Effectiveness of Using Social Media in a Family-based Intervention for Childhood Obesity

This intervention programme is targetted for parents of obese and overweight primary school children. It uses REDUCE intervention programme, which is developed based on the social cognitive theory (SCT). REDUCE is an acronym for REorganise Diet, Unnecessary sCreen time and Exercise. The theory explains behaviour as a reciprocal interaction between person, behaviour and environmental factors. Changing the children’s behaviours on dietary intake and physical activity requires improvement in parental knowledge, self-efficacy, healthy practices, parenting skills and environment that is conducive to change which help facilitate and influence the children’s engagement in healthy behaviours. The key components of SCT used include self-monitoring, goal setting, self-efficacy, problem-solving, relapse prevention and stimulus control. The intervention is provided to the parents in two phases. Phase one is a four-week group training using the REDUCE module. The training involves two face-to-face training and two sessions using Facebook. The face-to-face training is at week one and week four that take place at Universiti Putra Malaysia, half a day training for each session. It is delivered by the researcher who is a family health specialist. However, the intervention was developed to be delivered by paramedical staffs. The module has 8 units which covered on nutrition, physical activity, behavioural modification techniques and parental authoritative feeding style. The exercise tip in Unit 8 is delivered by a sport medicine specialist. For the two sessions using Facebook, the units in the REDUCE module are uploaded weekly and parents can download the units at their own convenience, with no time limit. Parents are encouraged to read, understand, give comments, and post questions on the same day. The researcher designates one-hour session to provide feedback and discussion in response to any queries by the parents on the same day. To ensure confidentiality, this Facebook group was made private, which is a readily built-in feature of Facebook. All sessions are delivered to parents only, except for face-to-face session two where both parents and children are invited. The training phase is followed by a booster phase. The duration of the booster phase is three months and it comprises of weekly information, delivered via WhatsApp, containing the gist of the content of each unit that is provided during the four-week training, as well as health tips and performance feedback. The information in the booster session are extracted from the REDUCE module and formatted as a poster before sending to the WhatsApp dedicated group. The booster acts as a refresher and to strengthen their knowledge of the targeted behaviours of the REDUCE programme. Parents are encouraged to communicate with the researcher and other parents in the designated WhatsApp group to improve knowledge and skills of the parents in achieving the targeted behaviours. In total, for the training and booster phase, parents are in contact with the researcher weekly for 16 weeks. Parents’ adherence in Facebook is assessed by the number and percentage of ‘seen’ in the Facebook. Parents’ adherence in WhatsApp is counted when they accessed the messages. To encourage participation in the social media, only members of the intervention group can access the dedicated social media groups (to assure confidentiality and privacy) and discussion are promoted among participants–researcher and participants–participants. Parents are also encouraged to support each other freely in the social media to maintain high motivation.