Xie Qian-Wen, Fan Xu Li, Chen Roujia, Chen Lingyi
Department of Social Welfare and Risk Management, School of Public Affairs, Zhejiang University, Hangzhou, Zhejiang, China.
Center of Social Welfare and Governance, Zhejiang University, Hangzhou, Zhejiang, China ; and.
J Dev Behav Pediatr. 2025 Apr 2;46(3):e275-e284. doi: 10.1097/DBP.0000000000001351.
Given the well-documented associations between excessive screen time (ST) and adverse health outcomes, this pilot study aimed to examine the applicability and effectiveness of a multicomponent intervention that combined strategies to enhance caregivers' screen-related parenting practices with efforts to create a supportive community environment to reduce children's ST in a county in China.
A 2-arm, cluster-randomized, wait-list controlled design was used. Eight communities and 336 caregivers of primary school-aged children were randomly assigned to intervention and control groups. Wilcoxon signed-rank tests and McNemar's χ 2 tests were applied to evaluate within-group changes over time. A linear mixed model was used to assess intervention effects.
The intervention significantly reduced children's daily average total ST and entertainment ST on weekends (β = -43.81; p < 0.05; β = -22.29, p < 0.05) and on a weekly basis (β = -30.32; p < 0.05; β = -14.40, p < 0.05). Moreover, it significantly reduced the odds of excessive entertainment ST on weekdays (β = -2.32, p < 0.05) weekly (β = -2.34, p < 0.05) and excessive academic ST weekly (β = -1.71, p < 0.05). No significant treatment effect was found for parenting practices and children's physical activities.
This study supports the feasibility of a multicomponent intervention and its effectiveness in reducing children's excessive ST, particularly in addressing entertainment ST.
鉴于过多的屏幕时间（ST）与不良健康结果之间的关联已得到充分记录，本试点研究旨在检验一种多成分干预措施的适用性和有效性，该干预措施将增强照顾者与屏幕相关的育儿行为的策略与营造支持性社区环境以减少中国某县儿童屏幕时间的努力相结合。
采用双臂、整群随机、等待列表对照设计。8个社区和336名小学适龄儿童的照顾者被随机分配到干预组和对照组。采用Wilcoxon符号秩检验和McNemar卡方检验来评估组内随时间的变化。使用线性混合模型来评估干预效果。
该干预显著降低了儿童周末的每日平均总屏幕时间和娱乐屏幕时间（β = -43.81；p < 0.05；β = -22.29，p < 0.05）以及每周的时间（β = -30.32；p < 0.05；β = -14.40，p < 0.05）。此外，它还显著降低了工作日过度娱乐屏幕时间的几率（β = -2.32，p < 0.05）、每周的几率（β = -2.34，p < 0.05）以及每周过度学习屏幕时间的几率（β = -1.71，p < 0.05）。在育儿行为和儿童身体活动方面未发现显著的治疗效果。
本研究支持多成分干预措施的可行性及其在减少儿童过多屏幕时间方面的有效性，特别是在解决娱乐屏幕时间方面。
