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Effectiveness of Screen-Time Interventions on BMI, Daily Screen Use and Diet Behaviours in Preschool Children: A
Shuqing Song1, Xuehui Hua2, Baozhen An1
1School of Educational Sciences, Shanxi Normal University, Taiyuan City, Shanxi Province, China.
Insights
Screen-time interventions modestly reduced body mass index (BMI) in preschoolers but had inconsistent effects on screen use and diet. Tailored strategies are needed, considering age and sex differences.
Area of Science:
- Pediatric Health
- Behavioral Science
- Public Health Interventions
Background:
- Excessive screen time in preschool children is linked to adverse health outcomes.
- Understanding the impact of screen-time interventions is crucial for child development.
- Existing research lacks a comprehensive synthesis of intervention effects on BMI, screen time, and diet.
Purpose of the Study:
- To systematically review and quantitatively synthesize the effects of screen-time interventions on preschool children's body mass index (BMI).
- To evaluate the impact of these interventions on daily screen time and diet-related behaviors.
- To identify moderators influencing intervention effectiveness, such as child's age and sex.
Main Methods:
- A PRISMA 2020-compliant systematic review and meta-analysis of randomized controlled trials (RCTs) involving children aged 2-6 years.
- Searches conducted across major databases (PubMed, Web of Science, Embase, Scopus).
- Random-effects meta-analyses with sensitivity analyses and meta-regression were employed to assess outcomes and moderators.
Main Results:
- Ten RCTs (approx. 2800 children) showed a small but statistically significant reduction in BMI (MD = -0.18 kg/m²).
- Reductions in daily screen time favored intervention groups but were not statistically significant (MD = -27.2 min/day).
- No consistent improvements were observed in diet-related behaviors; BMI effects were attenuated in studies with more girls.
Conclusions:
- Screen-time interventions offer modest BMI benefits for preschoolers but show inconsistent effects on screen use and diet.
- Intervention effectiveness varies by age and sex, indicating a need for personalized approaches.
- Family-centered strategies are recommended to optimize outcomes for preschool children's health.
Objective:
This study aimed to systematically review and quantitatively synthesise the effects of screen-time-focused interventions on body mass index (BMI), daily screen time and diet-related behaviours among preschool children.
Methods:
A PRISMA 2020-compliant systematic review and meta-analysis of randomised controlled trials (RCTs) involving children aged 2-6 years was conducted. Eligible trials targeted screen use via parent education, home-based programs, technology-assisted restriction or digital/app-based interventions, reporting ≥ 1 outcome (BMI, daily screen time or diet). Searches were performed in PubMed, Web of Science, Embase and Scopus. Risk of bias was assessed with RoB 2. Random-effects meta-analyses with Hartung-Knapp adjustment were performed, and heterogeneity (I2, τ2), sensitivity analyses, funnel plots and meta-regression were used to evaluate robustness and moderators.
Results:
Ten RCTs including approximately 2800 preschool children were analysed. Screen-time interventions resulted in a small but statistically significant reduction in BMI compared with controls (MD = -0.18 kg/m2; 95% CI - 0.33 to -0.03; I2 = 92.7%). Reductions in daily screen time favoured intervention groups but were not statistically significant (MD = -27.2 min/day; 95% CI - 66.9 to 12.5; I2 = 99.2%). No consistent improvements were observed for diet-related behaviours. Sensitivity analyses confirmed the robustness of BMI findings. Meta-regression indicated that BMI effects were attenuated in studies with higher proportions of girls, whereas screen-time reductions were greater among older preschool children.
Conclusions:
Screen-time interventions in preschool children yield modest BMI benefits but inconsistent effects on screen use and diet. Age- and sex-related differences in responsiveness highlight the need for tailored, family-centred intervention strategies.
