Review Article

Intervening to Reduce Sedentary Behaviors and Childhood Obesity among School-Age Youth: A Systematic Review of Randomized Trials

Table 1

Description of interventions to reduce sedentary behavior in youth.

ReferenceDesignTheorySettingStudy durationParticipantsInterventionControl

Sedentary behavior studies

Escobar-Chaves et al. [26]RCTNo specific theory reportedConvenient locations (clinics, public libraries, and schools); USI: 6 months
F/U: 6 months
N (C) = 101
N (I) = 101
Mean age (y):
Parents: 40 ± 7.6
Children: 8.2 ± 0.8
Sex:
Parents: 88.6% female
Children: 51.5% male
Race:
Parents: 43.6% white Children: not reported
2-hour workshop and 6 bimonthly newsletters to reduce media consumptionNo detail reported

Robinson [22]RCTSocial cognitive model2 public elementary schools; USI: 6 months
F/U: No detail reported
N (C) = 120
N (I) = 105
Mean age (y):
C: 8.9 ± 0.6
I: 8.9 ± 0.7
Sex:
C: 55.4% male
I: 52.8% male
Race:
C: 80.6% white
I: 77.2% white
18-lesson classroom curriculum to reduce screen time; 14 parent newslettersNo treatment control

Robinson and Borzekowski [23]RCTSocial cognitive theory2 public elementary schools; USI: 6 months
F/U: No detail reported
N (C) = 100
N (I) = 92
Mean age (y): 8.95 ± 0.64
Sex: 46% female
Race: not reported
18 in-class lessons; TV turnoff challenge followed by encouragement to budget TV time to 7 hrs/week; parent newslettersNo detail reported

Physical activity studies

Slootmaker et al. [27]RCTNo detail reported5 secondary schools; The NetherlandsI: 3 months
F/U: 5 months
N (C) = 41
N (I) = 38
Mean age (y):
C: Boys: 14.8 ± 1.4
Girls: 15.0 ± 1.2
I:
Boys: 15.3 ± 1.1
Girls: 15.4 ± 1.1
Sex: 63% female
Race: not reported
Accelerometer; web-based, tailored PA advice to increase PA and decrease SBBrochure with recommendations for PA

Sedentary behavior and physical activity studies

Epstein et al. [21]Randomized trialNo detail reportedClinic; USI: 6 months
F/U: 6 months
N = 61 families
Mean age (y):
Child: 10.1
Sex: 73% female
Race: 96% white
Weekly family-based treatment meetings focused on PA and SB; 3 intervention groups received reinforcement for either reducing sedentary activities, increasing PA, or combinationNot applicable

Epstein et al. [20]Randomized TrialNo detail reportedClinic; USI: 6 months
F/U: 6 months
N = 56
Mean age (y):
Children: 10.4 ± 1.2
Sex: 51.8% male
Race: 94.6% white
Family-based treatment meetings focused on reinforcing increasing PA or combination of reducing SB and increasing PANot applicable

Jones et al. [28]RCTSocial cognitive theory; Transtheoretical modelMiddle schools; USI: 1.5 academic years
F/U: no detail reported
N (C) = 371
N (I) = 347
Mean age (y): 11.6 ± 0.4
Sex: 100% female
Race: 72% white
16-session health curriculum; PE program and school food service component with emphasis on calcium-rich foodsUsual health program

Robinson et al. [29]RCTSocial cognitive modelLow-income neighborhood community centers; USI: 12 weeks
F/U: no detail reported
N (C) = 33
N (I) = 28
Mean age (y):
C: 9.5 ± 0.9
I: 9.5 ± 0.8
Sex: 100% female
Race: 100% AA
60 after-school dance classes plus 5 home lessons to reduce TV timeNewsletters and health education lectures

Salmon et al. [30]RCTSocial cognitive theory; Behavioral choice theoryGovernment schools in low socioeconomic areas; AustraliaI: 1 academic year F/U: 12 monthsN = 306
Mean age (m): 10.8 ± 5
Sex: 51% female
Race: not reported
19 in-class lessons promoting PA and decreasing SB; 3 intervention groups received either behavior modification of PA and SB, movement skill games or combination of bothUsual curriculum

Simon et al. [31]RCTNo detail reportedPublic middle schools; FranceI: 4 school years
F/U: no detail reported
N (C)= 479
N (I) = 475
Mean age (y):
C: 11.7 ± 0.7
I: 11.6 ± 0.6
Sex:
C: 52% male
I: 54% female
Multilevel program focused on changing knowledge/attitudes towards PA and SB; providing environmental opportunities for PAUsual health and PE curriculum

Sedentary behavior, physical activity and diet studies

Gortmaker et al. [32]RCTBehavioral choice theory; Social cognitive theory10 public schools; USI: 2 academic years F/U: No detail reportedN (5 C schools) = 654
N (6 I schools) = 641
Mean age (y): 11.7 ± 0.7
Sex: 48% female
Race:
C: 69% white
I: 63% white
Planet Health curriculum: 32 lessons on reducing TV time, increasing PA, decreasing high-fat food intake, and increasing F/V intakeRegular school curriculum

Sacher et al. [33]RCTSocial cognitive theoryCommunity centers and schools, UKI: 6 months
F/U: 6 months
N (C)= 56
N (I) = 60
Mean age (y):
C: 10.2 ± 1.3
I: 10.3 ± 1.3
Sex: C: 45% females
I: 63% females
Race:
C: 50% white
I: 50% white
18 2-hour group educational and PA sessions, followed by 12-week family swimming pass6-month delayed intervention

RCT, randomized controlled trial; US, United States; I, intervention; F/U, duration of followup after intervention completed; C, control; y, year; TV, television; hrs, hours; PA, physical activity; SB, sedentary behavior; PE, physical education; AA, African American; F/V, fruits and vegetables.
Note: N represented at baseline.