Identifying effective intervention strategies to reduce children’s screen time: a systematic review and meta-analysis
Abstract Background Excessive screen time ( $$\ge$$ ≥ 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...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-09-01
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| Series: | International Journal of Behavioral Nutrition and Physical Activity |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12966-021-01189-6 |
| _version_ | 1819136012543066112 |
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| author | Alexis Jones Bridget Armstrong R. Glenn Weaver Hannah Parker Lauren von Klinggraeff M. W. Beets |
| author_facet | Alexis Jones Bridget Armstrong R. Glenn Weaver Hannah Parker Lauren von Klinggraeff M. W. Beets |
| author_sort | Alexis Jones |
| collection | DOAJ |
| description | Abstract Background Excessive screen time ( $$\ge$$ ≥ 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. |
| first_indexed | 2024-12-22T10:28:13Z |
| format | Article |
| id | doaj.art-24088496e03f478eb88710329738bd39 |
| institution | Directory Open Access Journal |
| issn | 1479-5868 |
| language | English |
| last_indexed | 2024-12-22T10:28:13Z |
| publishDate | 2021-09-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Behavioral Nutrition and Physical Activity |
| spelling | doaj.art-24088496e03f478eb88710329738bd392022-12-21T18:29:24ZengBMCInternational Journal of Behavioral Nutrition and Physical Activity1479-58682021-09-0118112010.1186/s12966-021-01189-6Identifying effective intervention strategies to reduce children’s screen time: a systematic review and meta-analysisAlexis Jones0Bridget Armstrong1R. Glenn Weaver2Hannah Parker3Lauren von Klinggraeff4M. W. Beets5Department of Exercise Science, Arnold School of Public Health, University of South CarolinaDepartment of Exercise Science, Arnold School of Public Health, University of South CarolinaDepartment of Exercise Science, Arnold School of Public Health, University of South CarolinaDepartment of Exercise Science, Arnold School of Public Health, University of South CarolinaDepartment of Exercise Science, Arnold School of Public Health, University of South CarolinaDepartment of Exercise Science, Arnold School of Public Health, University of South CarolinaAbstract Background Excessive screen time ( $$\ge$$ ≥ 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.https://doi.org/10.1186/s12966-021-01189-6Screen timeChildrenInterventionsMeta-analysisBehavior change techniques |
| spellingShingle | Alexis Jones Bridget Armstrong R. Glenn Weaver Hannah Parker Lauren von Klinggraeff M. W. Beets Identifying effective intervention strategies to reduce children’s screen time: a systematic review and meta-analysis International Journal of Behavioral Nutrition and Physical Activity Screen time Children Interventions Meta-analysis Behavior change techniques |
| title | Identifying effective intervention strategies to reduce children’s screen time: a systematic review and meta-analysis |
| title_full | Identifying effective intervention strategies to reduce children’s screen time: a systematic review and meta-analysis |
| title_fullStr | Identifying effective intervention strategies to reduce children’s screen time: a systematic review and meta-analysis |
| title_full_unstemmed | Identifying effective intervention strategies to reduce children’s screen time: a systematic review and meta-analysis |
| title_short | Identifying effective intervention strategies to reduce children’s screen time: a systematic review and meta-analysis |
| title_sort | identifying effective intervention strategies to reduce children s screen time a systematic review and meta analysis |
| topic | Screen time Children Interventions Meta-analysis Behavior change techniques |
| url | https://doi.org/10.1186/s12966-021-01189-6 |
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