Effectiveness of Family Participation in Visual Care Program for School-Aged Children Using Digital Devices: A Quasi-Experimental Study

Main Article Content

Sukritta Jaichomcheun
Wilawan Tuanrat
Sivaporn Aungwattana


           Many cultures encourage children to learn through digital devices however, this can cause digital eye strain. Therefore, encouraging parental participation in visual care for school-aged children to promote the appropriate use of digital devices will aid in the prevention of digital device-induced eye strain. This quasi-experimental study aimed to determine the effect of eight-week family participation in the visual care programs for family practices and digital eye strain syndrome among school-aged children. Thirty-eight parents or guardians of school-aged children were randomly selected from two schools within two districts in Chiang Mai province in Thailand and randomly assigned to the experimental group (n = 19) or the control group (n = 19). The experimental group received family participation in the visual care program and routine health care services, and the control group received only routine health care service. Instruments for collecting the data were a personal information form, the Family Practice Questionnaire, and the Digital Eye Strain Syndrome Assessment Form for School-Aged Children. Descriptive statistics, Fisher's exact test, an independent t-test, and a paired t-test were used to analyze the data.
         The findings revealed that the mean scores for family practice in the experimental group at posttest were significantly higher than on pretest and significantly higher than those of the control group. Additionally, the experimental group had substantially fewer digital eye strain syndrome than the control group. This program should be further verified by being studied over a more extended period and in different locations in Thailand. It has the potential for nurses to use as a model to promote visual care for school-aged children against digital eye strain syndrome by integrating it as part of their services based on family participation.

Article Details

How to Cite
Jaichomcheun S, Tuanrat W, Aungwattana S. Effectiveness of Family Participation in Visual Care Program for School-Aged Children Using Digital Devices: A Quasi-Experimental Study. PRIJNR [Internet]. 2022 Sep. 12 [cited 2022 Nov. 27];26(4):555-68. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/259258
Original paper


Danet M. Parental concerns about their school-aged children’s use of digital devices. JCFS. 2020;29(4): 2890-2904. doi: 10.1007/s10826-020-01760-y.

Mohan A, Sen P, Shah C, Jain E, Jain S. Prevalence, and risk factor assessment of digital eye strain among children using online e-learning during the Covid-19 pandemic: digital eye strain among kids (DESK study-1). Indian J Ophthalmol. 2021;69(1): 140-4. doi: 10.4103/ijo.IJO_2535_20.

Enthoven CA, Tideman JW, Polling JR, Yang-Huang J, Raat H, Klaver CW. The impact of computers on myopia development in childhood: the generation R study. Prev Med.2020;132:105988. doi: 10.1016/j.ypmed.2020.105988.

Demirayak B, Tugan BY, Toprak M, Cinil R. Digital eye strain and its associated factors in children during the COVID-19 pandemic. Indian J Ophthalmol. 2022;70(3):988-92.doi: 10.4103/ijo.IJO_1920_21.

Department of Children and Youth Affairs. Report of a survey of children and youth on the topic “Children and youth think and do on a daily basis” [internet]. 2020 [cited2021 Oct 23]. Available from: https://www.dcy.go.th/webnew/main/ services/pdf/Report_of_the_Survey _of_

Juvenile_Thoughts.pdf (in Thai)

Lavin W, Taptagaporn S, Khruakhorn S, Kanchanaranya N. Prevalent and associated risk factor of digital eye strain among children in secondary schools in Pratumthani Province,Thailand. J Med Assoc Thai. 2018;101(7):957-63.

Mehra D, Galor A. Digital screen use and dry eye: a review. Asia Pac J Opthalmol. 2020;9(6):491-7. doi: 10.1097/APO.0000000000000328.

Gupta SK, Aparna S. Effect of yoga ocular exercises on eye fatigue. Int J Yoga. 2019;13:76-9. doi: 10.4103/ijoy. IJOY_26_19.

Rosenfield M. Computer vision syndrome (a.k.a. digital eye strain). OiP. 2016;17(1):1-10.

American Optometric Association. Computer vision syndrome [internet]. 2020 [cited 2021 Oct 20]. Available from: https://www.aoa.org/healthy-eyes/eye-andvision-conditions/computer-vision-syndrome?sso=y

Gupta R, Chauhan L, Varshney A. Impact of e-schooling on digital eye strain in coronavirus disease era: a survey of 654 students. J Curr Ophthalmol. 2021;33(2):158-64. doi:10.4103/joco.joco_89_20.

Minto H, Ho M. What is comprehensive school eye health? CEHJ. 2017;30(98):21-5.

Rizwana HJ, Aparna G, Viswanathan S, Meenakshi S. Managing the myopia epidemic and digital eye strain post COVID-19 pandemic–What eye care practitioners need to know and implement? Indian J Ophthalmol. 2020;68(8):1710-12. doi: 10.4103/ijo.IJO_2147_20.

Foreman J, Salim AT, Praveen A, Fonseka D, Weiting DS, He MG, et al. Association between digital smart devices use and myopia: a systematic review and meta-analysis. Lancet Digit Health. 2021;3(12): e806-18. doi: 10.1016/S25 89-7500(21)00135-7.

Teerawatananon K, Wongkittirak K, Myint CY, Teerawatananon Y. Assessment of accuracy and feasibility of visual acuity examination in Thai children in kindergarten and primary school levels by teachers; 2013 (in Thai).

Faculty of Nursing, Chiang Mai University. School health service practice report. Chiang Mai: Department of Public Health Nursing; 2019 (in Thai).

Bally JM, Buries M, Smith NR, Holtslander L, Mpofu C, Hodgson-Viden H, Zimmer M, et al. Exploring opportunities for holistic family care of parental caregivers of children with life-threatening or life limiting illness. QSW. 2020;29:1-19. doi: https://doi.org/10.1177/1473325020967739

Cohen JM, Uphoff NT. Participation place in rural development: seeking clarity through specificity. New York: World Development; 1980.

Marston C, Renedo A, McGowan CR, Portela A. Effects of community participation on improving uptake of skilled care for maternal and newborn health: a systematic review. PLoS Digit Health. 2013;8(2):e55012. doi: 10.1371/journal.pone.0055012.

Chokprajakchad M, Phuphaibul R, Sieving RE, Phumonsakul S. Effectiveness of parent participation in a technology-based adolescent sexuality education program:a randomized control trial. Pacific Rim Int J Nurs Res.2020;24(2):219-33.

Kunnavasate A, Chaipibansarit P, Kreuchotikun S. Effect of participation in supporting language development program toward knowledge and self-efficacy of pre-school care giver. Vajira Nurs J. 2018;20(1):40-53 (in Thai).

Nkwake AM, Trandafili H, Hughey J. Examining the relationship between community participation and program outcomes in metaevaluation. JMDE. 2013;9(20):1-17.

Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149-60. doi: 10.3758/BRM.41.4.1149.

Gupta KK, Attri JP, Singh A, Kaur H. Basic concepts for sample size calculation: critical step for any critical trials. Saudi J Anaesth. 2016;10(3):65-8. doi: 10.4103/1658-354X.174918.

Brennan CC, Sulley A, Young G. Management of digital eye strain. Clin Exp Optom. 2018;102(1):1-12. doi:10.1111/cxo.12798.

Goh WL, Bay S, Chen VH. Young school children’s use of digital devices and parental rules. Telemat Inform. 2015; 32: 787-95. doi: http://dx.doi.org/10.10 16/j.tele. 2015.04.002

Ministry of Public Health. Guidelines for the implementation of the good eyesight Thai children project to increase learning opportunities according to the policy, reduce study time, increase learning time [internet]. 2017 [cited 2021Oct 22]. Available from: https://hp.anamai.moph.go.th/th/general-of-30/193628 (in Thai)

Aarthun A, Qymar KA, Akerjordet K. Parental involvement in decision-making about their child’s health care at the hospital. SON. 2019;6:50-8. doi: 10.1002/nop2.180.

Bailey RR. Goal setting and action planning for health behavior change. Am J Lifestyle Med. 2019;13(6):615-8. doi: 10.1177/1559827617729634.

Ketchum C, Lafave DS, Yeats C, Phompheng E, Hardy JH. Video-based feedback on student work: an investigation into the instructors’ experience, workload, and student evaluations. Online Learning. 2020;24(3):85-105.doi: https://doi.org/ 10.24059/olj.v24i3.2194

Basheer A. The effectiveness of teachers’ use of demonstrations for enhancing students’ understanding of and attitudes to learning the oxidation-reduction concept. EURASIA J Math Sci Tech Ed. 2017;13(3):556-70. doi: 10.12973/eura sia.2017.00632a.

Shi H. Planning effective educational programs for adult learners. WJE. 2017;7(3):79-83. doi: https://doi.org/10.5430/wje.v7n3p79

Starwhacker A, Lee M, Bers MU. Teaching tools, teacher’s rule: exploring the impact of teaching styles on young children’s programming knowledge in Scratch Jr. Int J Technol Des Educ. 2018;28(5044):78-85. doi:10.1007/s10798-017-9400-9.

Kob CG, Shah A, Shamsuddin H, Norizan NA. The effect of using learning kit material among students. IJRTE 2019;7:239-42.

Chen KH. Using LINE Apps to encourage active participation in evidence-based practice journal club. University of Sydney: ISDM ISEHC Conference; 2015.

Stern RT. Implementing article 12 of the UN convention on the rights of the child: participation, power, and attitudes. Boston: Brill Nijhoff; 1974.

Rabeleanu A, Soitu DT. Perception of the family receiving social benefits regarding access to health care. SSCD. 2016;66:157-71.

Odera EL. Capturing the added value of participatory evaluation. AJE. 2021;7(2): 210-9. doi: https://doi.org/10.1177/1098214020910265

Polmark J, Thisara P, Weiangkham D, Duangpanya A. Development of a family participation model for promoting child development: a case study of Ban Sanpamuang childcare center. JRTAN. 2019;20(2):241-250 (in Thai).

Liu SM, Chang FC, Chen CY, Shih SF, Meng B, Ng E, et al. Effect of parental involvement in a preschool-based eye health intervention regarding children’s screen use in China. Int J Environ Res Public Health. 2021;18: 1-14. doi:https://doi.org/10.3390/ijerph182111330