Informação do artigo
Abstract
Objective
to evaluate the effects of intervention program strategies on the time spent on activities such as watching television, playing videogames, and using the computer among school children.
Sourcesa search for randomized controlled trials available in the literature was performed in the following electronic databases: PubMed, Lilacs, Embase, Scopus, Web of Science, and Cochrane Library using the following Keywords randomized controlled trial, intervention studies, sedentary lifestyle, screen time, and school. A summary measure based on the standardized mean difference was used with a 95% confidence interval.
Data synthesisa total of 1,552 studies were identified, of which 16 were included in the meta-analysis. The interventions in the randomized controlled trials (n=8,785) showed a significant effect in reducing screen time, with a standardized mean difference (random effect) of: −0.25 (−0.37, −0.13), p<0.01.
Conclusioninterventions have demonstrated the positive effects of the decrease of screentime among schoolchildren.
Keywords:
Child
Adolescent
School health
Sedentary lifestyle
Resumo
Objetivo
avaliar os efeitos das estratégias dos programas de intervenção sobre o tempo dedicado a atividades como assistir à televisão, jogar videogame e usar computador em escolares.
Fonte dos dadosfoi realizada busca de estudos controlados randomizados, disponí- veis nas bases de dados eletrônicas PubMed, Lilacs, Embase, Scopus, Web of Science e Cochrane Library, com os descritores: randomized controlled trial, intervention studies, sedentary lifestyle, screen time e school. Medida de sumário baseada na diferença das médias padronizadas foi usada com intervalo de confiança de 95%.
Síntese dos dadosforam identificados 1.552 estudos, dos quais 16 foram incluídos na metaanálise. As intervenções nos estudos controlados randomizados (n=8.785) apre- sentaram efeito significativo na redução do tempo em frente à tela, com diferença das médias padronizadas (efeito randômico): −0,25 (−0,37; −0,13), p<0,01.
Conclusãoas intervenções mostraram efeitos positivos na redução do tempo em frente à tela em escolares.
Palavras-chave:
Criança
Adolescente
Saúde escolar
Estilo de vida sedentário
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Referências
[1]
World Health Organization (WHO)..
Global recommendations on physical activity for health.
WHO, (2010), pp. 58
[2]
Brasil. Ministério do Planejamento Orçamento e Gestão. Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa Nacional de Saúde do Escolar. Rio de Janeiro: IBGE; 2013.
[3]
P.E. Pardee, G.J. Norman, R.H. Lustig, D. Preud’homme, J.B. Schwimmer.
Television viewing and hypertension in obese children.
Am J Prev Med., 33 (2007), pp. 439-443
[4]
A.E. Mark, I. Janssen.
Relationship between screen time and metabolic syndrome in adolescents.
J Public Health (Oxf)., 30 (2008), pp. 153-160
[5]
W.H. Dietz Jr., S.L. Gortmaker.
Do we fatten our children at the television set?. Obesity and television viewing in children and adolescents.
Pediatrics., 75 (1985), pp. 807-812
[6]
B.A. Dennison, T.A. Erb, P.L. Jenkins.
Television viewing and television in bedroom associated with overweight risk among low-income preschool children.
Pediatrics., 109 (2002), pp. 1028-1035
[7]
J.C. Lumeng, S. Rahnama, D. Appugliese, N. Kaciroti, R.H. Bradley.
Television exposure and overweight risk in preschoolers.
Arch Pediatr Adolesc Med., 160 (2006), pp. 417-422
[8]
S.J. Marshall, S.J. Biddle, T. Gorely, N. Cameron, I. Murdey.
Relationships between media use, body fatness and physical activity in children and youth: a meta-analysis.
Int J Obes Relat Metab Disord., 28 (2004), pp. 1238-1246
[9]
B. Jouret, N. Ahluwalia, C. Cristini, M. Dupuy, L. Nègre-Pages, H. Grandjean, et al.
Factors associated with overweight in preschool-age children in southwestern France.
Am J Clin Nutr., 85 (2007), pp. 1643-1649
[10]
M. Fonseca Vde, R. Sichieri, G.V. da Veiga.
Factors associated with obesity among adolescents.
Rev Saude Publica., 32 (1998), pp. 541-549
[11]
L. Mondini, R.B. Levy, S.R. Saldiva, S.I. Venâncio, J. de Azevedo Aguiar, M.L. Stefanini.
Overweight, obesity and associated factors in first grade schoolchildren in a city of the metropolitan region of São Paulo, Brazil.
Cad Saude Publica., 23 (2007), pp. 1825-1834
[12]
P.D. Campagnolo, M.R. Vitolo, C.M. Gama.
Factors associated with excessive television watching among adolescents.
Rev Bras Med Esporte., 14 (2008), pp. 197-200
[13]
K.S. Silva, M.V. Nahas, L.P. Hoefelmann, A.S. Lopes, E.S. Oliveira.
Associations between physical activity, body mass index, and sedentary behaviors in adolescents.
Rev Bras Epidemiol., 11 (2008), pp. 159-168
[14]
I.R. Rivera, M.A. Silva, R.D. Silva, B.A. Oliveira, A.C. Carvalho.
Physical inactivity, TV-watching hours and body composition in children and adolescents.
Arq Bras Cardiol., 95 (2010), pp. 159-165
[15]
L.G. Coelho, A.P. Cândido, G.L. Machado-Coelho, S.N. Freitas.
Association between nutritional status, food habits and physical activity level in schoolchildren.
J Pediatr (Rio J)., 88 (2012), pp. 406-412
[16]
N. Cain, M. Gradisar.
Electronic media use and sleep in school- aged children and adolescents: a review.
Sleep Med., 11 (2010), pp. 735-742
[17]
C.N. Hart, A. Cairns, E. Jelalian.
Sleep and obesity in children and adolescents.
Pediatr Clin North Am., 58 (2011), pp. 715-733
[18]
D.A. Thompson, D.A. Christakis.
The association between television viewing and irregular sleep schedules among children less than 3 years of age.
Pediatrics., 116 (2005), pp. 851-856
[19]
E.M. Jolin, R.A. Weller.
Television viewing and its impact on childhood behaviors.
Curr Psychiatry Rep., 13 (2011), pp. 122-128
[20]
B.J. Bushman, L.R. Huesmann.
Short-term and long-term effects of violent media on aggression in children and adults.
Arch Pediatr Adolesc Med., 160 (2006), pp. 348-352
[21]
L.R. Huesmann, L.D. Taylor.
The role of media violence in violent behavior.
Annu Rev Public Health., 27 (2006), pp. 393-415
[22]
R. Lowry, H. Wechsler, D.A. Galuska, J.E. Fulton, L. Kann.
Television viewing and its associations with overweight, sedentary lifestyle, and insufficient consumption of fruits and vegetables among US high school students: differences by race, ethnicity, and gender.
J Sch Health., 72 (2002), pp. 413-421
[23]
Y. Aktaş Arnas.
The effects of television food advertisement on children's food purchasing requests.
Pediatr Int., 48 (2006), pp. 138-145
[24]
J.C. Halford, J. Gillespie, V. Brown, E.E. Pontin, T.M. Dovey.
Effect of television advertisements for foods on food consumption in children.
Appetite., 42 (2004), pp. 221-225
[25]
C.M. Moriarty, K. Harrison.
Television exposure and disordered eating among children: a longitudinal panel study.
J Commun., 58 (2008), pp. 361-381
[26]
K. Harrison, V. Hefner.
Media exposure, current and future body ideals, and disordered eating among preadolescent girls: a longitudinal panel study.
J Youth Adolesc., 35 (2006), pp. 153-163
[27]
H. Dohnt, M. Tiggemann.
The contribution of peer and media influences to the development of body satisfaction and self- esteem in young girls: a prospective study.
Dev Psychol., 42 (2006), pp. 929-936
[28]
T.N. Robinson.
Reducing children's television viewing to prevent obesity: a randomized controlled trial.
JAMA., 282 (1999), pp. 1561-1567
[29]
S.L. Gortmaker, K. Peterson, J. Wiecha, A.M. Sobol, S. Dixit, M.K. Fox, et al.
Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health.
Arch Pediatr Adolesc Med., 153 (1999), pp. 409-418
[30]
T.N. Robinson, J.D. Killen, H.C. Kraemer, D.M. Wilson, D.M. Matheson, W.L. Haskell, et al.
Dance and reducing television viewing to prevent weight gain in African-American girls: the Stanford GEMS pilot study.
Ethn Dis., 13 (2003), pp. S65-S77
[31]
S.E. Barlow, Expert Committee.
Expert committee recommen- dations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary re- port.
Pediatrics., 120 (2007), pp. S164-S192
[32]
C.C. Enes, B. Slater.
Obesity in adolescence and its main determinants.
Rev Bras Epidemiol., 13 (2010), pp. 163-171
[33]
R. Telama, X. Yang, J. Viikari, I. Välimäki, O. Wanne, O. Raitakari.
Physical activity from childhood to adulthood: a 21-year tracking study.
Am J Prev Med., 28 (2005), pp. 267-273
[34]
Cochrane handbook for systematic reviews of interventions,
[35]
A.R. Jadad, R.A. Moore, D. Carroll, C. Jenkinson, D.J. Reynolds, D.J. Gavaghan, et al.
Assessing the quality of reports of randomized clinical trials: is blinding necessary?.
Control Clin Trials., 17 (1996), pp. 1-12
[36]
J.P. Higgins, S.G. Thompson.
Quantifying heterogeneity in a meta- analysis.
Stat Med., 21 (2002), pp. 1539-1558
[37]
J.P. Higgins, S.G. Thompson, J.J. Deeks, D.G. Altman.
Measuring inconsistency in meta-analyses.
BMJ., 327 (2003), pp. 557-560
[38]
J. Cohen.
Statistical power analysis for the behavioral sciences.
2a ed., Lawrence Erlbaum Associates, (1988),
[39]
P. Sahota, M.C. Rudolf, R. Dixey, A.J. Hill, J.H. Barth, J. Cade.
Randomised controlled trial of primary school based intervention to reduce risk factors for obesity.
BMJ., 323 (2001), pp. 1029-1032
[40]
M. Story, N.E. Sherwood, J.H. Himes, M. Davis, D.R. Jacobs Jr., Y. Cartwright, et al.
An after-school obesity prevention program for African-American girls: the Minnesota GEMS pilot study.
Ethn Dis., 13 (2003), pp. S54-S64
[41]
M.L. Fitzgibbon, M.R. Stolley, L. Schiffer, L. Van Horn, K. KauferChristoffel, A. Dyer.
Hip-Hop to Health Jr. for Latino preschool children.
Obesity (Silver Spring)., 14 (2006), pp. 1616-1625
[42]
G.D. Foster, S. Sherman, K.E. Borradaile, K.M. Grundy, S.S. Vander Veur, J. Nachmani, et al.
A policy-based school intervention to prevent overweight and obesity.
Pediatrics., 121 (2008), pp. e794-e802
[43]
D. Jones, D.M. Hoelscher, S.H. Kelder, A. Hergenroeder, S.V. Sharma.
Increasing physical activity and decreasing sedentary activity in adolescent girls-the Incorporating More Physical Activity and Calcium in Teens (IMPACT) study.
Int J Behav Nutr Phys Act., 5 (2008), pp. 42
[44]
D.L. Weintraub, E.C. Tirumalai, K.F. Haydel, M. Fujimoto, J.E. Fulton, T.N. Robinson.
Team sports for overweight children: the Stanford Sports to Prevent Obesity Randomized Trial (SPORT).
Arch Pediatr Adolesc Med., 162 (2008), pp. 232-237
[45]
D.A. Gentile, G. Welk, J.C. Eisenmann, R.A. Reimer, D.A. Walsh, D.W. Russell, et al.
Evaluation of a multiple ecological level child obesity prevention program: Switch what you Do.
View, and Chew. BMC Med., 7 (2009), pp. 49
[46]
D.R. Lubans, P.J. Morgan, R. Callister, C.E. Collins.
Effects of integrating pedometers, parental materials, and e-mail support within an extracurricular school sport intervention.
J Adolesc Health., 44 (2009), pp. 176-183
[47]
A.S. Singh, A. Chin, M.J. Paw, J. Brug, W. van Mechelen.
Dutch obesity intervention in teenagers: effectiveness of a school-based program on body composition and behavior.
Arch Pediatr Adolesc Med., 163 (2009), pp. 309-317
[48]
P.M. Sacher, M. Kolotourou, P.M. Chadwick, T.J. Cole, M.S. Lawson, A. Lucas, et al.
Randomized controlled trial of the MEND program: a family-based community intervention for childhood obesity.
Obesity (Silver Spring)., 18 (2010), pp. S62-S68
[49]
M. Bjelland, I.H. Bergh, M. Grydeland, K.I. Klepp, L.F. Andersen, S.A. Anderssen, et al.
Changes in adolescents’ intake of sugar- sweetened beverages and sedentary behaviour: results at 8 month mid-way assessment of the HEIA study–a comprehensive, multi-component school-based randomized trial.
Int J Behav Nutr Phys Act., 8 (2011), pp. 63
[50]
J.J. Puder, P. Marques-Vidal, C. Schindler, L. Zahner, I. Niederer, F. Bürgi, et al.
Effect of multidimensional lifestyle intervention on fitness and adiposity inpredominantly migrant preschool children (Ballabeina): cluster randomised controlled trial.
BMJ., 343 (2011), pp. d6195
[51]
N.P. Ezendam, J. Brug, A. Oenema.
Evaluation of the Web-based computer-tailored FATaintPHAT intervention to promote energy balance among adolescents: results from a school cluster randomized trial.
Arch Pediatr Adolesc Med., 166 (2012), pp. 248-255
[52]
C.C. Kamath, K.S. Vickers, A. Ehrlich, L. McGovern, J. Johnson, V. Singhal, et al.
Clinical review: behavioral interventions to prevent childhood obesity: a systematic review and metaanalyses of randomized trials.
J Clin Endocrinol Metab., 93 (2008), pp. 4606-4615
[53]
S.J. Biddle, S. O’Connell, R.E. Braithwaite.
Sedentary behaviour interventions in young people: a meta-analysis.
Br J Sports Med., 45 (2011), pp. 937-942
[54]
D.M. Maniccia, K.K. Davison, S.J. Marshall, J.A. Manganello, B.A. Dennison.
A meta-analysis of interventions that target children's screen time for reduction.
Pediatrics., 128 (2011), pp. e193-e210
[55]
M.E. Schmidt, J. Haines, A. O’Brien, J. McDonald, S. Price, B. Sherry, et al.
Systematic review of effective strategies for reducing screen time among young children.
Obesity (Silver Spring)., 20 (2012), pp. 1338-1354
[56]
G. Wahi, P.C. Parkin, J. Beyene, E.M. Uleryk, C.S. Birken.
Effectiveness of interventions aimed at reducing screen time in children: a systematic review and meta-analysis of randomized controlled trials.
Arch Pediatr Adolesc Med., 165 (2011), pp. 979-986
[57]
M.S. Tremblay, A.G. LeBlanc, M.E. Kho, T.J. Saunders, R. Larouche, R.C. Colley, et al.
Systematic review of sedentary behaviour and health indicators in school-aged children and youth.
Int J Behav Nutr Phys Act., 8 (2011), pp. 98
[58]
R.A. Fernandes, I.F. Júnior, J.R. Cardoso, E.R. Vaz Ronque, M.R. Loch, A.R. de Oliveira.
Association between regular participation in sports and leisure time behaviors in Brazilian adolescents: a cross-sectional study.
BMC Public Health., 8 (2008), pp. 329
[59]
S.C. Dumith, P.C. Hallal, A.M. Menezes, C.L. Araújo.
Sedentary behavior in adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study.
Cad Saúde Pública., 26 (2010), pp. 1928-1936
[60]
C. Linden, H.G. Ahlborg, J. Besjakov, P. Gardsell, M.K. Karlsson.
A school curriculum-based exercise program increases bone mineral accrual and bone size in prepubertal girls: two-year data from the pediatric osteoporosis prevention (POP) study.
J Bone Miner Res., 21 (2006), pp. 829-835
[61]
K.J. MacKelvie, K.M. Khan, M.A. Petit, P.A. Janssen, H.A. McKay.
A school-based exercise intervention elicits substantial bone health benefits: a 2-year randomized controlled trial in girls.
Pediatrics., 112 (2003), pp. e447
[62]
K.J. MacKelvie, M.A. Petit, K.M. Khan, T.J. Beck, H.A. McKay.
Bone mass and structure are enhanced following a 2-year randomized controlled trial of exercise in prepubertal boys.
Bone., 34 (2004), pp. 755-764
[63]
A.L. Carrel, R.R. Clark, S.E. Peterson, B.A. Nemeth, J. Sullivan, D.B. Allen.
Improvement of fitness, body composition, and insulin sensitivity in overweight children in a school-based exercise program: a randomized, controlled study.
Arch Pediatr Adolesc Med., 159 (2005), pp. 963-968
[64]
E.B. Kahn, L.T. Ramsey, R.C. Brownson, G.W. Heath, E.H. Howze, K.E. Powell, et al.
The effectiveness of interventions to increase physical activity. A systematic review.
Am J Prev Med., 22 (2002), pp. 73-107
[65]
H.S. Hansen, K. Froberg, N. Hyldebrandt, J.R. Nielsen.
A controlled study of eight months of physical training and reduction of blood pressure in children: the Odense schoolchild study.
BMJ., 303 (1991), pp. 682-685
[66]
M.P. Krause, T. Hallage, M.P. Gama, F.L. Goss, R. Robertson, S.G. da Silva.
Association of adiposity, cardiorespiratory fitness and exercise practice with the prevalence of type 2 diabetes in Brazilian elderly women.
Int J Med Sci., 4 (2007), pp. 288-292
[67]
R.G. Mcmurray, J.S. Harrell, S.I. Bangdiwala, C.B. Bradley, S. Deng, A. Levine.
A school-based intervention can reduce body fat and blood pressure in young adolescents.
J Adolesc Health., 31 (2002), pp. 125-132
[68]
O. Perichart-Perera, M. Balas-Nakash, V. Ortiz-Rodríguez, J.A. Morán- Zenteno, J.L. Guerrero-Ortiz, F. Vadillo-Ortega.
A program to improve some cardiovascular risk factors in Mexican school age children.
Salud Publica Mex., 50 (2008), pp. 218-226
[69]
M. Aarnio, T. Winter, J. Peltonen, U.M. Kujala, J. Kaprio.
Stability of leisure-time physical activity during adolescence--a longitudinal study among 16-, 17- and 18-year-old Finnish youth.
Scand J Med Sci Sports., 12 (2002), pp. 179-185
[70]
M.R. Azevedo, C.L. Araújo, M. Cozzensa da Silva, P.C. Hallal.
Tracking of physical activity from adolescence to adulthood: a population-based study.
Rev Saúde Pública., 41 (2007), pp. 69-75
[71]
J.A. Maia, J. Lefevre, A. Claessens, R. Renson, B. Vanreusel, G. Beunen.
Tracking of physical fitness during adolescence: a panel study in boys.
Med Sci Sports Exerc., 33 (2001), pp. 765-771
[72]
D.L. Katz, M. O’Connell, V.Y. Njike, M.C. Yeh, H. Nawaz.
Strategies for the prevention and control of obesity in the school setting: systematic review and meta-analysis.
Int J Obes (Lond)., 32 (2008), pp. 1780-1789
[73]
L.H. Epstein.
Family-based behavioural intervention for obese children.
Int J Obes Relat Metab Disord., 20 (1996), pp. S14-S21
[74]
M.S. Tremblay, R.C. Colley, T.J. Saunders, G.N. Healy, N. Owen.
Physiological and health implications of a sedentary lifestyle.
Appl Physiol Nutr Metab., 35 (2010), pp. 725-740
[75]
R.R. Pate, J.R. O’Neill, F. Lobelo.
The evolving definition of “sedentary”.
Exerc Sport Sci Rev., 36 (2008), pp. 173-178
Como citar este artigo: Friedrich RR, Polet JP, Schuch I, Wagner MB. Effect of intervention programs in schools to reduce screen time: a meta-analysis. J Pediatr (Rio J). 2014;90:232-41.
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