Review article
The Health Indicators Associated With Screen-Based Sedentary Behavior Among Adolescent Girls: A Systematic Review

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Abstract

Purpose

Evidence suggests sitting time is independently associated with a range of health issues in adults, yet the relationship between sedentary behavior and health indicators in young people is less clear. Age-related increases in sedentary behavior are well-documented; the behavioral patterns of adolescent girls are of particular concern. More than one third of adolescent girls’ sedentary behavior time is accumulated through use of recreational screen-based behaviors. The objective of this review was to investigate the association between recreational screen-based sedentary behavior and the physical, behavioral, and psychosocial health indicators for adolescent girls. A secondary objective was to identify studies that have adjusted sedentary behavior indicators for physical activity.

Methods

A structured electronic search of all publication years (through December 2011) was conducted to identify studies in: CINAHL, Communications and Mass Media Complete, ERIC, MEDLINE with Full Text, PsycINFO, and SPORTDiscus with Full Text. Included publications were observational and interventional studies involving adolescent girls (12–18 years) that examined associations between screen-based, sedentary behavior and health indicators (physical, psychosocial, and/or behavioral). The search identified 33 studies that evaluated health indicators of screen-based sedentary behaviors among adolescent girls.

Results

Strong evidence for a positive association between screen-based sedentary behavior and weight status was found. A positive association was observed between screen-time and sleep problems, musculoskeletal pain and depression. Negative associations were identified between screen time and physical activity/fitness, screen time and psychological well-being, and screen time and social support. The relationship between screen-based sedentary behavior and diet quality was inconclusive. Less than half of the studies adjusted sedentary behavior indicators for physical activity.

Conclusions

Screen-based sedentary behavior is associated with a range of adverse health consequences, but additional longitudinal studies are needed to better understand the health impacts. In addition, screen-time guidelines for youth should be regularly revised and updated to reflect rapid technological changes.

Section snippets

Search strategy

A structured electronic search employing PRISMA reporting guidelines [35] of all publication years (through December 2011) using CINAHL, Communications and Mass Media Complete, ERIC, MEDLINE with Full Text, PsycINFO, and SPORTDiscus with Full Text was conducted. The following search strings were used: (adolesce* or youth* or teen* or young person) AND (girl* or female*) AND (sedentary behavio* or screen time or television or TV or computer or internet or video game* or electronic game*). These

Overview of studies

Electronic literature searching yielded 492 studies (Figure 1). Of these, 33 studies met the inclusion criteria. The search identified 33 studies that evaluated the physical and/or psychosocial and/or behavioral health indicators associated with screen-based sedentary behaviors among adolescent girls (Table 1). Of these, 16 evaluated physical health associations, 6 evaluated the psychosocial health associations, 5 evaluated the behavioral health associations, and 6 studies evaluated a

Discussion

The primary objective of this review was to investigate the health indicators associated with screen-based sedentary behavior in adolescent girls; a secondary objective to examine the impact of sedentary behavior in studies that have specifically adjusted for physical activity participation. The majority of studies reported screen-based activities were associated with poor health. In addition, less than half of included studies have adjusted sedentary behavior for physical activity

Acknowledgments

R.C.P. is supported by a Senior Research Fellowship Salary Award from the National Health and Medical Research Council, Australia. The authors thank Nandini Karunamuni for her assistance in preparing this manuscript.

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    Conflict of Interest: The authors declare that there are no conflicts of interest.

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