Introduction
Rationale
Objectives
Methods
Information Sources and Search
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media, television, TV, mobile, handheld, tablet, smartphone, gaming, game, computer, electronic device, video, screen
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intervention, education, information, behavior, change, reduce,
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randomized controlled trial (RCT), controlled clinical trial (CCT), clinical trial (CT)
Study Selection and Eligibility Criteria
Author, year, design | Sample size, participants, age | Media | Intervention | Duration | Outcome | Results |
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Bandeira et al. 2019 [17], RCT | 1085 students, aged 11–13 and 14–17 years | TV/video games/computer | Teacher training, support material for teachers, environmental opportunities to encourage physical activity, health education messages in schools via posters etc | 4 months | Student reported screen time on weekdays and weekends | No significant differences between intervention and control groups for reduction on screen time (boys: 0.105 h/day, 95% CI: − 0.184 to 0.393, p = 0.477; girls: − 0.065 h/day, 95% CI: − 0.383 to 0.252, p = 0.686) and age groups (11–13 years: − 0.046 h/day, 95% CI: − 0.630 to 0.538, p = 0.878; 14–17 years: 0.193 h/day, 95% CI: − 0.077 to 0.464, p = 0.162) |
Smith et al., 2017 [18], RCT | 361 boys, mean age, 12.7 ± 0.5 years | Screen time in general | Smartphone App "ActiveTeen Leaders Avoiding Screen time” (ATLAS) | 18 months | Screen time reported each day of the week | Significant intervention effect was observed for recreational screen time at 8-months (CI = -33 min/d; p = 0.001), which was sustained at 18-months (CI = -27 min/d; p = 0.007) |
Babic et al., 2016 [19], RCT | 322 students, age unknown | TV/video/DVD/computer/tablet/smartphone | Interactive seminar, informational and motivational messages via preferred social media and messaging systems | 6 months | Adolescents reported mean daily screen time | Significant reductions in screen time were observed in both groups from baseline to posttest (Intervention = -50.5 min/d, p < 0.001; control = -29.2 min/d, p = 0.030) The adjusted between-group difference was not statistically significant (mean = -21.3 min/d; p = 0.255) |
Mendoza et al., 2016 [20], RCT | 211 children, aged 3–5 years | TV | Fit 5 Kids (F5K) TV reduction curriculum | 8 weeks | TV viewing screen time | Significant relative difference for the decrease in mean daily TV viewing minutes − 25.3 (95% CI = − 45.2, − 5.4) for the intervention versus the control group (p = 0.01) |
Yilmaz et al., 2015 [21], RCT | 363 children, mean age 3.5 ± 1.25 years | TV/video games/computer | Printed materials, interactive CD’s and 1 counselling call | 9 months | Length of screen time of children for 1 week | Significant reduction from baseline in screen time for the control and intervention groups over time (93.96 ± 18.84/21.15 ± 6.12/t = 50.1, p < 0.001) |
Andrade et al., 2015 [22], RCT | 1370 adolescents, mean age 12.8 ± 0.8 years | TV/video games/computer | Individual and environmental oriented strategies i.e. manuscript, textbook, parental workshops | 28 months | Adolescents reported screen time on week- and weekend days | While there was partial reduction of screen time in favor to the control group, no constant reduction in screen time was observed in the intervention group over the whole intervention period |
Lubans et al., 2014 [23], RCT | 361 adolescent boys, mean age, 12.7 ± 0.5 years | Screen time in general | Smartphone App "ActiveTeen Leaders Avoiding Screen time” (ATLAS) | 20 weeks | Intention to reduce screen time | Participants’ intentions to limit their recreational screen time in percent agreement (mean D 3.95 ± 1.07) were high following the completion of the program |
Maddison et al., 2014 [24], RCT | 251 children, aged 9–12 years | TV/video/computer | Face-to-face counseling of parent/caregiver/child, activity packages, online support via a website, monthly newsletters | 20 weeks | Screen-based sedentary time | No significant differences in screen-based sedentary behavior in intervention and control groups (95% CI − 33, − 73,7 p = 0.11) |
Hesketh et al., 2014 [25], RCT | 542 children, ∼3-months old | TV | Melbourne InFANT Program (Material and sources to provide knowledge, skills and strategies to promote healthy eating and active play) | 17 months | TV viewing screen time | The intervention reduced children’s television viewing time (-14.62; 95% CI − 28.02, − 1.24) |
Birken et al., 2012 [26], RCT | 351 children, 3-years-old | TV/video games/computer | 10-min behavioral counseling intervention by trained study personal directly after the health maintenance visit, which included information on the health impact of screen time in children and provided strategies to decrease screen time | 12 months | Parent-reported screen time of children | No significant differences in mean total weekday minutes of screen time (60 min, IQR: 35–120 vs. 65 min, IQR: 35–120; p = 0.68), or mean total weekend day minutes of screen time (80 min, IQR: 45–130 vs. 90 min, IQR: 60–120, p = 0.33), between the intervention and control groups |
Mendelsohn et al., 2011 [27], RCT | 410 families with a child, mean age, 6.9 ± 1,3 months | TV/video games/computer | Videotaping of mother–child interaction followed by review with the child development specialist, provision of learning materials, provision of parenting pamphlets, newsletters, learning materials, and parent-completed developmental questionnaires | 6 months | Total daily exposure for the child during a 24-h period | Differences were found across the 2 intervention group and 1 control groups for daily duration of media exposure (min/d 131.6 ± 118.7, 151.2 ± 116.7), 155.4 ± 138.7, p = 0.03). Further children in 1 of 2 intervention groups have been first exposed to media approximately half a month later than children in control groups (p = 0.01) |
Risk of Bias in Individual Studies
Risk of Bias Within Studies
Author | Eligibility criteria specifieda | Subjects randomly allocatedb | Concealed allocationc | Similar baselined | Subjectsblindede | Therapists blindedf | Assessors blindedg | Measures obtained from 85% of subjectsh | Intention to treat analysisi | Between-group comparisonj | Point and variability measuresk | Overall quality (PEDro-Score) |
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Bandeira et al. [17] | y | 1 | 0 | 1 | 0 | 0 | 0 | 1 | 1 | 1 | 1 | 6/10 |
Smith et al. [18] | n | 1 | 0 | 1 | 0 | 0 | 0 | 1 | 1 | 1 | 1 | 5/10 |
Babic et al. [19] | y | 1 | 1 | 1 | 0 | 0 | 0 | 1 | 1 | 1 | 1 | 7/10 |
Mendoza et al. [20] | y | 1 | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 1 | 1 | 6/10 |
Yilmaz et al. [21] | n | 1 | 0 | 1 | 0 | 0 | 1 | 1 | 0 | 1 | 1 | 6/10 |
Andrade et al. [22] | y | 1 | 0 | 1 | 0 | 0 | 1 | 0 | 1 | 1 | 1 | 6/10 |
Lubans et al. [23] | y | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 1 | 1 | 1 | 5/10 |
Maddison et al. [24] | y | 1 | 1 | 1 | 0 | 0 | 0 | 1 | 1 | 1 | 1 | 7/10 |
Hesketh et al. [25] | n | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 4/10 |
Birken et al. [26] | y | 1 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 1 | 8/10 |
Mendelsohn et al. [27] | y | 1 | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 1 | 1 | 6/10 |