ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Children and Health
Volume 13 - 2025 | doi: 10.3389/fped.2025.1382428
This article is part of the Research TopicDigital Media Use in Early Childhood - Contextual Factors, Developmental Outcomes and PathwaysView all 8 articles
Process Evaluation of a Germany-wide complex intervention to prevent dysregulated screen time in under threes: a RE-AIM-approach
Provisionally accepted
Juliane Schemmer1,2*
David D. Martin1,2,3
Hanno S. Krafft1
Tobias Maurer1Anke Emgenbroich4Sean Monks5Silke Schwarz1- 1Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany
- 2Interprofessional Graduate School Integrative Medicine and Health, Health Department, Witten/Herdecke University, Witten, Germany
- 3Department of Pediatrics, University of Tübingen, Tübingen, Baden-Württemberg, Germany
- 4BVKJ Service GmbH, Cologne, Germany
- 5Other, Munich, Germany
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Background: Children's current screen time is well above current recommendations and is associated with many health consequences in the first years of life.Methods: The complex intervention study "Screen free till 3" introduced parent education to a regular examination of 6-month-old children in outpatient pediatric practices. Pediatric practices were cluster-randomized in a 2:1 ratio (intervention group:control group). 2,581 pediatric practices received the intervention materials by cold call and participated by self-selection. The study includes a process evaluation that examines the implementation process. In this article, four different quantitative methods of the process evaluation are evaluated according to the RE-AIM scheme.Result: 33.4 % of pediatric practices confirmed their participation in the study. 10,391 parents took part in the pre-interventional app-based parent survey. 151 interested institutions contacted the research team by email. The majority (84.1 %) asked to take part in the study. 518 pediatric practices took part in a telephone survey, of which 87.2 % said that they supported the intervention materials and 91.6 % would recommend the project to others. Discussion: The RE-AIM analysis shows a high reach of parents via the app. The high adoption by pediatric practices and other institutions characterizes the relevance of the topic as well as the innovation of the study materials. After one and a half years, the intervention is firmly integrated into the structures of pediatric practices in Germany.Trial register number: DRKS00032258; https://drks.de/search/de/trial/DRKS00032258
Keywords: Birth cohort study, screen time, Pediatrics, outpatient, complex intervention, randomized controlled trial, re-aim, Healthcare research
Received: 05 Feb 2024; Accepted: 10 Apr 2025.
Copyright: © 2025 Schemmer, Martin, Krafft, Maurer, Emgenbroich, Monks and Schwarz. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Juliane Schemmer, Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.