Journal of Obesity / 2012 / Article / Tab 2

Review Article

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

Table 2

Evaluation of interventions to reduce sedentary behavior in youth.

ReferenceOutcomeKey findingsDemographic disparitiesLimitations
Sedentary behaviorAnthropometricOther

Sedentary behavior studies

Escobar-Chaves et al. [26]Self-reported household media environment and media use by childrenNo detail reportedNo detail reportedAt 6-month F/U, intervention group was less likely to report TV being ON when nobody was watching (AOR = 0.23, ). A trend towards reducing media consumption was also observed in the intervention group.No detail reportedSelf-reported behaviors; small sample size

Robinson [22]Self-reported media use (TV, video tape,and video game) and other SB (e.g., using computer, doing homework, and reading)BMI; waist/hip circumference; triceps skinfold thicknessSelf-reported PA, cardiorespiratory fitness, and dietary behaviorsCompared to controls, intervention group had significant decreases in anthropometric measures, such as BMI (ADJ DIFF = −0.45 kg/m2; ) and triceps skinfold thickness (ADJ DIFF= −1.47 mm; ). Intervention group reported reduced TV and video game use compared to controls.No detail reportedSmall sample size; snacking while watching TV assessed as a proportion

Robinson and Borzekowski [23]Self-reported household media environment, media use, and other activities (e.g., using TV, video, computer, doing homework, and talking with parents)No detail reportedNo detail reportedCompared to controls, intervention group significantly reduced weekday TV viewing (95% CI −1.22 to −0.35; ) and weekday (95% CI −0.48 to −0.01; ) and Saturday (95% CI −1.04 to −0.01; ) video game playing.Greater effects were observed among boys compared to girlsSelf-reported behaviors; and intervention conducted in two schools

Physical activity studies

Slootmaker et al. [27]Self-reported time spent sedentary (TV, computer)BMI; waist/hip circumference; skinfold thickness (biceps, triceps, subscapular, and suprailiac)Self-reported PA; determinants of PA; aerobic fitnessBoys in the intervention group showed significant reduction in sedentary time (−1801 min/week, −3545 to −57, 95% CI; ), after 5-month F/U.SB change was maintained in boys at 5-month F/USelf-reported behaviors; insufficient power due to high dropout rate and separation of analyses

Sedentary behavior and physical activity studies

Epstein et al. [21]Self-reported sedentary activities (e.g., TV, computer use, and talking on phone)Percent over weight; PBF; waist/hip circumferencesPhysical work capacity; activity preference; compliance and choiceAt 6-month F/U, the Sedentary group had greater decrease in percentage overweight than did the Combined and Exercise groups (−18.7 versus −10.3 and −8.7; ) and greater decrease in PBF (−4.7 versus −1.3; ).No detail reportedSelf-report; lack of blinding

Epstein et al. [20]Self-reported SB (TV viewing)BMI; percent overweightPsychological measures, adherence to diet, and PA questionnaireBoys showed larger decrease in percentage overweight than girls in Combined (F = 8.98; ) and Increased activity (F = 4.45; ) groups. At 6-month F/U, boys showed BMI decrease of −1.76 ± 1.86 in Combined group and 0.65 ± 1.37 in Increased activity group. Girls showed BMI increase of 1.00 ± 1.73 for Combined group and decrease of 0.27 ± 1.37 in Increased activity group.Treatment was more effective on boys, and they had better treatment adherence compared to girlsNo detail reported

Jones et al. [28]Self- reported sedentary activities (TV, video, computer/video games)No detail reportedSelf-reported calcium intake; PA; osteoporosis knowledgeRelative to control schools, the intervention significantly reduced duration of student daily TV/video watching (mean difference between I and C = 12.11 min; 95% CI, 11.74 to 12.48; ) and total daily sedentary activity (mean difference between I and C = 16.99 min; 95% CI, 16.59 to 17.50; ).No detail reportedEvaluation at two points only; a small number of groups randomized to treatment conditions; self-reported; limited information on covariates

Robinson et al. [29]Self-reported media use (TV, videotapes, and video games) and eating with TV onBMI; waist circumferenceInsulin and glucose levels; lipid levelsIntervention group showed trends towards BMI decrease (ADJ DIFF = −0.32 kg/m2; 95% CI, −0.11 to 0.12), waist circumference decrease (ADJ DIFF = −0.63 cm; 95% CI, −1.92 to 0.67), and reduced TV, videotape, and video game use (ADJ DIFF = −4.96 hrs/week; 95% CI, −11.41 to 1.49).Type 2 diabetes disproportionately affects girls and AAs; some of greatest increases in childhood obesity among AA girlsSelf-reported behaviors

Salmon et al. [30]Self-reported screen behaviors (TV, computer, and electronic games)BMIPA accelerometer; self-reported enjoyment of PA; FMS; body image; food intakeSignificant intervention effect on BM in BM/FMS group compared to controls, maintained at 6- and 12-month followup (AOR = 0.38; ). BM group reported highest levels of TV viewing compared to other groups .No findings related to anthropometric measures or SBSelf-report; Thepubertal staging not assessed; sample size underpowered; randomization by class

Simon et al. [31]Self-reported SB (e.g., TV, computer)BMI; PBFSelf-reported PA; PA self-efficacy, social support, and intentionIn the intervention group, high SB (>3 hrs/day) was reduced in girls (OR = 0.54; 95% CI, 0.38 to 0.77) and boys (OR = 0.52; 95% CI 0.35 to 0.76).No detail reportedSelf-reported behavior; lack of time to assess intervention effect on health outcomes

Sedentary behavior, physical activity and diet studies

Gortmaker et al. [32]Self-reported media use (TV and video viewing)BMI; triceps skinfold thicknessSelf-reported PA and dietary intakeIntervention reduced TV hrs among girls and boys . In intervention group, obesity prevalence was significantly reduced in girls compared to controls (23.6% to 20.3%), and each hr of TV reduction predicted reduced obesity prevalence (OR = 0.85; 95% CI, 0.75 to 0.97; ).Largest intervention effects observed among AA girls with obesity prevalence significantly reduced. No significant differences observed among boys or Hispanic girls.Self-reported behavior; participation rate of student at baseline was 65% due to required written consent

Sacher et al. [33]Self-reported sedentary activities (e.g., TV, computer)BMI; PBF; waist circumferenceCardiovascular fitness; self-esteem; self-reported PAAt 6-month F/U, intervention group participants had reduced waist circumference -score (−0.47; ) and BMI -score (−0.23; ) compared to controlsNo detail reportedLack of blinding; selective dropout; short followup

F/U, duration of follow-up after intervention completed; TV, television; AOR, adjusted odds ratio; SB, sedentary behavior; PA, physical activity; BMI, body mass index; ADJ DIFF, adjusted difference; CI, confidence interval; min, minutes; PBF, percent body fat; hrs, hours; AA, African American; FMS, fundamental movement skills; BM, behavioural modification; OR, odds ratio.

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