A Review of Different Behavior Modification Strategies Designed to Reduce Sedentary Screen Behaviors in Children

Table 1

Characteristics of randomized controlled trials focused on only reducing sedentary screen behaviors organized by method of reduction and age of children (𝑁=8).

Source	N, age (y), % girls	Delivery location, delivery target, duration	Treatment groups	Target behaviors and SSB goal(s)	Theoretical perspective, strategy to change SSB	Measure of SSB outcomes
Interventions using behavior modification techniques only
Dennison et al. 2004 [51]	(i) 77; (ii) 2.5–5.5; (iii) 50%	(i) Preschool/day care; (ii) Child focused; (iii) 7 sessions, 12 mos	(1) Modified curriculum (↓ TV); (2) Modified curriculum (health and safety)	(i) ↓ TV and video; (ii) Mealtime TV turn off, wk without TV (1)	(i) Not reported; (ii) 4 B Mods: (preplan, + reinforcement, prob solve, stim control) (1)	Self-report: parent report (recall)
Escobar-Chaves et al. 2010 [52]	(i) 202; (ii) 6–9; (iii) 48.5%	(i) Multispecialty medical practice; (ii) Child and parent focused; (iii) 2-h workshop and 6 newsletters, 6 mos	(1) Parent and child activities; (2) No treatment control	(i) TV and other media (DVD, video, handheld games, and computer); (ii) ↓ TV (turn TV off if not watching, no TV at meals, no TV in bedrooms)	(i) Social cognitive theory; (ii) 4 B Mods: (preplan, prob solve, social support, stim control); skill dev training and coaching (1)	Self-report: parent report (recall)
Interventions using behavior modification techniques plus a mandatory electronic TV monitoring device
Epstein et al. 2008 [53]	(i) 70; (ii) 4–7; (iii) 47%	(i) University children’s hospital; (ii) Child and parent focused; (iii) 6 meetings (1/mos), 18 newsletters (1/mos), 24 mos	(1) TV device and monthly newsletter; (2) Normal access to TV and computers	(i) TV and computer; (ii) ↓ TV by 50%	(i) Not reported; (ii) 3 B Mods: (goal set, + reinforcement, stim control); TV device (1)	Electronic: TV Allowance
Interventions using behavior modification techniques plus an optional electronic TV monitoring device
Ford et al. 2002 [54]	(i) 28; (ii) 7–12; (iii) 53.6%	(i) Urban community primary care clinic; (ii) Child and parent focused; (iii) Single session, 1 mos	(1) Counseling and education, plusTV device; (2) Counseling and education	(i) TV, videotape, and video games; (ii) TV budget	(i) Social cognitive theory; (ii) 3 B Mods: (goal set, stim control, self-monitor); optional TV device (1)	Self-report: parent aided child report (recall)
Robinson 1999 [49]	(i) 92; (ii) 8–10; (iii) 46.7%	(i) Elementary school; (ii) Child and parent focused; (iii) 18 sessions, 7 mos	(1) Modified curriculum; (2) Usual school curriculum	(i) TV, videotape, and video games; (ii) 10 day TV turnoff, ↓ SSB 7 h/wk	(i) Social cognitive theory; (ii) 5 B Mods: (goal set, preplan, stim control, self-monitor, social support); optional TV device (1)	Self-report: parent and child report (recall)
Robinson et al. 2003 [55]	(i) 61; (ii) 8–10; (iii) 100%	(i) Community centers and home visits; (ii) Child and parent focused; (iii) 60 dance classes, 5 in home lessons, 5 newsletters, 3 mos	(1) After school dance, home- based behavioral treatment, and TV device; (2) Information-based health education	(i) TV, videotape, and video games; (ii) ↓ TV (2-wk TV-turnoff)	(i) Social cognitive theory; (ii) 5 B Mods: (goal set, modeling, stim control, self-monitor, social support); optional TV device (1)	Self-report: child report (recall)
Todd et al. 2008 [56]	(i) 21; (ii) 8–11; (iii) 0%	(i) University research unit; (ii) Child and parent focused; (iii) 5 monthly meetings, 3 newsletters, and weekly phone contact	(1) Seminar on ↓ media use; (2) Control group	(i) Electronic media (TV, movies, videos, video games, and nonschool related computer and internet use); (ii) ↓ ST ≤ 90 min/day	(i) Not reported; (ii) 4 B Mods: (goal set, preplan, self-monitor, social support); optional TV device and computer software to limit computer and internet use (1)	Self-report: child report (log books)
Ni Mhurchu et al. 2009 [57]	(i) 29; (ii) 9–11; (iii) 38%	(i) University research unit; (ii) Child and parent focused; (iii) Single session, 2 mos	(1) Counseling, education, plus TV device; (2) Counseling and education	(i) TV and total ST (video games, computer, and DVDs); (ii) ↓ TV 1 h/day	(i) Not reported; (ii) 5 B Mods: (goal set, preplan, prob solve, stim control, self-monitor); optional TV device (1)	Self-report: child report (recall)

𝑁: number of participants randomized to conditions; y: years; SSB: sedentary screen behaviors; B: behavior; mos: months; wk: week; numbers in the ( ) in column 5 and 6: treatment groups; B Mods: behavior modification techniques; plan: planning; +: positive; prob solve: problem solving; stim: stimulus; h: hour; dev: development; set: setting; monitor: monitoring; ST: screen time; min: minutes.