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Interventions to reduce sedentary behaviour in 0–5-year-olds: a systematic review and meta-analysis of randomised controlled trials
  1. Katherine L Downing1,
  2. Jill A Hnatiuk1,2,
  3. Trina Hinkley1,
  4. Jo Salmon1,
  5. Kylie D Hesketh1
  1. 1 Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Geelong, Victoria, Australia
  2. 2 School of Science and Health, Western Sydney University, Penrith, New South Wales, Australia
  1. Correspondence to Katherine L Downing, Institute for Physical Activity and Nutrition, Deakin University, 221 Burwood Hwy, Burwood VIC 3125, Australia; k.downing{at}deakin.edu.au

Abstract

Aim or objective To evaluate the effectiveness of behavioural interventions that report sedentary behaviour outcomes during early childhood.

Design Systematic review and meta-analysis.

Data sources Academic Search Complete, CINAHL Complete, Global Health, MEDLINE Complete, PsycINFO, SPORTDiscus with Full Text and EMBASE electronic databases were searched in March 2016.

Eligibility criteria for selecting studies Inclusion criteria were: (1) published in a peer-reviewed English language journal; (2) sedentary behaviour outcomes reported; (3) randomised controlled trial (RCT) study design; and (4) participants were children with a mean age of ≤5.9 years and not yet attending primary/elementary school at postintervention.

Results 31 studies were included in the systematic review and 17 studies in the meta-analysis. The overall mean difference in screen time outcomes between groups was −17.12 (95% CI −28.82 to −5.42) min/day with a significant overall intervention effect (Z=2.87, p=0.004). The overall mean difference in sedentary time between groups was −18.91 (95% CI −33.31 to −4.51) min/day with a significant overall intervention effect (Z=2.57, p=0.01). Subgroup analyses suggest that for screen time, interventions of ≥6 months duration and those conducted in a community-based setting are most effective. For sedentary time, interventions targeting physical activity (and reporting changes in sedentary time) are more effective than those directly targeting sedentary time.

Summary/conclusions Despite heterogeneity in study methods and results, overall interventions to reduce sedentary behaviour in early childhood show significant reductions, suggesting that this may be an opportune time to intervene.

Trial registration number CRD42015017090.

  • Sedentary
  • Child
  • Meta-analysis

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Twitter Follow Katherine Downing at @kdowning_

  • Contributors KLD conceptualised the study, carried out the database searches, screened the titles, abstracts and full-text papers, extracted the data, conducted the quality assessment, conducted the meta-analysis and drafted the initial manuscript. JAH screened the abstracts and full-text papers, conducted the quality assessment, reviewed and revised the manuscript, and approved the final manuscript as submitted. TH, JS and KDH were consulted where necessary for full-text inclusion, reviewed and revised the manuscript, and approved the final manuscript as submitted.

  • Funding KLD is supported by a National Health and Medical Research Council Postgraduate Scholarship (GNT1092876). TH is supported by a National Health and Medical Research Council Early Career Fellowship (APP1070571). JS is supported by a National Health and Medical Research Council Principal Research Fellowship (APP1026216). KDH is supported by an Australian Research Council Future Fellowship (FT130100637) and an Honorary Heart Foundation Future Leader Fellowship (100370).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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