Sedentary Screen Time Research Articles

Financial Motivation Undermines Maintenance in an Intensive Diet and Activity Intervention

Financial incentives are widely used in health behavior interventions. However, self-determination theory posits that emphasizing financial incentives can have negative consequences if experienced as controlling. Feeling controlled into performing a behavior tends to reduce enjoyment and undermine maintenance after financial contingencies are removed (the undermining effect). We assessed participants' context-specific financial motivation to participate in the Make Better Choices trial—a trial testing four different strategies for improving four health risk behaviors: low fruit and vegetable intake, high saturated fat intake, low physical activity, and high sedentary screen time. The primary outcome was overall healthy lifestyle change; weight loss was a secondary outcome. Financial incentives were contingent upon meeting behavior goals for 3 weeks and became contingent upon merely providing data during the 4.5-month maintenance period. Financial motivation for participation was assessed at baseline using a 7-item scale (α = .97). Across conditions, a main effect of financial motivation predicted a steeper rate of weight regained during the maintenance period, t(165) = 2.15, P = .04. Furthermore, financial motivation and gender interacted significantly in predicting maintenance of healthy diet and activity changes, t(160) = 2.42, P = .016, such that financial motivation had a more deleterious influence among men. Implications for practice and future research on incentivized lifestyle and weight interventions are discussed.

Active gaming in Dutch adolescents: a descriptive study.

BackgroundAdequate levels of physical activity are part of a healthy lifestyle and in this way linked to better health outcomes. For children and adolescents, the physical activity guideline recommends at least 60 minutes of moderate-to-vigorous physical activity every day. However, many adolescents are not physically active enough and they spend a lot of their time on sedentary activities (such as video games). A new generation of video games that require body movements to play them, so-called "active games", could serve to increase physical activity in adolescents. The activity level while playing these games is comparable to light-to-moderate intensity physical activity. The current study aims to increase our understanding of 1) the demographic characteristics of adolescents who play active games regularly (≥ 1 hour per week) and non-regularly (<; 1 hour per week), 2) time spent on active games, 3) the contribution of active games to daily physical activity and 4) the type and amount of activities being replaced by active gaming.MethodsA cross-sectional survey was conducted in a Dutch internet panel, questioning adolescents in conjunction with one of their parents. A random sample of 320 households (with stratification on gender of the parent and the adolescent, the age of the adolescent and the region of the household) was selected that owned a console or application for active video games and that had a child aged 12 through 16 years. 201 child–parent couples (63% response) completed an internet survey with questions about demographics, physical activity and sedentary behaviour, and gaming behaviour. The questionnaire also contained questions designed to assess whether and how active gaming replaces other activities. Besides descriptive analyses, independent t-test, Pearson’s chi-square and Mann–Whitney test (when data were not normally distributed) were used for comparisons between regular and non-regular active gamers.ResultsEleven percent of the adolescents with an active game in their household never used the game. There were no significant differences in gender, education level (of adolescent and parent), ethnicity and sedentary behaviour between regular (n = 65) and non-regular active gamers (n = 114). Adolescents’ (regular and non-regular active gamers) meantime spent on active gaming was 80 (± 136) minutes a week; this potentially amounts to 11% of total physical activity. When time spent on active gaming was included in the calculation of the percentage of adolescents that met the physical activity guideline, the percentage increased significantly (p <; 0.05) from 67 to 73%. According to the adolescents, active gaming mainly replaces sedentary screen time such as TV viewing, internet and non-active gaming. Parental opinions concurred with this appraisal.ConclusionsThe results of this study confirm the idea that active gaming may contribute to an active lifestyle in adolescents, primarily because it potentially contributes substantially to time spent on physical activity. Secondly, active gamers indicate that they spent time on active games which they would have spent otherwise on less active activities.

Screen-based sedentary behaviours among a nationally representative sample of youth: are Canadian kids couch potatoes?

To determine the percentage of Canadian youth meeting screen-time guidelines and to identify characteristics associated with different screen-time behaviours. Using nationally representative data collected from the 2008/2009 Youth Smoking Survey (YSS), we analyzed three screen-time behaviours, cigarette smoking, weekly spending money, self esteem, region and grade by sex, and conducted four logistic regression models to examine factors associated with more than 2 hours a day of sedentary screen time. Of 51 922 Canadian youth in grades 6 to 12, 50.9% spent more than 2 hours per day in screen-based behaviours. The average daily screen time was 7.8 (± 2.3) hours. Males and current smokers were more likely to report over 2 hours per day watching TV and videos or playing video games, whereas students in higher grades and those with weekly spending money were more likely to report playing or surfing on a computer. Youth with higher self-esteem were less likely to report spending over 2 hours per day in each of the three screen-time behaviours examined. Developing a better understanding of the factors associated with more hours of screen time is required to develop and target interventions that reduce screen-time behaviours.

Screen-time Weight-loss Intervention Targeting Children at Home (SWITCH): A randomized controlled trial study protocol

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

Descriptive epidemiology of screen and non-screen sedentary time in adolescents: a cross sectional study

BackgroundMuch attention has been paid to adolescents' screen time, however very few studies have examined non-screen sedentary time (NSST). This study aimed to (1) describe the magnitude and composition of screen sedentary time (SST) and NSST in Australian adolescents, (2) describe the socio-demographic correlates of SST and NSST, and (3) determine whether screen time is an adequate surrogate for total sedentary behaviour in this population.Methods2200 9-16 year old Australians provided detailed use of time data for four days. Non-screen sedentary time (NSST) included time spent participating in activities expected to elicit <3 METs whilst seated or lying down (other than sleeping), excluding screen-based activities (television, playing videogames or using computers). Total sedentary time was the sum of screen time and NSST.ResultsAdolescents spent a mean (SD) of 345 (105) minutes/day in NSST, which constituted 60% of total sedentary time. School activities contributed 42% of NSST, socialising 19%, self-care (mainly eating) 16%, and passive transport 15%. Screen time and NSST showed opposite patterns in relation to key socio-demographic characteristics, including sex, age, weight status, household income, parental education and day type. Because screen time was negatively correlated with NSST (r = -0.58), and exhibited a moderate correlation (r = 0.53) with total sedentary time, screen time was only a moderately effective surrogate for total sedentary time.ConclusionsTo capture a complete picture of young people's sedentary time, studies should endeavour to measure both screen time and NSST.

Make Better Choices (MBC): Study design of a randomized controlled trial testing optimal technology-supported change in multiple diet and physical activity risk behaviors

BackgroundSuboptimal diet and physical inactivity are prevalent, co-occurring chronic disease risk factors, yet little is known about how to maximize multiple risk behavior change. Make Better Choices, a randomized controlled trial, tests competing hypotheses about the optimal way to promote healthy change in four bundled risk behaviors: high saturated fat intake, low fruit and vegetable intake, low physical activity, and high sedentary leisure screen time. The study aim is to determine which combination of two behavior change goals - one dietary, one activity - yields greatest overall healthy lifestyle change.Methods/DesignAdults (n = 200) with poor quality diet and sedentary lifestyle will be recruited and screened for study eligibility. Participants will be trained to record their diet and activities onto a personal data assistant, and use it to complete two weeks of baseline. Those who continue to show all four risk behaviors after baseline recording will be randomized to one of four behavior change prescriptions: 1) increase fruits and vegetables and increase physical activity, 2) decrease saturated fat and increase physical activity, 3) increase fruits and vegetable and decrease saturated fat, or 4) decrease saturated fat and decrease sedentary activity. They will use decision support feedback on the personal digital assistant and receive counseling from a coach to alter their diet and activity during a 3-week prescription period when payment is contingent upon meeting behavior change goals. They will continue recording on an intermittent schedule during a 4.5-month maintenance period when payment is not contingent upon goal attainment. The primary outcome is overall healthy lifestyle change, aggregated across all four risk behaviors.DiscussionThe Make Better Choices trial tests a disseminable lifestyle intervention supported by handheld technology. Findings will fill a gap in knowledge about optimal goal prescription to facilitate simultaneous diet and activity change. Results will shed light on which goal prescription maximizes healthful lifestyle change.Trial RegistrationClinical Trials Gov. Identifier NCT00113672

Update on physical activity including special needs populations

Childhood obesity rates remain high, especially among adolescents, minorities, and children with disabilities. The American Academy of Pediatrics and American Medical Association have released recommendations for childhood obesity treatment and prevention which include interventions related to physical and sedentary activity. This review explores recent updates in the area of physical activity and sedentary behavior related to these recommendations as well as emerging evidence relevant to physical activity among children with disabilities. Safety and access are among some of the environmental barriers to children's participation in extracurricular physical activity that need to be addressed. Analyses of the relationship between physical activity and sedentary screen time continue to show inconsistent results, although evidence in support of active video games is increasing. Children with disabilities are a special subpopulation for whom physical activity should particularly be encouraged. Increased physical activity and decreased sedentary behaviors are essential components of obesity management in children with and without disabilities. Pediatric providers are encouraged to address barriers to physical activity with all families and act as advocates for changes in the local community that support access to physical activity for all children.

A Pilot of a Video Game (DDR) to Promote Physical Activity and Decrease Sedentary Screen Time

We examined the feasibility of Dance Dance Revolution (DDR), a dance video game, in participants' homes, to increase physical activity (PA) and to decrease sedentary screen time (SST). Sixty children (7.5 +/- 0.5 years) were randomized in a 2:1 ratio to DDR or to wait-list control (10-week delay). DDR use was logged, PA was measured objectively by accelerometry. SST was self-reported at weeks 0 and 10. At week 28, after both groups had access to DDR, accelerometry and SST were repeated. Mean use of DDR was 89 +/- 82 (range 0-660 min) min per week (mpw). The DDR group showed increased vigorous PA and a reduction in light PA; the control group showed no increase in moderate and/or vigorous PA (MVPA) although they also had a reduction in light PA. Differences between the groups were not observed. The DDR group also reported a decrease in SST of -1.2 +/- 3.7 h per week (hpw) (P < 0.05), whereas the controls reported an increase of +3.0 +/- 7.7 hpw (nonsignificant). The difference in SST between the groups was significant, with less SST in the DDR group. Between weeks 10 and 28, numeric reductions in SST were reported in both groups. In the DDR group, SST at week 28 (8.8 +/- 6.0 hpw) was lower than baseline (10.5 +/- 5.5 hpw; P < 0.03). This pilot study suggests that DDR reduces SST and may facilitate slight increases in vigorous PA. Further study is needed to better characterize children and contexts in which DDR may promote a healthy lifestyle.

Energy Expenditure of Sedentary Screen Time Compared With Active Screen Time for Children

We examined the effect of activity-enhancing screen devices on children's energy expenditure compared with performing the same activities while seated. Our hypothesis was that energy expenditure would be significantly greater when children played activity-promoting video games, compared with sedentary video games. Energy expenditure was measured for 25 children aged 8 to 12 years, 15 of whom were lean, while they were watching television seated, playing a traditional video game seated, watching television while walking on a treadmill at 1.5 miles per hour, and playing activity-promoting video games. Watching television and playing video games while seated increased energy expenditure by 20 +/- 13% and 22 +/- 12% above resting values, respectively. When subjects were walking on the treadmill and watching television, energy expenditure increased by 138 +/- 40% over resting values. For the activity-promoting video games, energy expenditure increased by 108 +/- 40% with the EyeToy (Sony Computer Entertainment) and by 172 +/- 68% with Dance Dance Revolution Ultramix 2 (Konami Digital Entertainment). Energy expenditure more than doubles when sedentary screen time is converted to active screen time. Such interventions might be considered for obesity prevention and treatment.

Fed Up! Winning the War Against Childhood Obesity

By Susan Okie Washington, DC:Joseph Henry Press, 2005. 322 pp. ISBN: 0-309-09310-4, $27.95 cloth. Fed Up! traces the obesity epidemic through the lives of children, families, teachers, and researchers. Examining the origins of the obesity epidemic, Susan Okie, a family physician and journalist, covers the distance between the “toxic environment” and the family. Sodas, juice, portions, fast food, television, school lunches, and sedentary lifestyles are all environmental factors that parents and families must confront in their efforts to stop the obesity epidemic. This book gives a closeup view of obesity’s effects on children’s lives by recounting children’s and adolescents’ daily struggles with body image, school snacks, the pull to inactivity, and families’ efforts to change lifestyle and behavior. In particular, Okie puts a face on the epidemic—the girls in the fifth-grade class and the articulate teen who struggles with weight. Tracing the “thrifty gene” hypothesis—that such a gene allows storage of calories during times of plenty that can be expended during famine—Okie discusses the interaction between genetics and environment and puts obesity research into action. Chapters on pregnancy and the treatment of obesity are detailed and provide a start for parents who need an in-depth approach to the serious health implications and consequences of childhood obesity. Okie emphasizes that obesity is a family problem: “preventing unhealthy weight gain in American children will require adults to make profound changes in many of their own choices about diet, activity, and lifestyle.” Taking a detailed look at nutrition, Okie describes the rationale for a balanced diet, the dangers of fast food, and the slippery slope of increasing portion sizes, giving parents and families a clear picture of what has gone wrong in children’s nutritional environment. Likewise, a robust discussion of television provides evidence that decreased activity and increased snacking occurs when children and adolescents spend too much time in front of the screen. Okie suggests a variety of physical activities, both individual and group, that can take the place of sedentary screen time, and notes again that this change requires altering the entire family’s behavior. But school physical education, community and nonprofit organizations, and industry are also powerful influences. Among the most interesting parts of the book are the interviews with obesity researchers. Insights into what prompted their dedication to solving the obesity puzzle to examples of their struggles and solutions in their own families provide readers with a unique perspective on the fight for a healthier environment and healthy children. Schools are not spared in Okie’s search for solutions to obesity. Okie investigates the total school environment. School meals, snacks, soda machines, and the faulty economics of unhealthy eating are exposed. The ups and downs of school interventions are reviewed. Positive approaches to school change and the role of parents and teachers as advocates for change are refreshing. One example discussed is “school gardens and greenhouses, student-run fruit and vegetable stands, and farm-to-school programs,” such as the Berkeley, California, Edible Schoolyard. In the strong chapter “Action for Healthy Communities,” Okie recommends community activities including political action to improve school environments and derail food marketing to children, the creation of safe play spaces in the community, and improved food choices in local markets. Such ideas give parents the beginning of an agenda for change. Fed Up! is clear that “teaching children to make choices that add up to a healthier lifestyle requires a degree of sophistication that simply was not necessary for parents in the past.” This book will help parents and families close that gap and directs parents to look at their families, schools, communities, and beyond to improve the health of their children.