title: Rationale and study protocol for 'Switch-off 4 Healthy Minds' (S4HM): a cluster randomized controlled trial to reduce recreational screen time in adolescents.
abstract: BACKGROUND
  Excessive recreational screen time (i.e., screen use for entertainment) is a global public health issue associated with adverse mental and physical health outcomes. Considering the growing popularity of screen-based recreation in adolescents, there is a need to identify effective strategies for reducing screen time among adolescents. The aim of this paper is to report the rationale and study protocol for the 'Switch-off 4 Healthy Minds' (S4HM) study, an intervention designed to reduce recreational screen time among adolescents.
  
  
  METHODS
  The S4HM intervention will be evaluated using a cluster randomized controlled trial in eight secondary schools (N=322 students) in New South Wales, Australia. The 6-month multi-component intervention will encourage adolescents to manage their recreational screen time using a range of evidence-based strategies. The intervention is grounded in Self-Determination Theory (SDT) and includes the following components: an interactive seminar for students, eHealth messaging, behavioral contract and parental newsletters. All outcomes will be assessed at baseline and at 6-months (i.e., immediate post-test). The primary outcome is recreational screen time measured by the Adolescent Sedentary Activity Questionnaire (ASAQ). Secondary outcomes include: self-reported psychological well-being, psychological distress, global physical self-concept, resilience, pathological video gaming and aggression, and objectively measured physical activity (accelerometry) and body mass index (BMI). Hypothesized mediators of behavior change will also be explored.
  
  
  CONCLUSIONS
  The S4HM study will involve the evaluation of an innovative, theory-driven, multi-component intervention that targets students and their parents and is designed to reduce recreational screen time in adolescents. The intervention has been designed for scalability and dissemination across Australian secondary schools.
authors.affiliation: Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, Australia. Electronic address: Mark.Babic@uon.edu.au.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Babic
authors.affiliation: Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, Australia. Electronic address: Philip.Morgan@newcastle.edu.au.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Morgan
authors.affiliation: Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, Australia. Electronic address: Ronald.Plotnikoff@newcastle.edu.au.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Plotnikoff
authors.affiliation: Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, NSW, Australia. Electronic address: Chris.Lonsdale@acu.edu.au.
authors.forename: Chris
authors.initials: C
authors.lastname: Lonsdale
authors.affiliation: Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, Australia. Electronic address: Narelle.Eather@newcastle.edu.au.
authors.forename: Narelle
authors.initials: N
authors.lastname: Eather
authors.affiliation: Faculty of Science and IT, University of Newcastle, Newcastle, NSW, Australia. Electronic address: Geoff.Skinner@newcastle.edu.au.
authors.forename: Geoff
authors.initials: G
authors.lastname: Skinner
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia. Electronic address: Amanda.Baker@newcastle.edu.au.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Baker
authors.affiliation: Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, Australia. Electronic address: Emma.Pollock@newcastle.edu.au.
authors.forename: Emma
authors.initials: E
authors.lastname: Pollock
authors.affiliation: Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, Australia. Electronic address: David.Lubans@newcastle.edu.au.
authors.forename: David R
authors.initials: DR
authors.lastname: Lubans
mesh_terms: D061725:Accelerometry; D000293:Adolescent; D015992:Body Mass Index; D004032:Diet; D015444:Exercise / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008603:Mental Health; D009517:New South Wales; D012107:Research Design; D055500:Resilience, Psychological; D057185:Sedentary Behavior; D012649:Self Concept; D013315:Stress, Psychological / Q000523:psychology
keywords: Behavior; Physical activity; School; Screen