Screen-Time Weight-loss Intervention Targeting Children at Home (SWITCH): a randomized controlled trial

Area of Science:

• Pediatric obesity
• Behavioral science
• Public health interventions

Background:

• Sedentary screen-based behaviors are prevalent in youth, linked to increased energy intake and overweight.
• Previous interventions often focused solely on children, had small samples, or short follow-up periods.
• The SWITCH study addressed these limitations with a home-based, family-delivered approach.

Purpose of the Study:

• To evaluate the effectiveness of the Screen-Time Weight-loss Intervention Targeting Children at Home (SWITCH) study.
• To determine the intervention's impact on body composition, sedentary behavior, physical activity, and diet in overweight/obese children over 24 weeks.
• To assess a home-based, family-centered strategy for reducing screen time.

Main Methods:

• A two-arm, parallel, randomized controlled trial involving 251 children (9-12 years) and their primary caregivers in Auckland, New Zealand.
• The 20-week intervention included face-to-face sessions, monitoring devices, activity packages, online support, and newsletters.
• Primary outcome was change in children's BMI z-score from baseline to 24 weeks.

Main Results:

• No significant difference in BMI z-score change between the intervention and control groups (difference = -0.016; p=0.64).
• A trend towards increased moderate-intensity physical activity was observed in the intervention group (24.3 min/d; p=0.06).
• No significant differences were found for other secondary outcomes.

Conclusions:

• A home-based, family-delivered intervention targeting leisure-time screen use did not significantly reduce screen time or BMI in overweight/obese children.
• The findings suggest that comprehensive family involvement may not be sufficient to alter screen behavior or weight status in this population.
• Further research is needed to identify more effective strategies for managing childhood obesity related to sedentary behaviors.