Interventions Ineffective in Lowering Children's Screen Time - FYI

[Guest guest]

Interventions to lower screen time in children may be ineffective for

lowering body mass index (BMI) and screen time, according to the results of

a systematic review and meta-analysis published

online<http://archpedi.ama-assn.org/cgi/content/abstract/archpediatrics.2011.122\

>July

4 in the

*Archives of Pediatrics & Adolescent Medicine*.

" Screen time has steadily increased among youth, and approximately 1 in 4

children living in the United States watch an average of 4 hours of

television per day, " write Gita Wahi, MD, FRCPC, from the Department of

Pediatrics, McMaster University in Hamilton, Ontario, Canada, and

colleagues.

" Television viewing has been associated with important health outcomes in

children, including delayed language development, aggressive behavior, and

cigarette smoking. The focus of our study is to review the impact of

interventions aimed at reducing screen time on change in...(BMI, calculated

as weight in kilograms divided by height in meters squared) in children. "

The reviewers searched Medline, Embase, Cochrane Central Register of

Controlled Trials, PsycINFO, ERIC, and CINAHL through April 21, 2011, for

randomized controlled trials of interventions intended to reduce screen time

in children not more than 18 years of age. BMI was the main study endpoint,

and screen time (hours per week) was the secondary endpoint.

Of 1120 citations screened, 13 studies were included in the systematic

review. Age range was 3.9 to 11.7 years, sample size ranged from 21 to 1295

participants, and duration of the intervention ranged from 1 to 24 months.

Of the 13 included studies, 5 recruited participants from schools, 5 from

the community, 2 from medical clinics, and 1 from a community center.

The meta-analysis included 6 studies of BMI, in which 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). For the

secondary outcome of screen time, 9 studies were included in the

meta-analysis, which showed a difference in mean change from baseline of

-0.90 hours/week (95% CI, -3.47 to 1.66 hours/week; *P* = .49) for the

intervention group vs the control group.

However, the results were more encouraging in a subgroup analysis of

preschool children, which showed a difference in mean change in screen time

of -3.72 hours/week (95% CI, -7.23 to -0.20 hours/week; *P* = .04).

" 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, " the review authors write. " However,

interventions in the preschool age group hold promise. "

Limitations of this study include lack of cointervention in some of the

included studies, short duration of the interventions, lack of other

outcomes, heterogeneity among studies, and inability to include 7 trials in

the pooled analysis for BMI.

" We propose the evaluation of pragmatic interventions that could feasibly be

implemented in fewer sessions, during shorter periods of time, with longer

follow-up, and focused on key age groups where behavior change may be

sustainable, such as the preschool age group, " the study authors write.

" Given the prevalence of obesity in childhood, and the long-term

complications associated with obesity over the life course, testing and

implementing effective interventions early in life, including those that

focus on screen time, should be a priority for researchers, practitioners,

and policy makers. "

*The study authors have disclosed no relevant financial relationships.*

*Arch Pediatric Adolesc Med*. Published online July 4, 2011.

Abstract<http://archpedi.ama-assn.org/cgi/content/abstract/archpediatrics.2011.1\

22>

www.medscape.com

--

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