Digital Health Interventions for School-Aged Children: Effectiveness, Implementation, and Impact on 24-Hour Movement and Psychosocial Well-Being

Abstract

Introduction: Insufficient physical activity and prolonged sedentary behavior among school-aged children pose significant public health challenges. Historically, digital screens were viewed as drivers of this "sedentary pandemic," but post-2020 trends have repurposed digital tools, mobile apps, wearables, and exergames, as vectors for health promotion. This review synthesizes evidence on the effectiveness and theoretical mechanisms of these interventions, analyzing their impact on the 24-hour movement paradigm.

Material and Methods: A narrative review was conducted focusing on studies published between 2013 and 2025. Relevant literature was identified through PubMed, Web of Science, and Scopus. Interventions were categorized by technology type, setting (school vs. home), and outcomes, including physical activity (PA), sedentary time, sleep, and psychosocial well-being.

Results: Findings reveal a dichotomy between improved physical fitness and habitual behavior change. While apps improve metrics like agility, their impact on daily habitual activity is inconsistent. However, digital tools significantly reduced sedentary time (Mean Difference -33.12 min/day) and extended sleep (+17 min/night). Structural school-based programs, such as the "Super Quinas" project, outperformed standalone home interventions, achieving significant gains in MVPA (+18 min/day). Effectiveness relied on Behavior Change Techniques, though the "novelty effect" often limited engagement to 4–8 weeks. 

Conclusions: Digital health interventions offer promising opportunities to enhance pediatric well-being, particularly when embedded in "phygital" educational settings. Future research must address the "digital divide" and focus on strategies to sustain intrinsic motivation beyond the initial novelty phase.