title: Reducing Recreational Sedentary Screen Time: A Community Guide Systematic Review.
abstract: BACKGROUND
  Sedentary time spent with screen media is associated with obesity among children and adults. Obesity has potentially serious health consequences, such as heart disease and diabetes. This Community Guide systematic review examined the effectiveness and economic efficiency of behavioral interventions aimed at reducing recreational (i.e., neither school- nor work-related) sedentary screen time, as measured by screen time, physical activity, diet, and weight-related outcomes.
  
  
  METHODS
  For this review, an earlier ("original") review (search period, 1966 through July 2007) was combined with updated evidence (search period, April 2007 through June 2013) to assess effectiveness of behavioral interventions aimed at reducing recreational sedentary screen time. Existing Community Guide systematic review methods were used. Analyses were conducted in 2013-2014.
  
  
  RESULTS
  The review included 49 studies. Two types of behavioral interventions were evaluated that either (1) focus on reducing recreational sedentary screen time only (12 studies); or (2) focus equally on reducing recreational sedentary screen time and improving physical activity or diet (37 studies). Most studies targeted children aged ≤13 years. Children's composite screen time (TV viewing plus other forms of recreational sedentary screen time) decreased 26.4 (interquartile interval= -74.4, -12.0) minutes/day and obesity prevalence decreased 2.3 (interquartile interval= -4.5, -1.2) percentage points versus a comparison group. Improvements in physical activity and diet were reported. Three study arms among adults found composite screen time decreased by 130.2 minutes/day.
  
  
  CONCLUSIONS
  Among children, these interventions demonstrated reduced screen time, increased physical activity, and improved diet- and weight-related outcomes. More research is needed among adolescents and adults.
authors.affiliation: Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia.
authors.forename: Leigh
authors.initials: L
authors.lastname: Ramsey Buchanan
authors.affiliation: Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia.
authors.forename: Cherie R
authors.initials: CR
authors.lastname: Rooks-Peck
authors.affiliation: Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia.
authors.forename: Ramona K C
authors.initials: RKC
authors.lastname: Finnie
authors.affiliation: Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia. Electronic address: hwethington@cdc.gov.
authors.forename: Holly R
authors.initials: HR
authors.lastname: Wethington
authors.affiliation: Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia.
authors.forename: Verughese
authors.initials: V
authors.lastname: Jacob
authors.affiliation: Physical Activity and Health Branch, Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Fulton
authors.affiliation: Center for Public Health Nutrition, University of Washington, Seattle, Washington.
authors.forename: Donna B
authors.initials: DB
authors.lastname: Johnson
authors.affiliation: RTI International, Research Triangle Park, North Carolina.
authors.forename: Leila C
authors.initials: LC
authors.lastname: Kahwati
authors.affiliation: Clinical Applications and Prevention Branch, Prevention and Population Sciences Program, Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland.
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Pratt
authors.affiliation: School of Public Health, Texas A&M, College Station, Texas.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Ramirez
authors.affiliation: Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia.
authors.forename: Shawna L
authors.initials: SL
authors.lastname: Mercer
authors.affiliation: Schools of Medicine and Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Karen
authors.initials: K
authors.lastname: Glanz
mesh_terms: D000293:Adolescent; D000328:Adult; D001521:Behavior Therapy / Q000379:methods; D002648:Child; D003153:Community Health Services; D015444:Exercise; D006801:Humans; D009765:Obesity / Q000517:prevention & control*; D011998:Recreation; D012574:Schools; D057185:Sedentary Behavior; D013690:Television; D013997:Time Factors