Abstract
BACKGROUND: Early childhood represents a critical period for sex education and family-based education is essential to this process. However, many parents lack the knowledge and skills to deliver effective sex education, which significantly hinders implementation and effectiveness for this age group. METHODS: In a cluster-randomized trial conducted in 2022, parents of preschool children from four kindergartens in Luzhou City were assigned by class to receive either a 6-month online sex education program grounded in the Theory of Planned Behavior (TPB) via WeChat or conventional health education. Parental knowledge, attitudes, and practices (KAP) were assessed at baseline and post-intervention. Intervention effects were evaluated using Analysis of Covariance (ANCOVA) and Generalized Estimating Equations (GEE) to account for baseline covariates and potential cluster effects. RESULTS: A total of 217 parents were enrolled in the study. Post-intervention, the intervention group demonstrated significantly higher scores and improved pass and good rates across all KAP (knowledge, attitudes, and practices) dimensions compared to the control group (p < 0.05). Notably, the KAP consistency rate and parental preference for online learning channels also increased significantly in the intervention group (p = 0.001). CONCLUSION: The TPB-based online intervention effectively enhances parental competencies in early childhood sex education. This digital model provides a scalable and accessible strategy for health promotion, with significant implications for narrowing the implementation gap in family-based sex education and supporting children's long-term sexual health.