title: Screen-Time Weight-loss Intervention Targeting Children at Home (SWITCH): a randomized controlled trial.
abstract: BACKGROUND
  Screen-based activities, such as watching television (TV), playing video games, and using computers, are common sedentary behaviors among young people and have been linked with increased energy intake and overweight. Previous home-based sedentary behaviour interventions have been limited by focusing primarily on the child, small sample sizes, and short follow-up periods. The SWITCH (Screen-Time Weight-loss Intervention Targeting Children at Home) study aimed to determine the effect of a home-based, family-delivered intervention to reduce screen-based sedentary behaviour on body composition, sedentary behaviour, physical activity, and diet over 24 weeks in overweight and obese children.
  
  
  METHODS
  A two-arm, parallel, randomized controlled trial was conducted. Children and their primary caregiver living in Auckland, New Zealand were recruited via schools, community centres, and word of mouth. The intervention, delivered over 20 weeks, consisted of a face-to-face meeting with the parent/caregiver and the child to deliver intervention content, which focused on training and educating them to use a wide range of strategies designed to reduce their child's screen time. Families were given Time Machine TV monitoring devices to assist with allocating screen time, activity packages to promote alternative activities, online support via a website, and monthly newsletters. Control participants were given the intervention material on completion of follow-up. The primary outcome was change in children's BMI z-score from baseline to 24 weeks.
  
  
  RESULTS
  Children (n = 251) aged 9-12 years and their primary caregiver were randomized to receive the SWITCH intervention (n = 127) or no intervention (controls; n = 124). There was no significant difference in change of zBMI between the intervention and control groups, although a favorable trend was observed (-0.016; 95% CI: -0.084, 0.051; p = 0.64). There were also no significant differences on secondary outcomes, except for a trend towards increased children's moderate intensity physical activity in the intervention group (24.3 min/d; 95% CI: -0.94, 49.51; p = 0.06).
  
  
  CONCLUSIONS
  A home-based, family-delivered intervention to reduce all leisure-time screen use had no significant effect on screen-time or on BMI at 24 weeks in overweight and obese children aged 9-12 years.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials RegistryWebsite: http://www.anzctr.org.au
  
  
  BACKGROUND
  ACTRN12611000164998.
authors.affiliation: National Institute for Health Innovation, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. r.maddison@auckland.ac.nz.
authors.forename: Ralph
authors.initials: R
authors.lastname: Maddison
authors.forename: Samantha
authors.initials: S
authors.lastname: Marsh
authors.forename: Louise
authors.initials: L
authors.lastname: Foley
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Epstein
authors.forename: Timothy
authors.initials: T
authors.lastname: Olds
authors.forename: Ofa
authors.initials: O
authors.lastname: Dewes
authors.forename: Ihirangi
authors.initials: I
authors.lastname: Heke
authors.forename: Karen
authors.initials: K
authors.lastname: Carter
authors.forename: Yannan
authors.initials: Y
authors.lastname: Jiang
authors.forename: Cliona Ni
authors.initials: CN
authors.lastname: Mhurchu
mesh_terms: D001823:Body Composition; D015992:Body Mass Index; D002648:Child; D003201:Computers; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D009043:Motor Activity; D009520:New Zealand; D009765:Obesity / Q000628:therapy; D050177:Overweight / Q000628:therapy; D057185:Sedentary Behavior; D013690:Television; D016896:Treatment Outcome; D018910:Video Games; D055105:Waist Circumference; D015431:Weight Loss