BACKGROUND: Screen time, especially television viewing, is associated with risk of overweight and obesity in children. Although several interventions have been developed to reduce children's screen time, no systematic review of these interventions exists to date.OBJECTIVE: This is a systematic review and meta-analysis of interventions targeting a reduction in children's screen time. METHODS:Effect sizes and associated 95% confidence intervals (CIs) were calculated by using a random-effects model. Heterogeneity tests, moderator analyses, assessment of bias, and sensitivity analyses were conducted. Reliability was assessed with Cohen's . RESULTS:The systematic search identified 3002 documents; 33 were eligible for inclusion, and 29 were included in analyses. Most reported preintervention and postintervention data and were published in peerreviewed journals. Although heterogeneity was present, no moderators were identified. Overall Hedges g (Ϫ0.144 [95% CI: Ϫ0.217 to Ϫ0.072]) and standard mean difference (SMD) (Ϫ0.148 [95% CI: Ϫ0.224 to Ϫ0.071]) indicated that interventions were linked with small but statistically significant reductions in screen time in children. The results were robust; the failsafe N was large, and the funnel plot and trim-and-fill methods identified few missing studies. CONCLUSIONS:Results show that interventions to reduce children's screen time have a small but statistically significant effect. As the evidence base expands, and the number of screen-time interventions increases, future research can expand on these findings by examining the clinical relevance and sustainability of effects, conducting a more thorough analysis of effect modifiers, and identifying critical components of effective interventions. Pediatrics 2011;128:e193-e210 Dr Maniccia contributed to the study conception and design; data collection, analysis, and interpretation; and manuscript writing. Dr Davison contributed to the study design and manuscript writing and revision. Dr Marshall contributed to the study design, statistical analysis design, and manuscript revision. Drs Manganello and Dennison contributed to the study design and manuscript revision. Although the American Academy of Pediatrics recommends no more than 2 hours/day of screen time (watching television or videos/DVDs, playing video or computer games, and using a computer for purposes other than school work) for children aged 2 years old and older, 1,2 47% of children aged 2 to 15 years spend 2 or more hours/day using screen media. 3 A recent study 4 found that approximately two-thirds of a national sample of 3-year-old children watched ϳ3 hours/day of television and were exposed to more than 5 additional hours of indirect (ie, in the background) television daily. Contrary to the American Academy of Pediatrics recommendations, 33% of children aged 6 years and younger 5 and 71% of children aged 8 to 18 years 6 have televisions in their bedrooms, a characteristic associated with increased viewing. [5][6][7] Time spent watching television is associated w...

EHR adoption rates and participation in HIE are higher among New York hospitals than hospitals nationwide, suggesting that state initiatives funding community EHR implementation may influence these efforts by hospitals. However, overall rates of adoption and preparedness to meet meaningful use remain low. Direct support for hospitals, such as that provided through the national EHR Incentive Program, will likely be critical for rates of EHR adoption and HIE to significantly rise, even in advanced states.

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