Abstract
BackgroundDuring the recent decade presence of digital media, especially handheld devices, in everyday life, has been increasing. Survey data suggests that children and adults spend much of their leisure on screen media, including use of social media and video services. Despite much public debate on possible harmful effects of such behavioral shifts, evidence from rigorously conducted randomized controlled trials in free-living settings, investigating the efficacy of reducing screen media use on physical activity, sleep, and physiological stress, is still lacking. Therefore, a family and home-based randomized controlled trial – the SCREENS trial – is being conducted. Here we describe in detail the rationale and protocol of this study.MethodsThe SCREENS pilot trial was conducted during the fall of 2018 and spring of 2019. Based on experiences from the pilot study, we developed a protocol for a parallel group randomized controlled trial. The trial is being conducted from May 2019 to ultimo 2020 in 95 families with children 4–14 years recruited from a population-based survey. As part of the intervention family members must handover most portable devices for a 2-week time frame, in exchange for classic mobile phones (not smartphones). Also, entertainment-based screen media use during leisure must be limited to no more than 3 hours/week/person. At baseline and follow-up, 7-day 24-h physical activity will be assessed using two triaxial accelerometers; one at the right hip and one the middle of the right thigh. Sleep duration will be assessed using a single channel EEG-based sleep monitor system. Also, to assess physiological stress (only assessed in adults), parameters of 24-h heart rate variability, the cortisol awakening response and diurnal cortisol slope will be quantified using data sampled over three consecutive days. During the study we will objectively monitor the families’ screen media use via different software and hardware monitoring systems.DiscussionUsing a rigorous study design with state-of-the-art methodology to assess outcomes and intervention compliance, analyses of data from the SCREENS trial will help answer important causal questions of leisure screen media habits and its short-term influence on physical activity, sleep, and other health related outcomes among children and adults.Trial registrationNCT04098913 at https://clinicaltrials.gov [20-09-2019, retrospectively registered].
Highlights
During the recent decade presence of digital media, especially handheld devices, in everyday life, has been increasing
– Subjectively assessed sleep quality – The cortisol awakening response and diurnal cortisol obtained from saliva sampling, as markers of physiological stress – Heart rate variability using 24-h assessment, as a marker of physiological stress – Self-reported mental well-being and mood states
The study tests the hypotheses that restricting leisure screen media use to an amount much below habitual levels for a period of two weeks increases leisure time spent being non-sedentary, increases total sleep duration and decreases markers of physiological stress, in families of adults and children
Summary
During the recent decade presence of digital media, especially handheld devices, in everyday life, has been increasing. Survey data suggests that children and adults spend much of their leisure on screen media, including use of social media and video services. Time spent using screen-based media devices is ubiquitous in everyday life of children and adults of the twenty-first century. Results from the same study indicate a pronounced increase in screen time from 2010 to 2015 in British children [1] and an increase in computer use during leisure hours from 2001 to 2016 in most age groups in North America [2] has been reported. Beyond the amount and timing of screen time, data on the number of devices in the household, the age when the child had his/her own smartphone, rules regarding screen media use and screen media culture around family meals, among others, is collected. Data on gender and age will be collected for all participants
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