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Randomized Controlled Trial
. 2016 Oct:91:50-57.
doi: 10.1016/j.ypmed.2016.07.014. Epub 2016 Jul 26.

Intervention to reduce recreational screen-time in adolescents: Outcomes and mediators from the 'Switch-Off 4 Healthy Minds' (S4HM) cluster randomized controlled trial

Mark J Babic  1 , Jordan J Smith  2 , Philip J Morgan  3 , Chris Lonsdale  4 , Ronald C Plotnikoff  5 , Narelle Eather  6 , Geoff Skinner  7 , Amanda L Baker  8 , Emma Pollock  9 , David R Lubans  10
Affiliations
Randomized Controlled Trial

Intervention to reduce recreational screen-time in adolescents: Outcomes and mediators from the 'Switch-Off 4 Healthy Minds' (S4HM) cluster randomized controlled trial

Mark J Babic et al. Prev Med. 2016 Oct.

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.

Keywords: Physical activity; School; Screen; Sedentary behavior.

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