Ramsey Buchanan Leigh, Rooks-Peck Cherie R, Finnie Ramona K C, Wethington Holly R, Jacob Verughese, Fulton Janet E, Johnson Donna B, Kahwati Leila C, Pratt Charlotte A, Ramirez Gilbert, Mercer Shawna L, Glanz Karen
Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia.
Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia.
Am J Prev Med. 2016 Mar;50(3):402-415. doi: 10.1016/j.amepre.2015.09.030.
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 aimed 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.
For this review, an earlier ("original") review (search period, 1966 through July 2007) was combined with updated evidence (search period, April 2007 through June 2013) to assess effectiveness of behavioral interventions aimed at reducing recreational sedentary screen time. Existing Community Guide systematic review methods were used. Analyses were conducted in 2013-2014.
The review included 49 studies. Two types of behavioral interventions were evaluated that either (1) focus on reducing recreational sedentary screen time only (12 studies); or (2) focus equally on reducing recreational sedentary screen time and improving physical activity or diet (37 studies). Most studies targeted children aged ≤13 years. Children's composite screen time (TV viewing plus other forms of recreational sedentary screen time) decreased 26.4 (interquartile interval= -74.4, -12.0) minutes/day and obesity prevalence decreased 2.3 (interquartile interval= -4.5, -1.2) percentage points versus a comparison group. Improvements in physical activity and diet were reported. Three study arms among adults found composite screen time decreased by 130.2 minutes/day.
Among children, these interventions demonstrated reduced screen time, increased physical activity, and improved diet- and weight-related outcomes. More research is needed among adolescents and adults.
儿童和成人花在屏幕媒体上的久坐时间与肥胖有关。肥胖可能会带来诸如心脏病和糖尿病等严重的健康后果。本《社区指南》系统评价考察了旨在减少娱乐性（即与学校或工作无关的）久坐屏幕时间的行为干预措施的有效性和经济效率，这些干预措施通过屏幕时间、身体活动、饮食以及与体重相关的结果来衡量。
为进行本次评价，将一项早期（“原始”）评价（检索时间段为1966年至2007年7月）与更新后的证据（检索时间段为2007年4月至2013年6月）相结合，以评估旨在减少娱乐性久坐屏幕时间的行为干预措施的有效性。采用了现有的《社区指南》系统评价方法。分析于2013年至2014年进行。
该评价纳入了49项研究。评估了两种类型的行为干预措施，即（1）仅专注于减少娱乐性久坐屏幕时间的措施（12项研究）；或（2）同样专注于减少娱乐性久坐屏幕时间并改善身体活动或饮食的措施（37项研究）。大多数研究针对的是13岁及以下的儿童。与对照组相比，儿童的综合屏幕时间（看电视加上其他形式的娱乐性久坐屏幕时间）每天减少了26.4（四分位间距=-74.4，-12.0）分钟，肥胖患病率下降了2.3（四分位间距=-4.5，-1.2）个百分点。报告了身体活动和饮食方面的改善。在针对成人的三个研究组中发现综合屏幕时间每天减少了130.2分钟。
在儿童中，这些干预措施显示出屏幕时间减少、身体活动增加以及与饮食和体重相关的结果得到改善。在青少年和成人中还需要更多的研究。
