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Digital Learning Could Prevent Obesity in Low-Income Children


Overall, home visitation staff support the use of technology-enhanced educational tools in conjunction with home visits to promote positive weight outcomes.

Staff with the federally funded Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program, implemented in Florida, expressed mostly positive attitudes toward the use of home-based digital learning technology to educate parents about the prevention of early childhood obesity.

Findings of the qualitative study were published in Maternal and Child Health Journal.

One of 4 US children are overweight or obese by age 5 years, the authors noted. Further, rates disproportionately affect low-income children, continue to increase sharply into adulthood, and are associated with health-related comorbidities. 

Although home visitation programs successfully provide families with the education, resources, and skills they need to raise healthy children, little is known about the feasibility, acceptability, and efficacy of using digital learning technology in conjunction with home visits to enhance early childhood obesity prevention, they added.

“Determining visitation staff preferences and perceptions is an essential first step,” they said.

The aim of the study was to explore the attitudes and intentions of childhood obesity prevention staff toward using technology-enhanced tools.   

Researchers interviewed 27 home visitation staff representing all Florida counties or sites implementing the Parents as Teachers(PAT) curriculum, an evidence-based model that provides one-on-one home visits, monthly group meetings, developmental screenings, and a resource network for families. They purposely recruited study participants who represented varying types of MIECHV staff, including a state director, site supervisors, other professional staff, and parent educators.

Study participants had a mean (SD) age of 42.2 (9.9) years. All were female. Most (78%) were White and non-Hispanic and employed for an average of 5 years by the program. Ninety-three percent had a bachelor’s degree or higher.

In 30-minute individual virtual interviews, home visitation staff voiced positive and negative attitudes toward using technology during home visits. Study participants mostly expressed positive attitudes toward digital technology. Eighty-five percent of staff members already used videoconferencing for home visits, the result of COVID-19 restrictions.

The interview script was based on the Technology Acceptance Model and Theory of Planned Behavior, 2 models that predict an individual’s intention to use a digital information system. Specifically, interview questions probed the use of technology to enhance PAT curriculum during home visits, and staff preferences in digital learning formats.

Several themes emerged from the interviews. Overall, study participants:

  • Liked access to more resources, increased flexibility in scheduling, and decreased reliance on print materials, which would often get lost
  • Thought that digital learning tools made their job more time efficient, improved retention, provided greater job flexibility during home visits, and enhanced their ability to engage with families
  • Identified the potential for improved participant engagement and retention
  • Expressed concerns about lack of access to/cost associated with reliable internet or a data plan
  • Acknowledged many families had household distractions, such as children climbing on them during the visits
  • Suggested learning modules be kept short, user friendly, offered in more than 1 language, and at a low literacy level

They also recommended practical implemental strategies, such as staff trainings and built-in flexibility.

The study investigators stressed the need to consider technology-specific challenges that families may face, such as lack of access to devices, costs of reliable internet and data, and compatibility of devices. More than a quarter of low-income households rely on their smartphone for internet access, they said. 

The study was based in 1 state, so findings could not be extrapolated to all MIECHV programs. Moreover, the current use of technology may have influenced attitudes and perceptions among visitation staff.

Despite these limitations, results of the study provide a foundation for determining future directions to enhance content for families in childhood obesity home visitation programs, the authors concluded. 

“Home visitation programs reaching families of young children ages 0 to 5 years that are at risk for poor heath offer an innovative and untapped opportunity,” they said. “And, although staff perceptions are important, future work will include family members’ perceptions.”


Zeldman J, Varela EG, Gorin AA, et al.Home visitation program staff attitudes and intentions towards using digital technology to educate families about preventing early childhood obesity: a qualitative study. Matern Child Health J. Published online June 5, 2023. doi:10.1007/s10995-023-03731-3

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