Effects of an SMS-Based Parenting Intervention on Anxiety Symptoms in Preschool Children

Excessive screen use and anxiety symptoms in preschool children have become increasingly prominent public health problems. This randomized controlled trial aims to determine whether, compared with a control group, an ecological momentary parenting intervention delivered via text messages and a WeChat public account can reduce screen use, anxiety symptoms, and social-emotional behavior problems in preschool children. A total of 356 caregiver-child dyads with children aged 3 to 6 years will be randomly assigned to an intervention group with 178 dyads or a control group with 178 dyads. The intervention group will receive an ecological momentary parenting intervention, including text messages and posts on a WeChat public account, focusing on guidance for emotion recognition, anxiety soothing, establishing regular routines, and reasonable screen use management. The control group will receive only general pediatric health science popularization text messages, which do not include content related to child emotion management, anxiety intervention, or screen use management. The primary outcome is children's anxiety symptoms, assessed by the Spence Preschool Anxiety Scale. Secondary outcomes include children's screen use assessed by the ScreenQ scale and social-emotional behavior problems assessed by the Social Competence and Behavior Evaluation Scale-30 (SCBE-30)

Inclusion Criteria: 1. Children between 3 and 6 years of age and their primary caregivers; 2. The primary caregiver possesses a mobile phone with SMS-receiving capability, and is able to read and comprehend Chinese; 3. Provide informed consent to participate in both the intervention and the study assessments. Exclusion Criteria: 1. The child has a diagnosed neurodevelopmental or psychiatric disorder; 2. The child is undergoing other forms of intervention or psychological therapy at the time of the study;