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Naylor Patti-Jean, Tomlin Dona, Rhodes Ryan and McConnell Jennifer
Background: Screen-time (ST) has been associated with child health. We designed a brief intervention (Screen
Smart) based on social cognitive theory that targeted children and their parents to raise awareness of and support
management of recreational screen-time. Key components were: 3 brief school lessons, a 10-day ‘homework’
passport, a one day turn-it-off challenge and two weeks of follow-up tracking. Our purpose was to examine the
impact of Screen Smart on children’s knowledge, self-efficacy, and outcome expectancies, ST goals, ST, Physical
Activity (PA) and sedentary time.
Methods: We used mixed methods and randomly assigned 12 schools to Screen Smart or Usual Practice
and recruited Grade 4 and 5 children. We used The Physical Activity Questionnaire for Older Children (PAQ-C)
and accelerometers to measure PA and sedentary time and questionnaires assessed demographics, household
environment (access and limits), knowledge, self-efficacy, outcome expectancies, ST and PA. We used Repeated
Measures ANOVA to assess differences between groups over time and analyzed Passport entries qualitatively.
Results: 368 children (mean age 9.8 years, S.D.=.585; 167 boys, 201 girls) consented. Screen-time knowledge
and awareness of guidelines increased significantly (F=10.46, p<.001) and self-reported TV time decreased
(F=3.81, p<.05) in the intervention condition. Screen Smart children absorbed key messages. Self-efficacy, outcome
expectancies, ST goals and both self-reported and measured PAdecreased significantly in both groups over time.
Home screen access increased significantly while ST limits didn’t change. Conversely, accelerometry showed
that the intervention group became less physically active on weekends (F=5.75, p=.018). Seasonal reductions in
organized sport and outdoor activity participation may have contributed.
Conclusion: A brief school-facilitated ST intervention focused on students and families to enhance ST
management had a modest impact on knowledge and self-reported TV time but not on computer use, gaming or
physical activity. Enhanced dose may be required to change these behaviors.