentary behaviour; sleep.

Figure 1.. Sample of report, messages and advice generated in the online resource tool (green color shown) when recommendations are met for sedentary behavior.

Figure 2.. Sample of report, messages, and advice generated in the online resource tool (yellow color shown) when some recommendations are met for sleep.

Figure 3.. Sample of report, messages, and advice generated in the online resource tool (red color shown) when recommendations are not met for eating habits.

Figure 4.. Questions asked and sample response in the online resource tool for physical activity.

Figure 5.. Questions asked and sample response in the online resource tool for eating habits.