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Review
. 2021 May 29:23:101429.
doi: 10.1016/j.pmedr.2021.101429. eCollection 2021 Sep.

What behavior change techniques are associated with effective interventions to reduce screen time in 0-5 year olds? A narrative systematic review

Lesley Lewis  1   2 , Rachel Povey  2 , Sarah Rose  2 , Lisa Cowap  2 , Heather Semper  3 , Alexis Carey  2 , Julie Bishop  1 , David Clark-Carter  2
Affiliations
Review

What behavior change techniques are associated with effective interventions to reduce screen time in 0-5 year olds? A narrative systematic review

Lesley Lewis et al. Prev Med Rep. .

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.

Keywords: Behavior change techniques; Pre-school; Screen time; Young child.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: LL is employed by Public Health Wales where this project was developed.

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Fig. 1
PRISMA flow chart.
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References

    1. Altenburg T.M., Kist-van Holthe J., Chinapaw M.J. Effectiveness of intervention strategies exclusively targeting reductions in children's sedentary time: a systematic review of the literature. Int. J. Behav. Nutr. Phys. Act. 2016;13:65. doi: 10.1186/s12966-016-0387-5. - DOI - PMC - PubMed
    1. Armijo-Olivo S., Stiles C., Hagen N., Biondo P., Cummings G. Assessment of study quality for systematic reviews: a comparison of the Cochrane Collaboration Risk of Bias Tool and the Effective Public Health Practice Project Quality Assessment tool: methodological research. J. Eval. Clin. Pract. 2012;18(1):12–18. doi: 10.1111/j.1365-2753.2010.01516.x. - DOI - PubMed
    1. Bandura A. Prentice-Hall Inc; Englewood Cliffs, NJ: 1986. Social Foundations of Thought and Action: A Social Cognitive Theory.
    1. Behavior Change Techniques Taxonomy. (2020). BCT Taxonomy online training. Retrieved May 2020, from https://www.bct-taxonomy.com/.
    1. Biddle S., O'Connell S., Braithwaite R. Sedentary behavior interventions in young people: a meta-analysis. Br. J. Sports Med. 2011;45(11):937–942. doi: 10.1136/bjsports-2011-090205. - DOI - PubMed

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