Family‐based interventions for reducing sedentary time in youth: a systematic review of randomized controlled trials

Abstract

Family involvement in interventions to reduce sedentary time may help foster appropriate long-term screen-based habits in children. This review systematically synthesized evidence from randomized controlled trials of interventions with a family component that targeted reduction of sedentary time, including TV viewing, video games and computer use, in children. MEDLINE, PubMed, PsycInfo, CINAHL and Embase were searched from inception through March 2012. Seventeen articles were considered eligible and included in the review. Studies were judged to be at low-to-moderate risk of bias. Despite inconsistent study results, level of parental involvement, rather than the setting itself, appeared an important determinant of intervention success. Studies including a parental component of medium-to-high intensity were consistently associated with statistically significant changes in sedentary behaviours. Participant age was also identified as a determinant of intervention outcomes; all three studies conducted in pre-school children demonstrated significant decreases in sedentary time. Finally, TV exposure appeared to be related to changes in energy intake rather than physical activity. Future studies should assess the effects of greater parental involvement and child age on success of sedentary behaviour interventions. More research is required to better understand the relationship between screen time and health behaviours, particularly energy intake.

Screen-Time Weight-loss Intervention Targeting Children at Home (SWITCH): a randomized controlled trial

“…First, our older sample of children (9–12 years) may be less amenable to parental influence compared to the younger sample (4–7 years) in Epstein’s trial. According to a recent systematic review of family-focused interventions aimed at reducing sedentary behaviours [55], interventions targeting younger children may be more effective at decreasing sedentary time than those targeting older children. Second, we used a different time monitor (Time Machine versus TV Allowance) to budget screen time due to logistic issues associated with voltage differences between the two countries.…”

“…There is growing evidence to support active targeting of caregivers in sedentary behaviour interventions; however, level of caregiver intensity appears to be an important determinant of intervention success [55]. As such, despite it being a negative trial, SWITCH may be viewed as a lesson in intervention design.…”

Sedentary behaviour and health in children — Evaluating the evidence

“…Nevertheless, a number of countries have already set recommendations for limiting screen time in children and a growing number of interventions targeting the reduction of sedentary activities are being, or have been, evaluated (Marsh et al, 2014). Do we place too much emphasis on the few significant findings regarding an association between sedentary time and child cardiometabolic health while ignoring the majority of non-significant findings?…”

Screen-based sedentary behaviors, mental health, and social relationships among adolescents

“…For example, a bidirectional relationship was proposed between screen time and mental health 45 . On the other hand, we adjusted analyses by body mass index, somatic maturation, and physical activity, which are important correlates of mental health 46,47 . As a first threshold of "risk", we adopted the internationally recommended cutoff for young people (2h/d) 48 , followed by another cutoff widely used in the literature (4h/d) 4 , which also allowed the understanding of gradual relationships.…”