Effects of Open-Loop Feedback on Physical Activity and Television Viewing in Overweight and Obese Children: A Randomized, Controlled Trial

Goldfield, Gary S.; Mallory, Risa; Parker, Torrey; Cunningham, Terrell; Legg, Christine; Lumb, Andrew B; Parker, Kasey; Prud’homme, Denis; Gaboury, Isabelle; Adamo, Kristi B.

doi:10.1542/peds.2005-3052

Cited by 97 publications

(108 citation statements)

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“…Many of the interventions reviewed can provide children with the skills needed to decrease screen-media use. Parents and clinicians should incorporate the interventions or the strategies that are common to the effective interventions into their efforts to combat childhood *Refs 44,91,95,96,98,100,[102][103][104]46,91,92,97,98,[102][103][104], and 110. …”

Section: Discussionmentioning

confidence: 99%

“…[20][21][22][23][24][25][26][27] , 28 , [29][30][31][32][33][34][35][36][37][38][39][40][41] Recently, research has included developing and testing interventions that attempt to reduce children's screen time. [42][43][44][45][46][47] Although meta-analysis has been used to study the relationship between media use and weight and physical activity, 11 to date no systematic review and metaanalysis of interventions to reduce children's screen time has been completed. In this article we present the results of a systematic review and meta-analysis conducted to identify and examine the effectiveness of interventions to change children's screen time.…”

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confidence: 99%

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A Meta-analysis of Interventions That Target Children's Screen Time for Reduction

Maniccia¹,

Davison²,

et al. 2011

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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...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

A Meta-analysis of Interventions That Target Children's Screen Time for Reduction

Maniccia¹,

Davison²,

et al. 2011

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“…Indeed, earning access to television has been used to incentivize physical activity in obese youth. 204 There also is emerging research on homebased interactive media games to bolster the reinforcing value of physical activity in obese youth. 72 The assessment of specific parenting practices that encourage or discourage physical activity and screen time will be important for assessing such treatments.…”

Section: Structuring the Home Environment To Reduce Child Screen Timementioning

confidence: 99%

Evaluating Parents and Adult Caregivers as “Agents of Change” for Treating Obese Children: Evidence for Parent Behavior Change Strategies and Research Gaps

Faith¹,

Horn²,

Appel³

et al. 2012

Circulation

237

170

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Abstract-This scientific statement addresses parents and adult caregivers (PACs) as "agents of change" for obese children, evaluating the strength of evidence that particular parenting strategies can leverage behavior change and reduce positive energy balance in obese youth. The statement has 3 specific aims. The first is to review core behavior change strategies for PACs as used in family-based treatment programs and to provide a resource list. The second is to evaluate the strength of evidence that greater parental "involvement" in treatment is associated with better reductions in child overweight. The third is to identify research gaps and new opportunities for the field. This review yielded limited and inconsistent evidence from randomized controlled clinical trials that greater PAC involvement necessarily is associated with better child outcomes. For example, only 17% of the intervention studies reported differential improvements in child overweight as a function of parental involvement in treatment. On the other hand, greater parental adherence with core behavior change strategies predicted better child weight outcomes after 2 and 5 years in some studies. Thus, the literature lacks conclusive evidence that one particular parenting strategy or approach causally is superior to others in which children have a greater focus in treatment. A number of research gaps were identified, including the assessment of refined parenting phenotypes, cultural tailoring of interventions, examination of family relationships, and incorporation of new technologies. A conceptual model is proposed to stimulate research identifying the determinants of PAC feeding and physical activity parenting practices, the results of which may inform new treatments. The statement addresses the need for innovative research to advance the scope and potency of PAC treatments for childhood obesity. (Circulation. 2012;125:1186-1207.)Key Words: AHA Scientific Statements Ⅲ diet Ⅲ lifestyle Ⅲ nutrition Ⅲ obesity Ⅲ pediatrics Ⅲ preventionThe American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on October 10, 2011. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@wolterskluwer.com.The American Heart Association requests that this document be cited as follows: Faith MS, Van Horn L, Appel LJ, Burke LE, Carson JAS, Franch HA, Jakicic JM, Kral TVE, Odoms-Young A, Wansink B, Wylie-Rosett J; on ...

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“…This approach was then shown to be effective at increasing the physical activity of sedentary children over a 6-week period in the natural environment; in this study, the children's access to television was made contingent on achievement of a target number of counts on a Biotrainer accelerometer (where 400 counts earned 60 min of television time; Roemmich et al, 2004). A further study showed that obese children exposed to this contingency over an 8-week period showed significantly greater increases in daily physical activity than did control children who wore activity monitors to gain feedback on activity level but without behavioural goals or reward contingences (Goldfield et al, 2006). Such findings indicate that rewards combined with activity goals are effective above and beyond the effects of simply being able to monitor one's physical activity.…”

Section: Introductionmentioning

confidence: 97%

Increasing children's physical activity: a peer modelling, rewards and pedometer-based intervention

et al. 2007

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Effects of Open-Loop Feedback on Physical Activity and Television Viewing in Overweight and Obese Children: A Randomized, Controlled Trial

Abstract: Providing feedback of physical activity in combination with reinforcing physical activity with sedentary behavior is a simple method of modifying the home environment that may play an important role in treating and preventing child obesity.

Cited by 97 publications

References 41 publications

A Meta-analysis of Interventions That Target Children's Screen Time for Reduction

A Meta-analysis of Interventions That Target Children's Screen Time for Reduction

Evaluating Parents and Adult Caregivers as “Agents of Change” for Treating Obese Children: Evidence for Parent Behavior Change Strategies and Research Gaps

Increasing children's physical activity: a peer modelling, rewards and pedometer-based intervention

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