Associations Between Screen-Based Sedentary Behavior and Cardiovascular Disease Risk Factors in Korean Youth Screen-Time Weight-loss Intervention Targeting Children at Home (SWITCH): a randomized controlled trial Influence of a health education intervention on physical activity and screen time in primary school children: 'Switch Off--Get Active'. Screen-time Weight-loss Intervention Targeting Children at Home (SWITCH): A randomized controlled trial study protocol Investigating children's physical activity and sedentary behavior using ecological momentary assessment with mobile phones. Intervening to Reduce Sedentary Behaviors and Childhood Obesity among School-Age Youth: A Systematic Review of Randomized Trials Effects of Open-Loop Feedback on Physical Activity and Television Viewing in Overweight and Obese Children: A Randomized, Controlled Trial An intervention to preschool children for reducing screen time: a randomized controlled trial. Predictors of response to an intervention modifying physical activity and sedentary behavior in overweight/obese children: attitudes vs. behavior. Decreasing sedentary behaviors in treating pediatric obesity. Kids Out; evaluation of a brief multimodal cluster randomized intervention integrated in health education lessons to increase physical activity and reduce sedentary behavior among eighth graders Randomised controlled trial adapting US school obesity prevention to England Changes in physical activity and sedentary behavior in a randomized trial of an internet-based versus workbook-based family intervention study. The effect of a healthy lifestyle programme on 8–9 year olds from social disadvantage Household factors, family behavior patterns, and adherence to dietary and physical activity guidelines among children at risk for obesity. Evaluation of a multiple ecological level child obesity prevention program: Switch® what you Do, View, and Chew A cluster-randomized controlled trial to reduce sedentary behavior and promote physical activity and health of 8-9 year olds: The Transform-Us! Study
The purpose s of this study were to : 1 ) describe the patterns of screen-based sedentary behaviors  , and 2 ) examine the association between  screen-based sedentary behavior and cardiovascular disease ( CVD ) risk factors in representative Korean children and adolescents , aged 12 to 18 yr , in the Korean National Health and Nutrition Examination Survey .  Screen-based sedentary behavior  was measured using self-report question naires that included items for time spent watching TV and playing PC/video games . Physical activity  was measured using items for frequency and duration of moderate-to-vigorous physical activity ( MVPA )  . CVD risk factors such as body mass index ( BMI ) , waist circumference , LDL cholesterol , HDL cholesterol , total cholesterol , triglycerides , glucose , systolic blood pressure , and diastolic blood pressure were measured . Boys spent more time playing PC/video games , and girls spent more time watching TV . After adjusting for age , gender , annual household income , and MVPA , an additional hour of watching TV was significantly associated with the risk of overweight ( OR 1.17 [ 95 % CI 1.03 - 1.33 ] ) , high abdominal adiposity ( OR 1.27 [ 1.06 - 1.51 ] ) , and low HDL cholesterol ( OR 1.27 [ 1.10 - 1.47 ] ) . An additional hour spent playing PC/video games  also increased the risk of high abdominal adiposity ( OR 1.20 [ 1.03 - 1.40 ] ) . Prospect i ve observations and interventions are needed to determine causal relationships between  screen-based sedentary behavior  and CVD risk profiles in Korean youth Background Screen-based activities , such as watching television ( TV ) , playing video games , and using computers , are common sedentary behaviors among young people and have been linked with increased energy intake and overweight . Previous home-based sedentary behaviour interventions have been limited by focusing primarily on the child , small sample sizes , and short follow-up periods . The SWITCH ( Screen-Time Weight-loss Intervention Targeting Children at Home ) study aim ed to determine the effect of a home-based , family-delivered intervention to reduce screen-based sedentary behaviour on body composition , sedentary behaviour , physical activity , and diet over 24 weeks in overweight and obese children . Methods A two-arm , parallel , r and omized controlled trial was conducted . Children and their primary caregiver living in Auckl and , New Zeal and were recruited via schools , community centres , and word of mouth . The intervention , delivered over 20 weeks , consisted of a face-to-face meeting with the parent/caregiver and the child to deliver intervention content , which focused on training and educating them to use a wide range of strategies design ed to reduce their child ’s screen time . Families were given Time Machine TV monitoring devices to assist with allocating screen time , activity packages to promote alternative activities , online support via a website , and monthly newsletters . Control participants were given the intervention material on completion of follow-up . The primary outcome was change in children ’s BMI z-score from baseline to 24 weeks . Results Children ( n = 251 ) aged 9 - 12 years and their primary caregiver were r and omized to receive the SWITCH intervention ( n = 127 ) or no intervention ( controls ; n = 124 ) . There was no significant difference in change of z BMI between the intervention and control groups , although a favorable trend was observed ( -0.016 ; 95 % CI : -0.084 , 0.051 ; p = 0.64 ) . There were also no significant differences on secondary outcomes , except for a trend towards increased children ’s moderate intensity physical activity in the intervention group ( 24.3 min/d ; 95 % CI : -0.94 , 49.51 ; p = 0.06 ) . Conclusions A home-based , family-delivered intervention to reduce all leisure-time screen use had no significant effect on screen-time or on BMI at 24 weeks in overweight and obese children aged 9 - 12 years . Trial registration Australian New Zeal and Clinical Trials RegistryWebsite : http://www.anzctr.org.auTrial registration number : Low levels of physical activity coupled with high levels of television viewing have been linked with obesity in children . The objective of this study was to assess the efficacy of ' Switch Off-Get Active ' , a 16-week controlled health education intervention , in increasing physical activity and reducing screen time and BMI in primary school children . A secondary objective was to compare children with high and low screen time . Participants were 312 children aged 10.2+/-0.7 years , attending nine schools in areas of social disadvantage . The 10-lesson , teacher-led intervention , conducted in spring 2003 , emphasised self-monitoring , budgeting of time and selective viewing . Differences , adjusted for baseline values by ANCOVA , existed between intervention and control children at follow-up for self-reported physical activity ( intervention + 0.84 30 min blocks/day , 95%CI 0.11 - 1.57 , p<0.05 ) and self-efficacy for physical activity ( p<0.05 ) but not self-reported screen time ( intervention--0.41 blocks/day , 95%CI--0.93 - 0.12 , p=0.13 ) or BMI ( p=0.63 ) . Cross-sectional comparisons at baseline indicated lower physical activity , self-efficacy for physical activity and aerobic fitness and a higher BMI in children with high screen time . In conclusion , health education interventions can increase physical activity in primary school children but follow-ups of longer duration may be needed to demonstrate intervention effects on BMI Background Approximately one third of New Zeal and 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 aim ed 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 / Design The study design is a pragmatic two-arm parallel r and omized controlled trial . Two hundred and seventy overweight children aged 9 - 12 years and primary caregivers are being recruited . Participants are r and omized 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 st and ardized body mass index ( z BMI ) . 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 . Discussion This study provides an excellent example of a theory-based , pragmatic , community-based trial targeting sedentary behavior in overweight children . The study has been specifically design ed 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 Registration The risk of obesity during childhood can be significantly reduced through increased physical activity and decreased sedentary behavior . Recent technological advances have created opportunities for the real-time measurement of these behaviors . Mobile phones are ubiquitous and easy to use , and thus have the capacity to collect data from large numbers of people . The present study tested the feasibility , acceptability , and validity of an electronic ecological momentary assessment ( EMA ) protocol using electronic surveys administered on the display screen of mobile phones to assess children 's physical activity and sedentary behaviors .  A total of 121 children ( ages 9 - 13 , 51 % male , 38 % at risk for overweight/overweight ) participated in EMA monitoring from Friday afternoon to Monday evening during children 's nonschool time , with 3 - 7 surveys/day . Items assessed current activity ( e.g. , watching TV/movies , playing video games , active play/sports/exercising ) . Children simultaneously wore an Actigraph GT2 M accelerometer . EMA survey responses were time-matched to total step counts and minutes of moderate-to-vigorous physical activity ( MVPA ) occurring in the 30 min before each EMA survey prompt . No significant differences between answered and unanswered EMA surveys were found for total steps or MVPA . Step counts and the likelihood of 5 + min of MVPA were significantly higher during EMA-reported physical activity ( active play/sports/exercising ) vs. sedentary behaviors ( reading/computer/homework , watching TV/movies , playing video games , riding in a car ) ( P < 0.001 ) . Findings generally support the acceptability and validity of a 4-day EMA protocol using mobile phones to measure physical activity and sedentary behavior in children during leisure time Objective . To assess the effectiveness of interventions that focus on reducing  sedentary behavior ( SB ) among school-age youth and to identify elements associated with interventions ' potential for translation into practice setting s. Methods . A comprehensive literature search was conducted using 4 data bases for peer- review ed studies published between 1980 and April 2011 . R and omized trials , which lasted at least 12 weeks , aim ed at decreasing  SB among children aged 6 to 19 years were identified . Results . Twelve studies were included ; 3 focused only on SB , 1 focused on  physical activity ( PA )  , 6 were combined SB and PA interventions , and 2 studies targeted SB , PA , and diet .  The majority of the studies were conducted in a school setting , while others were conducted in such setting s as clinics , community centers , and libraries . Conclusions . Overall , interventions that focused on decreasing SB were associated with reduction in time spent on SB and /or improvements in anthropometric measurements related to childhood obesity . Several of the studies did consider elements related to the intervention 's potential for translation into practice setting OBJECTIVES . Television viewing and physical inactivity increase the risk of obesity in youth . Thus , identifying new interventions that increase physical activity and reduce television viewing would be helpful in the prevention and treatment of pediatric obesity . This study evaluated the effects of open-loop feedback plus reinforcement versus open-loop feedback alone on  physical activity , targeted sedentary behavior , body composition , and energy intake in youth . METHODS . Thirty overweight or obese 8- to 12-year-old children were r and omly assigned to an  intervention ( n = 14 ) or control group ( n = 16 ) . Participants wore accelerometers every day for 8 weeks and attended biweekly meetings to download the activity monitors . For children in the open-loop feedback plus reinforcement ( intervention ) group , accumulating 400 counts of physical activity on pedometers earned 1 hour of television/VCR/DVD time , which was controlled by a Token TV electronic device . Open-loop feedback control subjects wore activity monitors but had free access to targeted sedentary behavior . RESULTS . Compared with controls , the open-loop feedback plus reinforcement group demonstrated significantly greater increases in daily physical activity counts ( + 65 % vs + 16 % ) and minutes per day of moderate-to-vigorous physical activity ( + 9.4 vs + 0.3 ) and greater reductions in minutes per day spent in television viewing ( −116.1 vs + 14.3 ) . The intervention group also showed more favorable changes in body composition , dietary fat intake , and energy intake from snacks compared with controls . Reductions in sedentary behavior were directly related to reductions in BMI , fat intake , snack intake , and snack intake while watching television . CONCLUSIONS . Providing feedback of physical activity in combination with reinforcing physical activity with sedentary behavior is a simple method of modifying the home environment that may play an important role in treating and preventing child obesity BACKGROUND Screen time , defined as time spent watching television , DVDs , or videos or playing computer or video games , has been related to serious health consequences in children , such as impaired language acquisition , violent behaviour , tobacco smoking and obesity . Our aim was to determine if a simple intervention aim ed at preschool-aged children , applied at the health maintenance visits , in the primary care setting , would be effective in reducing screen time . METHODS We used a two group r and omized controlled trial design . Two- to 6-year-old children and their parents were r and omly assigned to receive an intervention to reduce their screen time , BMI and parental report of aggressive behaviour . At the end of the intervention we made home visits at 2 , 6 and 9 months and the parents completed question naire . RESULTS Parents in the intervention group reported less screen time and less aggressive behaviour than those in the control group but there were no differences in BMI z scores . CONCLUSIONS This study shows that a preschool-based intervention can lead to reductions in young children 's television/video viewing OBJECTIVE To compare liking and other attitudes toward physical activity ( PA )  and  television ( TV ) viewing versus PA behavior and time viewing TV at baseline as predictors of response to lifestyle intervention in 30 , 8 to 12 year old overweight/obese children . METHOD Secondary analyses from a r and omized controlled trial design ed to increase PA and reduce sedentary behavior . PA  was measured by accelerometers worn by participants every day for 8 weeks .  TV viewing at baseline and during intervention was assessed by self-report . RESULTS Multiple regression analyses showed that base rates of PA and TV viewing significantly predicted changes in PA ( Beta = .39 , P < .05 ) and TV viewing ( Beta = .37 , P < .05 ) during the intervention , even after statistically controlling for child age , gender , body mass index , as well as baseline attitudes and liking of PA and TV viewing . However , self-reported liking of TV viewing and PA , perceived adequacy , and predilection were not predictive of response to intervention . CONCLUSIONS Baseline measure of PA and TV viewing behaviors may be better predictors of response to lifestyle intervention than measure of liking and other attitudinal variables of PA . The theoretical and clinical implication s of these findings are discussed BACKGROUND Epidemiological studies have shown television watching to be a risk factor for the development of obesity in children . The effect of reducing television watching and other sedentary behaviors as a component of a comprehensive obesity treatment program has not been thoroughly tested . OBJECTIVE To compare the influence of targeting decreases in sedentary behavior vs. increases in physical activity in the comprehensive treatment of obesity in 8- to 12-year-old children . DESIGN R and omized , controlled outcome study . SETTING Childhood obesity research clinic . DESIGN Ninety families with obese 8- to 12-year-old children were r and omly assigned to groups that were provided a comprehensive family-based behavioral weight control program that included dietary , and behavior change information but differed in whether sedentary or physically active behaviors were targeted and the degree of behavior change required . RESULTS Results during 2 years showed that targeting either decreased sedentary behaviors or increased physical activity was associated with significant decreases in percent overweight and body fat and improved aerobic fitness . Self-reported activity minutes increased and targeted sedentary time decreased during treatment . Children substituted nontargeted sedentary behaviors for some of their targeted sedentary behaviors . CONCLUSION These results support reducing sedentary behaviors as an adjunct in the treatment of pediatric obesity Background Most Finnish adolescents are not sufficiently physically active . Health education ( HE ) provides beneficial starting point for physical activity ( PA ) promotion in schools . This study evaluates an intervention integrated into three HE lessons to increase  PA and reduce sedentary behavior ( SB )  among eighth grade rs . Methods All public secondary schools in Tampere , Finl and participated and were r and omized to intervention ( INT , n = 7 ) and comparison group ( COM , n = 7 ) . In INT ( 690 students , 36 classes ) the teachers ( n = 14 ) implemented behavioral theory-driven content during three HE lessons . In COM ( 860 students , 41 classes ) the teachers ( n = 14 ) carried out st and ard lessons . The evaluation was based on RE- AIM : Effectiveness was assessed from baseline to 4 weeks ( Follow-up 1 ) and Maintenance from 4 weeks to 7 months ( Follow-up 2 ) with change in students ’ PA and SB and related psychosocial and parental factors . Methods included question naire , accelerometer  and  activity diary . Linear mixed models with baseline adjustments and r and om effect correction were used to compare the difference in change between INT and COM . Data on Reach , Adoption and Implementation were collected during the process . Results Intervention effects were only seen in the self-reported data favoring INT in the weekly number of days with at least 1 h of brisk leisure PA ( 0.3 [ 95%CI 0.1 to 0.6 ] ) , proportion of students meeting PA recommendations ( 4.1 [ 95%CI 2.5 to 5.7 ] ) , proportion of students reporting that their family sets limitations for screen time ( 5.4 [ 95%CI 3.3 to 7.4 ] ) and in the number of days on which the students intended to do leisure PA in the following week ( 0.3 [ 95%CI 0.1 to 0.6 ] ) . The effects on PA were still beneficial for INT at Follow-up 2 . The intervention reached 96 % of the students , was adopted in all 7 schools and was implemented by 13/14 teachers in 35/36 classes . Conclusions The intervention was feasible and had small favorable effects on students ’ self-reported PA , intention to do PA and family norm in screen time . The effects on PA persisted until Follow-up 2 . It is likely that for greater impacts the HE lessons should have been supported with other actions without compromising feasibility . Trial registration NCT01633918 ( June 27th , 2012 ) Objectives : To determine whether a  school obesity prevention project developed in the United States can be adapted for use in Engl and . Methods : A pilot cluster r and omised controlled trial and interviews with teachers were carried out in 19 primary schools in South West Engl and . Participants included 679 children in year 5 ( age 9–10 ) . Baseline and follow-up assessment s were completed for 323 children ( screen viewing ) and 472 children ( body mass index ) .  Sixteen lessons on healthy eating , physical activity and reducing TV viewing were taught over 5 months by teachers . Main outcome measures were hours of screen activities , body mass index , mode of transport to school and teachers ’ views of the intervention . Results : Children from intervention schools spent less time on screen-viewing activities after the intervention but these differences were imprecisely estimated : mean difference in minutes spent on screen viewing at the end of the intervention ( intervention schools minus control schools ) adjusted for baseline levels and clustering within schools was −11.6 ( 95 % CI −42.7 to 19.4 ) for a week day and was −15.4 ( 95 % CI −57.5 to 26.8 ) for a Saturday . There was no difference in mean body mass index or the odds of obesity . Conclusions : It is feasible to transfer this US school-based intervention to UK schools , and it may be effective in reducing the time children spend on screen-based activities . The study has provided information for a full-scale trial , which would require 50 schools ( ∼1250 pupils ) to detect effects on screen viewing and body mass index over 2 years of follow-up BACKGROUND The America on the Move ( AOM ) Family Intervention Program has been shown to prevent excess weight gain in overweight children . Providing intervention material s via the internet would have the potential to reach more families but may increase sedentary behavior . The purpose was to evaluate whether delivering the AOM Family Intervention via the internet versus printed workbook would have a similar impact on sedentary behaviors in children . METHODS 131 children ( age 8 - 12 ) were r and omized to receive the AOM Family Intervention via the internet or workbook for 12 weeks . Changes in objective ly measured sedentary time and moderate-to vigorous physical activity ( MVPA ) as well as self-reported screen time were compared between groups . RESULTS There were no significant differences between groups in screen time , sedentary time , or MVPA at the end of the 12 week intervention . Families receiving the intervention via the internet were more likely to remain in the study ( 98 % vs. 82 % , P = .016 ) . CONCLUSIONS Using the internet to deliver the lifestyle intervention did not increase  sedentary behavior in children . Attrition rates were lower when the program was delivered by internet versus via printed material s. These results provide support for using the internet to deliver healthy lifestyle programs for children Aims This study assessed the efficacy of a school-based healthy lifestyle intervention ( Sport for LIFE ) for increasing physical activity , decreasing sedentary behaviour , reducing screen time behaviour , encouraging healthy attitudes and behaviour to nutrition , and reducing body mass index ( BMI ) in 8–9-year-old primary school children from lower socioeconomic background s in Northern Irel and . Methods A non-r and omised controlled trial of 416 children from 24 schools took part . Schools were r and omly assigned to one of two groups , an intervention or control group with 12 schools in each group . The intervention group received a 12-week school-based programme based on social cognitive theory . At baseline and follow-up , groups completed question naires assessing physical activity , screen time behaviour and dietary patterns . On each occasion anthropometric assessment  s of height and weight were taken . Physical activity and sedentary behaviour were measured by accelerometry . Results Significant effects were observed for vigorous , moderate and light activity for the intervention group at follow-up . Sedentary behaviour was significantly reduced for the intervention group but not for the control group . No significant effects of the intervention on BMI , screen time behaviour or attitudes to nutrition , with the exception of non-core foods , were shown . Conclusions The programme was effective in increasing physical activity and reducing sedentary behaviour , however no significant changes in screen time behaviour and attitude to nutrition , with the exception of non-core foods , were observed . Future research ideas are offered for tackling low levels of physical activity in children OBJECTIVE To describe the proportion of children adhering to recommended physical activity and dietary guidelines , and examine demographic and household correlates of guideline adherence . DESIGN Cross-sectional ( pre-r and omization ) data from a behavioral intervention trial design ed to prevent unhealthy weight gain in children . PARTICIPANTS A total of 421 children ( aged 5 - 10 years ) at risk for obesity ( body mass index percentile , 70 - 95 ) . MAIN OUTCOMES MEASURED Physical activity ( accelerometry ) , screen time ( parent survey ) , and fruit and vegetable and sugar-sweetened beverage intake ( 24-hour dietary recall ) . ANALYSIS Proportions meeting guidelines were calculated . Logistic regression examined associations between demographic and household factors and whether children met recommended guidelines for ( 1 ) physical activity ( ≥ 60 min/d ) , ( 2  ) screen time  ( ≤ 2 h/d ) , ( 3 ) fruit and vegetable intake ( ≥ 5 servings/d ) , and ( 4 ) sugar-sweetened beverage avoidance . RESULTS Few children met more than 1 guideline . Only 2 % met all 4 recommended guidelines and 19 % met none . Each guideline had unique sociodemographic and domain-specific household predictors ( ie , availability of certain foods and beverages , media , and active play and exercise equipment ) . CONCLUSIONS AND IMPLICATION S Families equipped to promote healthy child behavior patterns in 1 activity or dietary domain may not be in others . Results have implication s for the development of interventions to affect children 's weight-related behaviors and growth trajectories Background Schools are the most frequent target for intervention programs aim ed at preventing child obesity ; however , the overall effectiveness of these programs has been limited . It has therefore been recommended that interventions target multiple ecological levels ( community , family , school and individual ) to have greater success in changing risk behaviors for obesity . This study examined the immediate and short-term , sustained effects of the Switch program , which targeted three behaviors ( decreasing children 's screen time , increasing fruit and vegetable consumption , and increasing physical activity ) at three ecological levels ( the family , school , and community ) . Methods Participants were 1,323 children and their parents from 10 schools in two states . Schools were matched and r and omly assigned to treatment and control . Measures of the key behaviors and body mass index were collected at baseline , immediately post-intervention , and 6 months post-intervention . Results The effect sizes of the differences between treatment and control groups ranged between small ( Cohen 's d = 0.15 for body mass index at 6 months post-intervention ) to large ( 1.38 ; parent report of screen time at 6 months post-intervention ) , controlling for baseline levels . There was a significant difference in parent-reported screen time at post-intervention in the experimental group , and this effect was maintained at 6 months post-intervention ( a difference of about 2 hours/week ) . The experimental group also showed a significant increase in parent-reported fruit and vegetable consumption while child-reported fruit and vegetable consumption was marginally significant . At the 6-month follow-up , parent-reported screen time was significantly lower , and parent and child-reported fruit and vegetable consumption was significantly increased . There were no significant effects on pedometer measures of physical activity or body mass index in the experimental group . The intervention effects were moderated by child sex ( for fruit and vegetable consumption , physical activity , and weight status ) , family involvement ( for fruit and vegetable consumption ) , and child body mass index ( for screen time ) . The perception of change among the experimental group was generally positive with 23 % to 62 % indicating positive changes in behaviors . Conclusion The results indicate that the Switch program yielded small-to-modest treatment effects for promoting children 's fruit and vegetable consumption and minimizing screen time . The Switch program offers promise for use in youth obesity prevention Background Physical activity ( PA ) is associated with positive cardio-metabolic health and emerging evidence suggests sedentary behavior ( SB ) may be detrimental to children 's health independent of PA . The primary aim of the Transform-Us ! study is to determine whether an 18-month , behavioral and environmental intervention in the school and family setting s results in higher levels of PA and lower rates of SB among 8 - 9 year old children compared with usual practice ( post-intervention and 12-months follow-up ) . The secondary aims are to determine the independent and combined effects of PA and SB on  children 's cardio-metabolic health risk factors ; identify the factors that mediate the success of the intervention ; and determine whether the intervention is cost-effective . Methods / design A four-arm cluster-r and omized controlled trial ( RCT ) with a 2 × 2 factorial design , with schools as the unit of r and omization . Twenty schools will be allocated to one of four intervention groups , sedentary behavior ( SB-I ) , physical activity ( PA-I ) , combined SB and PA ( SB+PA-I ) or current practice control ( C ) , which will be evaluated among approximately 600 children aged 8 - 9 years in school year 3 living in Melbourne , Australia . All children in year 3 at intervention schools in 2010 ( 8 - 9 years ) will receive the intervention over an 18-month period with a maintenance ' booster ' delivered in 2012 and children at all schools will be invited to participate in the evaluation assessment s. To maximize the sample and to capture new students arriving at intervention and control schools , recruitment will be on-going up to the post-intervention time point . Primary outcomes are time spent sitting and in PA assessed via accelerometers and inclinometers and survey . Discussion To our knowledge , Transform-Us ! is the first RCT to examine the effectiveness of intervention strategies for reducing children 's overall sedentary time , promoting PA and optimizing health outcomes . The integration of consistent strategies and messages to children from teachers and parents in both school and family setting s is a critical component of this study , and if shown to be effective , may have a significant impact on educational policies as well as on pedagogical and parenting practice s . Trial registration ACTRN12609000715279 ; Current Controlled Trials IS RCT
Among children , these interventions demonstrated reduced screen time , increased physical activity , and improved diet- and weight-related outcomes .
CONTEXT Sedentary time spent with screen media is associated with obesity among children and adults .
Obesity has potentially serious health consequences , such as heart disease and diabetes .
This Community Guide systematic review examined the effectiveness and economic efficiency of behavioral interventions aim ed at reducing recreational ( i.e. , neither school- nor work-related ) sedentary screen time , as measured by screen time , physical activity , diet , and weight-related outcomes .