The Effectiveness of a Personalized Healthy Eating Report Card in Improving Children's Eating Practices: A Randomized Controlled Trial

Background: The present study developed an intervention using a personalized Healthy Eating Report Card to provide parents with personalized insights into the extent to which their child adhered to international healthy eating guidelines and engaged in favorable family home food environments. This study aimed to assess the effectiveness of this intervention in improving preschool-aged children’s eating practices. Methods: A three‐armed, single‐blinded randomized controlled trial was conducted with 331 parent-child dyads recruited from eight local kindergartens in Hong Kong. Parents were asked to complete the International Healthy Eating Report Card Scale at baseline and one-month post-intervention. The participants were randomly assigned to one of three groups: (i) the intervention group (who received a personalized Healthy Eating Report Card), (ii) the usual care group (who received a standard government-issued leaflet on healthy eating), or (iii) the mere-measurement control group (who received no healthy eating materials). We examined if the improvement in the overall report card score of the intervention group was statistically higher than that of the other two groups using ANCOVA. Results: The results of ANCOVA demonstrated that the overall report card score was significantly different among the three groups after adjusting for the baseline value [ F (2,327) = 3.98, p = .020, η _p ² = .02]. Bonferroni post-hoc tests revealed that children in the intervention group improved significantly more than those in the mere-measurement control group ( p < .05) with an improvement of 4.6%. The overall report card score of the usual care group was not significantly different from that of the intervention group or the mere-measurement control group ( p > .05). Conclusions: This study provides promising evidence for the effectiveness of the personalized Healthy Eating Report Card in promoting healthy eating practices among preschool-aged children. It also demonstrated its potential as a cost-efficient and scalable tool for health interventions. Trial registration: This trial was registered retrospectively on November 19, 2024, at chictr.org.cn (ChiCTR number: ChiCTR2400092558).