Identifying effective intervention strategies to reduce children's screen time: a systematic review and meta-analysis
Jones A, Armstrong B, Weaver RG, Parker H, von Klinggraeff L, Beets MW
The international journal of behavioral nutrition and physical activity · 74 citations
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- No health outcome
Who paid for it
- Funding
- Independent funding
- Government
- National Institutes of Health
- Government
- National Institute of General Medical Sciences
- Government
- NIGMS NIH HHS
- Grants
- National Institute of General Medical Sciences (T32-GM081740); National Institutes of Health (T32-GM081740)
Based on 3 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2021-09-16 · Int J Behav Nutr Phys Act · vol. 18 · issue 1 · p. 126
- Publisher
- BioMed Central
- Cited
- 138 citations · more than 97% of similar papers · 6.3× the field average
- Impact
- Top 10% most cited in its field
- References
- 263 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Child Development and Digital Technology · Obesity, Physical Activity, Diet · Mobile Health and mHealth Applications
- Keywords
- children's screen time, behaviour change techniques, study characteristics, sample size, intervention duration, intervention effectiveness, childhood obesity, sedentary behavior, sleep disruption, dietary behavior, physical inactivity, scaling up interventions, translational research, risk of bias, meta-regression, meta-analysis of interventions, children and adolescents
- MeSH
- humans, time factors, child, pediatric obesity, screen time, sedentary behavior
6 authors
From US
- Alexis Jones · correspondingUniversity of South Carolina
- Bridget ArmstrongUniversity of South Carolina
- Robert Glenn WeaverUniversity of South Carolina
- Hannah ParkerUniversity of South Carolina
- Lauren von KlinggraeffUniversity of South Carolina
- Michael W. BeetsUniversity of South Carolina
Abstract
Background
Excessive screen time ([Formula: see text] 2 h per day) is associated with childhood overweight and obesity, physical inactivity, increased sedentary time, unfavorable dietary behaviors, and disrupted sleep. Previous reviews suggest intervening on screen time is associated with reductions in screen time and improvements in other obesogenic behaviors. However, it is unclear what study characteristics and behavior change techniques are potential mechanisms underlying the effectiveness of behavioral interventions. The purpose of this meta-analysis was to identify the behavior change techniques and study characteristics associated with effectiveness in behavioral interventions to reduce children's (0-18 years) screen time.
Methods
A literature search of four databases (Ebscohost, Web of Science, EMBASE, and PubMed) was executed between January and February 2020 and updated during July 2021. Behavioral interventions targeting reductions in children's (0-18 years) screen time were included. Information on study characteristics (e.g., sample size, duration) and behavior change techniques (e.g., information, goal-setting) were extracted. Data on randomization, allocation concealment, and blinding was extracted and used to assess risk of bias. Meta-regressions were used to explore whether intervention effectiveness was associated with the presence of behavior change techniques and study characteristics.
Results
The search identified 15,529 articles, of which 10,714 were screened for relevancy and 680 were retained for full-text screening. Of these, 204 studies provided quantitative data in the meta-analysis. The overall summary of random effects showed a small, beneficial impact of screen time interventions compared to controls (SDM = 0.116, 95CI 0.08 to 0.15). Inclusion of the Goals, Feedback, and Planning behavioral techniques were associated with a positive impact on intervention effectiveness (SDM = 0.145, 95CI 0.11 to 0.18). Interventions with smaller sample sizes (n < 95) delivered over short durations (< 52 weeks) were associated with larger effects compared to studies with larger sample sizes delivered over longer durations. In the presence of the Goals, Feedback, and Planning behavioral techniques, intervention effectiveness diminished as sample size increased.
Conclusions
Both intervention content and context are important to consider when designing interventions to reduce children's screen time. As interventions are scaled, determining the active ingredients to optimize interventions along the translational continuum will be crucial to maximize reductions in children's screen time.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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