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Gangachin SE, Bayrami R, Rahimi B, Masudi S. Smartphone-based educational and counseling interventions for women with high body mass index at Urmia's health centers. BMC Womens Health 2024; 24:8. [PMID: 38166804 PMCID: PMC10763417 DOI: 10.1186/s12905-023-02807-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 11/26/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND AND PURPOSE Overweight and obesity in women of reproductive age not only contribute to chronic diseases but also lead to fertility issues, adverse pregnancy outcomes, and psychological challenges. Among the detrimental behaviors associated with obesity, the consumption of fast foods and sedentary lifestyles have the most significant impact on weight gain and require effective interventions. This study aims to examine the effectiveness of an educational and counseling smartphone intervention in raising awareness and modifying behaviors related to sedentary behavior and fast food consumption in women with high body mass index. MATERIALS AND METHODS This randomized controlled trial was conducted with two parallel groups comprising 106 women of reproductive age who sought assistance at Urmia health centers in 2022. Participants with diverse social and economic backgrounds were included. They were randomly assigned to either a control group or an intervention group. Valid and reliable questionnaires were administered to assess awareness regarding sedentary behaviors and fast foods consumption, as well as engagement in sedentary behaviors and consumption of fast foods. In addition to standard care, the intervention group received educational and counseling sessions through a dedicated smartphone application. Data analysis was performed using SPSS 20 software at a significance level of P < 0.05. FINDINGS The results of a statistical t-test indicated a noteworthy disparity between the control and intervention groups concerning the average awareness scores related to fast foods consumption (P < 0.001) and sedentary behaviors (P < 0.001) before and 3 months after the intervention. Additionally, a substantial statistical difference was observed in the mean consumption of fast foods (P < 0.001) and hours of sedentary behaviors (P < 0.001) before and 3 months after the intervention when comparing the two groups. CONCLUSION Educational and counseling programs, when applied effectively, can serve the dual purpose of enhancing awareness concerning sedentary behaviors and fast foods consumption while concurrently fostering a reduction in the prevalence of these behaviors. The study was registered in the Iranian Registry of Clinical Trials (IRCT Id: IRCT20210722051953N1) at 04/08/2021.
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Affiliation(s)
- Sayeh Ebrahimi Gangachin
- Graduate, Department of Midwifery, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Roghieh Bayrami
- Reproductive Health Research Center, Clinical Research Institute, Department of Midwifery, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
| | - Bahlol Rahimi
- Department of Health Information Technology, School of Allied Medical Sciences, Urmia University of Medical Sciences, Urmia, Iran
| | - Sima Masudi
- Department of Epidemiology and Biostatistics, School of Medicine, Urmia University of Medical Science, Urmia, Iran
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Keadle S, Hasanaj K, Leonard-Corzo K, Tolas A, Crosley-Lyons R, Pfisterer B, Legato M, Fernandez A, Lowell E, Hollingshead K, Yu TY, Phelan S, Phillips SM, Watson N, Hagobian T, Guastaferro K, Buman MP. StandUPTV: Preparation and optimization phases of a mHealth intervention to reduce sedentary screen time in adults. Contemp Clin Trials 2024; 136:107402. [PMID: 38000452 PMCID: PMC10922360 DOI: 10.1016/j.cct.2023.107402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/31/2023] [Accepted: 11/18/2023] [Indexed: 11/26/2023]
Abstract
Recreational sedentary screen time (rSST) is the most prevalent sedentary behavior for adults outside of work, school, and sleep, and is strongly linked to poor health. StandUPTV is a mHealth trial that uses the Multiphase Optimization Strategy (MOST) framework to develop and evaluate the efficacy of three theory-based strategies for reducing rSST among adults. This paper describes the preparation and optimization phases of StandUPTV within the MOST framework. We identified three candidate components based on previous literature: (a) rSST electronic lockout (LOCKOUT), which restricts rSST through electronic means; (b) adaptive prompts (TEXT), which provides adaptive prompts based on rSST behaviors; and (c) earning rSST through increased moderate-vigorous physical activity (MVPA) participation (EARN). We also describe the mHealth iterative design process and the selection of an optimization objective. Finally, we describe the protocol of the optimization randomized controlled trial using a 23 factorial experimental design. We will enroll 240 individuals aged 23-64 y who engage in >3 h/day of rSST. All participants will receive a target to reduce rSST by 50% and be randomized to one of 8 combinations representing all components and component levels: LOCKOUT (yes vs. no), TEXT (yes vs. no), and EARN (yes vs. no). Results will support the selection of the components for the intervention package that meet the optimization objective and are acceptable to participants. The optimized intervention will be tested in a future evaluation randomized trial to examine reductions in rSST on health outcomes among adults.
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Affiliation(s)
- Sarah Keadle
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, CA, United States of America
| | - Kristina Hasanaj
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States of America
| | - Krista Leonard-Corzo
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States of America
| | - Alexander Tolas
- Stanford School of Medicine, Stanford University, Palo Alto, CA, United States of America
| | - Rachel Crosley-Lyons
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Bjorn Pfisterer
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Maria Legato
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, CA, United States of America
| | - Arlene Fernandez
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States of America
| | - Emily Lowell
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States of America
| | - Kevin Hollingshead
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States of America
| | - Tsung-Yen Yu
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States of America
| | - Suzanne Phelan
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, CA, United States of America
| | - Siobhan M Phillips
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Nicole Watson
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, CA, United States of America
| | - Todd Hagobian
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, CA, United States of America
| | - Kate Guastaferro
- School of Global Public Health, New York University, New York, NY, United States of America
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States of America.
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Muppalla SK, Vuppalapati S, Reddy Pulliahgaru A, Sreenivasulu H. Effects of Excessive Screen Time on Child Development: An Updated Review and Strategies for Management. Cureus 2023; 15:e40608. [PMID: 37476119 PMCID: PMC10353947 DOI: 10.7759/cureus.40608] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2023] [Indexed: 07/22/2023] Open
Abstract
Children's heavy reliance on screen media has raised serious public health issues since it might harm their cognitive, linguistic, and social-emotional growth. This study examines the effects of screen time on many developmental domains and covers management and limitation techniques for kids' screen usage. Screen media has a wide range of cognitive consequences, with both beneficial and detrimental effects noted. Screens can improve education and learning; however, too much time spent in front of a screen and multitasking with other media has been related to worse executive functioning and academic performance. As screen time reduces the amount and quality of interactions between children and their caregivers, it can also have an impact on language development. Contextual elements like co-viewing and topic appropriateness are key in determining how language development is impacted. Additionally, excessive screen usage has detrimental effects on social and emotional growth, including a rise in the likelihood of obesity, sleep disorders, and mental health conditions including depression and anxiety. It can obstruct the ability to interpret emotions, fuel aggressive conduct, and harm one's psychological health in general. Setting boundaries, utilizing parental controls, and demonstrating good screen behavior are all techniques that parents may use to manage children's screen usage. We can reduce the possible negative impacts of excessive screen time and promote children's healthy development and well-being by increasing knowledge and encouraging alternative activities that stimulate development.
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Affiliation(s)
- Sudheer Kumar Muppalla
- Pediatrics, PES (People's Education Society) Institute of Medical Sciences and Research, Kuppam, IND
| | - Sravya Vuppalapati
- General Practice, PES (People's Education Society) Institute of Medical Sciences and Research, Kuppam, IND
| | - Apeksha Reddy Pulliahgaru
- Pediatric Medicine, PES (People's Education Society) Institute of Medical Sciences and Research, Kuppam, IND
| | - Himabindu Sreenivasulu
- General Medicine, PES (People's Education Society) Institute of Medical Sciences and Research, Kuppam, IND
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Jain S, Shrivastava S, Mathur A, Pathak D, Pathak A. Prevalence and Determinants of Excessive Screen Viewing Time in Children Aged 3-15 Years and Its Effects on Physical Activity, Sleep, Eye Symptoms and Headache. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3449. [PMID: 36834144 PMCID: PMC9958787 DOI: 10.3390/ijerph20043449] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 02/12/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
Screen viewing time is the total time spent by a child on any digital/electronic device. The objective of the present study was to determine the prevalence and predictors of excessive screen viewing time in children in Ujjain, India. This cross-sectional, community-based study was conducted through a house-to-house survey using the three-stage cluster sampling method in 36 urban wards and 36 villages of Ujjain District, India. Excessive screen viewing time was defined as screen viewing for >2 h/day. The prevalence of excessive screen viewing time was 18%. Risk factors identified using the multivariate logistic regression model were age (OR: 1.63, p < 0.001); mobile phone use before bedtime (OR: 3.35, p = 0.004); parents' perception about the child's habituation to screen time (OR: 8.46, p < 0.001); television in the bedroom (OR: 35.91, p < 0.001); morning mobile screen viewing time (OR: 6.40, p < 0.001); not reading books other than textbooks (OR: 6.45, p < 0.001); and lack of outdoor play for >2 h (OR: 5.17, p < 0.001). The presence of eye pain was a protective factor for excessive screen viewing time (OR: 0.13, p = 0.012). This study identified multiple modifiable risk factors for excessive screen viewing time.
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Affiliation(s)
- Shilpa Jain
- Department of Pediatrics, RD Gardi Medical College, Ujjain 456010, India
| | - Shreya Shrivastava
- Department of Pediatrics, RD Gardi Medical College, Ujjain 456010, India
| | - Aditya Mathur
- Department of Pediatrics, RD Gardi Medical College, Ujjain 456010, India
| | - Deepali Pathak
- Department of Pediatrics, RD Gardi Medical College, Ujjain 456010, India
| | - Ashish Pathak
- Department of Pediatrics, RD Gardi Medical College, Ujjain 456010, India
- Health Systems and Policy, Department of Global Public Health, Karolinska Institutet, 17176 Stockholm, Sweden
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Silva Filho RCDS, Sasaki JE, Gordia AP, Andaki ACR. Effects of a Physical Exercise Program and Health Advice on Sedentary Behavior of Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1064. [PMID: 36673819 PMCID: PMC9859598 DOI: 10.3390/ijerph20021064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/29/2022] [Accepted: 07/07/2022] [Indexed: 06/17/2023]
Abstract
Sedentary behavior (SB) is a risk factor for chronic non-communicable diseases. This study aimed to assess the effects of an extracurricular physical exercise program and health advice on SB in adolescents. This was a non-randomized experimental study involving 19 adolescents divided into an intervention group (IG) and a control group (CG), aged 13-16 years from a public school in a Brazilian municipality. SB was measured using self-reports and accelerometers. The intervention included physical exercise and health advice. Repeated measures analysis of variance with a significance level of α = 5% was used. There was a time*group interaction for the subscapular fold ((pre IG = 16.30 mm vs. CG = 13.44 mm, post IG = 14.00 mm vs. CG = 15.89 mm) p = 0.001), and VO2MAX ((pre IG = 32.75 mL/kg/min vs. CG = 30.66 mL/kg/min, post IG = 35.76 mL/kg/min vs. CG = 29.28 mL/kg/min) p = 0.008). The accelerometer showed significant differences between groups in the total SB ((pre IG = 647.49 min/day vs. CG = 535.24 min/day, post IG = 614.02 min/day vs. CG = 586.97 min/day) p = 0.045), with a significant decrease in the IG. In conclusion, an extracurricular physical exercise program and health advice was effective in reducing SB in adolescents.
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Affiliation(s)
| | - Jeffer Eidi Sasaki
- Postgraduate Program in Physical Education, Federal University of Triângulo Mineiro, Uberaba 38061-500, MG, Brazil
| | - Alex Pinheiro Gordia
- Teachers Training Center, Federal University of Recôncavo da Bahia, Amargosa 45300-000, BA, Brazil
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BMI and Physical Activity, Military-Aged U.S. Population 2015-2020. Am J Prev Med 2023; 64:66-75. [PMID: 36155710 PMCID: PMC9885292 DOI: 10.1016/j.amepre.2022.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/29/2022] [Accepted: 08/15/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Obesity and physical inactivity are considered possible U.S. national security threats because of their impact on military recruitment. The objectives of this study were to estimate the prevalence of (1) BMI eligibility for military entrance, (2) adequate physical activity participation among the BMI-eligible population, and (3) combined BMI eligibility and adequate physical activity. METHODS This cross-sectional study of nonpregnant, military-aged civilians (aged 17-42 years) used objectively measured weight and height data and self-reported aerobic physical activity data from the 2015-2020 National Health and Nutrition Examination Survey. BMI eligibility was defined as 19.0-27.5 kg/m2, per Department of Defense regulation. Adequate physical activity for entering initial military training was defined as ≥300 minutes/week of equivalent moderate-intensity aerobic physical activity from all domains, approximating U.S. Army guidance. Participants meeting both definitions were further classified as eligible and active. Analyses were conducted in 2021-2022. RESULTS Of military-aged participants (unweighted n=5,964), 47.3% were eligible by BMI. Among BMI-eligible participants, 72.5% reported adequate physical activity. Taken together, 34.3% were both eligible and active. The prevalence of eligible and active status was higher among males, persons who were younger and non-Hispanic White, college graduates, and those with higher family income than among their counterparts. CONCLUSIONS Among the military-aged U.S. population, slightly under half were eligible to enter the military on the basis of their BMI, and only 1 in 3 met BMI eligibility and were adequately physically active. Equitable promotion of healthy weight achievement and physical activity participation may improve military preparedness.
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Willis EA, Hales D, Smith FT, Burney R, El-Zaatari HM, Rzepka MC, Amft O, Barr R, Evenson KR, Kosorok MR, Ward DS. Feasibility and Acceptability of Wearable Sensor Placement for Measuring Screen Time of Children. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2022; 7:e000214. [PMID: 36420110 PMCID: PMC9677178 DOI: 10.1249/tjx.0000000000000214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Introduction/Purpose Wearables that include a color light sensor are a promising measure of electronic screen use in adults. However, to extend this approach to children, we need to understand feasibility of wear placement. The purpose of this study was to examine parent perceptions of children's acceptability of different sensor placements and feasibility of free-living 3- to 7-day wear protocols. Methods This study was conducted in three phases. In phase 1, caregivers (n=161) of 3- to 8-year-old children completed an online survey to rate aspects of fitting and likelihood of wear for seven methods (headband, eyeglasses, skin adhesive patch, shirt clip/badge, mask, necklace, and vest). In phase 2, children (n=31) were recruited to wear one of the top five prototypes for three days (n=6 per method). In phase 3, children (n=23) were recruited to wear prototypes of the top three prototypes from phase 2 (n=8 per method) for 7 days. In phases 2 and 3, parents completed wear logs and surveys about their experiences. Parents scored each wearable on three domains (ease of use, likelihood of wear, and child enjoyment). Scores were averaged to compute an everyday "usability" score (0, worst, to 200, best). Results Phase 1 results suggested that the headband, eyeglasses, patch, clip/badge, and vest had the best potential for long-term wear. In phase 2, time spent wearing prototypes and usability scores were highest for the eyeglasses (10.4 hours/day, score=155.4), clip/badge (9.8 hours/day, score=145.8), and vest (7.1 hours/day, score=141.7). In phase 3, wearing time and usability scores were higher for the clip/badge (9.4 hours/day, score=169.6) and eyeglasses (6.5 hours/day, score=145.3) compared to the vest (4.8 hours/day, score=112.5). Conclusion Results indicate that wearable sensors clipped to a child's shirt or embedded into eyeglasses are feasible and acceptable wear methods in free-living settings. The next step is to asses the quality, validity, and reliability of data captured using these wear methods.
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Affiliation(s)
- Erik A. Willis
- Center for Health Promotion and Disease Prevention, University of North Carolina-Chapel Hill, Chapel Hill, NC
- Department of Nutrition, University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Derek Hales
- Center for Health Promotion and Disease Prevention, University of North Carolina-Chapel Hill, Chapel Hill, NC
- Department of Nutrition, University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Falon T. Smith
- Center for Health Promotion and Disease Prevention, University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Regan Burney
- Center for Health Promotion and Disease Prevention, University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Helal M. El-Zaatari
- Department of Biostatistics, University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Michelle C. Rzepka
- Department of Biostatistics, University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Oliver Amft
- Chair of Digital Health, Friedrich Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
- Intelligent Embedded Systems Laboratory, Albert Ludwig University of Freiburg, Germany
- Hahn-Schickard, Freiburg, Germany
| | - Rachel Barr
- Department of Psychology, Georgetown University, Washington, DC
| | - Kelly R. Evenson
- Center for Health Promotion and Disease Prevention, University of North Carolina-Chapel Hill, Chapel Hill, NC
- Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Michael R. Kosorok
- Department of Biostatistics, University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Dianne S. Ward
- Center for Health Promotion and Disease Prevention, University of North Carolina-Chapel Hill, Chapel Hill, NC
- Department of Nutrition, University of North Carolina-Chapel Hill, Chapel Hill, NC
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Ryu S, Jang H, Oh H. Smartphone Usage Patterns and Dietary Risk Factors in Adolescents. J Nutr 2022; 152:2109-2116. [PMID: 35511219 DOI: 10.1093/jn/nxac098] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/08/2022] [Accepted: 04/26/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Whereas earlier studies have shown that traditional screen time such as TV watching influences dietary behaviors in adolescents, little is known about the effects of modern screen time such as smartphone use. OBJECTIVES We examined the associations of smartphone usage duration and content type with dietary risk factors among adolescents. METHODS We conducted a cross-sectional analysis using a nationally representative sample of 54,601 middle- and high-school students (aged 12-18 y; 26,928 boys and 27,673 girls) in the Korea Youth Risk Behavior Web-Based Survey 2017. Smartphone use (average duration and most frequently used content type) and dietary intakes [frequent breakfast skipping; less frequent intakes of fruits and vegetables; more frequent intakes of instant noodles, fast food, chips/crackers, and sugar-sweetened beverages (SSBs)] were self-reported via an online-based questionnaire. Multivariable logistic regression was performed to estimate ORs and 95% CIs for the associations of smartphone usage duration and content type with prevalence of dietary risk factors, adjusting for potential confounders. All analyses accounted for complex survey sampling. RESULTS Prolonged smartphone use (≥300 compared with 1-59 min/d) was associated with (OR; 95% CI) higher prevalence of frequent breakfast skipping (1.60; 1.45, 1.76); frequent intakes of instant noodles (1.65; 1.47, 1.84), fast food (1.36; 1.20, 1.53), and SSBs (1.92; 1.75, 2.11); and less frequent intakes of fruits (1.44; 1.30, 1.59) and vegetables (1.32; 1.18, 1.47). Adjusting for usage duration, using smartphones mainly for messenger/e-mail, social networking service (SNS)/forum, and games were associated with less frequent intakes of fruits (OR: 1.21; 95% CI: 1.12, 1.31; OR: 1.28; 95% CI: 1.17, 1.40; and OR: 1.20; 95% CI: 1.10, 1.32, respectively) and vegetables (OR: 1.24; 95% CI: 1.12, 1.37; OR: 1.26; 95% CI: 1.13, 1.40; and OR: 1.25; 95% CI: 1.12, 1.40, respectively) than was using smartphones for education/information search. Using smartphones mainly for messenger/e-mail (OR: 1.24; 95% CI: 1.14, 1.35) and SNS/forum (OR: 1.18; 95% CI: 1.08, 1.29) were also associated with more frequent intake of SSBs. CONCLUSIONS Our data suggest that both duration and content type of smartphone use are independently associated with dietary risk factors among adolescents.
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Affiliation(s)
- Seaun Ryu
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Hajin Jang
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Hannah Oh
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea.,Division of Health Policy and Management, College of Health Sciences, Korea University, Seoul, Republic of Korea
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Zhang J, Chen Z, Pärna K, van Zon SKR, Snieder H, Thio CHL. Mediators of the association between educational attainment and type 2 diabetes mellitus: a two-step multivariable Mendelian randomisation study. Diabetologia 2022; 65:1364-1374. [PMID: 35482055 PMCID: PMC9283137 DOI: 10.1007/s00125-022-05705-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 02/15/2022] [Indexed: 12/25/2022]
Abstract
AIMS/HYPOTHESIS Type 2 diabetes mellitus is a major health burden disproportionately affecting those with lower educational attainment (EA). We aimed to obtain causal estimates of the association between EA and type 2 diabetes and to quantify mediating effects of known modifiable risk factors. METHODS We applied two-step, two-sample multivariable Mendelian randomisation (MR) techniques using SNPs as genetic instruments for exposure and mediators, thereby minimising bias due to confounding and reverse causation. We leveraged summary data on genome-wide association studies for EA, proposed mediators (i.e. BMI, blood pressure, smoking, television watching) and type 2 diabetes. The total effect of EA on type 2 diabetes was decomposed into a direct effect and indirect effects through multiple mediators. Additionally, traditional mediation analysis was performed in a subset of the National Health and Nutrition Examination Survey 2013-2014. RESULTS EA was inversely associated with type 2 diabetes (OR 0.53 for each 4.2 years of schooling; 95% CI 0.49, 0.56). Individually, the largest contributors were BMI (51.18% mediation; 95% CI 46.39%, 55.98%) and television watching (50.79% mediation; 95% CI 19.42%, 82.15%). Combined, the mediators explained 83.93% (95% CI 70.51%, 96.78%) of the EA-type 2 diabetes association. Traditional analysis yielded smaller effects but showed consistent direction and priority ranking of mediators. CONCLUSIONS/INTERPRETATION These results support a potentially causal protective effect of EA against type 2 diabetes, with considerable mediation by a number of modifiable risk factors. Interventions on these factors thus have the potential of substantially reducing the burden of type 2 diabetes attributable to low EA.
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Affiliation(s)
- Jia Zhang
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Zekai Chen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Katri Pärna
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Sander K R van Zon
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Harold Snieder
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Chris H L Thio
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
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Bhat M, Dehury K, Chandrasekaran B, Palanisamy HP, Arumugam A. Does standing alter reaction times and event related potentials compared to sitting in young adults? A counterbalanced, crossover trial. THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2022. [DOI: 10.1080/1463922x.2022.2033877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Mayur Bhat
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, India
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Keshab Dehury
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Baskaran Chandrasekaran
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Hari Prakash Palanisamy
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS – Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Sustainable Engineering Asset Management Research Group, RISE – Research Institute of Sciences and Engineering, University of Sharjah, Sharjah, United Arab Emirates
- Adjunct Faculty, Department of Physiotherapy, Manipal College of Health professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Aoki A, Togoobaatar G, Tseveenjav A, Nyam N, Zuunnast K, Lkhagvasuren G, Shagdar BE, Mori R, Kikuchi A, Soya H, Kasai K, Takehara K. Socioeconomic and lifestyle factors associated with mental health problems among Mongolian elementary school children. Soc Psychiatry Psychiatr Epidemiol 2022; 57:791-803. [PMID: 34595562 PMCID: PMC8483169 DOI: 10.1007/s00127-021-02178-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/22/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE Lifestyle factors of children and adolescents' mental health problems are an emerging health issue in low- and middle-income countries (LMICs). However, there is a lack of studies on lifestyle factors in LMICs. This study examined the socioeconomic and lifestyle factors associated with mental health problems among school-age children in Mongolia. METHODS A population-based cross-sectional survey was conducted among 4th-year students at public elementary schools in one district in Ulaanbaatar. The Strengths and Difficulties Questionnaire (SDQ) and a self-administrated socioeconomic and lifestyle questionnaire were completed by participants' guardians. A multivariate logistic regression analysis was performed. RESULTS Of the 2301 children surveyed, 1694 without missing responses were included in the analysis. The multivariate logistic regression analysis showed that male gender [adjusted odds ratio (AOR) 1.64 (1.29-2.10)], low maternal education [AOR 1.89 (1.16-3.05)], short sleep [AOR 1.41 (1.10-1.80)], no physical activity [AOR 1.31 (1.03-1.67)], and long screen time (AOR 1.53 (1.20-1.94)) were associated with high risk of mental health problems. Low maternal education, low household income, no physical activity habit, and long screen time were associated with internalising problems. Meanwhile, male gender, low maternal education, and long screen time were associated with externalising problems. CONCLUSION The results are consistent with previous studies in high-income countries, indicating that there are globally common socioeconomic and lifestyle risk factors. The findings of this study may help develop a targeted preventive intervention for high-risk groups, such as socioeconomically disadvantaged groups, as well as a universal preventive intervention to foster a healthy lifestyle in Mongolia.
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Affiliation(s)
- Ai Aoki
- Department of Health Policy, National Center for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo, Japan. .,Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
| | - Ganchimeg Togoobaatar
- Faculty of Medicine, Global Health Nursing, University of Tsukuba, Tsukuba, Ibaraki Japan
| | - Anudari Tseveenjav
- School of Nursing, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia ,Global Leadership University, Ulaanbaatar, Mongolia
| | - Naranbaatar Nyam
- School of Nursing, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Khishigsuren Zuunnast
- Department of Mental Health, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | | | - Bat-Erdene Shagdar
- Mongolian National Institute of Physical Education, Ulaanbaatar, Mongolia
| | - Rintaro Mori
- Graduate School of Medicine, Kyoto University, Sakyoku, Kyoto, Japan
| | - Akihito Kikuchi
- Advanced Research Initiative for Human High Performance, Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Hideaki Soya
- Advanced Research Initiative for Human High Performance, Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan ,Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Kenji Takehara
- Department of Health Policy, National Center for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo, Japan
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12
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Nieto A, Suhrcke M. The effect of TV viewing on children's obesity risk and mental well-being: Evidence from the UK digital switchover. JOURNAL OF HEALTH ECONOMICS 2021; 80:102543. [PMID: 34710814 DOI: 10.1016/j.jhealeco.2021.102543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 10/01/2021] [Accepted: 10/01/2021] [Indexed: 06/13/2023]
Abstract
We examine the effect of screen-based activities on obesity and mental well-being for children, using a large survey dataset representative of the UK population and an event study model that exploits exogenous variation in the entry date of the digital television transition in the UK. The digital transition increased the number of available free television channels from 5 to 40, leading to a rise in television viewing time. Our results show that receiving access to digital television signal considerably increases the mental health total difficulties score among children, and that this impact grows over time. We also find suggestive evidence that the digital transition could have increased BMI for children. Underlying the net effects appear to be decreases in participation in social and physical activities.
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Affiliation(s)
- Adrián Nieto
- Luxembourg Institute of Socio-Economic Research (LISER), 11 Porte des Sciences, Esch-sur-Alzette 4366, Luxembourg.
| | - Marc Suhrcke
- Luxembourg Institute of Socio-Economic Research (LISER), 11 Porte des Sciences, Esch-sur-Alzette 4366, Luxembourg; Centre for Health Economics, University of York, Heslington, York YO105DD, UK
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13
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Dos Santos PC, Salmon J, Arundell L, Lopes MVV, Silva KS. Effectiveness and moderators of a multicomponent school-based intervention on screen time devices: the Movimente cluster-randomized controlled trial. BMC Public Health 2021; 21:1852. [PMID: 34645402 PMCID: PMC8515678 DOI: 10.1186/s12889-021-11895-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022] Open
Abstract
Background Interventions targeting reduce screen time in adolescents are urgently needed, mainly in low and middle-income countries because of the lack of evidence. Thus, the aims of the study were to examine the effect of a cluster-randomized controlled trial on screen time (ST) devices among Brazilian adolescents and to identify possible moderators. Methods Movimente was a multicomponent school-based intervention that was performed in 2017 and consisted of teacher training, education curriculum, and environmental improvements. Baseline and post-intervention assessments (over one academic year) were conducted with students aged 10–16 years at baseline (baseline n = 921, [n = 538 intervention group; n = 383 control group]). A self-report questionnaire was used to measure daily minutes of device specific screen time (TV, computer, video games and smartphone) and demographic variables. Linear mixed models were used to examine intervention effects and an exploratory moderation analysis (sex, grade and socioeconomic status) was performed. Results The intervention had no significant effects on TV time (β = − 6.4, 95% CI: − 6.1;13.4), game time (β = − 8.2, 95% CI: − 7.2;10.8), computer time (β = 1.1, 95% CI: − 6.3;18.5), smartphone time (β = − 10.2, 95% CI: − 32.5;12.1), screen time (β = − 12.8, 95% CI: − 50.5;24.8), meeting screen time guidelines (OR: 1.29, 95% CI: 0.65,2.57) and meeting screen time guidelines with smartphone (OR: 1.66, 95% CI: 0.37,7.40). There was a significant intervention effect on reducing TV time (β = − 37.1, 95% CI: − 73.0, − 1.3) among 8th grade students only. Conclusions The Movimente intervention was effective only for TV time among 8th grade students. Understanding how school-based interventions can improve adolescents’ device specific screen time across age groups is needed. Future strategies should cover all screen-based devices. Further, there is a need for more studies in low- and-middle income countries to assist in the development of effective strategies. Trial registration Clinicaltrials.gov identifier NCT02944318 (25/10/2016). Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11895-2.
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Affiliation(s)
- Priscila Cristina Dos Santos
- Federal University of Santa Catarina - Sports center - Physical Education Department, University campus, Trindade, Florianópolis, SC, 88040-900, Brazil.
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia
| | - Lauren Arundell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia
| | - Marcus Vinicius Veber Lopes
- Federal University of Santa Catarina - Sports center - Physical Education Department, University campus, Trindade, Florianópolis, SC, 88040-900, Brazil
| | - Kelly Samara Silva
- Federal University of Santa Catarina - Sports center - Physical Education Department, University campus, Trindade, Florianópolis, SC, 88040-900, Brazil
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14
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Akçay D, Barış N. Evaluating the effectiveness of interventions to reducing screen time in children: meta-analysis of randomized controlled trials. JOURNAL OF PUBLIC MENTAL HEALTH 2021. [DOI: 10.1108/jpmh-03-2021-0039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to evaluate the impact of interventions focused on reducing screen time in children.
Design/methodology/approach
Studies that aim to investigate the effects of interventions aimed at reducing the time spent in front of the screen (i.e. screen time). A Random-effects model was used to calculate the pooled standard mean differences. The outcome was to evaluate the screen time in children in the 0–18 age range. A subgroup analysis was performed to reveal the extent to which the overall effect size varied by subgroups (participant age, duration of intervention and follow).
Findings
For the outcome, the meta-analysis included 21 studies, and the standard difference in mean change in screen time in the intervention group compared with the control group was −0.16 (95% confidence interval [CI], −0.21 to −0.12) (p < 0.001). The effect size was found to be higher in long-term (=7 months) interventions and follow-ups (p < 0.05).
Originality/value
Subgroup analysis showed that a significant effect of screen time reduction was observed in studies in which the duration of intervention and follow-up was =7 months. As the evidence base grows, future researchers can contribute to these findings by conducting a more comprehensive analysis of effect modifiers and optimizing interventions to reduce screen time.
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15
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Kenney EL, Mozaffarian RS, Long MW, Barrett JL, Cradock AL, Giles CM, Ward ZJ, Gortmaker SL. Limiting Television to Reduce Childhood Obesity: Cost-Effectiveness of Five Population Strategies. Child Obes 2021; 17:442-448. [PMID: 33970695 PMCID: PMC8568801 DOI: 10.1089/chi.2021.0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective: To quantify the potential population-wide costs, number of individuals reached, and impact on obesity of five effective interventions to reduce children's television viewing if implemented nationally. Study Design: Utilizing evidence from systematic reviews, the Childhood Obesity Intervention Cost Effectiveness Study (CHOICES) microsimulation model estimated the cost, population reach, and impact on childhood obesity from 2020 to 2030 of five hypothetical policy strategies to reduce the negative impact of children's TV exposure: (1) eliminating the tax deductibility of food and beverage advertising; (2) targeting TV reduction during home visiting programs; (3) motivational interviewing to reduce home television time at Women, Infants, and Children (WIC) clinic visits; (4) adoption of a television-reduction curriculum in child care; and (5) limiting noneducational television in licensed child care settings. Results: Eliminating the tax deductibility of food advertising could reach the most children [106 million, 95% uncertainty interval (UI): 105-107 million], prevent the most cases of obesity (78,700, 95% UI: 30,200-130,000), and save more in health care costs than it costs to implement. Strategies targeting young children in child care and WIC also cost little to implement (between $0.19 and $32.73 per child reached), and, although reaching fewer children because of the restricted age range, were estimated to prevent between 25,500 (95% UI: 4600-59,300) and 35,400 (95% UI: 13,200-62,100) cases of obesity. Home visiting to reduce television viewing had high costs and a low reach. Conclusions: Interventions to reduce television exposure across a range of settings, if implemented widely, could help prevent childhood obesity in the population at relatively low cost.
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Affiliation(s)
- Erica L. Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Address correspondence to: Erica L. Kenney, ScD, Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.
| | - Rebecca S. Mozaffarian
- Department of Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michael W. Long
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Jessica L. Barrett
- Department of Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Angie L. Cradock
- Department of Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Catherine M. Giles
- Edmond J. Safra Center for Ethics, Harvard University, Cambridge, MA, USA
| | - Zachary J. Ward
- Department of Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Steven L. Gortmaker
- Department of Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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16
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Weaver RG, Hunt ET, Armstrong B, Beets MW, Brazendale K, Turner-McGrievy G, Pate RR, Youngstedt SD, Dugger R, Parker H, von Klinggraeff L, Jones A, Burkart S, Ressor-Oyer L. COVID-19 Leads to Accelerated Increases in Children's BMI z-Score Gain: An Interrupted Time-Series Study. Am J Prev Med 2021; 61:e161-e169. [PMID: 34148734 PMCID: PMC8443301 DOI: 10.1016/j.amepre.2021.04.007] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/25/2021] [Accepted: 04/06/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The COVID-19 pandemic may have negatively impacted children's weight status owing to the closure of schools, increased food insecurity and reliance on ultraprocessed foods, and reduced opportunities for outdoor activity. METHODS In this interrupted time-series study, height and weight were collected from children (n=1,770 children, mean age=8.7 years, 55.3% male, 64.6% Black) and were transformed into BMI z-score in each August/September from 2017 to 2020. Mixed-effects linear regression estimated yearly BMI z-score change before the COVID-19 pandemic year (i.e., 2017-2019) and during the COVID-19 pandemic year (i.e., 2019-2020). Subgroup analyses by sex, race (i.e., Black, White, other race), weight status (overweight or obese and normal weight), and grade (i.e., lower=kindergarten-2nd grade and upper=3rd-6th grade) were conducted. RESULTS Before the COVID-19 pandemic, children's yearly BMI z-score change was +0.03 (95% CI= -0.10, 0.15). Change during the COVID-19 pandemic was +0.34 (95% CI=0.21, 0.47), an acceleration in BMI z-score change of +0.31 (95% CI=0.19, 0.44). For girls and boys, BMI z-score change accelerated by +0.33 (95% CI=0.16, 0.50) and +0.29 (95% CI=0.12, 0.46), respectively, during the pandemic year. Acceleration in BMI z-score change during the pandemic year was observed for children who were Black (+0.41, 95% CI=0.21, 0.61) and White (+0.22, 95% CI=0.06, 0.39). For children classified as normal weight, BMI z-score change accelerated by +0.58 (95% CI=0.40, 0.76). Yearly BMI z-score change accelerated for lower elementary/primary (+0.23, 95% CI=0.08, 0.37) and upper elementary/primary (+0.42, 95% CI=0.42, 0.63) children. CONCLUSIONS If similar BMI z-score accelerations occurred for children across the world, public health interventions to address this rapid unhealthy BMI gain will be urgently needed.
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Affiliation(s)
- R Glenn Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
| | - Ethan T Hunt
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Michael W Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Keith Brazendale
- Department of Health Sciences, UCF College of Health Professions and Sciences, University of Central Florida, Orlando, Florida
| | - Gabrielle Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Shawn D Youngstedt
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona
| | - Roddrick Dugger
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Hannah Parker
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Lauren von Klinggraeff
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Alexis Jones
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Sarah Burkart
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Layton Ressor-Oyer
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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17
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Jones A, Armstrong B, Weaver RG, Parker H, von Klinggraeff L, Beets MW. Identifying effective intervention strategies to reduce children's screen time: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2021; 18:126. [PMID: 34530867 PMCID: PMC8447784 DOI: 10.1186/s12966-021-01189-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/12/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Excessive screen time ([Formula: see text] 2 h per day) is associated with childhood overweight and obesity, physical inactivity, increased sedentary time, unfavorable dietary behaviors, and disrupted sleep. Previous reviews suggest intervening on screen time is associated with reductions in screen time and improvements in other obesogenic behaviors. However, it is unclear what study characteristics and behavior change techniques are potential mechanisms underlying the effectiveness of behavioral interventions. The purpose of this meta-analysis was to identify the behavior change techniques and study characteristics associated with effectiveness in behavioral interventions to reduce children's (0-18 years) screen time. METHODS A literature search of four databases (Ebscohost, Web of Science, EMBASE, and PubMed) was executed between January and February 2020 and updated during July 2021. Behavioral interventions targeting reductions in children's (0-18 years) screen time were included. Information on study characteristics (e.g., sample size, duration) and behavior change techniques (e.g., information, goal-setting) were extracted. Data on randomization, allocation concealment, and blinding was extracted and used to assess risk of bias. Meta-regressions were used to explore whether intervention effectiveness was associated with the presence of behavior change techniques and study characteristics. RESULTS The search identified 15,529 articles, of which 10,714 were screened for relevancy and 680 were retained for full-text screening. Of these, 204 studies provided quantitative data in the meta-analysis. The overall summary of random effects showed a small, beneficial impact of screen time interventions compared to controls (SDM = 0.116, 95CI 0.08 to 0.15). Inclusion of the Goals, Feedback, and Planning behavioral techniques were associated with a positive impact on intervention effectiveness (SDM = 0.145, 95CI 0.11 to 0.18). Interventions with smaller sample sizes (n < 95) delivered over short durations (< 52 weeks) were associated with larger effects compared to studies with larger sample sizes delivered over longer durations. In the presence of the Goals, Feedback, and Planning behavioral techniques, intervention effectiveness diminished as sample size increased. CONCLUSIONS Both intervention content and context are important to consider when designing interventions to reduce children's screen time. As interventions are scaled, determining the active ingredients to optimize interventions along the translational continuum will be crucial to maximize reductions in children's screen time.
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Affiliation(s)
- Alexis Jones
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - R. Glenn Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Hannah Parker
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Lauren von Klinggraeff
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - M. W. Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
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18
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Lewis L, Povey R, Rose S, Cowap L, Semper H, Carey A, Bishop J, Clark-Carter D. What behavior change techniques are associated with effective interventions to reduce screen time in 0-5 year olds? A narrative systematic review. Prev Med Rep 2021; 23:101429. [PMID: 34178587 PMCID: PMC8213959 DOI: 10.1016/j.pmedr.2021.101429] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 04/28/2021] [Accepted: 05/25/2021] [Indexed: 01/01/2023] Open
Abstract
Screen time has been linked to obesity in young children. Therefore, this systematic review aims to investigate which Behavior Change Techniques (BCTs) are associated with the effectiveness of interventions to reduce screen time in 0-5 year olds. Seven databases were searched, including PsycInfo, PubMed, and Medline. Grey literature searches were conducted. Inclusion criteria were interventions reporting pre- and post- outcomes with the primary objective of reducing screen time in 0-5 year olds. Studies were quality assessed using the Effective Public Health Practice Project criteria. Data extracted included participant characteristics, intervention characteristics and screen time outcomes. The BCT Taxonomy was used to extract BCTs. Interventions were categorised as "very", "quite" or "non" promising based on effect sizes. BCTs were deemed promising if they were in twice as many very/quite promising interventions as non-promising interventions. Seven randomised controlled trials were included, involving 642 participants between 2.5 and 5.0 years old. One very promising, four quite promising, and two non-promising interventions were identified. Screen time decreased by 25-39 min per day in very/quite promising interventions. Eleven BCTs were deemed promising, including "behavior substitution" and "information about social and environmental consequences". This review identified eleven promising BCTs, which should be incorporated into future screen time interventions with young children. However, most included studies were of weak quality and limited by the populations targeted. Therefore, future methodologically rigorous interventions targeting at-risk populations with higher screen time, such as those of a low socioeconomic status and children with a high BMI, should be prioritized.
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Affiliation(s)
- Lesley Lewis
- Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff CF10 4BZ, United Kingdom
- Staffordshire University, Leek Road, Stoke-on-Trent ST4 2DF, United Kingdom
| | - Rachel Povey
- Staffordshire University, Leek Road, Stoke-on-Trent ST4 2DF, United Kingdom
| | - Sarah Rose
- Staffordshire University, Leek Road, Stoke-on-Trent ST4 2DF, United Kingdom
| | - Lisa Cowap
- Staffordshire University, Leek Road, Stoke-on-Trent ST4 2DF, United Kingdom
| | - Heather Semper
- Sheffield Hallam University, Howard St, Sheffield S1 1WB, United Kingdom
| | - Alexis Carey
- Staffordshire University, Leek Road, Stoke-on-Trent ST4 2DF, United Kingdom
| | - Julie Bishop
- Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff CF10 4BZ, United Kingdom
| | - David Clark-Carter
- Staffordshire University, Leek Road, Stoke-on-Trent ST4 2DF, United Kingdom
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19
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Vercammen KA, Frelier JM, Poole MK, Kenney EL. Obesity prevention in early care and education: a comparison of licensing regulations across Canadian provinces and territories. J Public Health (Oxf) 2021; 42:362-373. [PMID: 32090258 DOI: 10.1093/pubmed/fdaa019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/10/2020] [Accepted: 01/13/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Early care and education (ECE) settings represent an important point of intervention for childhood obesity prevention efforts. The objective of this paper was to compare ECE licensing regulations for each Canadian province/territory to evidence-based, obesity prevention standards. METHODS Two authors reviewed existing ECE regulations for each province/territory and examined whether the regulatory text supported standards for nutrition (n = 11), physical activity (n = 5) and screen time (n = 4). Provinces/territories were evaluated on the strength of regulatory language for each standard (i.e. fully, partially, or not addressed) and a total comprehensiveness score (maximum score of 20). ECE centres and homes were examined separately. RESULTS The majority of provinces/territories required providers to follow Canada's Food Guide, but few had regulations for specific foods or beverages. Most provinces/territories included standards related to written menus and drinking water, but the strength of these standards was weak. Many provinces/territories required physical activity and outdoor opportunities to be provided daily, but few included a time requirement. Only two provinces included any screen time standards. Total comprehensiveness scores averaged 5.7 for centres and 5.4 for homes. CONCLUSIONS Canadian provinces/territories have insufficient obesity prevention regulations in ECE settings, highlighting a potential point of intervention to prevent obesity.
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Affiliation(s)
- Kelsey A Vercammen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Johannah M Frelier
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mary Kathryn Poole
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Erica L Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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20
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Fruh S, Williams S, Hayes K, Hauff C, Hudson GM, Sittig S, Graves RJ, Hall H, Barinas J. A practical approach to obesity prevention: Healthy home habits. J Am Assoc Nurse Pract 2021; 33:1055-1065. [PMID: 33534281 PMCID: PMC8313625 DOI: 10.1097/jxx.0000000000000556] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 11/06/2020] [Indexed: 12/11/2022]
Abstract
ABSTRACT Families have the potential to foster a healthy home environment aimed at reducing the risk of overweight and obesity. Establishing habits associated with reduced risk of obesity and overweight early in childhood can have lasting effects into adulthood. Nurse practitioners can encourage families to participate in healthy habits by addressing areas of growth for obesity prevention within the home. A review of the most recent literature, approximately over the past decade, was used to provide a consolidated source of reference for healthy home habits for the nurse practitioner. The search included terms such as "obesity," "overweight," "healthy habits," "physical activity," "obesogenic behaviors," "family meals," "screen time," "depression," "sugary beverages," and "portion sizes." The information was synthesized into three content areas: nutrition and consumption, patterns of activity, and stress within the home. Establishing healthy habits early in life can protect against the development of overweight and obesity. Nurse practitioners can serve a vital role in the prevention of pediatric, adolescent, and adult obesity. Equipped with the unique role of assisting those from a diverse patient base, nurse practitioners can inform patients how to improve healthy habits to decrease the likelihood of obesity or overweight. Encouraging behavior change related to the healthy habits associated with the prevention of overweight and obesity can have a long-term impact on the health of an entire family.
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Affiliation(s)
- Sharon Fruh
- Research, Evaluation, and Development, College of Nursing, University of South Alabama, Mobile, Alabama
| | - Susan Williams
- College of Nursing, University of South Alabama, Mobile, Alabama
| | - Katey Hayes
- Department of Psychology, University of South Alabama, Mobile, Alabama
| | - Caitlyn Hauff
- Department of Health, Kinesiology, and Sport, University of South Alabama, Mobile, Alabama
| | - Geoffrey M. Hudson
- Department of Health, Kinesiology, and Sport, University of South Alabama, Mobile, Alabama
| | - Scott Sittig
- Department of Information Systems and Technology, University of South Alabama, Mobile, Alabama
| | - Rebecca J. Graves
- Special Projects and Evaluation, College of Nursing, University of South Alabama, Mobile, Alabama
| | - Heather Hall
- College of Nursing, University of South Alabama, Mobile, Alabama
| | - Jennifer Barinas
- Combined-Integrated Clinical & Counseling Psychology Program, University of South Alabama, Mobile, Alabama
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21
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Han JW, Kim DJ. Prediction model study of overweight and obesity in preschool children with allergic diseases from an ecological perspective. BMC Pediatr 2021; 21:53. [PMID: 33494733 PMCID: PMC7831245 DOI: 10.1186/s12887-021-02515-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/20/2021] [Indexed: 11/17/2022] Open
Abstract
Background Allergic diseases have a high incidence in childhood and a high chance to be carried over into adulthood unless appropriately treated during childhood, it is important that healthcare providers actively manage these diseases. This study was to identify multidimensional factors that affect weight gain in preschool children with allergic diseases. Methods The overweight and obesity prediction model for children with allergic diseases was analyzed using multiple logistic regression analysis and a decision tree model and the present study was a secondary data analysis study that used data from the Panel Study on Korean Children conducted by the Korea Institute of Child Care and Education. Results The significance of this study is identify multidimensional factors that affect weight gain in preschool children with allergic diseases, which found that children (gender, sitting time during weekdays, sleeping hours during weekends,), parent (education level, mother’s job, quality of the home environment), local community (convenience of local community facilities, satisfaction level with local community facilities, quality of childcare in the local community) characteristics affected overweight and obesity at multidimensional levels as risk factors. Conclusions The significance of this study is identify multidimensional factors that affect weight gain in preschool children with allergic diseases using the data of the Panel Study on Korean Children, which found that children, parent, local community characteristics affected overweight and obesity at multidimensional levels as risk factors. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02515-4.
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Affiliation(s)
- Jeong-Won Han
- College of Nursing Science, Kyung Hee University, 26, Kyunghee-daero, Dongdaemun-gu, Seoul, 02453, South Korea.
| | - Da-Jung Kim
- College of Nursing Science, Kyung Hee University, 26, Kyunghee-daero, Dongdaemun-gu, Seoul, 02453, South Korea
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22
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Oberle E, Ji XR, Kerai S, Guhn M, Schonert-Reichl KA, Gadermann AM. Screen time and extracurricular activities as risk and protective factors for mental health in adolescence: A population-level study. Prev Med 2020; 141:106291. [PMID: 33069689 DOI: 10.1016/j.ypmed.2020.106291] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 10/23/2022]
Abstract
This study examines adolescents' (N = 28,712; 49% female; Mage = 12.25, SDage = 0.51) recreational screen time and participation in extracurricular activities during after-school hours in association to indicators of positive (optimism, satisfaction with life) and negative (anxiety, depressive symptoms) mental health and wellbeing. Data were drawn from a population-level study with the Middle Years Development Instrument (MDI) with grade 7 students in British Columbia (BC), Canada. The research was implemented in public school districts between 2014 and 2018. We found that adolescents who participated in extracurricular activities (e.g., sports, arts programs, community programs) were significantly less likely to engage in recreational screen-based activities (e.g., watching programs, browsing the internet, playing computer games) for 2 or more hours after school. Findings from Multilevel Structural Equation Modeling analyses showed that extracurricular participation was associated with higher levels of satisfaction with life and optimism, and lower levels of anxiety and depressive symptoms. In contrast, longer screen time (≥2 h/day) was associated with lower levels of satisfaction with life and optimism, and higher levels of anxiety and depressive symptoms; shorter screen time (<2 h/day) was associated with favorable mental health and wellbeing. For screen time, the effect was moderated by gender; the association between longer screen time and poorer mental health and wellbeing was significantly more pronounced for girls than boys. For both boys and girls, mental health and wellbeing were most favorable if they participated in extracurricular activities and reported less than 2 h of recreational screen time per day.
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Affiliation(s)
- Eva Oberle
- School of Population and Public Health, The Human Early Learning Partnership, The University of British Columbia, Vancouver, Canada.
| | - Xuejun Ryan Ji
- Department of Educational and Counselling Psychology, The University of British Columbia, Vancouver, Canada.
| | - Salima Kerai
- School of Population and Public Health, The Human Early Learning Partnership, The University of British Columbia, Vancouver, Canada.
| | - Martin Guhn
- School of Population and Public Health, The Human Early Learning Partnership, The University of British Columbia, Vancouver, Canada.
| | - Kimberly A Schonert-Reichl
- School of Population and Public Health, The Human Early Learning Partnership, The University of British Columbia, Vancouver, Canada; Department of Educational and Counselling Psychology, The University of British Columbia, Vancouver, Canada.
| | - Anne M Gadermann
- School of Population and Public Health, The Human Early Learning Partnership, The University of British Columbia, Vancouver, Canada.
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23
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Scott-Sheldon LAJ, Hedges LV, Cyr C, Young-Hyman D, Khan LK, Magnus M, King H, Arteaga S, Cawley J, Economos CD, Haire-Joshu D, Hunter CM, Lee BY, Kumanyika SK, Ritchie LD, Robinson TN, Schwartz MB. Childhood Obesity Evidence Base Project: A Systematic Review and Meta-Analysis of a New Taxonomy of Intervention Components to Improve Weight Status in Children 2-5 Years of Age, 2005-2019. Child Obes 2020; 16:S221-S248. [PMID: 32936038 PMCID: PMC7482126 DOI: 10.1089/chi.2020.0139] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective: To evaluate the efficacy of childhood obesity interventions and conduct a taxonomy of intervention components that are most effective in changing obesity-related health outcomes in children 2-5 years of age. Methods: Comprehensive searches located 51 studies from 18,335 unique records. Eligible studies: (1) assessed children aged 2-5, living in the United States; (2) evaluated an intervention to improve weight status; (3) identified a same-aged comparison group; (4) measured BMI; and (5) were available between January 2005 and August 2019. Coders extracted study, sample, and intervention characteristics. Effect sizes [ESs; and 95% confidence intervals (CIs)] were calculated by using random-effects models. Meta-regression was used to determine which intervention components explain variability in ESs. Results: Included were 51 studies evaluating 58 interventions (N = 29,085; mean age = 4 years; 50% girls). Relative to controls, children receiving an intervention had a lower BMI at the end of the intervention (g = 0.10, 95% CI = 0.02-0.18; k = 55) and at the last follow-up (g = 0.17, 95% CI = 0.04-0.30; k = 14; range = 18-143 weeks). Three intervention components moderated efficacy: engage caregivers in praise/encouragement for positive health-related behavior; provide education about the importance of screen time reduction to caregivers; and engage pediatricians/health care providers. Conclusions: Early childhood obesity interventions are effective in reducing BMI in preschool children. Our findings suggest that facilitating caregiver education about the importance of screen time reduction may be an important strategy in reducing early childhood obesity.
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Affiliation(s)
- Lori A J Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Larry V Hedges
- Department of Statistics, Northwestern University, Evanston, IL, USA
| | - Chris Cyr
- Impact Genome Project, Mission Measurement, Chicago, IL, USA
| | - Deborah Young-Hyman
- Office of Behavioral and Social Sciences, Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | - Laura Kettel Khan
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Heather King
- Impact Genome Project, Mission Measurement, Chicago, IL, USA
| | - Sonia Arteaga
- Office of the Director, National Institutes of Health, National Institutes of Health, Bethesda, MD, USA
| | - John Cawley
- Department of Policy Analysis and Management, Cornell University, Ithaca, NY, USA
- Department of Economics, Cornell University, Ithaca, NY, USA
| | - Christina D Economos
- Division of Nutrition Interventions, Communication, and Behavior Change, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Debra Haire-Joshu
- Center for Obesity Prevention and Policy Research, Brown School, Washington University, Saint Louis, MO, USA
| | - Christine M Hunter
- Office of Behavioral and Social Sciences, Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | - Bruce Y Lee
- CUNY Graduate School of Public Health and Policy, New York, NY, USA
| | - Shiriki K Kumanyika
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Lorrene D Ritchie
- Nutrition Policy Institute, University of California, Division of Agriculture and Natural Resources, Berkeley, CA, USA
| | - Thomas N Robinson
- Departments of Pediatrics and Medicine, Stanford Solutions Science Lab, Stanford University, Stanford, CA, USA
| | - Marlene B Schwartz
- Department of Human Development and Family Studies, University of Connecticut, Hartford, CT, USA
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Silva KS, da Silva JA, Barbosa Filho VC, dos Santos PC, da Silveira PM, Lopes MV, Salmon J. Protocol paper for the Movimente school-based program: A cluster-randomized controlled trial targeting physical activity and sedentary behavior among Brazilian adolescents. Medicine (Baltimore) 2020; 99:e21233. [PMID: 32756101 PMCID: PMC7402733 DOI: 10.1097/md.0000000000021233] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/25/2020] [Accepted: 06/10/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND A better understanding of how multicomponent school-based interventions work and their effects on health and education outcomes are needed. This paper described the methods of the Movimente Program, a school-based intervention that aims to increase physical activity (PA) and decrease sedentary behavior (SB) among Brazilian students. METHODS This is a cluster randomized controlled trial with adolescents from 7th to 9th grade in public schools from Florianopolis, Southern Brazil. After agreement, 6 schools were randomly selected to intervention or control groups (3 schools each), and all eligible students were invited to the study. The Movimente intervention program was performed during a school year and included 3 main components: Teacher training (including face-to-face meeting, social media platform, and handbook with lesson plans); improvements in the PA environment in school; and educational strategies. Control schools continued with their traditional schedule. Baseline (March/April 2017), postintervention (November/December 2017), and maintenance (June/July 2018) evaluations included PA and SB as primary outcomes (assessed by self-report and accelerometry). Secondary outcomes included psychosocial factors related to PA and SB (e.g., social support and self-efficacy), as well as health (e.g., quality of life and nutritional status) and education (e.g., academic achievement) outcomes. A program evaluation was performed based on the RE-AIM framework. Participants, intervention staffs, and evaluators were not blinded to group assignment, but a standardized evaluation protocol was applied independently of the trial allocation. RESULTS Statistical analyses will include a multilevel approach for repeated measurements and mediation analysis. Any side effects of the intervention will be recorded. The sample size close to that expected (n = 1090) was reached (n = 999). The results of this trial will involve valuable information about the effect and the evaluation of a multicomponent intervention carried out in a middle-income country. CONCLUSION By creating opportunities for adolescents to be active at school using multicomponent strategies, the Movimente program has the potential to enhance students health and academic performance which may encourage the school community (e.g., teachers, principals) to adopt the program. Also, this trial will provide evidence for practitioners, policy makers, and researchers on how multicomponent program may be implemented in a school setting. TRIAL REGISTRATION The trial is registered at the Clinical Trial Registry (Trial ID: NCT02944318; date of registration: 18 October 2016).
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Affiliation(s)
- Kelly Samara Silva
- Department of Physical Education, Research Centre in Physical Activity and Health, Sport Centre, Federal University of Santa Catarina, Florianopolis
| | - Jaqueline Aragoni da Silva
- Department of Physical Education, Research Centre in Physical Activity and Health, Sport Centre, Federal University of Santa Catarina, Florianopolis
| | | | - Priscila Cristina dos Santos
- Department of Physical Education, Research Centre in Physical Activity and Health, Sport Centre, Federal University of Santa Catarina, Florianopolis
| | - Pablo Magno da Silveira
- Department of Physical Education, Research Centre in Physical Activity and Health, Sport Centre, Federal University of Santa Catarina, Florianopolis
| | - Marcus V.V. Lopes
- Department of Physical Education, Research Centre in Physical Activity and Health, Sport Centre, Federal University of Santa Catarina, Florianopolis
| | - Jo Salmon
- Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Victoria, Australia
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Martin KB, Bednarz JM, Aromataris EC. Interventions to control children's screen use and their effect on sleep: A systematic review and meta-analysis. J Sleep Res 2020; 30:e13130. [PMID: 32567219 DOI: 10.1111/jsr.13130] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 01/09/2023]
Abstract
Prolonged viewing of screen-based media is associated with poor sleep in children. Previous systematic reviews have analysed the effectiveness of interventions that aim to limit children's screen use; however, none have evaluated its effect on sleep. The aim of this systematic review was to evaluate the effect of interventions that incorporate strategies to control children's screen use on screen use and sleep. The databases Pubmed, Embase, Eric, Scopus and PsycInfo were searched during October 2017 and updated in February 2019 for experimental studies with a control that assessed interventions to control screen use in children aged 2-14 years and reported both screen use and sleep outcomes. From 3,872 initial records, 11 studies (six randomized control [RCT], four cluster RCT and one cluster, quasi-experimental) were eligible for inclusion. A total of 4,656 children aged 2-13 years were included in the studies. The mean reduction in screen time was 0.56 hr (33 min)/day (95% confidence interval [CI], 0.92, 0.20) and the mean sleep duration increased by 0.19 hr (11 min)/day (95% CI, 0.05, 0.33). Bedtime was advanced by 0.16 hr (10 min) on weekdays and by 1.0 hr at the weekend. Subgroup analyses indicated stronger intervention effects for interventions of shorter duration (<3 months), which specifically targeted screen use or sleep, and those with direct participant contact. In conclusion, small improvements in screen time and sleep duration can be achieved in children. It is not possible to determine if a reduction in screen time directly improves sleep, due to the limited number of studies, the presence of co-interventions, issues with studies' methodological quality and heterogeneity.
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Affiliation(s)
- Katie B Martin
- Joanna Briggs Institute, University of Adelaide, Adelaide, SA, Australia
| | - Jana M Bednarz
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
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Smith C, de Wilde T, Taylor RW, Galland BC. Prebedtime Screen Use in Adolescents: A Survey of Habits, Barriers, and Perceived Acceptability of Potential Interventions. J Adolesc Health 2020; 66:725-732. [PMID: 32044232 DOI: 10.1016/j.jadohealth.2019.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 12/01/2019] [Accepted: 12/10/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE This study aimed to investigate (1) access to screens and screen use in the hour before bedtime and in bed; (2) attitudes and barriers to reducing screen time, and (3) perceptions of potential interventions to reduce screen time to benefit the sleep of New Zealand adolescents. METHODS Adolescents (aged 13-17 years, n = 4,811) living in New Zealand were recruited online between November 2015 and March 2016 with a direct link to complete a questionnaire about screen use in the hour before bedtime (including the types of screens used and activities) and screen use when in bed. Sleep patterns and quality were measured, and attitudes to reducing screen time using potential interventions were explored. RESULTS The most common prebedtime screen activities reported on most nights were social media (88%) and texting/instant messaging (77%). The majority of participants reported they used phones in bed (86%) and "agreed" they spent too much time on screens (70%), a perception that increased with age (p = .008). Being unable to communicate with friends was the most common barrier to reducing screen time (67% agreed). CONCLUSIONS Screen use in adolescents is complex; however, there is scope to improve sleep by reducing the impact of in-bed use of portable devices and addressing barriers to reduce screen time in adolescents.
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Affiliation(s)
- Claire Smith
- Department of Women's & Children's Health, University of Otago, Dunedin, New Zealand.
| | - Tanja de Wilde
- Department of Women's & Children's Health, University of Otago, Dunedin, New Zealand
| | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Barbara C Galland
- Department of Women's & Children's Health, University of Otago, Dunedin, New Zealand
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Barroso CS, Springer AE, Ledingham CM, Kelder SH. A qualitative analysis of the social and cultural contexts that shape screen time use in Latino families living on the U.S.-Mexico border. Int J Qual Stud Health Well-being 2020; 15:1735766. [PMID: 32118520 PMCID: PMC7067164 DOI: 10.1080/17482631.2020.1735766] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Purpose: The purpose of this study was to understand how first generation Latino parents, whose primary language is Spanish and live in a colonia on the U.S.-Mexico border, use screen time in their homes. Methods: A purposeful sampling approach was used to recruit eligible parents of pre-adolescents (ages 9–14) who were native Spanish speakers, and living on the U.S.-Mexico border. Three focus groups in Spanish (two with mothers and one with fathers) were conducted. Data were codified using a general inductive approach based on grounded theory. A consensus process was repeated until a final codebook was developed. Results: Screen time allowed parents to foster familismo (family cohesiveness and bonding) and respeto (respect). Parents knew that a healthy balance of media use is important, but broader social contexts (marital discord and economics) challenged the enforcement of familial screen time rules and parents were often permissive. Conclusions: Our study addressed research gaps by examining the understudied social and cultural contexts (practices, routines, rules, and beliefs) that shape children’s screen time use among a sample of Latino immigrants living on the U.S.-Mexico border. This sample of parents indicated that familismo and respeto (i.e., cohesiveness and bonding) influence familial decision-making including screen time.
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Affiliation(s)
- Cristina S Barroso
- Department of Public Health, University of Tennessee, Knoxville, TN, USA
| | - Andrew E Springer
- Michael & Susan Dell Center for Healthy Living, Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health, Austin, TX, USA
| | - Christopher M Ledingham
- Health and Human Performance, The University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Steven H Kelder
- Michael & Susan Dell Center for Healthy Living, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health, Austin, TX, USA
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Sitting time and long-term weight change in adolescents with severe obesity undergoing surgical and nonoperative weight management. Surg Obes Relat Dis 2020; 16:431-436. [PMID: 31892470 DOI: 10.1016/j.soard.2019.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/07/2019] [Accepted: 11/19/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Prolonged sitting time has been associated with numerous deleterious effects on humans. The degree to which sitting time influences weight loss outcomes of obesity treatments is poorly understood. OBJECTIVES The objective was to characterize and describe the amount of time spent sitting in an adolescent bariatric surgical and nonoperative cohort and evaluate its relationship with long-term change in body mass index (BMI). SETTING Tertiary care hospital, United States. METHODS From 2011 to 2014, a 1-time study visit was conducted to collect long-term outcomes of Roux-en-Y gastric bypass (RYGB; n = 58) and nonoperative (n = 30) management of adolescents with severe obesity. The International Physical Activity Questionnaire was used to assess sitting time. Linear regression was used to evaluate the association between sitting time and percent BMI change from baseline. RESULTS A total of 88 patients participated in the long-term follow-up visit at an average of 8 years from baseline. Percent BMI loss for participants who underwent RYGB (mean age at follow-up 25 yr) and for nonoperative (mean age at follow-up 23 yr) participants was -29% and +8%, respectively. The surgical group reported a median sitting time of 5.1 hr/d, while the nonoperative group reported a median sitting time of 7.0 hr/d (P = .11). Increasing sitting time was significantly associated with decreased percent BMI loss (P < .01). CONCLUSIONS RYGB was associated with long-term weight loss. Those participants with and without prior RYGB self-reported similar amounts of time spent sitting each day. Irrespective of whether participants had previously undergone surgery, lower levels of sitting time were found to be associated with greater BMI loss many years later.
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Guo C, Zhou Q, Zhang D, Qin P, Li Q, Tian G, Liu D, Chen X, Liu L, Liu F, Cheng C, Qie R, Han M, Huang S, Wu X, Zhao Y, Ren Y, Zhang M, Liu Y, Hu D. Association of total sedentary behaviour and television viewing with risk of overweight/obesity, type 2 diabetes and hypertension: A dose-response meta-analysis. Diabetes Obes Metab 2020; 22:79-90. [PMID: 31468597 DOI: 10.1111/dom.13867] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 08/25/2019] [Accepted: 08/25/2019] [Indexed: 01/08/2023]
Abstract
AIMS To explore the quantitative dose-response association of total sedentary behaviour and television viewing with overweight/obesity, type 2 diabetes and hypertension in a meta-analysis. MATERIALS AND METHODS We searched three databases to identify English-language reports that assessed the association of total sedentary behaviour or television viewing with the aforementioned health outcomes. Restricted cubic splines were used to evaluate possible linear or non-linear associations of total sedentary behaviour and television viewing with these health outcomes. RESULTS We included 48 articles (58 studies) with a total of 1 071 967 participants in the meta-analysis; 21 (six cohort and 15 cross-sectional) studies examined the association of total sedentary behaviour with overweight/obesity, 23 (13 cohort and 10 cross-sectional) studies examined the association with type 2 diabetes and 14 (one cohort and 13 cross-sectional) studies examined the association with hypertension. We found linear associations between total sedentary behaviour and type 2 diabetes (Pnon-linearity = 0.190) and hypertension (Pnon-linearity = 0.225) and a non-linear association between total sedentary behaviour and overweight/obesity (Pnon-linearity = 0.003). For each 1-h/d increase in total sedentary behaviour, the risk increased by 5% for type 2 diabetes and 4% for hypertension. We also found linear associations between television viewing and type 2 diabetes (Pnon-linearity = 0.948) and hypertension (Pnon-linearity = 0.679) and a non-linear association for overweight/obesity (Pnon-linearity = 0.007). For each 1-h/d increase in television viewing, the risk increased by 8% for type 2 diabetes and 6% for hypertension. CONCLUSIONS High levels of total sedentary behaviour and television viewing were associated with overweight/obesity, type 2 diabetes and hypertension.
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Affiliation(s)
- Chunmei Guo
- Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
- Study Team of Shenzhen's Sanming Project, Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
| | - Qionggui Zhou
- Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
- Study Team of Shenzhen's Sanming Project, Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
| | - Dongdong Zhang
- Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
- Study Team of Shenzhen's Sanming Project, Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
| | - Pei Qin
- Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
- Study Team of Shenzhen's Sanming Project, Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
| | - Quanman Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, Zhengzhou, People's Republic of China
| | - Gang Tian
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, Zhengzhou, People's Republic of China
| | - Dechen Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, Zhengzhou, People's Republic of China
| | - Xu Chen
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, Zhengzhou, People's Republic of China
| | - Leilei Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, Zhengzhou, People's Republic of China
| | - Feiyan Liu
- Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
- Study Team of Shenzhen's Sanming Project, Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
| | - Cheng Cheng
- Study Team of Shenzhen's Sanming Project, Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
| | - Ranran Qie
- Study Team of Shenzhen's Sanming Project, Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
| | - Minghui Han
- Study Team of Shenzhen's Sanming Project, Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
| | - Shengbing Huang
- Study Team of Shenzhen's Sanming Project, Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
| | - Xiaoyan Wu
- Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
| | - Yang Zhao
- Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
- Study Team of Shenzhen's Sanming Project, Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
| | - Yongcheng Ren
- Study Team of Shenzhen's Sanming Project, Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
| | - Ming Zhang
- Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
- Study Team of Shenzhen's Sanming Project, Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
| | - Yu Liu
- Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
- Study Team of Shenzhen's Sanming Project, Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
| | - Dongsheng Hu
- Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
- Study Team of Shenzhen's Sanming Project, Affiliated Luohu Hospital of Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China
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Bandeira ADS, Silva KS, Bastos JLD, Silva DAS, Lopes ADS, Barbosa Filho VC. Psychosocial mediators of screen time reduction after an intervention for students from schools in vulnerable areas: A cluster-randomized controlled trial. J Sci Med Sport 2019; 23:264-269. [PMID: 31543460 DOI: 10.1016/j.jsams.2019.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 04/24/2019] [Accepted: 09/05/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To investigate whether psychosocial variables mediate the effect of a multicomponent intervention on screen time reduction among Brazilian students from schools located in vulnerable areas. DESIGN A cluster-randomized controlled trial with a 4-month follow-up. METHODS This study was conducted with 1085 students (548 in the intervention group and 537 in the control group), aged 11-17years. The intervention strategies focused on training teachers, increasing opportunities for physical activity at school, and reducing screen time, as well as health education. The questionnaire was administered before and after intervention with questions about the amount of time spent on TV and computer/video games on weekdays and weekend days (combined screen time). The potential psychosocial mediators (attitude, self-efficacy, family and school support) were measured through validated scales. Socioeconomic status was used as control variable. Multilevel mediation analyses were conducted using a product-of-coefficients test. RESULTS Psychosocial factors were not mediators of the effect of the intervention on screen time. The intervention significantly improved school support for both sexes (boys: 1.307; girls: 0.759; p<0.05) and older students (1.154; p<0.001). Attitude (boys: -0.228; 11-13years: -0.133; 14-17years: -0.152; p<0.05) and self-efficacy scales (boys: -0.040; girls: -0.104; 11-13years: -0.048; 14-17years: -0.100; p<0.05) were associated with reduced screen time. CONCLUSIONS The intervention produced a significant improvement of school support for both sexes, as well as older students. Enhancing attitude and self-efficacy may be a useful strategy for reducing screen time among boys and students of any age groups. TRIAL REGISTRATION ClinicalTrials.Gov: NCT02439827. Registration date: May 3, 2015.
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Affiliation(s)
- Alexsandra da Silva Bandeira
- Federal University of Santa Catarina, Department of Physical Education, Campus Universitário Reitor João David Ferreira Lima, Brazil.
| | - Kelly Samara Silva
- Federal University of Santa Catarina, Department of Physical Education, Campus Universitário Reitor João David Ferreira Lima, Brazil
| | - João Luiz Dornelles Bastos
- Federal University of Santa Catarina, Department of Public Health, Campus Universitário Reitor João David Ferreira Lima, Brazil
| | - Diego Augusto Santos Silva
- Federal University of Santa Catarina, Department of Physical Education, Campus Universitário Reitor João David Ferreira Lima, Brazil
| | - Adair da Silva Lopes
- Federal University of Santa Catarina, Department of Physical Education, Campus Universitário Reitor João David Ferreira Lima, Brazil
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O'Connor TM, Elias C, Thompson RR, Arlinghaus KR, Vollrath K, Hernandez DC, Power TG, Hughes SO. The association of TV viewing during dinner meals with quality of dietary intake and BMI z-scores among low income, ethnic minority preschool children. Appetite 2019; 140:231-238. [PMID: 31121200 DOI: 10.1016/j.appet.2019.05.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 04/18/2019] [Accepted: 05/18/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND TV viewing has been associated with children's weight status and is thought to be mediated mostly through children's dietary intake. However, the mechanisms underlying this association are not understood. OBJECTIVE Assess the associations of having the TV on and the child watching TV during dinners with the dietary quality consumed at that meal and with the child's weight status. METHODS Secondary analysis of a directly-observed study of 144 preschool-aged African American and Hispanic, low-income children's dinner meals. Three home dinners were video recorded per child (428 meals observed) and what children were served and consumed measured. The Healthy Eating Index-2010 assessed dietary quality of dinners served and consumed. Child height and weight were measured and parents completed questionnaires. Videos were coded for whether the TV was on and the proportion of the dinner the child watched TV. Mixed models with meal observations nested within child assessed the associations. RESULTS 77% of children consumed at least one dinner with the TV on. The proportion of the meal the child watched TV was not associated with lower dietary quality consumed. TV on was associated with the dietary quality consumed only in the fully adjusted model (p < 0.05). The dietary quality of dinner served was most strongly associated with the dietary quality consumed (p < 0.0001). Neither having the TV on nor child watching the TV while eating were associated with the child's BMI z-score. CONCLUSION Having the TV on during meals was common, but watching TV during the meal was not associated with the dietary quality of what the children consumed. Further controlled studies should evaluate if turning the TV off during dinner directly improves the dietary quality children consume at that meal.
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Affiliation(s)
- Teresia M O'Connor
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA; Public Health and Primary Care, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
| | - Cindy Elias
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Ralf Richard Thompson
- Public Health and Primary Care, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Katherine R Arlinghaus
- Department of Health and Human Performance and HEALTH Research Institute, University of Houston, Houston, TX, USA
| | - Kristin Vollrath
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Daphne C Hernandez
- Department of Health and Human Performance and HEALTH Research Institute, University of Houston, Houston, TX, USA
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA, USA
| | - Sheryl O Hughes
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
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Marker C, Gnambs T, Appel M. Exploring the myth of the chubby gamer: A meta-analysis on sedentary video gaming and body mass. Soc Sci Med 2019; 301:112325. [PMID: 31262505 DOI: 10.1016/j.socscimed.2019.05.030] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 05/10/2019] [Accepted: 05/18/2019] [Indexed: 02/07/2023]
Abstract
RATIONALE High body mass and obesity are frequently linked to the use of sedentary media, like television (TV) or non-active video games. Empirical evidence regarding video gaming, however, has been mixed, and theoretical considerations explaining a relationship between general screen time and body mass may not generalize to non-active video gaming. OBJECTIVE The current meta-analysis had two main goals. First, we wanted to provide an estimate of the average effect size of the relationship between sedentary video gaming and body mass. In doing so we acknowledged several context variables to gauge the stability of the average effect. Second, to provide additional evidence on processes, we tested the displacement effect of physical activity by video gaming time with the help of a meta-analytic structural equation model (MASEM). METHOD Published and unpublished studies were identified through keyword searches in different databases and references in relevant reports were inspected for further studies. We present a random-effects, three-level meta-analysis based on 20 studies (total N = 38,097) with 32 effect sizes. RESULTS The analyses revealed a small positive relationship between non-active video game use and body mass, ρˆ=.09, 95% CI [0.03, 0.14], indicating that they shared less than 1% in variance. The studies showed significant heterogeneity, Q (31) = 593.03, p < .001, I2 = 95.13. Moderator analyses revealed that the relationship was more pronounced for adults, ρˆ=.22, 95% CI [0.04, 0.40], as compared to adolescents, ρˆ=.01, 95% CI [-0.21, 0.23], or children, ρˆ=.09, 95% CI [-0.07, 0.25]. Meta-analytic structural equation modeling found little evidence for a displacement of physical activity through time spent on video gaming. CONCLUSION These results do not corroborate the assumption of a strong link between video gaming and body mass as respective associations are small and primarily observed among adults.
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Affiliation(s)
- Caroline Marker
- Human-Computer-Media Institute, University of Würzburg, Germany.
| | - Timo Gnambs
- Johannes Kepler University Linz, Austria; Leibniz Institute for Educational Trajectories, Bamberg, Germany.
| | - Markus Appel
- Human-Computer-Media Institute, University of Würzburg, Germany.
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Barbosa Filho VC, Bandeira AS, Rech CR, Lopes AS, Mota J, Silva KS. Validity and reliability of an instrument to measure factors associated with screen time in Brazilian students. CIENCIA & SAUDE COLETIVA 2019; 26:1047-1061. [PMID: 33729358 DOI: 10.1590/1413-81232021263.31322018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/04/2019] [Indexed: 11/21/2022] Open
Abstract
This study analyzed the validity and reliability of an instrument with scales measuring factors associated with screen time in adolescents. Two cross-sectional studies included students for analyses of validity and internal consistency (n=1138, 51.5% boys) and test-retest reproducibility (n=194, 56.2% boys). Individual (attitude, self-efficacy and expectations), social (behaviors, rules, beliefs and family support and support of school members) and physical environmental (home and bedroom equipment) factors of screen time were evaluated. All the scales of the instrument met the statistical criteria of the validity of the exploratory factorial analysis (p<0.001). The exploratory factorial analysis indicated five one-dimensional and three two-factor scales (self-efficacy, expectations and familiar behavior), with factorial loads of 0.56 to 0.88. There were significant correlations between the scores of almost all the scales and the reported screen time (p<0.05). Eight of nine scales/subscales showed Cronbach's α value being higher than 0.70, and ICC ranged from 0.63 to 0.83. In conclusion, the instrument presented scales with acceptable validity and reliability and can be used to measure factors associated with screen time in Brazilian students.
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Affiliation(s)
- Valter Cordeiro Barbosa Filho
- Instituto Federal de Educação, Ciência e Tecnologia do Ceará. Rod. Pres. Juscelino Kubitschek s/n, Campus Boa Viagem. 63870-000 Boa Viagem CE Brasil. .,Centro de Pesquisa em Atividade Física e Saúde, Departamento de Educação Física, Universidade Federal de Santa Catarina. Florianópolis SC Brasil.,Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual do Ceará. Fortaleza CE Brasil
| | - Alexsandra Silva Bandeira
- Centro de Pesquisa em Atividade Física e Saúde, Departamento de Educação Física, Universidade Federal de Santa Catarina. Florianópolis SC Brasil
| | - Cassiano Ricardo Rech
- Centro de Pesquisa em Atividade Física e Saúde, Departamento de Educação Física, Universidade Federal de Santa Catarina. Florianópolis SC Brasil
| | - Adair Silva Lopes
- Centro de Pesquisa em Atividade Física e Saúde, Departamento de Educação Física, Universidade Federal de Santa Catarina. Florianópolis SC Brasil
| | - Jorge Mota
- Centro de Pesquisa em Atividade Física, Saúde e Lazer, Faculdade de Esportes, Universidade do Porto. Porto Portugual
| | - Kelly Samara Silva
- Centro de Pesquisa em Atividade Física e Saúde, Departamento de Educação Física, Universidade Federal de Santa Catarina. Florianópolis SC Brasil
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Prevalence of excessive screen time and TV viewing among Brazilian adolescents: a systematic review and meta-analysis. J Pediatr (Rio J) 2019; 95:155-165. [PMID: 29859903 DOI: 10.1016/j.jped.2018.04.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 04/16/2018] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate the prevalence of excessive screen-based behaviors among Brazilian adolescents through a systematic review with meta-analysis. DATA SOURCE Systematic review and meta-analysis were recorded in the International Prospective Register of Ongoing Systematic Reviews (PROSPERO-CRD 2017 CRD42017074432). This review included observational studies (cohort or cross-sectional) that evaluated the prevalence of excessive screen time (i.e. combinations involving different screen-based behaviors) or TV viewing (≥2h/day or >2h/day in front of screen) through indirect or direct methods in adolescents aged between 10 and 19 years. The research strategy included the following databases: MEDLINE, LILACS, SciELO and ADOLEC. The search strategy included terms for "screen time", "Brazil", and "prevalence". Random effect models were used to estimate the prevalence of excessive screen time in different categories. DATA SUMMARY Twenty-eight out of 775 studies identified in the search met the inclusion criteria. The prevalence of excessive screen time and TV viewing was 70.9% (95% CI: 65.5-76.1) and 58.8% (95% CI: 49.4-68.0), respectively. There was no difference between sexes in both analyses. The majority of studies included showed a low risk of bias. CONCLUSIONS The prevalence of excessive screen time and TV viewing was high among Brazilian adolescents. Intervention are needed to reduce the excessive screen time among adolescents.
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Schaan CW, Cureau FV, Sbaraini M, Sparrenberger K, Kohl III HW, Schaan BD. Prevalence of excessive screen time and TV viewing among Brazilian adolescents: a systematic review and meta‐analysis. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2019. [DOI: 10.1016/j.jpedp.2018.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Martin K, Porritt K, Aromataris E. Effectiveness of interventions to control screen use and children's sleep, cognitive and behavioral outcomes: a systematic review protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2018; 16:1338-1345. [PMID: 29894401 DOI: 10.11124/jbisrir-2017-003522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
REVIEW QUESTIONS.
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Affiliation(s)
- Katie Martin
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
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38
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Patterson R, McNamara E, Tainio M, de Sá TH, Smith AD, Sharp SJ, Edwards P, Woodcock J, Brage S, Wijndaele K. Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: a systematic review and dose response meta-analysis. Eur J Epidemiol 2018; 33:811-829. [PMID: 29589226 PMCID: PMC6133005 DOI: 10.1007/s10654-018-0380-1] [Citation(s) in RCA: 690] [Impact Index Per Article: 115.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 03/12/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE To estimate the strength and shape of the dose-response relationship between sedentary behaviour and all-cause, cardiovascular disease (CVD) and cancer mortality, and incident type 2 diabetes (T2D), adjusted for physical activity (PA). Data Sources: Pubmed, Web of Knowledge, Medline, Embase, Cochrane Library and Google Scholar (through September-2016); reference lists. Study Selection: Prospective studies reporting associations between total daily sedentary time or TV viewing time, and ≥ one outcome of interest. Data Extraction: Two independent reviewers extracted data, study quality was assessed; corresponding authors were approached where needed. Data Synthesis: Thirty-four studies (1,331,468 unique participants; good study quality) covering 8 exposure-outcome combinations were included. For total sedentary behaviour, the PA-adjusted relationship was non-linear for all-cause mortality (RR per 1 h/day: were 1.01 (1.00-1.01) ≤ 8 h/day; 1.04 (1.03-1.05) > 8 h/day of exposure), and for CVD mortality (1.01 (0.99-1.02) ≤ 6 h/day; 1.04 (1.03-1.04) > 6 h/day). The association was linear (1.01 (1.00-1.01)) with T2D and non-significant with cancer mortality. Stronger PA-adjusted associations were found for TV viewing (h/day); non-linear for all-cause mortality (1.03 (1.01-1.04) ≤ 3.5 h/day; 1.06 (1.05-1.08) > 3.5 h/day) and for CVD mortality (1.02 (0.99-1.04) ≤ 4 h/day; 1.08 (1.05-1.12) > 4 h/day). Associations with cancer mortality (1.03 (1.02-1.04)) and T2D were linear (1.09 (1.07-1.12)). CONCLUSIONS Independent of PA, total sitting and TV viewing time are associated with greater risk for several major chronic disease outcomes. For all-cause and CVD mortality, a threshold of 6-8 h/day of total sitting and 3-4 h/day of TV viewing was identified, above which the risk is increased.
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Affiliation(s)
- Richard Patterson
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, W6 8RP, UK.
| | - Eoin McNamara
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Marko Tainio
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Thiago Hérick de Sá
- Centre for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Andrea D Smith
- Research Department of Behavioural Science and Health, University College London, London, WC1E 6BT, UK
| | - Stephen J Sharp
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Phil Edwards
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - James Woodcock
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Søren Brage
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Katrien Wijndaele
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
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Shrestha N, Grgic J, Wiesner G, Parker A, Podnar H, Bennie JA, Biddle SJH, Pedisic Z. Effectiveness of interventions for reducing non-occupational sedentary behaviour in adults and older adults: a systematic review and meta-analysis. Br J Sports Med 2018; 53:1206-1213. [DOI: 10.1136/bjsports-2017-098270] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2017] [Indexed: 12/17/2022]
Abstract
BackgroundNo systematic reviews of the effectiveness of interventions for reducing non-occupational sedentary behaviour are available. Therefore, the aim of this systematic review was to assess the effectiveness of interventions for reducing non-occupational sedentary behaviour in adults and older adults.MethodsAn electronic search of nine databases was performed. Randomised controlled trials (RCT) and cluster RCTs among adults testing the effectiveness of interventions aimed to reduce non-occupational sedentary behaviour were considered for inclusion. Two review authors independently screened studies for eligibility, completed data extraction and assessed the risk of bias.ResultsNineteen studies that evaluated multicomponent lifestyle interventions, counselling or education, television (TV) control devices and workplace interventions were included. Evidence from the meta-analyses suggested that interventions can reduce leisure sitting time in adults in the medium term (−30 min/day; 95% CI −58 to –2), and TV viewing in the short term (−61 min/day; 95% CI −79 to –43) and medium term (−11 min/day; 95% CI −20 to –2). No significant pooled effects were found for transport sitting time, leisure-time computer use and longer term outcomes. No evidence was available on the effectiveness of interventions for reducing non-occupational sedentary time in older adults.ConclusionsThe findings of this systematic review suggest the interventions may be effective in reducing non-occupational sedentary behaviour in the short to medium term in adults. However, no significant effect was found on longer term outcomes. The quality of evidence was, however, low to very low. No evidence was available on the effectiveness of non-occupational interventions on reducing sedentary time in older adults. Further high-quality research with larger samples is warranted.
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Abstract
OBJECTIVE Excessive screen time has been associated with a multitude of child health problems. This pilot study examined the feasibility and preliminary outcome of a novel 1-session intervention designed to help parents reduce their child's screen time. METHODS Thirty-nine parents of 5- to 12-year-old children were randomized to the intervention (a combined didactics and hands-on approach focused on technology-specific parenting) or waitlist control group. RESULTS The findings suggested that a sample could be recruited in a reasonable time (6 wk) at a reasonable cost, randomized, and retained at 6 weeks postintervention. Preliminary evidence suggested the intervention, which was implemented with fidelity, was associated with change in technology-specific parenting and 1 of 2 measures of child screen time. Parents reported satisfaction with the intervention and confidence in managing their child's screen time. CONCLUSION The results of this pilot study suggest that this 1-session intervention is a promising approach to managing child screen time.
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Wijndaele K, Sharp SJ, Wareham NJ, Brage S. Mortality Risk Reductions from Substituting Screen Time by Discretionary Activities. Med Sci Sports Exerc 2017; 49:1111-1119. [PMID: 28106621 DOI: 10.1249/mss.0000000000001206] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Leisure screen time, including TV viewing, is associated with increased mortality risk. We estimated the all-cause mortality risk reductions associated with substituting leisure screen time with different discretionary physical activity types, and the change in mortality incidence associated with different substitution scenarios. METHODS A total of 423,659 UK Biobank participants, without stroke, myocardial infarction, or cancer history, were followed for 7.6 (1.4) yr, median (interquartile range [IQR]). They reported leisure screen time (TV watching and home computer use) and leisure/home activities, categorized as daily life activities (walking for pleasure, light do-it-yourself [DIY], and heavy DIY) and structured exercise (strenuous sports and other exercises). Isotemporal substitution modeling in Cox regression provided hazard ratios (95% confidence intervals) for all-cause mortality when substituting screen time (30 min·d) with different discretionary activity types of the same duration. Potential impact fractions estimated the proportional change in mortality incidence associated with different substitution scenarios. RESULTS During 3,202,105 person-years of follow-up, 8928 participants died. Each 30-min·d difference in screen time was associated with lower mortality hazard when modeling substitution of screen time by an equal amount of daily life activities (0.95, 0.94-0.97), as well as structured exercise (0.87, 0.84-0.90). Reallocations from screen time into specific activity subtypes suggested different reductions in mortality hazard: walking for pleasure (0.95, 0.92-0.98), light DIY (0.97, 0.94-1.00), heavy DIY (0.93, 0.90-0.96), strenuous sports (0.87, 0.79-0.95), and other exercises (0.88, 0.84-0.91). The lowest hazard estimates were found when modeling replacement of TV viewing. Potential impact fractions ranged from 4.3% (30-min·d substitution of screen time into light DIY) to 14.9% (TV viewing into strenuous sports). CONCLUSION Substantial public health benefits could be gained by replacing small amounts of screen time with daily life activities and structured exercise. Daily life activities may provide feasible screen time alternatives, if structured exercise is initially too ambitious.
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Affiliation(s)
- Katrien Wijndaele
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UNITED KINGDOM
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Robinson TN, Banda JA, Hale L, Lu AS, Fleming-Milici F, Calvert SL, Wartella E. Screen Media Exposure and Obesity in Children and Adolescents. Pediatrics 2017; 140:S97-S101. [PMID: 29093041 PMCID: PMC5769928 DOI: 10.1542/peds.2016-1758k] [Citation(s) in RCA: 251] [Impact Index Per Article: 35.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2017] [Indexed: 01/27/2023] Open
Abstract
Obesity is one of the best-documented outcomes of screen media exposure. Many observational studies find relationships between screen media exposure and increased risks of obesity. Randomized controlled trials of reducing screen time in community settings have reduced weight gain in children, demonstrating a cause and effect relationship. Current evidence suggests that screen media exposure leads to obesity in children and adolescents through increased eating while viewing; exposure to high-calorie, low-nutrient food and beverage marketing that influences children's preferences, purchase requests, consumption habits; and reduced sleep duration. Some evidence also suggests promise for using interactive media to improve eating and physical activity behaviors to prevent or reduce obesity. Future interdisciplinary research is needed to examine the effects of newer mobile and other digital media exposures on obesity; to examine the effectiveness of additional interventions to mitigate the adverse effects of media exposures on obesity and possible moderators and mediators of intervention effects; to effectively use digital media interventions to prevent and reduce obesity; and to uncover the mechanisms underlying the causal relationships and interactions between obesity-related outcomes and media content, characteristics, and context.
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Affiliation(s)
- Thomas N. Robinson
- Stanford Solutions Science Laboratory, Department of Pediatrics, Stanford University, Stanford, California;,Lucile Packard Children’s Hospital Stanford, Palo Alto, California;,Address correspondence to Thomas N. Robinson, MD, MPH, Stanford Solutions Science Laboratory, Department of Pediatrics, Stanford University, 1265 Welch Rd, MSOB X129, Stanford, CA 94305. E-mail:
| | - Jorge A. Banda
- Stanford Solutions Science Laboratory, Department of Pediatrics, Stanford University, Stanford, California
| | - Lauren Hale
- Program in Public Health, Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, New York
| | - Amy Shirong Lu
- Department of Communication Studies, College of Arts, Media and Design, and,Health Technology Laboratory, Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
| | - Frances Fleming-Milici
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, Connecticut
| | - Sandra L. Calvert
- Children’s Digital Media Center, Department of Psychology, Georgetown University, Washington, District of Columbia; and
| | - Ellen Wartella
- Center on Media and Human Development, School of Communication, Northwestern University, Evanston, Illinois
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Biddle SJH, García Bengoechea E, Wiesner G. Sedentary behaviour and adiposity in youth: a systematic review of reviews and analysis of causality. Int J Behav Nutr Phys Act 2017; 14:43. [PMID: 28351363 PMCID: PMC5371200 DOI: 10.1186/s12966-017-0497-8] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 03/20/2017] [Indexed: 01/08/2023] Open
Abstract
Background Sedentary behaviour (sitting time) has becoming a very popular topic for research and translation since early studies on TV viewing in children in the 1980s. The most studied area for sedentary behaviour health outcomes has been adiposity in young people. However, the literature is replete with inconsistencies. Methods We conducted a systematic review of systematic reviews and meta-analyses to provide a comprehensive analysis of evidence and state-of-the-art synthesis on whether sedentary behaviours are associated with adiposity in young people, and to what extent any association can be considered ‘causal’. Searches yielded 29 systematic reviews of over 450 separate papers. We analysed results by observational (cross-sectional and longitudinal) and intervention designs. Results Small associations were reported for screen time and adiposity from cross-sectional evidence, but associations were less consistent from longitudinal studies. Studies using objective accelerometer measures of sedentary behaviour yielded null associations. Most studies assessed BMI/BMI-z. Interventions to reduce sedentary behaviour produced modest effects for weight status and adiposity. Accounting for effects from sedentary behaviour reduction alone is difficult as many interventions included additional changes in behaviour, such as physical activity and dietary intake. Analysis of causality guided by the classic Bradford Hill criteria concluded that there is no evidence for a causal association between sedentary behaviour and adiposity in youth, although a small dose-response association exists. Conclusions Associations between sedentary behaviour and adiposity in children and adolescents are small to very small and there is little to no evidence that this association is causal. This remains a complex field with different exposure and outcome measures and research designs. But claims for ‘clear’ associations between sedentary behaviour and adiposity in youth, and certainly for causality, are premature or misguided.
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Affiliation(s)
- Stuart J H Biddle
- Institute of Sport, Exercise & Active Living, Victoria University, Melbourne, Australia. .,Institute for Resilient Regions, University of Southern Queensland, Education City, 37 Sinnathamby Boulevard, Springfield Central, QLD, 4300, Australia.
| | - Enrique García Bengoechea
- Institute of Sport, Exercise & Active Living, Victoria University, Melbourne, Australia.,McGill University, Montreal, Canada
| | - Glen Wiesner
- Institute of Sport, Exercise & Active Living, Victoria University, Melbourne, Australia
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Matthews KA, Croft JB, Liu Y, Lu H, Kanny D, Wheaton AG, Cunningham TJ, Khan LK, Caraballo RS, Holt JB, Eke PI, Giles WH. Health-Related Behaviors by Urban-Rural County Classification - United States, 2013. MMWR. SURVEILLANCE SUMMARIES : MORBIDITY AND MORTALITY WEEKLY REPORT. SURVEILLANCE SUMMARIES 2017; 66:1-8. [PMID: 28151923 PMCID: PMC5829834 DOI: 10.15585/mmwr.ss6605a1] [Citation(s) in RCA: 191] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Problem/Condition Persons living in rural areas are recognized as a health disparity population because the prevalence of disease and rate of premature death are higher than for the overall population of the United States. Surveillance data about health-related behaviors are rarely reported by urban-rural status, which makes comparisons difficult among persons living in metropolitan and nonmetropolitan counties. Reporting Period 2013. Description of System The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit-dialed landline- and cellular-telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. BRFSS collects data on health-risk behaviors, chronic diseases and conditions, access to health care, and use of preventive health services related to the leading causes of death and disability. BRFSS data were analyzed for 398,208 adults aged ≥18 years to estimate the prevalence of five self-reported health-related behaviors (sufficient sleep, current nonsmoking, nondrinking or moderate drinking, maintaining normal body weight, and meeting aerobic leisure time physical activity recommendations) by urban-rural status. For this report, rural is defined as the noncore counties described in the 2013 National Center for Health Statistics Urban-Rural Classification Scheme for Counties. Results Approximately one third of U.S. adults practice at least four of these five behaviors. Compared with adults living in the four types of metropolitan counties (large central metropolitan, large fringe metropolitan, medium metropolitan, and small metropolitan), adults living in the two types of nonmetropolitan counties (micropolitan and noncore) did not differ in the prevalence of sufficient sleep; had higher prevalence of nondrinking or moderate drinking; and had lower prevalence of current nonsmoking, maintaining normal body weight, and meeting aerobic leisure time physical activity recommendations. The overall age-adjusted prevalence of reporting at least four of the five health-related behaviors was 30.4%. The prevalence among the estimated 13.3 million adults living in noncore counties was lower (27.0%) than among those in micropolitan counties (28.8%), small metropolitan counties (29.5%), medium metropolitan counties (30.5%), large fringe metropolitan counties (30.2%), and large metropolitan centers (31.7%). Interpretation This is the first report of the prevalence of these five health-related behaviors for the six urban-rural categories. Nonmetropolitan counties have lower prevalence of three and clustering of at least four health-related behaviors that are associated with the leading chronic disease causes of death. Prevalence of sufficient sleep was consistently low and did not differ by urban-rural status. Public Health Action Chronic disease prevention efforts focus on improving the communities, schools, worksites, and health systems in which persons live, learn, work, and play. Evidence-based strategies to improve health-related behaviors in the population of the United States can be used to reach the Healthy People 2020 objectives for these five self-reported health-related behaviors (sufficient sleep, current nonsmoking, nondrinking or moderate drinking, maintaining normal body weight, and meeting aerobic leisure time physical activity recommendations). These findings suggest an ongoing need to increase public awareness and public education, particularly in rural counties where prevalence of these health-related behaviors is lowest.
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Affiliation(s)
- Kevin A Matthews
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Janet B Croft
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Yong Liu
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Hua Lu
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Dafna Kanny
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Anne G Wheaton
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Timothy J Cunningham
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Laura Kettel Khan
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Ralph S Caraballo
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - James B Holt
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Paul I Eke
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Wayne H Giles
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
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Kubik MY, Gurvich OV, Fulkerson JA. Association Between Parent Television-Viewing Practices and Setting Rules to Limit the Television-Viewing Time of Their 8- to 12-Year-Old Children, Minnesota, 2011-2015. Prev Chronic Dis 2017; 14:E06. [PMID: 28103183 PMCID: PMC5268793 DOI: 10.5888/pcd14.160235] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Television (TV) viewing is popular among adults and children, and child TV-viewing time is positively associated with parent TV-viewing time. Efforts to limit the TV-viewing time of children typically target parent rule-setting. However, little is known about the association between parent TV-viewing practices and rule-setting. Methods We used baseline height and weight data and survey data collected from 2011 through 2015 on parents and their 8- to 12-year-old children (N = 212 parent/child dyads) who were participants in 2 community-based obesity prevention intervention trials conducted in metropolitan Minnesota. Multivariable binary logistic regression analysis was used to assess the association between parent TV-viewing time on weekdays or weekend days (dichotomized as ≤2 hrs/d vs ≥2.5 hrs/d) and parent rules limiting child TV-viewing time. Results Child mean age was 10 (standard deviation [SD], 1.4) years, mean body mass index (BMI) percentile was 81 (SD, 16.7), approximately half of the sample were boys, and 42% of the sample was nonwhite. Parent mean age was 41 (SD, 7.5) years, and mean BMI was 29 (SD, 7.5); most of the sample was female, and 36% of the sample was nonwhite. Parents who limited their TV-viewing time on weekend days to 2 hours or fewer per day were almost 3 times more likely to report setting rules limiting child TV-viewing time than were parents who watched 2.5 hours or more per day (P = .01). A similar association was not seen for parent weekday TV-viewing time. Conclusion For most adults and children, a meaningful decrease in sedentariness will require reductions in TV-viewing time. Family-based interventions to reduce TV-viewing time that target the TV-viewing practices of both children and parents are needed.
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Affiliation(s)
- Martha Y Kubik
- Temple University, College of Public Health, Department of Nursing, 3307 North Broad St, Philadelphia, PA 19140.
| | - Olga V Gurvich
- University of Minnesota, School of Nursing, Minneapolis, Minnesota
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Smith JJ, Morgan PJ, Lonsdale C, Dally K, Plotnikoff RC, Lubans DR. Mediators of change in screen-time in a school-based intervention for adolescent boys: findings from the ATLAS cluster randomized controlled trial. J Behav Med 2016; 40:423-433. [DOI: 10.1007/s10865-016-9810-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/04/2016] [Indexed: 10/20/2022]
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Intervention to reduce recreational screen-time in adolescents: Outcomes and mediators from the 'Switch-Off 4 Healthy Minds' (S4HM) cluster randomized controlled trial. Prev Med 2016; 91:50-57. [PMID: 27471018 DOI: 10.1016/j.ypmed.2016.07.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 07/19/2016] [Accepted: 07/23/2016] [Indexed: 01/05/2023]
Abstract
INTRODUCTION The primary objective was to evaluate the impact of the 'Switch-off 4 Healthy Minds' (S4HM) intervention on recreational screen-time in adolescents. METHODS Cluster randomized controlled trial with study measures at baseline and 6-months (post-intervention). Eligible participants reported exceeding recreational screen-time recommendations (i.e., >2h/day). In total, 322 adolescents (mean age=14.4±0.6years) from eight secondary schools in New South Wales, Australia were recruited. The S4HM intervention was guided by Self-Determination Theory and included: an interactive seminar, eHealth messaging, a behavioral contract and parental newsletters. The primary outcome was recreational screen-time. Secondary outcomes included mental health (i.e., well-being, psychological distress, self-perceptions), objectively measured physical activity, and body mass index (BMI). Outcome analyses were conducted using linear mixed models and mediation was examined using a product-of-coefficients test. RESULTS At post-intervention, significant reductions in screen-time were observed in both groups, with a greater reduction observed in the intervention group (-50min/day versus -29min, p<0.05 for both). However, the adjusted difference in change between groups was not statistically significant (mean=-21.3min/day, p=0.255). There were no significant intervention effects for mental health outcomes, physical activity or BMI. Significant mediation effects for autonomous motivation were found. CONCLUSIONS Participants in both the S4HM intervention and control groups significantly reduced their screen-time, with no group-by-time effects. Enhancing autonomous motivation might be a useful intervention target for trials aimed at reducing adolescents' recreational screen-time. TRIAL REGISTRATION ACTRN12614000163606.
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Rider BC, Bassett DR, Strohacker K, Overstreet BS, Fitzhugh EC, Raynor HA. Psycho-Physiological Effects of Television Viewing During Exercise. J Sports Sci Med 2016; 15:524-531. [PMID: 27803632 PMCID: PMC4974866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 07/12/2016] [Indexed: 06/06/2023]
Abstract
We propose that enjoyment is an important factor in the adoption and long-term maintenance of exercise. Television (TV) viewing is believed to be a highly enjoyed leisure-time activity, combining it with exercise may make for a more enjoyable exercise experience. The objective of this study was to examine the effects of television (TV) viewing on psychological and physiological variables during a moderate-intensity exercise bout. Twenty-eight insufficiently active (<150 minutes per week of moderate intensity PA and/or 75 minutes of vigorous PA) adults (Age: M = 47.4 ± 7.6 years) participated in this study. Each participant performed three separate 30-minute walking bouts on a motorized treadmill. During each bout, participants watched a program they selected (30-minute scripted show) (self-selected TV condition), a British Broadcasting Corporation (BBC) nature program (standardized TV condition), or no TV program (no TV condition). Participants were unable to select the nature program as their self-selected program, as it was not a 30-minute scripted program. A Polar Heart Rate (HR) monitor and validated surveys on affect and enjoyment were used. Participants reported greater enjoyment of exercise for both self-selected and standardized TV conditions (97.1 ± 15.2 and 92.7 ± 15.2), compared to the No TV condition (77.5 ± 13.4, p < 0.001). The two TV conditions resulted in similar levels of focus on TV viewing (self-selected TV: 81.2 ± 19.7; standardized TV: 79.1 ± 14.2, p > 0.05) and dissociation from walking (self-selected TV: 38.1 ± 6.7 and standardized TV: 33.2 ± 3.9); they also resulted in more dissociation than the no TV condition (TV: 72.6 ± 5.6, p = 0.002). The findings indicate that TV viewing, regardless of whether the programming is self-selected or standardized, associates with greater enjoyment of exercise.
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Affiliation(s)
- Brian C Rider
- Department of Kinesiology, Recreation, & Sport Studies, Knoxville TN, USA; Department of Kinesiology, Hope College, Holland MI
| | - David R Bassett
- Department of Kinesiology, Recreation, & Sport Studies , Knoxville TN, USA
| | - Kelley Strohacker
- Department of Kinesiology, Recreation, & Sport Studies , Knoxville TN, USA
| | | | - Eugene C Fitzhugh
- Department of Kinesiology, Recreation, & Sport Studies , Knoxville TN, USA
| | - Hollie A Raynor
- Department of Nutrition, The University of Tennessee , Knoxville TN, USA
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