title: Reducing youth screen time: qualitative metasynthesis of findings on barriers and facilitators.
abstract: OBJECTIVE
  An integrated perspective on the relevant qualitative findings on the experience of screen time in youth can inform the development of hypotheses to be tested in future research and can guide the development of interventions to decrease sedentary behavior. The purpose of this qualitative metasynthesis was to explore parent, youth, and educational professionals' perceptions of barriers to, and facilitators of, reducing youth screen time.
  
  
  METHODS
  Qualitative metasynthesis techniques were used to analyze and synthesize 15 qualitative studies of screen time among youth (11-18 years) meeting inclusion criteria. The phrases, quotes, and/or author interpretations (i.e., theme or subtheme) were recorded in a data display matrix to facilitate article comparisons. Codes were collapsed into 23 categories of similar conceptual meaning and 3 overarching themes were derived using thematic analysis procedures.
  
  
  RESULTS
  Study sample sizes ranged from 6 to 270 participants from 6 countries. Data collection methods included focus groups (n = 6), interviews (n = 4), focus group and interviews (n = 4), and naturalistic observation (n = 1) with youth and/or parents. Data analysis techniques included thematic analysis (n = 9), content analysis (n = 3), grounded theory (n = 1), observation (n = 1), and interpretive phenomenological analysis (n = 1). Three thematic categories were identified: (a) youth's norms-screen time is an integral part of daily life, and facilitates opportunities for entertainment, social interaction, and escapism; (b) family dynamics and parental roles-parents are conflicted and send mixed messages about the appropriate uses and amounts of screen time; and, (c) resources and environment-engagement in screen time is dependent on school, community, neighborhood, and home environmental contexts.
  
  
  CONCLUSIONS
  Screen time is an established norm in many youth cultures, presenting barriers to behavior change. Parents recognize the importance of reducing youth screen time, but model and promote engagement themselves. For youth and parents, mutually agreed rules, limits, and parental monitoring of screen time were perceived as likely to be effective.
authors.affiliation: School of Nursing, Yale University.
authors.forename: Karl E
authors.initials: KE
authors.lastname: Minges
authors.affiliation: Behavioural Epidemiology Laboratory, Baker IDI Heart and Diabetes Institute.
authors.forename: Neville
authors.initials: N
authors.lastname: Owen
authors.affiliation: School of Exercise and Nutrition Sciences, Deakin University.
authors.forename: Jo
authors.initials: J
authors.lastname: Salmon
authors.affiliation: School of Nursing, Yale University.
authors.forename: Ariana
authors.initials: A
authors.lastname: Chao
authors.affiliation: Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute.
authors.forename: David W
authors.initials: DW
authors.lastname: Dunstan
authors.affiliation: School of Nursing, Yale University.
authors.forename: Robin
authors.initials: R
authors.lastname: Whittemore
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006801:Humans; D008297:Male; D064887:Observational Studies as Topic; D010290:Parents / Q000523:psychology; D036301:Qualitative Research; D057185:Sedentary Behavior; D013690:Television; D018910:Video Games / Q000523:psychology*
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