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Systematic Review of Effective Strategies for Reducing Screen Time Among Young Children
Abstract
Screen-media use among young children is highly prevalent, disproportionately high among children from lower-income families and racial/ethnic minorities, and may have adverse effects on obesity risk. Few systematic reviews have examined early intervention strategies to limit TV or total screen time; none have examined strategies to discourage parents from putting TVs in their children's bedrooms or remove TVs if they are already there. In order to identify strategies to reduce TV viewing or total screen time among children <12 years of age, we conducted a systematic review of seven electronic databases to June 2011, using the terms "intervention" and "television," "media," or "screen time." Peer-reviewed intervention studies that reported frequencies of TV viewing or screen-media use in children under age 12 were eligible for inclusion. We identified 144 studies; 47 met our inclusion criteria. Twenty-nine achieved significant reductions in TV viewing or screen-media use. Studies utilizing electronic TV monitoring devices, contingent feedback systems, and clinic-based counseling were most effective. While studies have reduced screen-media use in children, there are several research gaps, including a relative paucity of studies targeting young children (n = 13) or minorities (n = 14), limited long-term (>6 month) follow-up data (n = 5), and few (n = 4) targeting removing TVs from children's bedrooms. Attention to these issues may help increase the effectiveness of existing strategies for screen time reduction and extend them to different populations.
... Some studies have reported early interventions aiming to reduce screen time and improve well-being. Schmidt systematically reviewed intervention strategies and identified four school-based and two family-based early education interventions for young children [92]. The four school-based interventional studies were all randomized controlled trials conducted in the United States, and three tested the effectiveness of the "Hip Hop to Health" intervention program, which aimed to prevent obesity among black preschool children through a teacher-delivered intervention. ...
... The four school-based interventional studies were all randomized controlled trials conducted in the United States, and three tested the effectiveness of the "Hip Hop to Health" intervention program, which aimed to prevent obesity among black preschool children through a teacher-delivered intervention. The results indicated that through the "Hip Hop to Health" intervention program, the total screen time was reduced to 28 min per day [92]. The two family-based interventional studies were also conducted in the United States. ...
... In this scoping review, we identified two approaches to reducing young children's digital usage time and avoiding problematic digital usage. However, the effectiveness of these approaches has not been demonstrated in a scientifically sound manner [92], and some of these approaches have been proven to be ineffective for improving digital wellbeing [94,95]. Several reasons may account for these mixed results. ...
Digital well-being concerns the balanced and healthy use of digital technology, and the existing studies in this area have focused on adolescents and adults. However, young children are more vulnerable to digital overuse and addiction than adults; thus, their digital well-being deserves empirical exploration. In this scoping review, we synthesized and evaluated 35 collected studies on young children's digital use and their associated well-being that were published up to October of 2022 to understand the related definitions, measurements, contributors, and interventions. The synthesis of the evidence revealed that (1) there was no consensus about the definition of the concept of digital well-being; (2) there were no effective ways of measuring young children's digital well-being; (3) both child factors (the duration and place of digital use, as well as the child's demographic characteristics) and parent factors (digital use, parental perception, and mediation) contribute to young children's well-being; and (4) there were some effective applications and digital interventions reported in the reviewed studies. This review contributes to the development of this concept by mapping the existing research on young children's digital well-being, as well as proposing a model and identifying the research gaps for future studies.
... The four school-based interventional studies were all randomized controlled trials in the United States, and three tested the effectiveness of the "Hip Hop to Health" intervention program, which aimed to prevent obesity for black preschool children through teacherdelivered intervention. The results indicated that the total screen time of the "Hip Hop to Health" intervention program had been reduced to 28 min per day [76]. The two familybased interventional studies were also conducted in the United States. ...
... This scoping review has identified two approaches to reducing young children's digital using time and avoiding problematic digital use. However, the effectiveness of these approaches is not scientifically sound [50,76], and some have been proven useless for improving digital wellbeing [79]. The reasons might count for the mixed results. ...
... Furthermore, digital use has been no longer limited to screens, as there are many screenless digital technologies (e.g., voice robots, VR, AI) [26,87]. Second, the existing intervention studies only followed young children for a short-term period, ranging between 2 to 20 weeks, and few studies exceeded six months [76,79]. Therefore, an integrated, long-period, systematic digital literacy improvement program is needed to enhance young children's digital wellbeing. ...
Digital wellbeing concerns the balance and health we may experience in digital use, and the existing studies have focused on adolescents and adults. However, young children are more vulnerable to digital overuse and addiction than adults; thus, their digital wellbeing deserves empirical exploration. This scoping review synthesized and evaluated 35 collected studies on young children’s digital use and their wellbeing that were published until October of 2022 to understand the definitions, measurements, contributors, and interventions. The synthesis of evidence revealed that: (1) there was no consensus about its definition; (2) there were no effective measurements of young children’s digital wellbeing; (3) both child factors (duration and place of digital use, child demographic characteristics) and parent factors (digital use, parental perception, and mediation) contribute to young children’s wellbeing; and (4) there were some effective applications and interventions. This review contributes to the theoretical development by mapping the existing work on young children's digital wellbeing, proposing a model, and identifying the research gaps for future studies.
... Numerous studies have shown that extensive screen exposure during very early childhood can be harmful: for cognitive development [5][6][7], social competences [8,9], mental health [9,10] and physical wellbeing [1,11]. In their review of effective strategies for reducing screen time among young children from 2012, Schmidt et al. [12] put forward some research priorities and recommendations for the planning of an intervention based on gaps in the current literature. Developing interventions that are scalable to children, adolescence and adults needs multifaceted programs with different components and such components need to be evaluated for their single and combined effectiveness. ...
... Interventions utilizing electronic TV monitoring devices, contingent feedback systems, and clinic-based counseling were most effective. Schmidt et al. found several research gaps, including a relative paucity of studies targeting young children or minorities, limited long-term (> 6 month) follow-up data, and few targeting removing TVs from children's bedrooms [12]. ...
... The majority of studies showed that different interventions can have an effect on screen time [18-21, 25, 27] or at least have a positive influence on the participants' awareness and behavior concerning the use of screen media [23,27]. These results are consistent with the existing review of Schmidt et al. [12]. It is hard to speculate on why there are also studies that show no significant differences between intervention and control groups [17,22,24,26] since the included participants, applied interventions as well as measurements were similar to other studies. ...
Excessive use of screen media is a global public health issue and especially extensive screen exposure during very early childhood. This review was conducted in order to update previous reviews on the effectiveness of interventions to reduce screen time. An electronic literature search was carried out in MEDLINE, COCHRANE LIBRARY and CINAHL for articles indexed from June 2011 until October 2019. The search identified 933 publications of which 11 publications were included in this review. There are studies showing interventions with a positive influence on reduction of screen time and the participants’ awareness and behavior concerning the use of screen media, as well as studies without such effects. No intervention was identified to be superior. This warrants further investigation of potentially effective combinations of intervention components and long-term follow-up.
... This review included 972 participants who were mostly from western countries. Unlike previous reviews that included sedentary behaviours (35)(36)(37), our review included solely studies on ST to enable the extraction of focused strategies. It is also focused on children aged between 2 and 5 years, as compared to adolescents in which promising effects of intervention have been demonstrated by previous studies (38). ...
... This is especially applicable to those with different cultural backgrounds that require culturally adaptive interventions in the future. We concur with others (36,38) that interventions aimed at preschool children hold promise. Similar to a study by Schmidt (36), our review revealed that the delivery of interventions was done in various settings. ...
Aims: Children below five years have been the target of screen time guidelines. The adverse health outcomes associated with it require focusing on prime strategies for reducing screen time. The current study reviews parental intervention strategies to reduce screen time among preschool-aged children. Design: Systematic review. Data sources: A total of five databases of the Cochrane register of controlled trials, CINAHL, Medline PubMed, and Scopus databases were searched from May 1 to 31, 2020. Review Methods: The keywords of “screen time”, “television”, “video”, “computer”, “mobile device”, “hand phone”, “media use”, “preschool-aged children”, “interventions”, and “strategies” used for search. The inclusion criteria are limited to specific study populations, intervention, comparison and outcomes (PICOs), language, and published study types. The quality of articles was assessed using the Cochrane Risk of Bias (RoB) tool. Results: A total of six studies that met the inclusion criteria were further analysed. It showed that besides providing knowledge and awareness regarding screen time, restrictive practices, offering alternative activities to parents and removing the screen from the child’s bedroom were the most common strategies used by successful studies. The duration of intervention between 6-8weeks was sufficient to observe screen time reduction, while face-to-face methods dominated the mode of delivery. Increasing parental self-efficacy, listing outcome expectations, and reinforcement strategies targeting both the parents and their home environment were beneficial in reducing screen time. Conclusion: Future screen time reduction studies could benefit from incorporating the above approaches for screen time reduction intervention among preschool children.
... Notes: Subgroup 1: Children who achieved AAP goal of average daily screen time no more than 120 min; Subgroup 2: Children with reduction in average daily screen time; Subgroup 3: Children with significant reduction (no less than 51 min) in average daily screen time; Subgroup 4: Children who achieved significant reduction in and maintenance of average daily screen time to no more than 120 min; SCI = Social communication and interaction; RRB = Restricted interests and repetitive behaviour; *P-values were derived from paired t-test; bolded parts indicated significant findings verbal screen time advice by doctors (28). The lack of awareness in the community presents an opportunity for paediatric health workers to impart knowledge to parents about the potential pros and cons of ESM use to reduce their children's screen time and thus improve their social interaction (24). ...
... Paediatricians can explore and understand each family's values and health goals and enhance their wellbeing through meaningful use of ESM (25)(26)(27). In comparison with other studies with more complicated methodologies, such as electronic monitoring systems or child education with parental involvement (28), this intervention is feasible and easily replicable, as the materials used are simple and the information is readily accessible on the AAP's website. This parental education programme's approach is not only to reduce total screen time but also to encourage parents to promote balancing screen time with other important activities for health and wellbeing. ...
Background:
Children with autism spectrum disorder (ASD) are susceptible to excessive electronic screen media (ESM) use. This study aimed to evaluate the effectiveness of a parent training programme in improving the screen time and social functioning of children with ASD.
Methods:
This pre-/post-test quasi-experimental study involved parents by providing them with structured education based on the American Academy of Pediatrics (AAP)' screen time recommendations. In total, 259 children with ASD aged 3 years old-12 years old were eligible. Of those children, 26 were excluded due to comorbidities or taking medications. Additionally, 28 parents participated. Children's screen time were recorded, and social behaviour was scored using the Social Responsiveness Scale pre- and post-intervention.
Results:
There were significant reductions in the average daily screen time of children with ASD after their parents attended the training programme (-51.25 min; 95% CI: -78.40, -24.10). In subgroups with reduced screen time, the treatment effect of the intervention was significant in improving the social responsiveness total score (-3.09; 95% CI: -5.96, -0.22), the social communication scale (-3.64; 95% CI: -5.91, -1.36) and the restricted interest and repetitive behaviour (RRB) scale (-5.27; 95% CI: -10.29, -0.25).
Conclusion:
Parental training is effective in reducing screen time and improving social functioning in children with ASD.
... This is consistent with previous reviews which found no effect of parent-based digital interventions among overweight/obese youth (Hammersley et al., 2016) but some evidence among youth <12 years. (Schmidt et al., 2012) Future directions include interventions delivered in primary care, which have the potential to access large numbers of parents in a setting where they may be receptive to receiving counselling about adolescent health. (Schmidt et al., 2012) Findings in relation to alcohol and tobacco use were mixed. ...
... (Schmidt et al., 2012) Future directions include interventions delivered in primary care, which have the potential to access large numbers of parents in a setting where they may be receptive to receiving counselling about adolescent health. (Schmidt et al., 2012) Findings in relation to alcohol and tobacco use were mixed. Interventions were not associated with reductions in alcohol use despite long follow-up periods of >12 months for many studies. ...
Lifestyle risk behaviors often co-occur and are prevalent among adolescents. Parent-based interventions addressing risk behaviors concurrently have the potential to improve youth and parent outcomes. This systematic review evaluated the efficacy of parent-based interventions targeting multiple lifestyle risk behaviors among adolescents and parents. MEDLINE (Ovid), Embase (Ovid), PsycInfo (Ovid), Scopus, CINAHL, the Cochrane Database of Systematic Reviews (CDSR) and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from 2010-May 2021. Eligible studies were randomised controlled trials (RCTs) of parent-based interventions addressing 2+ risk behaviors: alcohol use, smoking, poor diet, physical inactivity, sedentary behaviors, and poor sleep. Studies directly targeting parents, and that assessed adolescent outcomes (11–18 years) were eligible. Where possible, random-effects meta-analysis was conducted. From 11,975 identified records, 46 publications of 36 RCTs (n = 28,322 youth, n = 7385 parents) were eligible. Parent-based interventions were associated with improved adolescent moderate-to-vigorous physical activity (MVPA) [Odds Ratio (OR) = 1.82, 95% CI = 1.18, 2.81; p = 0.007], and reduced screen time (SMD = −0.39, 95% CI = -0.62, −0.16, p = 0.0009) and discretionary food intake (SMD = -0.18; 95% CI = −0.30, −0.06; p = 0.002) compared to controls. However, there was some evidence that interventions increased the odds of ever using tobacco in the medium-term (OR = 1.47, 95% CI = 0.99, 2.18, p = 0.06) and of past month tobacco use in the long-term (OR = 1.46, 95% CI = 1.12, 1.90; p = 0.005). Overall, the quality of evidence was moderate. Parent-based interventions targeting multiple risk behaviors improved adolescent MVPA, and reduced screen time discretionary food intake. Further research is needed to address sleep problems and increase intervention efficacy, particularly for alcohol and tobacco use.
... Previous research has shown that parents increased screentime may be related to increased screentime in young children (Duch, Fisher, Ensari, & Harrington, 2013;Lauricella, Wartella, & Rideout, 2015). Likewise, parental attitudes regarding the potential negative effects or perceived benefits of screentime for young children has been related to the amount of screentime parents allow for their young children (Lauricella et al., 2015;Schmidt et al., 2012). Therefore, in the current study parental attitudes about television and parents own television usage will be examined as potential predictors of young children's television viewing. ...
... Similarly, parental stress has been associated with increased television time for young children (Seguin, Kuenzel, Morton, & Duerden, 2021) and parental support has been associated with less overall screentime, including television time, for children (Lampard, Jurowski, & Davison, 2013). The research regarding the influence of household income of children's television exposure has been mixed (Schmidt et al., 2012). Given the potential influence of the above variables on young children's television exposure, the current study will examine the roles of maternal depression, stress, and household income on young children's varying trajectories of television exposure over the first four years of life. ...
Infant television exposure has been related to poorer language development and poorer executive functions in preschool and early childhood. Wide variability exists in the amount of television infants are exposed to in the first few years of life. The current study examined 256 primary caregiver-infant dyads over the first four years of life. Primary caregivers reported on their infant's television viewing each year as well as their language development and executive functions (year 4 only). Children also completed direct assessments of language development (year 4) and executive functions (including effortful control measures year 4). Growth mixture models showed three distinct trajectories of infant television exposure across the four years. Infants who started high and remained high in terms of their television viewing at the end of four years performed the most poorly on all assessments of language development and emerging executive functions. Infants with low television exposure in the first year of life who remained low in television exposure across the four years preformed the best on measures of language development and executive functions. Trajectories associated with early and persistent television exposure in the first few years of life were particularly problematic to preschooler's cognitive development. The current study supports AAP recommendations for limited screen-based media in the first few years of life.
... This depended on the duration of the program and the method employed. Schmidt et al. (2012) found that educational programs delivered at the clinic were highly effective. Therefore, and because it was the most logistically feasible, this method was chosen for our research. ...
... Some were obesity prevention programs and some targeted screen-time specifically. Educating the parents was found to be the most effective method in reducing children's screen-time in several studies (Bleakley et al., 2013;Harrison et al., 2006;Schmidt et al., 2012). Still, other methods should be implemented to reinforce knowledge and enhance outcome including: long-term programs with follow-up classes, the use of messaging services (SMS for example) to send educational messages (Shapiro et al., 2008), and the employment of active screen-time programs, like the use of video games that require physical activity (Lanningham-Foster et al., 2006). ...
The proliferation of electronic content and limited exposure of children to books in Jordan has made both parents and health-care providers more concerned about healthy child development. This research aimed to determine if pediatric primary prevention programs were helpful in reducing screen-time and improving reading habits of children in Jordan, and if there was a correlation between these two factors. Parents attended classes on various topics, one of which dealt with screen-time and reading. Six months later, they were surveyed on these topics. The test group (took the relevant class) and control group (did not take the class) included 30 families each. The mean screen-time was above the recommended guideline of 2 h/day in both groups. Only 37% of the families in the test group, and 17% in the control group followed the guideline. A significant difference in screen-time between the groups was found only during weekends. When asked about the ideal screen-time, parents from the test group reported screen-times that were significantly closer to the recommendations, showing an increase in knowledge, but not a significant change in behavior. Parents, also, believed that children’s exposure to books should be at the much later age of 3–4 years, with actual exposure being < 1 h/day. Moreover, no correlation was found between screen-time and reading time. These findings suggest that short, evidence-based classes helped raise awareness, but were not sufficient for parents to fully adopt the guidelines. Programs that promote behavior modification should be explored to reinforce knowledge gained from educational classes.
... Given that mobile phone usage has increased rapidly throughout the world, one possibility to increase parental involvement in monitoring their children's progression is to train parents or primary caregivers on the use of mobile technology to track their children's developmental milestones. This is in light of earlier reports which suggest that high levels of parental involvement increase the likelihood that an intervention will be effective [5]. Moreover, enabling primary caregivers to track their children's development facilitates the timely identification of developmental delays. ...
... Although there are several studies reporting the use of mobile phone technology to track a range of health and behavioral outcomes, there are hardly any reports on its application among parents to monitor developmental progression of very young children [5]. Moreover, few studies have used mobile phone technology specifically to train parents or caregivers on how to monitor their children's developmental progress. ...
Given that mobile phone usage has increased rapidly throughout the world, one possibility to increase parental involvement in monitoring their children’s progression is to train parents or primary caregivers on the use of mobile phone technology to track their children’s developmental milestones. The current paper aimed to describe the development of a mobile phone application for use among primary caregivers and establish the feasibility and preliminary impact of caregivers using a mobile phone application to track the progression of their children’s development in a context where there is a paucity of similar studies. This study is a substudy that focusses on the intervention group only of a recently completed two-armed quasi-experimental study in an informal settlement in Nairobi. The mobile phone application which consisted of questions on children’s developmental progression, as well as stimulation messages, was developed through a step-wise approach. The questions covered five child developmental domains: communication; fine motor; gross motor; personal-social; and, problem-solving. Depending on the response received, the child would be classified as having ‘achieved a milestone’ or ‘milestone not achieved.’ If a child had achieved the milestone for a specific age, a caregiver would receive an SMS on how to stimulate the child to achieve the next milestone. Where the milestone was not achieved, the caregiver would get a message to enhance development in the area of delay. Caregivers with children aged between six months and two years were recruited into the study and received questions and messages regarding their children’s development (age-specific) on a monthly basis for 12 months. Caregiver adherence to the intervention was above 90% in the first three months of implementation. Thereafter, the response rate fluctuated between 76% and 86% across the subsequent months of the intervention. The high level and fairly stable caregivers’ rate of response to the 12 rounds of messaging indicated feasibility of the mobile technology. Further, in the first three months of intervention implementation, the majority of caregivers were able to keep track of how their children attained their developmental milestones. The intervention seems to be scalable, practical and potentially low-cost because of the wide coverage of phones.
... A small number of systematic reviews have attempted to document the strategies used in interventions to reduce screen time in children across all ages. Goal setting, positive reinforcement, problem solving, and using electronic monitoring have been identified as strategies used in interventions targeting this behavior (Altenburg et al., 2016;Schmidt et al., 2012;Steeves et al., 2012). However, these findings are limited for the current study in that the reviews included a wide age range of children aged up to 18 years or included other sedentary behaviors (i.e., reading) as well as screen time behaviors. ...
... In particular "behavior substitution" and "instruction on how to perform the behavior" were identified in both interventions targeting children. The other six promising BCTs found in this review appear to map on to the strategies found in other systematic reviews, which mostly focus on older children (Altenburg et al., 2016;Schmidt et al., 2012;Steeves et al., 2012). Therefore, it is possible that similar strategies might be effective to reduce screen time across the age ranges of children. ...
Screen time has been linked to obesity in young children. Therefore, this systematic review aims to investigate which Behavior Change Techniques (BCTs) are associated with the effectiveness of interventions to reduce screen time in 0-5 year olds.
Seven databases were searched, including PsycInfo, PubMed, and Medline. Grey literature searches were conducted. Inclusion criteria were interventions reporting pre- and post- outcomes with the primary objective of reducing screen time in 0-5 year olds. Studies were quality assessed using the Effective Public Health Practice Project criteria. Data extracted included participant characteristics, intervention characteristics and screen time outcomes. The BCT Taxonomy was used to extract BCTs. Interventions were categorised as “very”, “quite” or “non” promising based on effect sizes. BCTs were deemed promising if they were in twice as many very/quite promising interventions as non-promising interventions.
Seven randomised controlled trials were included, involving 642 participants between 2.5-5.0 years old. One very promising, four quite promising, and two non-promising interventions were identified. Screen time decreased by 25-39 minutes per day in very/quite promising interventions. Eleven BCTs were deemed promising, including “behavior substitution” and “information about social and environmental consequences”.
This review identified eleven promising BCTs, which should be incorporated into future screen time interventions with young children. However, most included studies were of weak quality and limited by the populations targeted. Therefore, future methodologically rigorous interventions targeting at-risk populations with higher screen time, such as those of a low socioeconomic status and children with a high BMI, should be prioritized.
... Relatively few studies have tested approaches to reduce screen use by young children; these have largely focused on early education and school-or clinic-based studies and delivered mixed results (Schmidt et al. 2012;Wu et al. 2016). Greatest improvements appear to be found for programs delivered in home-or clinic-based settings, however, underscoring the key role that parents play in intervention success (Schmidt et al. 2012). ...
... Relatively few studies have tested approaches to reduce screen use by young children; these have largely focused on early education and school-or clinic-based studies and delivered mixed results (Schmidt et al. 2012;Wu et al. 2016). Greatest improvements appear to be found for programs delivered in home-or clinic-based settings, however, underscoring the key role that parents play in intervention success (Schmidt et al. 2012). More recently, interventions seeking to reduce children's screen time via parenting interventions targeting parenting skills and confidence, responsive parenting and parent-child interaction have demonstrated positive effects on screen use (Adams et al. 2018;Sanders et al. 2018), and our preliminary results provide some rationale for considering parenting skills and confidence with managing children's screen use behaviours as targets for future intervention research. ...
The impact of excessive screen use on child health and development is now a public health concern, and research efforts are focused on finding ways to moderate screen use. To date, the focus has mainly been on school-aged children and adolescents, and the early childhood context has been comparatively neglected. Moreover, relationships between factors likely to influence screen use by young children (e.g., child behaviour, parenting style and self-efficacy) remain largely unexplored. Our study aimed to test relationships between parenting style, parents’ self-efficacy, parental distress, child behaviour, and young children’s screen time. We used a cross-sectional study design. Parents (N = 106) of young children (aged 0–4 years) living in Australia completed an online survey which assessed parent-reported child screen use, screen time-related child behaviour problems, parents’ self-efficacy for managing child behaviour and screen time, parents’ beliefs about the positive/negative effects of screen time, parenting style, general child adjustment and parent efficacy, and parent distress. Correlation coefficients revealed relationships between dysfunctional parenting styles, screen time-related child behaviour problems, and parent self-efficacy for dealing with these behaviours. Using hierarchical multiple regression models, children’s screen time behaviour problems explained the greatest variance in parents’ self-efficacy for managing screen time, and parents’ self-efficacy for managing child screen time explained the greatest variance in parent-reported child screen time. Further research is needed to disentangle these relationships; however, preliminary results suggest that child behaviour difficulties and parents’ self-efficacy warrant further investigation as potentially useful targets for interventions aiming to improve screen use in early childhood.
... Com base nas evidências citadas, algumas lacunas foram levantadas: em geral, o tempo de tela não foi reportado como foco primário das intervenções (FRIEDRICH et al., 2014); são necessários estudos de intervenção voltados à redução do tempo de tela em países de baixa e média renda (SCHMIDT et al., 2012); e por fim, a maioria das intervenções não incluíram variáveis que possam potencializar o efeito sobre o tempo de tela ( VAN STRALEN et al., 2011). ...
... Diante dessas evidências, intervenções foram propostas com a finalidade de reduzir a prevalência de jovens que passam muito tempo em atividades de tela (BIDDLE; PETROLINI; PEARSON, 2014). Contudo, a maioria das intervenções realizadas não adotou como foco primário a redução do tempo de tela (FRIEDRICH et al., 2014) e, ainda, foram realizados em países de alta renda (SCHMIDT et al., 2012). ...
Introduction: High exposures to screen time justify interventions to
reduce this behavior in children and adolescents. Objective: To evaluate
the effect of an intervention on screen time and to identify possible
mediating variables (attitude, self-efficacy, support of the family and
school members) of the intervention effect among students. Method:
This was a cluster-randomized controlled trial. Of the six full-time
schools in Fortaleza, northeastern Brazil, three were submitted to the
"Fortaleça sua Saúde" program and three comprised the control group
during the second half of 2014 (July to December). The study involved
students aged 11 to 17 years, who were in the 7th to 9th grade of
elementary school. Thus, 548 students in the intervention group and 537
in the control group. The intervention focused on the training of
teachers, opportunities to practice physical activity in school and
reduction of screen time, as well as health education. The students
answered a pre- and post-intervention questionnaire about sedentary
issues. TV time, computer / video game and total screen time were the
dependent variables. The potential mediating variables were obtained
through scales of intrapersonal (self-efficacy and attitude) and
interpersonal factors (support of the family and school members).
Control variables were sex, age, school and economic class measured at
baseline. The interventions’ effect were analyzed by McNemar test,
binary logistic regression models, generalized linear models and effect
sizes. For the mediation analysis was applied the product approach of the
coefficients a and b. The significance level of 5% was adopted. All
analyzes were performed using statistical software STATA v.13.0 and
SPSS v.23.0. Results: During follow-up, students in the intervention
group had a better chance of reducing TV time (boys) and computer /
video game (girls and younger adolescents) to less than two hours per
day (p <0.05). Positive intervention effect on attitude was observed
among girls and adolescents of both age groups (p <0.05), and school
support for all subgroups (p <0.05). Finally, the attitude was found as a
mediating variable of the interventions’ effect on girls and adolescents
of both age groups. Conclusion: The intervention had an impact on both
subgroups, improving components of screen time as well as in
intrapersonal and interpersonal aspects. Attitude had a role as a mediator
on interventions’ effects on screen time. These findings may help fill the
gaps about strategies to interventions for reduce screen time in
schoolchildren.
... Intervention studies have attempted to reduce children's screen time, and meta-analyses suggest that they are sometimes effective. In one meta-analysis, 29 of 47 studies had significant effects on reducing screen time (Schmidt et al., 2012). Another meta-analysis found a small, but statistically significant difference in intervention groups (Maniccia, Davison, Marshall, Manganello, & Dennison, 2011). ...
... As interesting as the studies that show an effect might be, several well-designed intervention studies show no effect on children's screen time (Babic et al., 2016;Birken et al., 2012). All meta-analyses identify weaknesses in the studies, including lack of long-term follow-ups and few studies with young children (Schmidt et al.;Wahi et al. 2011). More work is needed to identify the critical components of those intervention studies that do show an effect (Maniccia et al. 2011). ...
Children's screen time (i.e., time spent using computers, televisions, mobile devices) has rapidly increased with the development of mobile technology, and this increase has become a matter of serious concern for teachers, parents, family life educators, psychologists, and other health professionals. High usage rates (more than 2 hours per day) have been associated with low‐quality sleep, language acquisition difficulties, and attentional problems in young children. Results of experimental trials to limit screen time have been mixed. Interventions may be improved with guidance from a systematic theoretical framework focused directly on children's well‐being. This article proposes a multifaceted goal‐theoretic approach to reducing screen time through involvement in alternative activities. It is proposed that a focus on approach goals involving shared activities that are constitutive of children's well‐being can naturally displace excessive screen time, enhance child development, reduce parental stress, and improve familial well‐being.
... According to the ecosystem theory, children's behavior and development are affected by and controlled by environmental factors like the family. Schmidt et al. reported that parent education program effectively reduced preschoolers' screen time [28]. Given the similarity of the study findings, the researchers integrated the views of numerous scholars to come to that conclusion. ...
The relative contribution of screen time and media content to young children's social development has been unclear recently, and information on effective interventions to reduce children's screen time is limited. This review investigates the current status of electronic media use among young children and the effect of screen media usage on children's social development and attempts to explore the correlation between the two in order to enrich and improve related research. It is also supposed to give ideas for how families can use electronic media better to help children develop socially and reduce behavior problems. Parenting styles, media content, household income, the number of children in the family, how the parents use media, their habits, and cognitive stimuli in the home were also linked to young children's media use. The correlations identified in this study suggest intervention pathways to decrease children's screen time consumption and optimize media content. But more research needs to be done to look at some of the environmental, sociocultural, and behavioral factors that haven't been looked at much in young children. This could help make prevention and intervention plans better.
... When usage times of these devices were examined, it was observed that students were mostly occupied with television. American Association of Pediatrics does not recommend more than 2 hours of exposure to screen (Schmidt et al., 2012). In this context, in this study, students' daily screen time as approximately 2 hours can be met as a desired result. ...
This study was carried out to examine the relationship between physical activity (PA) levels of secondary school students and their safe environment, playing conditions and media usage. The sample of the study was consisted of 628 students aged between 11-14 years old. The universe of the study was composed of students studying in the secondary schools in these provinces. The data of the study were collected by means of "The Questionnaire for Safe Environment, Playing Conditions and Media Usage Affecting PA Level" and "Physical Activity Questionnaire for Children". The results of the study showed that the average screen time of students was 114.25 ± 97.24 minutes per day, the most occupied device was television and screen time on all devices was more among the boys. When analyzed for devices one by one, the difference between the genders was not found to be statistically significant, but it was statistically significant when evaluated over total time. It was also found that students who did not have internet access were physically more active than the students with limited or unlimited internet access at home; and the students without media restrictions were found to be more active than students with media restrictions. The results also showed that PA levels of the students were found to be significantly different based on the factors such as the presence of a playground close to student's home, having a playmate, playing actively with parents, and having a toy or device that enhancing PA. In addition, the PA levels of students who were helping with the housework, playing in an amateur sports team or performing exercise regularly were found to be significantly higher. In the multivariate model analysis, it was found that media restriction and playing conditions together were not found to represent the change in PA level.
... Moreover, the current findings recommend effective interventions which can be designed to reduce overweight in-school adolescents and improve their health status. The types of behavioral interventions including classroom-based physical education lessons, changing school diet patterns in the school cafeteria, and automated screen monitoring devices to control screen time at school and home may provide useful evidence to adolescents for reducing their weight [54][55][56]. Additionally, active video games and healthy diet-related videos have the potential to improve body composition in overweight and obese adolescents [57,58]. ...
Background
Electronic media usage is recently considered a modifiable risk factor for overweight and obesity among adolescents. The purpose of this present study was to evaluate the association of electronic media (EM) usage with overweight and obesity among school-going adolescents.
Methods
This cross-sectional study was conducted from October to December 2019 among school-going adolescents (14–16 years old) residing in the Jashore Sadar Upazila, Jashore district of Bangladesh. A standardized questionnaire was used to collect information regarding the socio-economic status, time spent watching television, video games playing, computer, and smart mobile phone use through face-to-face interviews. Age- and sex-specific body mass index (BMI) cut-off values for overweight and obesity were determined for Asian adolescents by the International Obesity Task Force (IOTF). Multinomial logistic regression analysis was carried out to determine the association between electronic media use with overweight and obesity.
Findings
The findings suggest that the overall prevalence of overweight and obesity was 13.5% and 25.2%, respectively. Among the total adolescent students, about 49.1% highly (above 3 hours per day) spent their time on EM use whereas 30.6% moderately (≥121 to 180 min/day) use EM. The regression analysis showed that spending high time using total screen-based electronic devices, television viewing, video game playing, computer use, and smartphone use were significantly associated with overweight (RRR: 7.36, 95% CI: 3.64–11.54; RRR: 4.58, 95% CI: 1.46–7.95; RRR: 4.45, 95% CI: 2.75–6.12; RRR: 3.18, 95% CI: 1.87–4.70; RRR: 2.15, 95% CI: 1.23–3.51) and obesity (RRR: 8.72, 95% CI: 4.64–12.54; RRR: 2.89, 95% CI: 1.31–5.21; RRR: 3.88, 95% CI: 1.74–5.13; RRR: 3.08, 95% CI: 1.32–4.86; RRR: 1.19, 95% CI: 0.93–1.48) in adolescents, respectively.
Conclusion
The results support the total time spent using electronic media was associated with an increased risk of being overweight and obesity. Finally, this study strongly suggests the proper use of electronic media may be necessary to reduce the risk of being overweight and obesity in early adolescents.
... For clinicians, a first step is to increase the use of screeners that inquire about sleeping behaviors and the use of technology (Merdad et al., 2017;Schmidt et al., 2012). Commonly utilized screeners include the Cleveland Clinic Sleep Adolescent Screener (Merdad et al., 2017), and the Pediatric Sleep Questionnaire (Chervin et al., 2000). ...
Media has become fundamentally integrated into the everyday lives of children and adolescents. Despite this, the consequences of media use on child and adolescent sleep remain incompletely understood. This chapter summarizes the current literature on four main mechanisms through which media consumption affects sleep health. (1) Increased media use is associated with decreased sleep duration secondary to sleep time displacement and delayed sleep onset. (2) Increased media use is associated with decreased sleep quality as a result of heightened arousal and greater sleep fragmentation. (3) Nighttime media use is associated with dysregulation of the circadian rhythm via blue light re-entrainment. (4) Mental health modulates both sleep and media use. Sleep and media use in-turn affect mental health, forming a bidirectional relationship. A biopsychosocial approach is taken to analyze each pathway. Key considerations such as age, sex, type of device used, passive vs. active use, and content of media are considered. Finally, evidence-based recommendations for clinicians, parents and policymakers are offered.
... Parents' highly positive belief in screen viewing results in more screen viewing for children (43). Thus, education programs are needed to alter parents' attitude toward screen viewing (44). Examining crosscultural differences in the reasons for screen viewing can provide more culture-sensitive strategies to reduce screen viewing time effectively in infancy and toddlerhood in different countries. ...
Aim
Currently young children have more opportunity to access all kinds of media, while their sleep duration has been steadily decreasing. However, little is known about the relationships between screen viewing and sleep quality, and the reasons of screen viewing for children under three years old in China. This study aimed to describe the relationships between screen viewing and sleep quality of infants and toddlers in mainland China.
Methods
A cross-sectional study was conducted. Eight hundred twenty-seven children were recruited at a health care unit from a university affiliated hospital in China, and the questionnaires were completed by their parents. An extended Brief Infant Sleep Questionnaire and a Screen Viewing Questionnaire were used to collect information on children's sleep quality and screen viewing. Multivariate linear regression models were used to assess the relationships between screen viewing and sleep quality among infants and toddlers, adjusted for sociodemographic variables.
Results
Of the 827 children, 26.9% of the infants and 61.4% of the toddlers did not comply with the World Health Organization (WHO) guideline on screen time. Even after adjusting for the sociodemographic covariates for both infants and toddlers, negative relationships between screen time and total sleep time ( P < 0.001), and screen time and nighttime sleep ( P < 0.001) existed. TV viewing time was negatively related to infants' total sleep time ( β = −0.15, P < 0.001) and toddlers' nighttime sleep ( β = −0.1, P < 0.05). Smartphone viewing time was negatively related to toddlers' total sleep time ( β = −0.12, P < 0.05) and daytime sleep ( β = −0.22, P < 0.05). Parents who offered screen media for children when they needed to do house chores were more likely to report that their children had less total sleep time ( β = −0.1, P < 0.05) and shorter longest sleep episode ( β = −0.1, P < 0.05).
Conclusion
The majority of toddlers did not meet the WHO guidelines on screen time in China. Screen time was negatively related to total sleep time and nighttime sleep among infants and toddlers. Practical strategies, such as education programs on children's screen viewing, more outdoor exercises and indoor parent-child activities, providing other educational materials instead of screening, early sleep, restricted use of TVs and smartphones, and screen co-viewing, are needed to improve young children's sleep quality and promote their development.
... 49,107,108 Studies with the greatest effect sizes were those which set explicit goals for reduced use, monitored outcomes using objective measures, had methods to provide timely feedback to parents of ongoing efficacy and use, involved counselling services, and promoted high levels of parental monitoring. 109 Another review found that interventions that were short-term (less than seven months in duration) and were supported with counselling or health promotion curricula had larger effect sizes. 107 While, parents and families alone cannot be expected to address sharp increases in screen time, there are some strategies at the individual level which have been found to be effective at promoting healthy screen hygiene. ...
Screen time has substantially increased for children and youth in Ontario and globally during the COVID-19 pandemic. Emergency measures introduced during the pandemic such as closures of schools and recreation contributed to increased screen time. There is a growing body of evidence associating increased screen time with harms to physical (e.g., decreased physical activity, eye strain and headaches), cognitive (e.g., attentiveness) and mental (e.g., reported symptoms of depression and anxiety) health in children and youth. There are evidence-based strategies to promote healthy screen habits for children and their families which offer an approach to encourage healthier screen use in the home setting and mitigate potential harms. However, the burden to reduce screen time cannot fall to parents and families alone. Policies are needed to avoid closures of schools and recreation, and ensure alternatives to screen time for children and youth of all ages that promote socialization and physical activity. In addition, there are key equity considerations when it comes to accessibility of alternatives to screen time such as child care and community recreation.
... 32,48 Providers should address this behaviour by assessing the duration and use of recreational screen time, and suggesting parenting strategies to limit screen time as much as possible. 32,46,48,49 6. Build in regular breaks to move around during times of prolonged sitting or inactivity. There are inevitable situations when children are required to remain seated for prolonged periods, such as during lessons in the classroom or a long-distance trip. ...
Introduction:
Lifestyle activities, such as regular physical activity, are important for good metabolic health and the prevention of non-communicable diseases. Epidemiological studies highlight an increase in the proportion of overweight children in Singapore. A workgroup was formed to develop recommendations to encourage children and adolescents (aged 7-17 years) to adopt a holistic approach towards integrating beneficial activities within a daily 24-hour period for good metabolic and general health.
Methods:
The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence to Decision framework was employed to formulate the public health question, assess the evidence and draw conclusions for the guide. The evidence for international 24-hour movement guidelines, and guidelines for physical activity, sedentary behaviour, and sleep and eating habits were reviewed. An update of the literature review from August 2018 to end of September 2020 was conducted through an electronic search of Medline and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases.
Results:
Ten consensus statements were developed. The statements focused on the overall aim of achieving good metabolic health through integration of these activities and initiatives: light and moderate- to vigorous-intensity physical activity on a regular basis; muscle- and bone-strengthening activities; limiting sedentary behaviour; regular and adequate sleep; good eating habits and choosing nutritionally balanced foods and drinks; practise safety in exercise; and aiming to achieve more or all aforementioned recommendations for the best results.
Conclusion:
This set of recommendations provides guidance to encourage Singapore children and adolescents to adopt health-beneficial activities within a 24-hour period.
... However, media usage has also been associated with negative developmental outcomes in early childhood resulting in warnings against excessive use in pediatric guidelines ( AAP, 2016 ). Media use has been associated with changes in neural structures ( Hutton, Dudley, Horowitz-Kraus, DeWitt, & Holland, 2019 ), obesity ( Ebbeling, Pawlak, & Ludwig, 2002 ;Schmidt et al., 2012 ), and visual problems Yang et al., 2020 ). Several features of passive screen media, such as when images change rapidly of encourage multitasking (i.e., consuming 2 media at once), may negatively affect executive functions ( Corkin et al., 2021 ;Lillard & Peterson, 2011 ;Nathanson, Aladé, Sharp, Rasmussen, & Christy, 2014 ), including attention-deficit hyperactivity disorder symptomatology ( Nikkelen, Valkenburg, Huizinga, & Bushman, 2014 ) and self-regulation ( Cliff, Howard, Radesky, McNeill, & Vella, 2018 ). ...
Media form an integral part of children's environments and represent, amongst other domains, altered sensorimotor experiences. Fine motor skills (FMS) represent a fundamental prerequisite for learning and cognition and initial work has begun to show links with screen media usage-although work is scarce and the directionality is uncertain. Therefore, using a cross-lagged-panel design with 2 waves 1 year apart, we examined longitudinal links between media usage and FMS in 141 preschool children. Results show a negative cross-lagged path from media usage to FMS, which was also statistically significant when only newer media were examined, after controlling for parental educational attainment, immigrant status , device ownership, age of first use, working memory, and vocabulary. The study contributes to our understanding of links between media usage and FMS development.
... As a rule, excessive behaviors are divided into substance dependence and behavioral or activity-related dependence (Mudry et al., 2011). Recent studies (Sigerson et al., 2017;Sussman & Moran, 2013) differentiate another branch of excessiveness that involves new technologies with one similar characteristic: screen use, for example, television watching, Internet, smartphones, online gaming, social media (Marshall et al., 2006;Schmidt et al., 2012). This new branch of behaviors can hardly be ignored when US users over 18 years old spend 11 h 54 min daily being connected to some form of digital media via desktop computers, smartphones, tablets, and other devices (O'brien, C., 2020). ...
Drawing on dual‐system theories, this study shows that excessive social media users demonstrate a psychological imbalance between the impulsive and reflective systems in their minds. We provide empirical evidence of an inconsistency between conscious attitudes and the actual behavior towards social media. The findings show that excessive users are driven more by their implicit attitudes rather than explicit beliefs in consuming social media. Although a high level of self‐control indicates healthy social media use, the findings suggest that self‐control has no significant influence on excessive users with a positive implicit attitude and high impulsive social media use. This duality of self‐control dispels beliefs about its ability to regulate excessive online behaviors. Therefore, this study (1) theorizes what constitutes excessive social media use, (2) outlines how implicit measurements are incorporated in consumer research, and (3) offers practical implications for managing unhealthy online behaviors. This article is protected by copyright. All rights reserved.
... Various types of time monitors were used in seven randomized controlled trials of this review (Epstein et al., 2008;Faith et al., 2001;Goldfield et al., 2006;Maddison et al., 2014;Ni Mhurchu et al., 2009;Robinson, 1999;Robinson et al., 2003), with effect sizes nearly three times that of trials without monitors. This result was consistent with two previous studies (Maniccia et al., 2011;Schmidt et al., 2012). However, a study from Lei Wu et al. illustrated that using automated monitors was less effective than health promotion sessions/counseling. ...
Several studies have investigated the effect of screen time interventions on obesity in children and adolescents, but the existing results were controversial. This study aimed to analyze the effect of screen time intervention on obesity in children and adolescents. PubMed, Cochrane, Web of Science, Embase databases were searched through December 2020 to identify publications meeting a priori inclusion criteria and references in the published articles were also reviewed. Finally, 14 randomized controlled trials and 1894 subjects were included in this meta-analysis. The results showed that interventions targeting screen time are effective in reducing total screen time (MD: −6.90 h/week, 95% CI: [−9.19 to −4.60], p < 0.001) and television time (MD: −6.17 h/week, 95% CI: [−10.70 to −1.65], p < 0.001) in children and adolescents. However, there was no significant difference between the intervention and control groups in body mass index and body mass index-z score.
In conclusion, there is no evidence that screen time interventions alone can decrease obesity risk in children and adolescents, though they can effectively reduce screen time.
... Most studies were from western world; Indian data is meager. The most effective interventions included those which specifically targeted and set goals for reduced TV viewing or screen-media use, used electronic monitoring devices, contingent feedback systems or clinic-based counseling, had high levels of parental involvement, and/or recruited participants who were already overweight or obese at baseline, had restricted access to the television or computer, or by providing opportunities for physical activity [55,56]. In a systematic review [57] of 21 studies in children between 3 to 11 years, 'TV turnoff week' strategy was documented beneficial to reduce screen time. ...
Justification:
Screen-based media have become an important part of human lifestyle. In view of their easy availability and increasing use in Indian children, and their excessive use being linked to physical, developmental and emotional problems, there is a need to develop guidelines related to ensure digital wellness and regulate screen time in infants, children, and adolescents.
Objectives:
To review the evidence related to effects of screen-based media and excessive screen time on children's health; and to formulate recommendations for limiting screen time and ensuring digital wellness in Indian infants, children and adolescents.
Process:
An Expert Committee constituted by the Indian Academy of Pediatrics (IAP), consisting of various stakeholders in private and public sector, reviewed the literature and existing guidelines. A detailed review document was circulated to the members, and the National consultative meet was held online on 26th March 2021 for a day-long deliberation on framing the guidelines. The consensus review and recommendations formulated by the Group were circulated to the participants and the guidelines were finalized.
Conclusions:
Very early exposure to screen-based media and excessive screen time (>1-2h/d) seems to be widely prevalent in Indian children. The Group recommends that children below 2 years age should not be exposed to any type of screen, whereas exposure should be limited to a maximum of one hour of supervised screen time per day for children 24-59 months age, and less than two hours per day for children 5-10 years age. Screen time must not replace other activities such as outdoor physical activities, sleep, family and peer interaction, studies and skill development, which are necessary for overall health and development of the children and adolescents. Families should ensure a warm, nurturing, supportive, fun filled and secure environment at home, and monitor their children's screen use to ensure that the content being watched is educational, age-appropriate and non-violent. Families, schools and pediatricians should be educated regarding the importance of recording screen exposure and digital wellness as a part of routine child health assessment, and detect any signs of cyberbullying or media addiction; and tackle it timely with expert consultation if needed.
... No caso do primeiro aspecto, não foram encontrados estudos que tivessem abordado o tema no mesmo formato ou com tópicos semelhantes (Schmidt et al., 2012;Wu et al., 2016). Assim, a partir de revisão de literatura e do conhecimento adquirido sobre a temática nas pesquisas anteriores do grupo, criou-se um questionário a ser aplicado antes do início das palestras e reaplicado ao final dos encontros. ...
The use of digital media by babies is a recent phenomenon. Some evidence highlights associations between the use of screens in early childhood and adverse developmental outcomes. This study aims to report the development, implementation, and evaluation processes of an educational intervention for parents, health professionals, and educators on the use of digital media in early childhood. The intervention follows the model of continuing education, with four face-to-face meetings and presentations followed by group discussions. It was evaluated by participants' learning and satisfaction with the course. Sixteen people participated, mostly health and education professionals. The results indicate a significant improvement in participants' knowledge and high satisfaction rates. Findings are discussed to support the development of new interventions on the subject.
... Most studies were from western world; Indian data is meager. The most effective interventions included those which specifically targeted and set goals for reduced TV viewing or screen-media use, used electronic monitoring devices, contingent feedback systems or clinic-based counseling, had high levels of parental involvement, and/or recruited participants who were already overweight or obese at baseline, had restricted access to the television or computer, or by providing opportunities for physical activity [55,56]. Another systematic review [57] included 21 studies in children between 3 to 11 years. ...
Indian Academy of Pediatrics Guidelines on Screen Time and Digital Wellness in Infants, Children
and Adolescents
... However, as schools, teachers, students, and parents started to build familiarity and proficiency in their use of educational technology platforms, a concern slowly began to emerge over the potential physiological, psychological and academic risks associated between increased screen time and student wellbeing (Jarrett & Pomrenze, 2020;Shih & Killeen, 2020). Screen time (ST) implies any time spent engaged in screen-based activities such as watching TV or DVDs, using a computer or tablet for educational or recreational activities, playing video games, or using a cell phone to access the internet or social media apps (Xu et al., 2015;Hale & Guan, 2015;Schmidt et al., 2012). ...
There is an urgent need for consensus around the matter of screen time (ST) during the COVID-19 pandemic. Some governments announced restrictions for online schooling time per day to protect students from perceived risks of prolonged screen-use, but critics and an emerging body of research question such regulations. Our review of 52 empirical studies found (a) an overwhelming majority of literature shows effect sizes too small to be of practical or clinical significance, and (b) findings more specifically on educational ST are inconclusive and critically underrepresented. These facts, along with the undeniable benefits of online learning in the absence of brick-and-mortar schooling and the ominous forecasts of learning loss caused by prolonged school closure, inform our recommendations for a more moderate policy and practical stance on restrictions - one that is focused on responsibly leveraging the educational and social benefits of ST in a world still recovering from the COVID-19 pandemic.
... Annelerin çocuklarını ekrandan uzak tutmak istedikleri ortaya konmuştur. Okul öncesi çocukları için ekran sürelerinin azaltılasına yönelik yapılan çalışmaların (Schmidt, Haines, O'brien, McDonald, Price, Sherry ve Taveras, 2012;Staiano, Webster, Allen, Jarrell, ve Martin, 2018) mevcut bulguyla benzerlik gösterdiği söylenebilir. Tüm dünyada çocukların ekran kullanımının artışı karşısında ebeveynlerin almaları gereken önlemlerin pandemi sonrasında daha önemli hale geldiği düşünülebilir. ...
Covid-19 Salgın Sürecinde Müzik Öğretmeni Olmak
... Annelerin çocuklarını ekrandan uzak tutmak istedikleri ortaya konmuştur. Okul öncesi çocukları için ekran sürelerinin azaltılasına yönelik yapılan çalışmaların (Schmidt, Haines, O'brien, McDonald, Price, Sherry ve Taveras, 2012;Staiano, Webster, Allen, Jarrell, ve Martin, 2018) mevcut bulguyla benzerlik gösterdiği söylenebilir. Tüm dünyada çocukların ekran kullanımının artışı karşısında ebeveynlerin almaları gereken önlemlerin pandemi sonrasında daha önemli hale geldiği düşünülebilir. ...
... The high use of tablet/smartphone for leisure amongst youth and parents has previously been identified [19], and it has further been identified as the top behaviour parents believe they and their child could reduce [19]. This finding, coupled with the small differences in TV viewing from pre-lockdown to during lockdown restrictions, reinforces the need to review screen time recommendations and intervention strategies, which have previously been established primarily based upon TV viewing literature [37,38]. For example, screen time intervention strategies that have been effective prior to lockdown restrictions (typically targeting total screen time or TV viewing time) have incorporated family involvement, parental support and role modelling, which have resulted in reduced screen time among children and parents [35,39,40]. ...
This study aimed to understand differences in leisure, educational/work and social screen time behaviours experienced by parents and children due to COVID-19 lockdown restrictions, which may inform behaviour change strategies and policy in the transition to a COVID-normal life. Participants in the “Our Life at Home” study (n = 218 parents from Australia, 43.4 ± 6.8 years, 88% female) completed a cross-sectional online survey in April/May 2020. Parents recalled their own and their child (8.7 ± 2.0 years, 42% female) or adolescents (15.0 ± 1.5 years, 50% female) participation in nine screen time behaviours in the past month (during lockdown) and retrospectively for February 2020 (pre-lockdown), providing data on 436 individuals. Screen time behaviours included leisure (computer/laptop and tablet/smartphone for leisure, TV/videos/DVDs and game consoles); education/work (computer/laptop and tablet/smartphone for work/education); and social screen time (computer/tablet/smartphone for social communication with friends, family and work (parents only)). Wilcoxon signed-rank tests and effect sizes (r) compared the time spent in each behaviour pre-lockdown and during lockdown. Large differences were observed in social (parents: r = 0.41–0.57; children: r = 0.55–0.65; adolescents: r = 0.28–0.43) and education (children: r = 0.50–0.65 and adolescents: r = 0.25–0.37) behaviours. There were small or no differences in leisure time screen use. COVID-19 lockdown restrictions have impacted parent’s and children’s screen time, and future research and policy should consider strategies to support families to manage screen time.
... To account for articles indexed after the initial search process, an updated search of articles published between February 2020 and July 2021 was performed in July 2021 using the original search strategy described above. The search strategy was developed by two authors (AJ and MB) and is provided in Additional file 1. Reference lists of systematic reviews and meta-analyses were reviewed to identify additional studies that were not captured in the initial search [14,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. The citations for identified articles were uploaded into an EndNote (version X9.2) library for reference management. ...
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.
... It is suggested that negative effects of screen-time are often associated with numerous confounding variables, including the adolescents' age, gender, socio-economic status, parent education, home environment, attachment to friends, sedentary time, and ethnicity, for example (Anderson, 2008;Cameron, 2016;Carson, 2010;Gingold, 2014;Jago, 2012;Ramirez, 2011;Sirard, 2013;Smith, 2010;Tandon, 2012). Behavioral interventions used to minimize sedentary screen-time and mitigate identified negative effects are often effective, particularly in the context of randomized controlled trials (Buchanan, 2016;Schmidt, 2012;Wahi, 2011). ...
... Specific parental involvement was associated with decreased odds of a child being an excessive screen viewer. This result was expected and is consistent with past evidence (Schmidt et al., 2012). As a parent is more engaged in a child's schoolwork, a child is less likely to spend a significant amount of time in front of screens. ...
... We found a similar trend for men aged below 50 years in Sweden. A possible explanation may be reduced sun exposure in younger individuals due to sun protection information, less outdoor work and reduced outdoor leisure activities [14,34,35]. ...
Background:
The incidence of invasive cutaneous melanoma (CM) is increasing in Sweden. The aim was to present age- and sex-specific trends of the age-standardised incidence and the average annual percentage change (AAPC) for in situ and invasive CM.
Methods:
Joinpoint regression models were used to analyse data from the Swedish Cancer Register and the Swedish Melanoma Registry 1997-2018 (N = 35,350 in situ CM; 59,932 CM).
Results:
The AAPC of CM for women was 4.5 (4.1-5.0; p < 0.001) for the period 1997-2018. For men, the APCC was 4.2 (3.0-5.4; p < 0.001), with a significantly higher annual percentage change (APC) for the period 2000-2018 (5.0; 4.6-5.4; p < 0.001) compared to 1997-1999. An increasing annual incidence of CM ≤ 0.6 mm and 0.7 mm Breslow tumour thickness was found for men with a significant incidence shift for the period 2006-2015, respectively. Similarly for women, with a significantly higher APC for CM ≤ 0.6 mm from 2005. The incidence of intermediate thick CM (2.1-4.0 mm) has not increased since 2011. The incidence of CM > 4.0 mm has been increasing among both sexes, with a significantly lower APC among women from 2005.
Conclusions:
The incidence of in situ and low-risk CM ≤ 1.0 mm in tumour thickness has been rising among both sexes since the 2000s.
... Although television still exerts considerable effects on children's sleep-time, this study suggests that, in the era of the mobile devices, laptops and tablets in the bedroom may start having a greater impact on sleep than passive screen media. Previous studies have advocated the removal of electronic media from children's bedroom as a means of limiting screentime and improving sleep-quality [18]; findings of the current study provide some support for this strategy. Nevertheless, children and parents may be resistant to the idea of removing media devices from the bedroom once they have been installed [19]. ...
Background
The literature has shown a widespread use of portable electronic devices among children over the last years. This study aimed to identify the availability of different media devices at home versus in children’s bedroom according to the socioeconomic status (SES), and analyze the association between that availability and children’s screen- and sleep-time on week and weekend days.
Methods
Data from 3 to 10 year-old children (n=8430) from a cross-sectional study conducted in Portugal (2016/17) was used. Screen- and sleep-time, availability of media devices, father and mother education (as a proxy measured of SES) were assessed via questionnaire.
Results
Available devices at home was significantly more common among high-SES families; while media devices in the bedroom were more frequent in low-SES families (p<0.001). In preschool and elementary school-aged children, media devices in the bedroom was associated with increase screen-time and shorter sleep per day. Also, mobile devices in the bedroom were shown to exert similar, or even more, influence on children’s screen- and sleep-time as television.
Conclusions
Further research is needed to explore the pathways by which different electronic media negatively impacts on children’s sleep and screen-time and to develop effective strategies to minimize device access at bedtime.
... This reveals the need for physicians to give counseling to families on this issue. Other studies have reported that only 16% pediatricians asked families about social media use, whereas 29% families considered the recommendations given by pediatricians 1,35 . ...
Purpose: The aim of this study was to investigate the screen time of preschool children in relation to their parents’ screen-use habits and family functions.
Materials and Methods: We included 198 parents whose children were attending a kindergarten in Sarıçam district of Adana. Data were collected using a questionnaire and the Family Assessment Scale. Screen times were calculated by adding up the time spent in front of tablets, TV, mobile phones, and computers.
Results: The screen times were >2 h in 57.6% children on weekdays and in 76.3% on weekends, and screen times increased as age increased. Further, 88.9% parents indicated that they had family rules about screen use, 62.6% stated that their children were in front of the screen while eating, and 44.4% said their children had a screen of their own, whereas 90.9% told that they had not received any recommendations regarding screen use from family physicians or pediatricians. Low education level of parents, lack of family rules on screen use, children having their own screens, and having received no recommendations from doctors regarding screen use were noted to increase the screen times of children. There was a relationship between the screen times of children and that of parents as well as between screen times of children on weekdays and the communication subscale of family functions.
Conclusion: From the results of the study, individual and institutional initiatives are recommended for family physicians and pediatricians who have many contacts with this age group to turn it into an opportunity and have a more active role in advising parents regarding screen use
... It is also focused on children aged between 2 and 5 years, as compared to adolescents in which promising effects of intervention have been demonstrated by previous studies (38). In contrast to a previous review that revealed only a handful of successful interventions (39), this review recorded a higher percentage of success in ST reduction. One of the possible reasons could be the inclusion of only studies that targeted ST reduction as a sole primary outcome. ...
BACKGROUND
The increasing screen time exposure among young children in general and the reported negative consequences associated with excessive ST, calls for focused strategies to reduce ST, especially among young children.
OBJECTIVE
This systematic review aimed to identify effective parental intervention strategies to reduce ST among preschool children.
METHODS
A total of five databases, namely Cochrane Central Register of Controlled Trials, CINAHL, Medline Complete, PubMed, and Scopus, were searched for randomised controlled trials that involved intervention strategies in ST reduction among preschool children. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines were used.
RESULTS
A total of nine studies were assessed. The results showed that besides providing knowledge and awareness regarding ST, having restrictive practices, offering alternative activities to parents, and removal of screen from child’s bedroom were the most common strategies used by studies that reported successful intervention. Intervention duration of between six to eight weeks was sufficient to produce ST reduction. Face-to-face method was the commonest mode of delivery. Theoretical constructs that aimed at increasing parental self-efficacy, listing outcome expectations, and offering reinforcement of strategies that targeted both the parents and home environment were beneficial in reducing ST.
CONCLUSIONS
By offering appropriate strategies to parents, a reduction in the amount of ST was observed among the children. Future intervention studies could benefit in exploring culturally adapted strategies, especially in developing countries. Trials of higher quality would also facilitate the drawing of conclusions in future research.
CLINICALTRIAL
PROSPERO No: CRD42020199398
... 2,3,4 In response to these trends, a number of studies have sought to identify effective strategies to promote healthy screen media use in children and teens. 5 The American Academy of Pediatrics (AAP) and the World Health Organization (WHO) have produced guidelines for appropriate screen media use (Table 1). 6,7,8 In 2016, the American Academy of Pediatrics (AAP) published the Family Media Plan, an online tool to help families generate a personalized plan to effectively manage screen media use. ...
Background: Children are growing up in an increasingly digital world. As mobile devices and digital screens become more accessible, greater attention is being paid to screen media use and its effect on pediatric development. The American Academy of Pediatrics (AAP) and the World Health Organization (WHO) have released recommended screen time limits for children of various ages and emphasize the importance of high-quality screen media when used. In 2016, the AAP released the Family Media Plan: an online tool developed for families to create personalized strategies to manage screen media use.
Objective: While a useful tool, the AAP’s Family Media Plan does not lend itself to use by pediatricians in the clinical setting. The aim of this quality improvement (QI) project is to determine whether screen media use can be reduced in the pediatric population through patient counseling and use of a take-home goal sheet, adapted from the AAP’s Family Media Plan.
Methods: Thirty-eight children, ages 6 to 13, agreed to participate in this study. Pre-intervention hours of screen media use per week was collected. The Media Use Plan, a summarized, print version of the AAP’s Family Media Plan, was developed and distributed to study participants’ families to be used in their homes. One month later, families were contacted to complete a post-intervention telephone interview.
Results: Of the 38 patients that consented to participating in the study, 35 completed both pre- and postintervention surveys. The median screen time per week decreased from 16 hours to 12 hours after pediatrician counseling and Media Use Plan intervention.
Conclusion: Our data suggests that engaging patients in goal-oriented discussions and use of the Media Use Plan was effective in reducing screen time per week. Future iterations of this study may explore demographic effects and the sustainability of these results beyond the one-month period.
... In diesem Kapitel möchten wir zunächst die Bedeutung von Health Literacy für die adäquate Nutzung digitaler Medien erläutern, die Rolle des sozialen Umfeldes beim Erlernen eines gesunden Umgangs mit digitalen Medien diskutieren und Anforderungen an eine gelingende Prävention daraus ableiten. Im Anschluss stellen wir das Präventionsprogramm ECHT DABEI vor, welches sich als setting-basiertes Programm an pädagogische Fachkräfte, Eltern und Kinder in Kindertagesstätten und Grundschulen richtet und die primäre Prävention problematischer Bildschirmmediennutzung zum Ziel hat.Health Literacy beschreibt das Wissen, die Motivation und die Fähigkeit von Individuen, Gesundheitsinformationen zu finden, zu verstehen, zu beurteilen und anzuwenden, um im Alltag angemessene Entscheidungen für die Gesundscheint daher die Sensibilisierung und Schulung sowohl der Eltern als auch der Fachkräfte in Betreuungs-und Bildungsinstitutionen ein erfolgsversprechender Weg zu sein.Eine gelingende Prävention sollte dabei inhaltlich auf alle drei Dimensionen problematischer Bildschirmmediennutzung ausgerichtet sein, namentlich Zeit, Inhalt und Funktion(Bleckmann und Mößle 2014;Schmidt et al. 2012). Problematische Nutzung in Bezug auf die Dimension Zeit fokussiert die Verdrängung anderer Freizeitaktivitäten durch die Nutzung von Bildschirmmedien ("Wie lange und häufig werden Bildschirmmedien genutzt?"). ...
Eine exzessive Nutzung von Bildschirmmedien in der Kindheit kann negative Auswirkungen auf die Entwicklung und Gesundheit haben (z. B. Übergewicht, Aufmerksamkeitsdefizite). Wir legen in diesem Kapitel dar, dass ein hohes Maß an Health Literacy eine Voraussetzung für den adäquaten Umgang mit digitalen Medien darstellt und dass für die Health Literacy von Kindern vor allem systembezogene Faktoren eine Rolle spielen. Das Präventionsprogramm ECHT DABEI hat die primäre Prävention problematischer Bildschirmmediennutzung zum Ziel und richtet sich mit einem Setting-Ansatz an pädagogische Fachkräfte, Eltern und Kinder in Kindertagesstätten und Grundschulen. Daten aus der Qualitätssicherung von ECHT DABEI zeigen, dass das Präventionsprogramm zur Schaffung eines gesundheitskompetenten Settings beitragen kann, in dem Kinder langfristig und entsprechend ihrer entwicklungsabhängigen Möglichkeiten einen eigenverantwortlichen und gesunden Umgang mit digitalen Medien erlernen.
This study aimed to verify the correlates of non-participation in Physical Education (PE) classes among Brazilian schoolchildren in the five regions of Brazil. This is a cross-sectional study using data from 9th-grade elementary school students, of both sexes, participating in the National Adolescent School-based Health Survey (PeNSE), 2015. The dependent variable was non-participation in PE classes. Sociodemographic, school structure, and behavioral indicators were the independent variables, assessed by self-administered questionnaires. Binary logistic regression was used to estimate the odds ratios, in the crude and adjusted analyzes. A total of 84,807 students participated in the study. The prevalence of non-participation in PE classes was 17.9%, being higher in the Northeast (26.9%). The female gender, not having sports equipment in a condition of use and being inactive during leisure time showed greater chances of not participating in PE classes in all regions. Schoolchildren from non-capital municipalities in the Northeast, Southeast, South, and Midwest regions had lower chances of non-participation. The other correlates showed associations with higher or lower chances depending on the region of the country. For the five regions of the country, a clear pattern of correlates of non-participation in PE classes was identified, involving sex, insufficient physical activity in leisure, and class materials. The other correlates of participation in PE classes varied in the associations, depending on the region of the country. The proposition of interventions to increase participation in PE classes among Brazilian students must consider the potential regional differences in terms of their correlates.
Objective:
This study aimed to systematically review and analyse intervention programs in a school context centred on the family, focused on increasing youths' physical activity.
Data source:
The research was carried out in the PubMed, Scopus and Web of Science databases.
Study inclusion criteria:
Studies were included if participants were children or adolescents, focusing on school-based intervention studies with parental involvement and physical activity, sedentary behaviour or physical fitness outcomes.
Data extraction:
The search was performed according to the PRISMA protocol. A total of 416 articles were identified. After being considered for eligibility and duplicates, 22 studies were identified as relevant for inclusion.
Data synthesis:
Sample and intervention characteristics, objective, the role of the family, outcomes measures, main findings regarding the outcomes and risk of bias.
Results:
Ten studies reported improvements in physical activity, 6 in sedentary behaviour and 9 in the components of physical fitness and/or skills related to healthy behaviours and lifestyles. Most of the interventions adopted a multidisciplinary and multi-component approach.
Conclusions:
Most interventions employed a school's multidisciplinary/multi-component approach to promoting physical activity, nutrition, and general education for healthier lifestyle behaviours. The impact of school-based interventions involving families on youth's physical activity levels is still a relatively emerging theme. Further research is needed given the diversity of the intervention's characteristics and the disparity in the results' efficacy.
Objetivo: O objetivo deste estudo foi analisar o excessivo tempo assistindo televisão e usando computador em dias úteis e no fim de semana em estudantes do ensino médio da cidade do Rio Branco. Método: Trata-se de um estudo transversal de base escolar com 1391 estudantes na faixa etária entre 14 e 18 anos do ensino médio de escolas públicas e particulares. Utilizou-se ponto de corte de igual ou maior a 2 horas por dia para categorizar excessivo tempo assistindo televisão e usando computador em dias úteis e fim de semana. A regressão logística múltipla identificou o modelo final. Resultados: A prevalência para tempo excessivo de assistir televisão foi de 8,9% em dias úteis e 39,7% no fim de semana. Enquanto a prevalência de excessivo uso de computador identificada em dias úteis e fim de semana foram de 6,9% e 27,4%, respectivamente. As prevalências altas de excessivo tempo de tela ocorreram para assistir televisão e uso de computador no fim de semana. A permissão para assistir televisão e usar computador no quarto de dormir foram os principais contribuintes ao excessivo tempo de tela, tanto em dias úteis e como no fim de semana. Além disso, o excessivo tempo assistindo televisão associou-se com as variáveis ir semanalmente a ginásios ou estádios e ler semanalmente em dias úteis e ter idade entre 16 e 18 anos em fim de semana. Enquanto ser filho único em dias úteis e estar matriculado em escola privada no fim de semana associaram-se ao excessivo uso de computador. Conclusão: Maior vulnerabilidade ao excessivo tempo assistindo televisão e usando computador ocorreram no fim de semana em estudantes do ensino médio de Rio Branco. Tanto assistir computador no quarto e quanto usar computador no quarto foram os principais contribuintes para os excessivos tempos de tela em dias úteis e no final de semana. Esses achados sugerem a necessidade de implementação de ações governamentais voltadas a prevenção do excessivo tempo de tela em estudantes. Palavras-chave: Tempo de tela; fatores epidemiológicos; adolescentes; estudantes.
The health of babies, children and young people is fundamentally different from that of adults, so their healthcare must reflect their unique needs and engage their parents, family members and communities. Paediatric Nursing in Australia and New Zealand introduces nursing students to the care of infants, children, young people and their families in a range of clinical and community settings across Australasia. This third edition includes New Zealand content and an increased focus on families. New chapters cover health services available for Aboriginal, Torres Strait Islander and Māori children, the transition to parenthood for new families, children's sleep patterns and behaviour, and paediatric health in school settings. Case studies and reflective questions encourage students to develop critical thinking and problem-solving skills. Written by an expert team, Paediatric Nursing in Australia and New Zealand equips future nurses with the knowledge and skills to provide evidence-based care to babies, children and their families.
Non-communicable diseases (NCDs) constitute a significant public health challenge and pose a great burden on health and social systems throughout the world. The Asia-Pacific region is in a vulnerable position as the prevalence of NCDs will inevitably increase with rapid socioeconomic transitions; yet it is ill prepared for this public health challenge as Asian children are among the most physically inactive in the world. Aligned with the WHO’s global strategy to control NCDs via preventive measures and health promotion policies, representatives from the Asia-Pacific region came together to develop consensus statement on integrated 24-hour activity guidelines for children and adolescents. These guidelines apply to children and adolescents, aged 5–18 years, in the Asia-Pacific region, regardless of gender, cultural background or socioeconomic status. These guidelines aim to provide the latest evidence-based recommendations, taking a holistic approach to lifestyle activities and adopting a practical perspective by framing these activities within a 24-hour period. Eating and dietary elements were incorporated as they closely influence the energy balance of the movement behaviours and vice versa. By investing in the younger generations through advocacy for healthier lifestyles, we aim to reduce the burden of NCDs in the Asia-Pacific region.
Purpose
The purpose of this paper is to evaluate the impact of interventions focused on reducing screen time in children.
Design/methodology/approach
Studies that aim to investigate the effects of interventions aimed at reducing the time spent in front of the screen (i.e. screen time). A Random-effects model was used to calculate the pooled standard mean differences. The outcome was to evaluate the screen time in children in the 0–18 age range. A subgroup analysis was performed to reveal the extent to which the overall effect size varied by subgroups (participant age, duration of intervention and follow).
Findings
For the outcome, the meta-analysis included 21 studies, and the standard difference in mean change in screen time in the intervention group compared with the control group was −0.16 (95% confidence interval [CI], −0.21 to −0.12) ( p < 0.001). The effect size was found to be higher in long-term (=7 months) interventions and follow-ups ( p < 0.05).
Originality/value
Subgroup analysis showed that a significant effect of screen time reduction was observed in studies in which the duration of intervention and follow-up was =7 months. As the evidence base grows, future researchers can contribute to these findings by conducting a more comprehensive analysis of effect modifiers and optimizing interventions to reduce screen time.
The increase in children’s screen time over the last few decades has concerned parents, educators, and policymakers alike, due to its association with negative developmental outcomes. Interventions have focused on cautioning parents against screen time and coaching them on how to limit it. Such interventions are unlikely to be effective if screen time is driven less by parental preference than by parental necessity, supplementing insufficient adult caretaker availability. We show that during the COVID crisis, screen time in the United States increased dramatically as a direct result of sudden decrease in adult caretaker availability. This indicates that lower screen time rates prior to the pandemic were not (merely) a function of well-informed parenting but of well-resourced parenting. It also supports claims that the associations between screen time and developmental outcomes are epiphenomenal and due to their joint dependence on family well being.
Clinical guidelines have long been one of the working tools of the modern doctor, helping him quickly navigate the most effective proven methods of treatment and prevention of various diseases, and also to adapt these methods to the specific tasks of their patients and to achieve maximum personalization of treatment. Clinical practice guidelines are drawn up by professional non-profit associations and are approved by the Scientific Council of the Ministry of Health of the Russian Federation, while often one recommendation is prepared by two or even three associations. The peculiarity of the recommendations offered to your attention is that not only endocrinologists, but also therapists, cardiologists, gynecologists, gastroenterologists, and experts of many other specialties are involved in the prevention and treatment of obesity. The Multidisciplinary Working Group presents this a project in a multidisciplinary journal to bring together the efforts of several professional associations that associated with the need to pay attention not only to obesity itself but also to comorbid conditions. We are looking forward to constructive criticism and a comprehensive discussion of the problem on the pages of our journal. © 2021 Russian Association of Endocrinologists. All rights reserved.
Screen media usage is a major public health issue. Nearly all children grow up in households with a TV and some type of mobile device. National and international studies report an increase in the amount of time children spend with screen media. The resulting negative effects on the physical, emotional and cognitive development of children have led to a need for primary prevention of developmental problems. Besides parental media education, child care settings are important for media education. MEDIA PROTECT aims to support screen media-sensitive environments in the home and the child care setting. It is a program to sustainably prevent children’s problematic and, in the long run addictive use of screen media in a multi-setting approach through the targeting of parents, children and teachers. To test the effectiveness of MEDIA PROTECT, a longitudinal cluster-controlled trial was conducted, with 49 kindergartens and nine elementary schools located in areas with a need for action in the social field.
The aim of this chapter is to describe practical experiences gained while implementing MEDIA PROTECT in child care settings. We use data from the evaluation study to analyse the prerequisites of childcare settings for the willingness to participate. Furthermore, we describe the sociodemographic characteristics of the target group reached. One part of this description addresses the children’s bedroom screen media equipment and screen time. We examine the parents’ perceived need for media education support in the target group and its dependence on actual screen media use and equipment in the family.
Objective:
To assess if a school based intervention was effective in reducing risk factors for obesity.
Design:
Group randomised controlled trial.
Setting:
10 primary schools in Leeds.
Participants:
634 children aged 7-11 years.
Intervention:
Teacher training, modification of school meals, and the development of school action plans targeting the curriculum, physical education, tuck shops, and playground activities.
Main outcome measures:
Body mass index, diet, physical activity, and psychological state.
Results:
Vegetable consumption by 24 hour recall was higher in children in the intervention group than the control group (weighted mean difference 0.3 portions/day, 95% confidence interval 0.2 to 0.4), representing a difference equivalent to 50% of baseline consumption. Fruit consumption was lower in obese children in the intervention group (-1.0, -1.8 to -0.2) than those in the control group. The three day diary showed higher consumption of high sugar foods (0.8, 0.1 to 1.6)) among overweight children in the intervention group than the control group. Sedentary behaviour was higher in overweight children in the intervention group (0.3, 0.0 to 0.7). Global self worth was higher in obese children in the intervention group (0.3, 0.3 to 0.6). There was no difference in body mass index, other psychological measures, or dieting behaviour between the groups. Focus groups indicated higher levels of self reported behaviour change, understanding, and knowledge among children who had received the intervention.
Conclusion:
Although it was successful in producing changes at school level, the programme had little effect on children's behaviour other than a modest increase in consumption of vegetables.
This study examined associations between bedroom television, media use, and adolescents' health risk behaviors. A sample of 1,017 12- to 14-year-old adolescents completed computer-assisted interviews at baseline and 2-year follow-up. Among White adolescents, having a bedroom television predicted risk-promoting media use practices and significantly greater odds of initiating health risk behaviors—cigarette smoking and sexual intercourse—over 2 years. Although significantly more Black than White adolescents had a bedroom television, bedroom television was unrelated to Black adolescents' media use practices or health risk behaviors. Research is needed to understand ethnic differences in family media use and consequences for adolescent development.
Objective To examine whether televised food commercials influence preschool children's food preferences.Design In this randomized, controlled trial, preschool children viewed a videotape of a popular children's cartoon either with or without embedded commercials. Children were then asked to identify their preferences from pairs of similar products, one of which was advertised in the videotape with embedded commercials. Preschoolers' parents were interviewed to determine children's demographic characteristics and media use patterns.Subjects Forty-six 2- to 6-year-olds from a Head Start program in northern California. Statistical analyses For demographic and media use characteristics, univariate data were examined and Student t and χ2 tests were used to test for differences between the control and treatment groups. We calculated the Cochran Q statistic to assess whether the proportion of those choosing advertised food items was significantly higher in the treatment group than in the control group.Results Children exposed to the videotape with embedded commercials were significantly more likely to choose the advertised items than children who saw the same videotape without commercials (Qdiff=8.13, df=l, P
Despite the plethora of new electronic media aimed at very young children, little is known about which media are available to children and whether or how children engage with them. This study reports on a nationally representative telephone survey of more than 1,000 parents of children ages 6 months through 6 years, conducted in Spring 2003. The most significant findings cited in the study are as follows: (1) children six and under spend an average of 2 hours daily with screen media, mostly TV and videos; (2) TV watching begins at very early ages, well before the medical community recommends; (3) a high proportion of very young children are using new digital media, including 50 percent of 4- to 6-year-olds who have played video games and 70 percent who have used computers; (4) two out of three 6-year-olds and under live in homes where the TV is left on at least half the time, even without viewers present, and one-third live in homes where the TV is on "almost all" or "most" of the time-- children in the latter group appear to read less than other children and to be slower to learn to read; (5) many parents see media as an important educational tool, beneficial to their children's intellectual development, and parents' attitudes on this issue appear to be related to the amount of time their children spend using each medium; and (6) parents clearly perceive that their children's TV watching has a direct effect on their behavior, and are more likely to see positive rather than negative behaviors being copied. (KB)
A 2-year longitudinal study of children from ages 3 to 5 and 5 to 7 investigated age changes and environmental influences on TV viewing. Viewing child-informative programs declined with age; viewing cartoons and comedies increased. No age changes occurred on other types of entertainment programs. With increasing age, children watched programs with increasing cognitive demands—less redundancy, longer temporal integration demands, and increasing complexity. Boys watched more cartoons and action–adventure programs than did girls. Cable subscription and changes in program availability over time also accounted for amount and type of viewing. Individual differences in TV viewing remained highly stable over 2 years. It was concluded that cognitive and developmental changes are less important determinants of TV use than are family patterns and external variables affecting the opportunity to view. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Physical inactivity contributes to weight gain in adults, but whether this relationship is true for children of different ethnic groups is not well established.
To assess participation in vigorous activity and television watching habits and their relationship to body weight and fatness in US children.
Nationally representative cross-sectional survey with an in-person interview and medical examination. SETTING and
Between 1988 and 1994, 4063 children aged 8 through 16 years were examined as part of the National Health and Nutrition Examination Survey III. Mexican Americans and non-Hispanic blacks were oversampled to produce reliable estimates for these groups.
Episodes of weekly vigorous activity and daily hours of television watched, and their relationship to body mass index and body fatness.
Eighty percent of US children reported performing 3 or more bouts of vigorous activity each week. This rate was lower in non-Hispanic black and Mexican American girls (69% and 73%, respectively). Twenty percent of US children participated in 2 or fewer bouts of vigorous activity perweek, and the rate was higher in girls (26%) than in boys (17%). Overall, 26% of US children watched 4 or more hours of television per day and 67% watched at least 2 hours per day. Non-Hispanic black children had the highest rates of watching 4 or more hours of television per day (42%). Boys and girls who watch 4 or more hours of television each day had greater body fat (P<.001) and had a greater body mass index (P<.001) than those who watched less than 2 hours per day.
Many US children watch a great deal of television and are inadequately vigorously active. Vigorous activity levels are lowest among girls, non-Hispanic blacks, and Mexican Americans. Intervention strategies to promote lifelong physical activity among US children are needed to stem the adverse health consequences of inactivity.
Screen time, especially television viewing, is associated with risk of overweight and obesity in children. Although several interventions have been developed to reduce children's screen time, no systematic review of these interventions exists to date.
This is a systematic review and meta-analysis of interventions targeting a reduction in children's screen time.
Effect sizes and associated 95% confidence intervals (CIs) were calculated by using a random-effects model. Heterogeneity tests, moderator analyses, assessment of bias, and sensitivity analyses were conducted. Reliability was assessed with Cohen's κ.
The systematic search identified 3002 documents; 33 were eligible for inclusion, and 29 were included in analyses. Most reported preintervention and postintervention data and were published in peer-reviewed journals. Although heterogeneity was present, no moderators were identified. Overall Hedges g (-0.144 [95% CI: -0.217 to -0.072]) and standard mean difference (SMD) (-0.148 [95% CI: -0.224 to -0.071]) indicated that interventions were linked with small but statistically significant reductions in screen time in children. The results were robust; the failsafe N was large, and the funnel plot and trim-and-fill methods identified few missing studies.
Results show that interventions to reduce children's screen time have a small but statistically significant effect. As the evidence base expands, and the number of screen-time interventions increases, future research can expand on these findings by examining the clinical relevance and sustainability of effects, conducting a more thorough analysis of effect modifiers, and identifying critical components of effective interventions.
Video game playing has been linked to obesity in many observational studies. However, the influence of this sedentary activity on food intake is unknown.
The objective was to examine the acute effects of sedentary video game play on various components of energy balance.
With the use of a randomized crossover design, 22 healthy, normal-weight, male adolescents (mean ± SD age: 16.7 ± 1.1 y) completed two 1-h experimental conditions, namely video game play and rest in a sitting position, followed by an ad libitum lunch. The endpoints were spontaneous food intake, energy expenditure, stress markers, appetite sensations, and profiles of appetite-related hormones.
Heart rate, systolic and diastolic blood pressures, sympathetic tone, and mental workload were significantly higher during the video game play condition than during the resting condition (P < 0.05). Although energy expenditure was significantly higher during video game play than during rest (mean increase over resting: 89 kJ; P < 0.01), ad libitum energy intake after video game play exceeded that measured after rest by 335 kJ (P < 0.05). A daily energy surplus of 682 kJ (163 kcal) over resting (P < 0.01) was observed in the video game play condition. The increase in food intake associated with video game play was observed without increased sensations of hunger and was not compensated for during the rest of the day. Finally, the profiles of glucose, insulin, cortisol, and ghrelin did not suggest an up-regulation of appetite during the video game play condition.
A single session of video game play in healthy male adolescents is associated with an increased food intake, regardless of appetite sensations. The trial was registered at clinicaltrials.gov as NCT01013246.
Active Families is a program developed to increase outdoor play and decrease television viewing among preschool-aged children enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Our objective was to assess its feasibility and efficacy.
We implemented Active Families in a large WIC clinic in New York State for 1 year. To this end, we incorporated into WIC nutrition counseling sessions a community resource guide with maps showing recreational venues. Outcome measures were children's television viewing and time playing outdoors and parents' behaviors (television viewing, physical activity), self-efficacy to influence children's behaviors, and parenting practices specific to television viewing. We used a nonpaired pretest and posttest design to evaluate the intervention, drawing on comparison data from 3 matched WIC agencies.
Compared with the children at baseline, the children at follow-up were more likely to watch television less than 2 hours per day and play outdoors for at least 60 minutes per day. Additionally, parents reported higher self-efficacy to limit children's television viewing and were more likely to meet physical activity recommendations and watch television less than 2 hours per day.
Results suggest that it is feasible to foster increased outdoor play and reduced television viewing among WIC-enrolled children by incorporating a community resource guide into WIC nutrition counseling sessions. Future research should test the intervention with a stronger evaluation design in multiple settings, with more diverse WIC populations, and by using more objective outcome measures of child behaviors.
To examine the effectiveness of a primary care-based obesity intervention over the first year (6 intervention contacts) of a planned 2-year study.
Cluster randomized controlled trial.
Ten pediatric practices, 5 intervention and 5 usual care.
Four hundred seventy-five children aged 2 to 6 years with body mass index (BMI) in the 95th percentile or higher or 85th to less than 95th percentile if at least 1 parent was overweight; 445 (93%) had 1-year outcomes.
Intervention practices received primary care restructuring, and families received motivational interviewing by clinicians and educational modules targeting television viewing and fast food and sugar-sweetened beverage intake.
Change in BMI and obesity-related behaviors from baseline to 1 year.
Compared with usual care, intervention participants had a smaller, nonsignificant change in BMI (-0.21; 95% confidence interval [CI], -0.50 to 0.07; P = .15), greater decreases in television viewing (-0.36 h/d; 95% CI, -0.64 to -0.09; P = .01), and slightly greater decreases in fast food (-0.16 serving/wk; 95% CI, -0.33 to 0.01; P = .07) and sugar-sweetened beverage (-0.22 serving/d; 95% CI, -0.52 to 0.08; P = .15) intake. In post hoc analyses, we observed significant effects on BMI among girls (-0.38; 95% CI, -0.73 to -0.03; P = .03) but not boys (0.04; 95% CI, -0.55 to 0.63; P = .89) and among participants in households with annual incomes of $50 000 or less (-0.93; 95% CI, -1.60 to -0.25; P = .01) but not in higher-income households (0.02; 95% CI, -0.30 to 0.33; P = .92).
After 1 year, the High Five for Kids intervention was effective in reducing television viewing but did not significantly reduce BMI.
To determine whether pediatric primary care-based programs to enhance parenting and early child development reduce media exposure and whether enhanced parenting mediates the effects.
Randomized controlled trial.
Urban public hospital pediatric primary care clinic.
A total of 410 mother-newborn dyads enrolled after childbirth.
Patients were randomly assigned to 1 of 2 interventions, the Video Interaction Project (VIP) and Building Blocks (BB) interventions, or to a control group. The VIP intervention comprised 1-on-1 sessions with a child development specialist who facilitated interactions in play and shared reading through review of videotapes made of the parent and child on primary care visit days; learning materials and parenting pamphlets were also provided. The BB intervention mailed parenting materials, including age-specific newsletters suggesting activities to facilitate interactions, learning materials, and parent-completed developmental questionnaires (Ages and Stages questionnaires).
Electronic media exposure in the home using a 24-hour recall diary.
The mean (SD) exposure at 6 months was 146.5 (125.0) min/d. Exposure to VIP was associated with reduced total duration of media exposure compared with the BB and control groups (mean [SD] min/d for VIP, 131.6 [118.7]; BB, 151.2 [116.7]; control, 155.4 [138.7]; P = .009). Enhanced parent-child interactions were found to partially mediate relations between VIP and media exposure for families with a ninth grade or higher literacy level (Sobel statistic = 2.49; P = .01).
Pediatric primary care may represent an important venue for addressing the public health problem of media exposure in young children at a population level.
clinicaltrials.gov Identifier: NCT00212576.
Translational or implementation research that assesses the effectiveness of strategies to promote health behaviours among children that have been previously tested under 'ideal' conditions is rarely reported. Switch-2-Activity aimed to examine the effectiveness of an abbreviated programme delivered by teachers targeting children's television viewing, computer use, physical activity and potential mediators of behaviour change. Fifteen schools from disadvantaged areas in Melbourne, Australia agreed to participate in the study (43% school-level response rate). Out of the 1566 Grades 5 and 6 (9-12 year old) children invited to take part in the study, 1048 (67% response rate) provided informed consent. Schools were randomized to either an intervention or wait-list control condition. Teachers delivered six lessons, which included strategies such as self-monitoring, behavioural contracting and budgeting of screen time. Children completed a self-report survey at baseline and post-intervention examining screen-based behaviours, physical activity, self-efficacy and behavioural capability. Teachers reported implementation of and attitudes to the programme. Seventy-one per cent of teachers delivered at least four of the six lessons. Most teachers reported that the materials were easy to follow and deliver; however, many teachers reported modifying the materials in some way. Among boys, there were favourable small intervention effects on weekend screen time [(coefficient = -0.62, 95% 95% confidence interval: -1.15, -0.10, p = 0.020)]. The intervention also had significant positive effects on children's self-efficacy for reducing television viewing and on behavioural capability (television viewing styles). Future studies that assess the translation of efficacious programmes and that test whether such programmes are equally effective in different settings (e.g. in the family setting) are urgently required.
The aim of this study was to evaluate the impact of an intervention program on the patterns of physical activity in 8- to 10-year-old Mexican children from lower socioeconomic status. This study performed a randomized controlled field trial in 498 children aged 8-10 years from 10 public schools of low socioeconomic status in Mexico City. Schools were randomly assigned to intervention (n = 5) or control (n = 5) groups and followed up during 12 months. Physical and sedentary activities were assessed at the beginning of the program and after 6 and 12 months. At the end of follow-up, there was a significant increase in the performance of moderate physical activity (MPA) among children in intervention group who had not performed MPA at baseline any day of the week (40%, P = 0.04) but not in the control group (8%, P = not significant). The intervention group also showed a significant reduction in the proportion of children who spent more than 3 hours a day playing video games (from 23 to 13%, P = 0.01), while control group did not show significant changes. Given these findings, we conclude that intervention was able to modify positively physical activity and reduce time spent on such sedentary activities as video games among those at highest risk studied children.
To systematically review levels of metabolic expenditure and changes in activity patterns associated with active video game (AVG) play in children and to provide directions for future research efforts.
A review of the English-language literature (January 1, 1998, to January 1, 2010) via ISI Web of Knowledge, PubMed, and Scholars Portal using the following keywords: video game, exergame, physical activity, fitness, exercise, energy metabolism, energy expenditure, heart rate, disability, injury, musculoskeletal, enjoyment, adherence, and motivation.
Only studies involving youth (< or = 21 years) and reporting measures of energy expenditure, activity patterns, physiological risks and benefits, and enjoyment and motivation associated with mainstream AVGs were included. Eighteen studies met the inclusion criteria. Articles were reviewed and data were extracted and synthesized by 2 independent reviewers. MAIN OUTCOME EXPOSURES: Energy expenditure during AVG play compared with rest (12 studies) and activity associated with AVG exposure (6 studies).
Percentage increase in energy expenditure and heart rate (from rest).
Activity levels during AVG play were highly variable, with mean (SD) percentage increases of 222% (100%) in energy expenditure and 64% (20%) in heart rate. Energy expenditure was significantly lower for games played primarily through upper body movements compared with those that engaged the lower body (difference, -148%; 95% confidence interval, -231% to -66%; P = .001).
The AVGs enable light to moderate physical activity. Limited evidence is available to draw conclusions on the long-term efficacy of AVGs for physical activity promotion.
There is growing evidence that community-based interventions can reduce childhood obesity in older children.
We aimed to determine the effectiveness of the Romp & Chomp intervention in reducing obesity and promoting healthy eating and active play in children aged 0-5 y.
Romp & Chomp was a community-wide, multisetting, multistrategy intervention conducted in Australia from 2004 to 2008. The intervention occurred in a large regional city (Geelong) with a target group of 12,000 children and focused on community capacity building and environmental (political, sociocultural, and physical) changes to increase healthy eating and active play in early-childhood care and educational settings. The evaluation was repeat cross-sectional with a quasiexperimental design and comparison sample. Main outcome measures were body mass index (BMI), standardized BMI (zBMI; according to the Centers for Disease Control and Prevention 2000 reference charts), and prevalence of overweight/obesity and obesity-related behaviors in children aged 2 and 3.5 y.
After the intervention there was a significantly lower mean weight, BMI, and zBMI in the 3.5-y-old subsample and a significantly lower prevalence of overweight/obesity in both the 2- and 3.5-y-old subsamples (by 2.5 and 3.4 percentage points, respectively) than in the comparison sample (a difference of 0.7 percentage points; P < 0.05) compared with baseline values. Intervention child-behavioral data showed a significantly lower intake of packaged snacks (by 0.23 serving), fruit juice (0.52 serving), and cordial (0.43 serving) than that in the comparison sample (all P < 0.05).
A community-wide multisetting, multistrategy intervention in early-childhood settings can reduce childhood obesity and improve young children's diets. This trial was registered with the Australian Clinical Trials Registry at anzctr.org.au as ACTRN12607000374460.
The aim of this study was to evaluate the effectiveness of the Mind, Exercise, Nutrition, Do it (MEND) Program, a multicomponent community-based childhood obesity intervention (www.mendcentral.org). One hundred and sixteen obese children (BMI >or= 98 th percentile, UK 1990 reference data) were randomly assigned to intervention or waiting list control (6-month delayed intervention). Parents and children attended eighteen 2-h group educational and physical activity sessions held twice weekly in sports centers and schools, followed by a 12-week free family swimming pass. Waist circumference, BMI, body composition, physical activity level, sedentary activities, cardiovascular fitness, and self-esteem were assessed at baseline and at 6 months. Children were followed up 12 months from baseline (0 and 6 months postintervention for the control and intervention group, respectively). Participants in the intervention group had a reduced waist circumference z-score (-0.37; P < 0.0001) and BMI z-score (-0.24; P < 0.0001) at 6 months when compared to the controls. Significant between-group differences were also observed in cardiovascular fitness, physical activity, sedentary behaviors, and self-esteem. Mean attendance for the MEND Program was 86%. At 12 months, children in the intervention group had reduced their waist and BMI z-scores by 0.47 (P < 0.0001) and 0.23 (P < 0.0001), respectively, and benefits in cardiovascular fitness, physical activity levels, and self-esteem were sustained. High-attendance rates suggest that families found this intensive community-based intervention acceptable. Further larger controlled trials are currently underway to confirm the promising findings of this initial trial.
We tested the associations of content types of children's television viewing with subsequent body mass index (BMI) to assess the plausibility of different causal pathways.
We used time-use diary data from the Panel Survey of Income Dynamics to measure television viewing categorized by format and educational and commercial content. Analyses were stratified by age because children younger than 7 years are less able to understand the persuasive intent of advertising. BMI z scores in 2002 were regressed on television viewing, sociodemographic variables, mother's BMI, and BMI in 1997 (for older children only).
Among children aged 0 to 6 years in 1997, commercial viewing in 1997 was significantly associated with BMI z scores in 2002 in fully adjusted regressions. Among children older than 6 years, commercial viewing in 2002 was associated with 2002 BMI. These results were robust after adjustment for exercise and eating while watching television.
The evidence does not support the contention that television viewing contributes to obesity because it is a sedentary activity. Television advertising, rather than viewing per se, is associated with obesity.
Schools are the most frequent target for intervention programs aimed at preventing child obesity; however, the overall effectiveness of these programs has been limited. It has therefore been recommended that interventions target multiple ecological levels (community, family, school and individual) to have greater success in changing risk behaviors for obesity. This study examined the immediate and short-term, sustained effects of the Switch program, which targeted three behaviors (decreasing children's screen time, increasing fruit and vegetable consumption, and increasing physical activity) at three ecological levels (the family, school, and community).
Participants were 1,323 children and their parents from 10 schools in two states. Schools were matched and randomly assigned to treatment and control. Measures of the key behaviors and body mass index were collected at baseline, immediately post-intervention, and 6 months post-intervention.
The effect sizes of the differences between treatment and control groups ranged between small (Cohen's d = 0.15 for body mass index at 6 months post-intervention) to large (1.38; parent report of screen time at 6 months post-intervention), controlling for baseline levels. There was a significant difference in parent-reported screen time at post-intervention in the experimental group, and this effect was maintained at 6 months post-intervention (a difference of about 2 hours/week). The experimental group also showed a significant increase in parent-reported fruit and vegetable consumption while child-reported fruit and vegetable consumption was marginally significant. At the 6-month follow-up, parent-reported screen time was significantly lower, and parent and child-reported fruit and vegetable consumption was significantly increased. There were no significant effects on pedometer measures of physical activity or body mass index in the experimental group. The intervention effects were moderated by child sex (for fruit and vegetable consumption, physical activity, and weight status), family involvement (for fruit and vegetable consumption), and child body mass index (for screen time). The perception of change among the experimental group was generally positive with 23% to 62% indicating positive changes in behaviors.
The results indicate that the Switch program yielded small-to-modest treatment effects for promoting children's fruit and vegetable consumption and minimizing screen time. The Switch program offers promise for use in youth obesity prevention.
To test the hypothesis that media use mediates the relation between socioeconomic status (SES) and body mass index (BMI).
Analysis of 2 large cross-sectional surveys, 1 from Germany and 1 from the United States.
Twenty-seven public schools in northern Germany; telephone interviews in the United States.
A total of 4810 German children and adolescents aged 10 to 17 years (mean age, 12.8 years); 4473 US children and adolescents aged 12 to 16 years (mean age, 14.0 years) recruited using random-digit-dial methods. Main Exposures Media exposure was assessed via survey questions about the presence of a television in the bedroom, television screen time, computer and video game screen time, and movie viewing. The SES was derived from type of school (German sample) or parental reports of their own education and family income (US sample).
The BMI was assessed by the use of self-reports in both samples, supplemented by parental reports (US sample) for height and weight.
In both samples, SES was inversely associated with BMI, and media use was directly associated with BMI. The effect of SES on overweight was partially mediated by media exposure, which explained 35% of the SES-BMI association in the German sample and 16% in the US sample. In both groups, television in the bedroom and television screen time had statistically significant indirect paths, whereas video game use and movie viewing did not.
Students from low-SES backgrounds are at higher risk for overweight in part because of higher levels of television viewing. The change of media use habits could modify this health disparity.
Entertainment media exposure may predict teenager alcohol use, but few longitudinal studies have been reported.
A longitudinal study was conducted of 2708 German adolescents aged 10 to 16 years who had never drunk alcohol. Each adolescent was surveyed at school about daily television use, whether they had a television in their bedroom, and their exposure to movie alcohol depictions. Adolescents were resurveyed 12 to 13 months later (retention rate: 85%) to determine onset of drinking alcohol without parental knowledge and binge drinking (>/=5 consecutive drinks).
Overall, 885 (33%) students initiated alcohol use without parental knowledge (17% in quartile 1 movie alcohol exposure), and 387 (14%) initiated binge drinking during follow-up. After controlling for baseline covariates, exposure to movie alcohol use significantly increased percent initiating alcohol use (to 24% in exposure quartile 2, 33% in quartile 3 and 34% in quartile 4) and percent initiating binge drinking (to 8.6% in exposure quartile 2, 12% in quartile 3 and 13% in quartile 4). Having a television in the bedroom also predicted both outcomes, but daily television use did not.
Movie exposure and having a television in the bedroom are both independent predictors of onset of problematic alcohol use among German teenagers. Media restrictions could play a role in prevention.
To develop, implement and test an innovative, theory-based classroom media intervention known as Get Moving! to increase physical activity and decrease sedentary behaviors in predominantly Latina middle school girls.
School-based intervention on five to seven consecutive school days in seven schools (four intervention and three control) with high Latino populations (above 60%). Intervention schools were matched to control schools by ethnic makeup and socioeconomic status (SES). Measures conducted 3 months before and 3 months after intervention included height, weight, percentage body fat (bioimpedance analysis), physical activity and psychosocial aspects of activity by questionnaire. Subjects were middle school girls, mean age 12.5 years old, 73% Latina (N=459 girls).
Get Moving! significantly reduced time spent on sedentary behavior (beta+/- standard error, SE=-0.27+/-0.14, p<0.05) and significantly increased intrinsic motivation (beta+/-SE=0.11+/-0.05, p<0.05). There was a trend for mediation effects of intrinsic motivation, but this did not reach significance.
Get Moving! is a promising school-based approach that specifically targets physical activity and sedentary behavior in Latina girls, a population at high risk for obesity and related diseases.
Lack of regular physical activity and consequent sub-optimal bone mass acquisition in youth has been implicated as a primary cause of adult-onset osteoporosis. IMPACT was a behavioral theory-based 1 1/2 year randomized controlled field study aimed at increasing bone accretion in middle school girls. The objective of this study was to determine the intervention effects of the IMPACT program upon key physical and sedentary activity endpoints among schools that participated in the IMPACT study. Endpoints examined included weight bearing physical activity (WBPA); moderate to vigorous physical activity (MVPA); vigorous physical activity (VPA); MET (metabolic equivalent) - weighted WBPA and MVPA; sedentary activity; before/after-school physical activity; and weekend physical activity.
Primary data analysis using a pretest-posttest control group design was conducted utilizing mixed model analysis of covariance. Data gathered from the IMPACT cohort from 2000-2002 were analyzed to determine baseline versus follow-up differences in activity endpoints. Confounders investigated included ethnicity, body mass index, menarcheal status, participation in 7th grade PE/athletics, friend/familial support and neighborhood safety.
Follow-up means were higher for participating intervention schools relative to control schools for all physical activity variables but were statistically significant only for the following variables: daily minutes of vigorous physical activity (mean difference between Intervention (I) and Control (C) = 6.00 upward arrow minutes, 95% CI = 5.82-6.18, p = 0.05), daily after school activity minutes (mean difference between I and C = 8.95 upward arrow minutes, 95% CI = 8.69-9.21, p = 0.04), and daily weekend activity minutes (mean difference between I and C = 19.00 upward arrow minutes, 95% CI = 18.40-19.60, p = 0.05). The intervention significantly reduced duration of student daily TV/Video watching (mean difference between I and C = 12.11 downward arrow minutes, 95% CI = 11.74-12.48, p = 0.05) and total daily sedentary activity minutes (mean difference between I and C = 16.99 downward arrow minutes, 95% CI = 16.49-17.50, p = 0.04).
A well designed and implemented school based health and physical activity intervention can result in a positive influence upon increasing physical activity levels and decreasing sedentary activity. Future interventions should consider a more structured intervention component to obtain significant changes in WBPA.