Determinants of Change in Sedentary Behaviour In Young Children: a Systematic Review

Abstract

High levels of sedentary behaviour have been suggested to be harmful in young children and appear to track from early to middle childhood years, suggesting the need to intervene before the behaviour becomes embedded. PURPOSE: To identify determinants of change in sedentary behaviour in young children (≤6 years old). METHODS: Eleven databases were searched up to March 2018. Duplicate paper selection focussed on the inclusion of longitudinal and intervention studies which: a) targeted sedentary behaviour in young children (≤6 years old); b) assessed a within-child change in objectively-measured sedentary behaviour; and c) reported on at least one determinant of sedentary behaviour. Intervention components were coded according to the cluster of behaviour change technique (BCT). Data synthesis was guided by the socio-ecological model and Harvest plots and included duplicate quality assessment. RESULTS: Sixteen studies (4 longitudinal and 12 intervention studies) met the inclusion criteria out of 14,966 papers identified in searches. Five determinants were identified from four longitudinal studies and 21 determinants (i.e. BCT components) were identified from 12 intervention studies. Studies were considered to be of high (n=9) or intermediate (n=7) quality. Interventions targeted a mean of 3.6 (SD 2.4) BCT clusters. The BCT cluster “shaping knowledge” and “antecedents” were targeted in 11 and 8 out of the 12 studies respectively. The following determinants at the interpersonal level were associated with a decrease in sedentary behaviour: goals and planning (i.e. behavioural contract), repetition and substitution (i.e. graded tasks) and reward and treat (i.e. incentives). In single studies, two environmental-level determinants were associated with an increase in sedentary behaviour: afterschool period and transition from childcare to school. CONCLUSION: A limited range of determinants of change in young children’s sedentary behaviour have been studied. Of these, only a few were associated with objectively measured change in sedentary behaviour. There is a need for more evidence, particularly from interventions targeting sedentary behaviour only to provide more robust evidence and to support the development of future interventions.