Review Article: The effectiveness of school-based interventions for reducing screen time - a systematic review and meta-analysis.

IF 6.8 3区医学 Q1 PEDIATRICS

Child and Adolescent Mental Health Pub Date : 2025-07-14 DOI:10.1111/camh.70022

Nai Ming Lai, Yin Sear Lim, Nathorn Chaiyakunapruk, Shaun Wen Huey Lee, Tippawan Liabsuetrakul, Mohammad Sabbir, S M Hasan Mahmud, Umme Ruman Siddiqi, Tanvir Ahmed, Faheem U L Hasan, Pei Xuan Kuan

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引用次数: 0

Abstract

Background: Excessive screen time is associated with adverse physical and mental well-being for children. Interventions to reduce screen time in different settings have been studied extensively, with mixed findings. We systematically reviewed evidence that evaluated the effects of screen time reduction interventions conducted in school settings on screen usage, physical, and mental health of school children.

Methods: PubMed, Cochrane, PsycInfo, and Education Resources Information Centre (ERIC) (from inception till 12 September 2024) were searched for relevant randomised and cluster-randomised trials. We assessed risk of bias using the Cochrane risk of bias 2 tool, performed Bayesian random-effects meta-analysis, and rated certainty of evidence using GRADE.

Results: Thirty-nine studies (95,033 participants), published between 1999 and 2024, were included. High risk of bias and great heterogeneity contributed to low-certainty evidence for most outcomes. School-based interventions modestly reduced screen time (SMD: -0.10, 95% CrI: -0.14, -0.06, 27 studies, n = 19,751, I²: 85%) and increased physical activity (SMD: 0.10, 95% CrI: 0.02, 0.19, 21 studies, n = 14,944, I²: 88%). No clear difference was observed in BMI (MD: -0.15, 95% CrI: -0.39, 0.03, 13 studies, n = 4683, I²: 51%), although the subgroup of studies evaluating comprehensive lifestyle interventions appeared to show a slight BMI reduction, while studies evaluating screen-time focused interventions showed no difference.

Conclusions: School-based interventions modestly reduce screen time and increase physical activity, but their effects on BMI are inconclusive. Variations in local school systems and cultural practices might have contributed to heterogeneity in study findings and should be considered in policy decisions. Future studies should strengthen the cluster-randomization process and include academic performance as an outcome.

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综述文章：以学校为基础的减少屏幕时间的干预措施的有效性——一项系统回顾和荟萃分析。

背景：过多的屏幕时间与儿童不利的身心健康有关。在不同环境下减少屏幕时间的干预措施已经进行了广泛的研究，结果好坏参半。我们系统地回顾了评估在学校环境中进行的减少屏幕时间干预对学生屏幕使用、身体和心理健康的影响的证据。方法：检索PubMed、Cochrane、PsycInfo和教育资源信息中心（ERIC）自成立至2024年9月12日的相关随机和集群随机试验。我们使用Cochrane偏倚风险2工具评估偏倚风险，进行贝叶斯随机效应荟萃分析，并使用GRADE评价证据的确定性。结果：纳入1999年至2024年间发表的39项研究（95,033名参与者）。高偏倚风险和巨大异质性导致大多数结果证据的低确定性。以学校为基础的干预措施适度减少了屏幕时间（SMD: -0.10, 95% CrI: -0.14, -0.06, 27项研究，n = 19,751, I2: 85%），增加了身体活动（SMD: 0.10, 95% CrI: 0.02, 0.19, 21项研究，n = 14,944, I2: 88%）。BMI没有明显差异（MD: -0.15, 95% CrI: -0.39, 0.03, 13项研究，n = 4683, I2: 51%），尽管评估综合生活方式干预的研究亚组似乎显示BMI略有下降，而评估以屏幕时间为重点的干预的研究没有显示差异。结论：以学校为基础的干预措施适度减少了屏幕时间并增加了身体活动，但其对BMI的影响尚无定论。当地学校制度和文化习俗的差异可能导致研究结果的异质性，在决策时应予以考虑。未来的研究应加强聚类随机化过程，并将学习成绩作为结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Child and Adolescent Mental Health PEDIATRICS-PSYCHIATRY

CiteScore

8.30

自引率

3.30%

发文量

审稿时长

>12 weeks

期刊介绍： Child and Adolescent Mental Health (CAMH) publishes high quality, peer-reviewed child and adolescent mental health services research of relevance to academics, clinicians and commissioners internationally. The journal''s principal aim is to foster evidence-based clinical practice and clinically orientated research among clinicians and health services researchers working with children and adolescents, parents and their families in relation to or with a particular interest in mental health. CAMH publishes reviews, original articles, and pilot reports of innovative approaches, interventions, clinical methods and service developments. The journal has regular sections on Measurement Issues, Innovations in Practice, Global Child Mental Health and Humanities. All published papers should be of direct relevance to mental health practitioners and clearly draw out clinical implications for the field.