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

Abstract

BackgroundScreen-based activities, such as watching television (TV), playing video games, and using computers, are common sedentary behaviors among young people and have been linked with increased energy intake and overweight. Previous home-based sedentary behaviour interventions have been limited by focusing primarily on the child, small sample sizes, and short follow-up periods. The SWITCH (Screen-Time Weight-loss Intervention Targeting Children at Home) study aimed to determine the effect of a home-based, family-delivered intervention to reduce screen-based sedentary behaviour on body composition, sedentary behaviour, physical activity, and diet over 24 weeks in overweight and obese children.MethodsA two-arm, parallel, randomized controlled trial was conducted. Children and their primary caregiver living in Auckland, New Zealand were recruited via schools, community centres, and word of mouth. The intervention, delivered over 20 weeks, consisted of a face-to-face meeting with the parent/caregiver and the child to deliver intervention content, which focused on training and educating them to use a wide range of strategies designed to reduce their child’s screen time. Families were given Time Machine TV monitoring devices to assist with allocating screen time, activity packages to promote alternative activities, online support via a website, and monthly newsletters. Control participants were given the intervention material on completion of follow-up. The primary outcome was change in children’s BMI z-score from baseline to 24 weeks.ResultsChildren (n = 251) aged 9–12 years and their primary caregiver were randomized to receive the SWITCH intervention (n = 127) or no intervention (controls; n = 124). There was no significant difference in change of zBMI between the intervention and control groups, although a favorable trend was observed (−0.016; 95% CI: −0.084, 0.051; p = 0.64). There were also no significant differences on secondary outcomes, except for a trend towards increased children’s moderate intensity physical activity in the intervention group (24.3 min/d; 95% CI: −0.94, 49.51; p = 0.06).ConclusionsA home-based, family-delivered intervention to reduce all leisure-time screen use had no significant effect on screen-time or on BMI at 24 weeks in overweight and obese children aged 9–12 years.Trial registrationAustralian New Zealand Clinical Trials RegistryWebsite: http://www.anzctr.org.auTrial registration number: ACTRN12611000164998

Effective Weight Loss for Children: A Meta‐analysis of Intervention Studies 2002–2015

“…That is, could one see why the investigators expected this particular intervention to work and what framework was used to guide the variables in each investigation? Only three studies (Croker et al, 2012;Maddison et al, 2014;Sacher et al, 2010) of the 16 included in the current meta-analysis provided the theoretical basis for their study, suggesting that there is minimal theoretical guidance evident for interventions addressing childhood overweight or obesity.…”

“…The weight loss interventions also varied from providing a single intervention (n = 5): Dietary (Rosado, Arellano, Montemayor, García, & Caamaño, 2008 [two interventions]), or physical activity (Farpour-Lambert et al, 2009;Lazaar et al, 2007;Maddison et al, 2011). A majority of the studies (n = 14) used a combination of strategies: education and behavior (Wong & Cheng, 2013 (Carrel et al, 2005;Davis, Ventura, Cook, Gyllenhammer, & Gatto, 2011;Harder-Lauridsen et al, 2014); diet and education (Rosado et al, 2008); diet, physical activity, and behavioral changes (Adam, Westenhofer, Rudolphi, & Kraaibeek, 2009;Croker et al, 2012;Janicke et al, 2008;Korsten-Reck, Kromeyer-Hauschild, Wolfarth, Dickhuth, & Berg, 2005;Maddison et al, 2014;Reinehr, 2010;Satcher et al, 2010) (see Table S3, available with online version of this article).…”

Supporting health-related parenting: A scoping review of programs assisted by the Internet and related technologies

“…Most online programs are theory-driven interventions, and replicate face-to-face programs that have been previously empirically validated (Clarke, Calam, Estudos de Psicologia I Campinas I 34(3) I 331-344 I julho -setembro 2017 Morawska, & Sanders, 2013;Doherty, Calam, & Sanders, 2013). In some cases, the technologymediated programs are delivered combined with face-to-face sessions (e.g., Maddison et al, 2014).…”

Effects of two types of low impact physical training on screen time among overweight adolescents

“…With a longer intervention time of 24 weeks, the study of Maddison et al 24 did not show a significant effect either in screen time or in the BMI of the overweight adolescents. This intervention was based on physical activities and diet carried out at home, on the sedentary behavior of the whole family, through home visits and incentives for both physical activity practice and reduction of screen time.…”