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Interventions to reduce sedentary behaviour in 0-5-year-olds: a systematic review and meta-analysis of randomised
Katherine L Downing1, Jill A Hnatiuk1,2, Trina Hinkley1
1Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Geelong, Victoria, Australia.
Insights
Behavioral interventions significantly reduce sedentary behavior and screen time in young children. Interventions lasting six months or longer and community-based programs are most effective for reducing screen time.
Area of Science:
- Child Health
- Public Health
- Behavioral Science
Background:
- Sedentary behavior in early childhood is a growing public health concern.
- Early childhood is a critical period for establishing lifelong health behaviors.
- Limited evidence exists on the effectiveness of interventions to reduce sedentary behavior in this age group.
Purpose of the Study:
- To evaluate the effectiveness of behavioral interventions targeting sedentary behavior outcomes in early childhood.
- To synthesize findings from randomized controlled trials (RCTs) on early childhood sedentary behavior interventions.
Main Methods:
- Systematic review and meta-analysis of peer-reviewed English language studies.
- Searched multiple electronic databases (e.g., MEDLINE, PsycINFO) for RCTs published up to March 2016.
- Included studies with participants aged ≤5.9 years, reporting sedentary behavior outcomes.
Main Results:
- Meta-analysis of 17 studies revealed significant reductions in screen time (mean difference -17.12 min/day) and sedentary time (mean difference -18.91 min/day).
- Interventions of ≥6 months duration and community-based settings were most effective for reducing screen time.
- Interventions targeting physical activity were more effective for reducing sedentary time than those directly targeting sedentary behavior.
Conclusions:
- Behavioral interventions demonstrate significant effectiveness in reducing sedentary behavior in early childhood.
- Early childhood presents an opportune window for implementing interventions to curb sedentary behaviors.
- Further research may explore optimal intervention strategies for different settings and target behaviors.
Aim Or Objective:
To evaluate the effectiveness of behavioural interventions that report sedentary behaviour outcomes during early childhood.
Design:
Systematic review and meta-analysis.
Data Sources:
Academic Search Complete, CINAHL Complete, Global Health, MEDLINE Complete, PsycINFO, SPORTDiscus with Full Text and EMBASE electronic databases were searched in March 2016.
Eligibility Criteria For Selecting Studies:
Inclusion criteria were: (1) published in a peer-reviewed English language journal; (2) sedentary behaviour outcomes reported; (3) randomised controlled trial (RCT) study design; and (4) participants were children with a mean age of ≤5.9 years and not yet attending primary/elementary school at postintervention.
Results:
31 studies were included in the systematic review and 17 studies in the meta-analysis. The overall mean difference in screen time outcomes between groups was -17.12 (95% CI -28.82 to -5.42) min/day with a significant overall intervention effect (Z=2.87, p=0.004). The overall mean difference in sedentary time between groups was -18.91 (95% CI -33.31 to -4.51) min/day with a significant overall intervention effect (Z=2.57, p=0.01). Subgroup analyses suggest that for screen time, interventions of ≥6 months duration and those conducted in a community-based setting are most effective. For sedentary time, interventions targeting physical activity (and reporting changes in sedentary time) are more effective than those directly targeting sedentary time.
Summary/Conclusions:
Despite heterogeneity in study methods and results, overall interventions to reduce sedentary behaviour in early childhood show significant reductions, suggesting that this may be an opportune time to intervene.
Trial Registration Number:
CRD42015017090.
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