Abstract
BackgroundApproximately one third of New Zealand children and young people are overweight or obese. A similar proportion (33%) do not meet recommendations for physical activity, and 70% do not meet recommendations for screen time. Increased time being sedentary is positively associated with being overweight. There are few family-based interventions aimed at reducing sedentary behavior in children. The aim of this trial is to determine the effects of a 24 week home-based, family oriented intervention to reduce sedentary screen time on children's body composition, sedentary behavior, physical activity, and diet.Methods/DesignThe study design is a pragmatic two-arm parallel randomized controlled trial. Two hundred and seventy overweight children aged 9-12 years and primary caregivers are being recruited. Participants are randomized to intervention (family-based screen time intervention) or control (no change). At the end of the study, the control group is offered the intervention content. Data collection is undertaken at baseline and 24 weeks. The primary trial outcome is child body mass index (BMI) and standardized body mass index (zBMI). Secondary outcomes are change from baseline to 24 weeks in child percentage body fat; waist circumference; self-reported average daily time spent in physical and sedentary activities; dietary intake; and enjoyment of physical activity and sedentary behavior. Secondary outcomes for the primary caregiver include change in BMI and self-reported physical activity.DiscussionThis study provides an excellent example of a theory-based, pragmatic, community-based trial targeting sedentary behavior in overweight children. The study has been specifically designed to allow for estimation of the consistency of effects on body composition for Māori (indigenous), Pacific and non-Māori/non-Pacific ethnic groups. If effective, this intervention is imminently scalable and could be integrated within existing weight management programs.Trial RegistrationACTRN12611000164998
Highlights
One third of New Zealand children and young people are overweight or obese
The study has been designed to allow for estimation of the consistency of effects on body composition for Māori, Pacific and non-Māori/nonPacific ethnic groups
The family-based intervention described in this paper is the first of its kind in New Zealand and is one of few interventions targeting screen-based sedentary behaviors in the home environment
Summary
One third of New Zealand children and young people are overweight or obese. In New Zealand, more than one third (35.5%) of children and young people aged 5-24 years are overweight or obese [1], which is a level similar to that in other western countries [2]. Current obesity levels are linked to energy imbalance as a result of reduced energy expenditure and increased energy intake [6]. Derived from the Latin term sedere ("to sit”), sedentary behavior refers to sitting and lying activities that do not increase energy expenditure substantially above the resting level. Sedentary behavior includes activities that involve energy expenditure at the level of 1.0-1.5 metabolic equivalent units (METs) (one MET is the energy cost of resting quietly) [8]. Sedentary behavior includes a wide range of activities such as screen-based activities, reading and doing homework
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