Wu Yan, Xi Xiaobin, Zhang Chunkai, Jiang Jieying, Ye Sunyue
College of Education, Jiaxing University, Jiaxing, China.
Longquan Jinsha Kindergarten, Longquan, China.
BMC Public Health. 2025 Aug 11;25(1):2724. doi: 10.1186/s12889-025-23700-5.
Excessive screen time (ST) is linked to adverse physical and mental development in children, with habits forming in preschool and solidifying over time. Previous studies on interventions to reduce ST in preschoolers aged 0-7 years have shown inconsistent results. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate intervention effectiveness and identify potential moderators. METHODS: We searched CNKI (Chinese), Wanfang Data (Chinese), SinoMed, Ebscohost, Web of Science, EMBASE, PubMed, and Cochrane Library for RCTs (January 1, 2000-December 31, 2024) targeting ST reduction in preschool children. Study quality was assessed using the Cochrane Risk of Bias Assessment tool and Jadad scale. Effect size were reported as standardized mean difference (SMD) with 95% confidence intervals (CI). Subgroup analyses (e.g., sample size, child age, gender, intervention duration) were conducted, with statistical tests (e.g., the chi-square test) comparing subgroup differences.
A total of 41 studies with 14,514 participants were included in the meta-analysis. The overall summary of random effects showed a small, beneficial impact of ST interventions compared to controls (SMD = 0.26, 95% CI: 0.12 to 0.39). Subgroup analysis showed that the intervention effect was moderated by child age (χ = 6.25, P = 0.04), intervention duration (χ = 7.38, P = 0.007), target behavior of the intervention (χ = 6.72, P = 0.01) and intervention recipient (χ = 10.5, P = 0.01).
Despite heterogeneity in study methods and results, overall interventions to reduce ST in early childhood show significant reductions, suggesting that this may be an opportune time to intervene. Future research should explore strategies for implementing large-scale interventions and sustaining long-term intervention effects, investigate the potential impact of different theoretical frameworks on intervention outcomes, and examine the role of caregivers in supporting behavior change. These findings provide a robust foundation for developing evidence-based strategies to promote healthy ST habits in young children.
儿童长时间看屏幕（ST）与不良的身心发育有关，相关习惯在学龄前形成并随时间固化。以往关于减少0至7岁学龄前儿童ST的干预措施的研究结果并不一致。我们对随机对照试验（RCT）进行了系统评价和荟萃分析，以评估干预效果并确定潜在的调节因素。
我们在知网（中文）、万方数据（中文）、中国生物医学文献数据库、EBSCOhost、科学网、EMBASE、PubMed和考克兰图书馆中检索了2000年1月1日至2024年12月31日期间针对减少学龄前儿童ST的RCT。使用考克兰偏倚风险评估工具和雅达量表评估研究质量。效应量以标准化均数差（SMD）及95%置信区间（CI）报告。进行了亚组分析（如样本量、儿童年龄、性别、干预持续时间），并采用统计检验（如卡方检验）比较亚组差异。
荟萃分析共纳入41项研究，14514名参与者。随机效应的总体汇总显示，与对照组相比，ST干预有小的有益影响（SMD = 0.26，95% CI：0.12至0.39）。亚组分析表明，干预效果受儿童年龄（χ = 6.25，P = 0.04）、干预持续时间（χ = 7.38，P = 0.007）、干预的目标行为（χ = 6.72，P = 0.01）和干预接受者（χ = 10.5，P = 0.01）的调节。
尽管研究方法和结果存在异质性，但总体而言，减少幼儿ST的干预措施显示出显著效果，表明这可能是进行干预的适当时机。未来的研究应探索实施大规模干预措施和维持长期干预效果的策略，调查不同理论框架对干预结果的潜在影响，并研究照顾者在支持行为改变中的作用。这些发现为制定基于证据的策略以促进幼儿健康的ST习惯提供了坚实的基础。
