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Nov 2011

Effectiveness of Interventions Aimed at Reducing Screen Time in Children: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Author Affiliations

Author Affiliations: Division of General Pediatrics, Department of Pediatrics (Dr Wahi), and Program in Population Genomics, Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences (Dr Beyene), McMaster University, Hamilton, Ontario, Canada; Division of Pediatric Medicine and the Pediatric Outcomes Research Team (Drs Parkin and Birken), and Hospital Library (Ms Uleryk), Hospital for Sick Children, Toronto, Ontario, Canada; Child Health Evaluative Sciences (Drs Parkin, Beyene, and Birken), Hospital for Sick Children Research Institute, Toronto; and Departments of Pediatrics and Health Policy, Management and Evaluation, University of Toronto Faculty of Medicine, Toronto (Drs Parkin and Birken).

Arch Pediatr Adolesc Med. 2011;165(11):979-986. doi:10.1001/archpediatrics.2011.122

Objective To evaluate the impact of interventions focused on reducing screen time.

Data Sources Medline, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, ERIC, and CINAHL through April 21, 2011.

Study Selection Included studies were randomized controlled trials of children aged 18 years or younger with interventions that focused on reducing screen time.

Intervention Efforts to reduce screen time.

Main Outcome Measures The primary outcome was body mass index (BMI); the secondary outcome was screen time (hours per week).

Results A total of 1120 citations were screened, and 13 studies were included in the systematic review. Study samples ranged in age (3.9-11.7 years) and size (21-1295 participants). Interventions ranged in length (1-24 months) and recruitment location (5 in schools, 2 in medical clinics, 1 in a community center, and 5 from the community). For the primary outcome, the meta-analysis included 6 studies, and the difference in mean change in BMI in the intervention group compared with the control group was −0.10 (95% confidence interval [CI], −0.28 to 0.09) (P = .32). The secondary outcome included 9 studies, and the difference in mean change from baseline in the intervention group compared with the control group was −0.90 h/wk (95% CI, −3.47 to 1.66 h/wk) (P = .49). A subgroup analysis of preschool children showed a difference in mean change in screen time of −3.72 h/wk (95% CI, −7.23 to −0.20 h/wk) (P = .04).

Conclusions Our systematic review and meta-analysis did not demonstrate evidence of effectiveness of interventions aimed at reducing screen time in children for reducing BMI and screen time. However, interventions in the preschool age group hold promise.