Obesity Prevention Program, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA.
Obesity (Silver Spring). 2012 Jul;20(7):1338-54. doi: 10.1038/oby.2011.348. Epub 2012 Jan 5.
Screen-media use among young children is highly prevalent, disproportionately high among children from lower-income families and racial/ethnic minorities, and may have adverse effects on obesity risk. Few systematic reviews have examined early intervention strategies to limit TV or total screen time; none have examined strategies to discourage parents from putting TVs in their children's bedrooms or remove TVs if they are already there. In order to identify strategies to reduce TV viewing or total screen time among children <12 years of age, we conducted a systematic review of seven electronic databases to June 2011, using the terms "intervention" and "television," "media," or "screen time." Peer-reviewed intervention studies that reported frequencies of TV viewing or screen-media use in children under age 12 were eligible for inclusion. We identified 144 studies; 47 met our inclusion criteria. Twenty-nine achieved significant reductions in TV viewing or screen-media use. Studies utilizing electronic TV monitoring devices, contingent feedback systems, and clinic-based counseling were most effective. While studies have reduced screen-media use in children, there are several research gaps, including a relative paucity of studies targeting young children (n = 13) or minorities (n = 14), limited long-term (>6 month) follow-up data (n = 5), and few (n = 4) targeting removing TVs from children's bedrooms. Attention to these issues may help increase the effectiveness of existing strategies for screen time reduction and extend them to different populations.
儿童使用屏幕媒体的现象非常普遍，低收入家庭和少数族裔儿童的这一比例过高，可能对肥胖风险产生不利影响。很少有系统评价研究过限制电视或总屏幕时间的早期干预策略；也没有研究过鼓励父母不在孩子卧室放置电视或如果已经放置了电视就将其移除的策略。为了确定减少 12 岁以下儿童看电视或总屏幕时间的策略，我们对 2011 年 6 月之前的七个电子数据库进行了系统评价，使用了“干预”和“电视”、“媒体”或“屏幕时间”等术语。符合纳入标准的研究为报告了 12 岁以下儿童看电视或使用屏幕媒体频率的同行评审干预研究。我们确定了 144 项研究；其中 47 项符合我们的纳入标准。其中 29 项研究显著减少了儿童看电视或使用屏幕媒体的时间。利用电子电视监测设备、条件反馈系统和诊所咨询的研究最有效。虽然研究已经减少了儿童的屏幕媒体使用，但仍存在几个研究空白，包括针对幼儿（n=13）或少数族裔（n=14）的研究相对较少，长期（>6 个月）随访数据有限（n=5），以及很少（n=4）针对从儿童卧室移除电视的研究。关注这些问题可能有助于提高现有减少屏幕时间策略的有效性，并将其扩展到不同人群。
