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Obesity Prevention and Control: Behavioral Interventions that Aim to Reduce Recreational Sedentary Screen Time Among Children

Task Force Finding

The Community Preventive Services Task Force recommends behavioral interventions to reduce recreational sedentary screen time among children aged 13 years and younger. This finding is based on strong evidence of effectiveness in reducing recreational sedentary screen time, increasing physical activity, improving diet, and improving or maintaining weight-related outcomes. Evidence includes studies of interventions that focus only on reducing recreational sedentary screen time (screen-time-only) and studies that focus on reducing recreational sedentary screen time and improving physical activity and/or diet (screen-time-plus). Limited evidence was available to assess the effectiveness of these interventions among adults.

Read the full Task Force Finding and Rationale Statement for details including implementation issues, possible added benefits, potential harms, and evidence gaps.

Intervention Definition

Behavioral interventions that aim to reduce recreational (i.e., neither school-related nor work-related) sedentary screen time teach behavioral self-management skills to initiate or maintain behavior change.

Behavioral screen time interventions are classified into two types:

  1. Screen-time-only interventions only focus on reducing recreational sedentary screen time.
  2. Screen-time-plus interventions focus on reducing recreational sedentary screen time and increasing physical activity and/or improving diet.

Screen-time-only and screen-time-plus interventions teach behavioral self-management skills through one or more of the following components:

  • Classroom-based education
  • Tracking and monitoring
  • Coaching or counseling sessions
  • Family-based or peer social support

Interventions may include one or more additional components: use of an electronic monitoring device to limit screen time; TV Turnoff Challenge; screen time contingent on physical activity; or small media.

Screen-time-only and screen-time-plus interventions are stratified by intensity:

  • High-intensity interventions must include use of an electronic monitoring device to limit screen time or at least 3 personal or computer-tailored interactions. Interactions must focus on screen time and may be in person or by phone or computer.
  • Low-intensity interventions include two or fewer personal or computer-tailored interactions.

Childhood obesity has been positively associated with time spent watching TV (Marshall, et al. 2004, Tremblay, et al. 2011). The American Academy of Pediatrics (AAP) recommends no more than 2 hours per day of screen time for children 2 years and older and none for children younger than 2 years (American Academy of Pediatrics 2001). In the U.S., children aged 8-18 years report an average of 7 hours of screen time per day, of which 4.5 hours are spent watching TV content, that is, TV programs, DVDs, or movies, viewed on a TV, computer, cell phone, or other device (Rideout, et al. 2010). Children aged 5 years and younger spend an average of 2 hours per day with screen media (i.e., TV, DVDs, videos, video/computer games), of which approximately 1.5 hours are spent watching TV or videos (Rideout 2011).

About the Systematic Review

The Task Force finding is based on evidence from a Community Guide systematic review completed in 2008 (7 studies with 9 study arms, search period 1966–July 2007) combined with an updated search for evidence in 2013 (42 studies with 52 study arms, search period April 2007–June 2013). The systematic review was conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice, and policy related to obesity prevention and control. This finding updates and replaces the 2008 Task Force findings on Behavioral Interventions to Reduce Screen Time and Mass Media Interventions to Reduce Screen Time.

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Publication Status

Full peer-reviewed articles of this systematic review will be posted on the Community Guide website when published. Subscribe External Web Site Icon to be notified when we post these publications or other materials. See our library for previous Community Guide publications on this and other topics.




Disclaimer

The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC. Task Force evidence-based recommendations are not mandates for compliance or spending. Instead, they provide information and options for decision makers and stakeholders to consider when determining which programs, services, and policies best meet the needs, preferences, available resources, and constraints of their constituents.

Sample Citation

The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services.  Obesity prevention and control: behavioral interventions that aim to reduce recreational sedentary screen time among children (abbreviated). www.thecommunityguide.org/obesity/behavorial.html. Last updated: MM/DD/YYYY.

Review completed: August 2014