clinicaltrials.gov Identifier: NCT00632775.

WHAT'S KNOWN ON THIS SUBJECT: Interventions to reduce screen time in preschool-aged children are promising. WHAT THIS STUDY ADDS:A screen time intervention in 3-year-old children implemented in the primary care setting did not reduce screen time or BMI. abstract OBJECTIVE: To determine if an intervention for preschool-aged children in primary care is effective in reducing screen time, meals in front of the television, and BMI. METHODS:A randomized controlled trial was conducted at a primary care pediatric group practice in Toronto, Canada. Three-year-old children and their parents were randomly assigned to receive a short behavioral counseling intervention on strategies to decrease screen time. The primary outcome 1 year later was parent reported screen time. Secondary outcomes included television in the child' s bedroom, number of meals in front of the television, and BMI. RESULTS:In the intention-to-treat analysis at 1 year, there were no significant differences in mean total weekday minutes of screen time (60, interquartile range [IQR]: 35-120 vs 65, IQR: 35-120; P = .68) or mean total weekend day minutes of screen time (80, IQR: 45-130 vs 90, IQR: 60-120; P = .33) between the intervention and control group. Adjusting for baseline BMI, there was a reduction in the number of weekday meals in front of the television (1.6 6 1.0 vs 1.9 6 1.2; P = .03) but no differences in BMI or number of televisions in the bedroom.CONCLUSIONS: This pragmatic trial was not effective in reducing screen time or BMI but was effective in reducing meals in front of the screen. Short interventions focused solely on reducing screen time implemented in the primary care practice setting may not be effective in this age group.

• The results of this study indicate a possible therapeutic benefit of lymph node removal in node negative patients. Future research should focus on gaining a better understanding of the biologic mechanisms of a possible therapeutic benefit of PLND, particularly for those lower risk patients with histologically negative lymph nodes.