What Works in Sedentary Behavior Interventions for Youth: A Review of Reviews
Previous reviews have summarized the results of interventions aimed at reducing sedentary behavior among youth, but evidence-based best practice is needed. This systematic review aimed to synthesize evidence to determine which intervention strategies/characteristics are powerful in reducing sedentary behavior among children and adolescents. Eight electronic databases were used. The eligibility criteria were systematic reviews (published in English, Spanish and Portuguese) that analyzed clinical trials to reduce sedentary behavior in young people (age ≤ 18 years). Twenty-nine studies were included. Eleven out of 29 previous reviews had low methodological quality. Almost all reviews reported that interventions were effective in reducing sedentary behavior; however, most of them (26 reviews) had limited evidence due to the inconsistency of results, low methodological quality and/or small sample size. School have been the most used context and strategies that involve family, used control devices, educational materials and standing desks show effectiveness. However, other answers are still unclear, such as the effectiveness of interventions for different types of sedentary behaviors (e.g., TV time), the necessary length for intervention, and the effectiveness of mediators. Thus, future and high-quality studies should consider addressing such questions in order to support evidence-based interventions to reduce sedentary behavior.
KeywordsAdolescents Public health Evidence-based practice Systematic review
We thank the authors of previous reviews who contributed important information.
PCS participated in all stages of the study, including review design, searching and screening of studies, data extraction, methodological quality assessment and draft the first version of the review. JAS, AB and VCBF participated in review design, searching and screening of studies, methodological quality assessment and contributed to the text. GM and KSS participated in review design, data extraction and contributed to the text. All authors approved the final version of the manuscript.
The authors declare that they have no funding.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
- Altenburg, T. M., Kist-van Holthe, J., & Chinapaw, M. J. M. (2016). Effectiveness of intervention strategies exclusively targeting reductions in children’s sedentary time: A systematic review of the literature. International Journal of Behavioral Nutrition and Physical Activity, 13(1). https://doi.org/10.1186/s12966-016-0387-5.
- Arundell, L., Fletcher, E., Salmon, J., Veitch, J., & Hinkley, T. (2016). A systematic review of the prevalence of sedentary behavior during the after-school period among children aged 5–18 years. The International Journal of Behavioral Nutrition and Physical Activity, 13(93), 1–9. https://doi.org/10.1186/s12966-016-0419-1.CrossRefGoogle Scholar
- Barbosa Filho, V. C., Minatto, G., Mota, J., Silva, K. S., Campos, W., & Lopes, A. D. S. (2016). Promoting physical activity for children and adolescents in low- and middle-income countries: An umbrella systematic review: A review on promoting physical activity in LMIC. Preventive Medicine, 88(1216), 115–126. https://doi.org/10.1186/s12889-015-2543-2.CrossRefPubMedGoogle Scholar
- Buchanan, R. L., Rooks-Peck, C. R., Finnie, R. K. C., Wethington, H. R., Jacob, V., Fulton, J. E., et al. (2016). Reducing recreational sedentary screen time: a community guide systematic review. American Journal of Preventive Medicine, 50(3), 402–415. https://doi.org/10.1016/j.amepre.2015.09.030.CrossRefGoogle Scholar
- Chastin, S. F. M., De Craemer, M., Lien, N., Bernaards, C., Buck, C., Oppert, J.-M., et al. (2016). The SOS-framework (Systems of Sedentary behaviours): an international transdisciplinary consensus framework for the study of determinants, research priorities and policy on sedentary behaviour across the life course: a DEDIPAC-study. The International Journal of Behavioral Nutrition and Physical Activity, 13(83), 1–13. https://doi.org/10.1186/s12966-016-0409-3.CrossRefGoogle Scholar
- Corder, K., Atkin, A. J., Bamber, D. J., Brage, S., Dunn, V. J., Ekelund, U., et al. (2015). Revising on the run or studying on the sofa: prospective associations between physical activity, sedentary behaviour, and exam results in British adolescents. International Journal of Behavioral Nutrition and Physical Activity, 12, 1–8. https://doi.org/10.1186/s12966-015-0269-2.CrossRefGoogle Scholar
- Dobbins, M., Husson, H., Decorby, K., & Rl, L. (2013). School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18 (Review) Summary of findings for the main comparison. Cochrane Library, 18(2), 1–260. https://doi.org/10.1002/14651858.CD007651.pub2.www.cochranelibrary.com.CrossRefGoogle Scholar
- Dobbins, M., Robeson, K. D. C., Husson, P., H., & Tirilis, D. (2009). School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6–18 (Review). Cochrane Database Systematic Review, 18(1), 6–18Google Scholar
- Grieken, A., Van Ezendam, N. P. M., Paulis, W. D., Wouden, J. C., Van Der, & Raat, H. (2012). Primary prevention of overweight in children and adolescents: a meta-analysis of the effectiveness of interventions aiming to decrease sedentary behaviour. International Journal of Behavioral Nutrition and Physical Activity, 9(61), 1–11.Google Scholar
- Hegarty, L. M., Mair, J. L., Kirby, K., Murtagh, E., & Murphy, M. H. (2016). School-based Interventions to reduce sedentary behaviour in children: A systematic review school-based interventions to reduce sedentary behaviour in children. A Systematic Review, 3(3), 520–541. https://doi.org/10.3934/publichealth.2016.3.520.CrossRefGoogle Scholar
- Higgins, J. P., & Green, S. (2011). Cochrane Handbook for Systematic Reviews of Interventions. http://handbook.cochrane.org/. Accessed 15 Feb 2012.
- Hynynen, S.-T., van Stralen, M. M., Sniehotta, F. F., Araújo-Soares, V., Hardeman, W., Chinapaw, M. J. M., et al. (2016). A systematic review of school-based interventions targeting physical activity and sedentary behaviour among older adolescents. International Review of Sport and Exercise Psychology, 9(1), 22–44. https://doi.org/10.1080/1750984X.2015.1081706.CrossRefPubMedGoogle Scholar
- Jalali-Farahani, S., Amiri, P., & Chin, Y. S. (2016). Are physical activity, sedentary behaviors and sleep duration associated with body mass index-for-age and health-related quality of life among high school boys and girls? Health and Quality of Life Outcomes, 14(30), 1–9. https://doi.org/10.1186/s12955-016-0434-6.CrossRefGoogle Scholar
- Kamath, C. C., Vickers, K. S., Ehrlich, A., McGovern, L., Johnson, J., Singhal, V., et al. (2008). Clinical review: behavioral interventions to prevent childhood obesity: A systematic review and metaanalyses of randomized trials. The Journal of Clinical Endocrinology and Metabolism, 93(12), 4606–4615. https://doi.org/10.1210/jc.2006-2411.CrossRefPubMedGoogle Scholar
- Laws, R., Campbell, K. J., Pligt, P., Van Der Russell, G., Ball, K., Lynch, J., et al. (2014). The impact of interventions to prevent obesity or improve obesity related behaviours in children (0–5 years) from socioeconomically disadvantaged and/or indigenous families: A systematic review. BMC Public Health, 14(779), 1–18.Google Scholar
- LeBlanc, A. G., Katzmarzyk, P. T., Barreira, T. V., Broyles, S. T., Chaput, J.-P., Church, T. S., et al. (2015). Correlates of total sedentary time and screen time in 9–11 year-old children around the world: The international study of childhood obesity, lifestyle and the environment. PloS One, 10(6), 1–20. https://doi.org/10.1371/journal.pone.0129622.CrossRefGoogle Scholar
- Leung, M. M., Agaronov, A., Grytsenko, K., & Yeh, M.-C. (2012). Intervening to reduce sedentary behaviors and childhood obesity among school-age youth: A systematic review of randomized trials. Journal of Obesity, 2012, 1–14. https://doi.org/10.1155/2012/685430.
- Maitland, C., Stratton, G., Foster, S., Braham, R., & Rosenberg, M. (2013). A place for play ? The influence of the home physical environment on children’ s physical activity and sedentary behaviour. International Journal of Behavioral Nutrition and Physical Activity, 10(99), 1–21.Google Scholar
- Ng, S. W., & Pupkin, B. (2012). Time use and physical activity: A shift away from movement across the globe. Obesity Reviews, 13(8), 659–680. https://doi.org/10.1111/j.1467-789X.2011.00982.x.Time.CrossRefPubMedPubMedCentralGoogle Scholar
- Shea, B. J., Grimshaw, J. M., Wells, G., Boers, M., Andersson, N., Hamel, C., et al. (2007). Development of AMSTAR: A measurement tool to assess the methodological quality of systematic reviews. BMC Medical Research Methodology, 7(10), 1–7. https://doi.org/10.1186/1471-2288-7-10.CrossRefGoogle Scholar
- Siron, S., Dagenais, C., & Ridde, V. (2015). What research tells us about knowledge transfer strategies to improve public health in low-income countries: A scoping review. International Journal of Public Health, 60(7), 849–863. https://doi.org/10.1007/s00038-015-0716-5.CrossRefPubMedPubMedCentralGoogle Scholar
- Tremblay, M. S., LeBlanc, A. G., Kho, M. E., Saunders, T. J., Larouche, R., Colley, R. C., et al. (2011). Systematic review of sedentary behaviour and health indicators in school-aged children and youth. The International Journal of Behavioral Nutrition and Physical Activity, 8(98), 1–22. https://doi.org/10.1186/1479-5868-8-98.CrossRefGoogle Scholar
- van Stralen, M., Yildirim, M., Velde, S., Brug, J. W., Mechelen, V., & Chinapaw, M. (2004). What work in school-based energy balance behaviour interventions and what does not? A systematic review of mediating mechanisms. Pediatric Review, 35, 1251–1265.Google Scholar
- van Stralen, M. M., Yildirim, M., Velde, te, Brug, S. J., van Mechelen, J., W., & Chinapaw, M. J. M. (2011). What works in school-based energy balance behaviour interventions and what does not? A systematic review of mediating mechanisms. International Journal of Obesity, 35(10), 1251–1265. https://doi.org/10.1038/ijo.2011.68.CrossRefPubMedGoogle Scholar
- Wahi, G., Parkin, P. C., Beyene, J., Uleryk, E. M., & Birken, C. S. (2011). Effectiveness of interventions aimed at reducing screen time in children: a systematic review and meta-analysis of randomized controlled trials. Archives of Pediatrics & Adolescent Medicine, 165(11), 979–986. https://doi.org/10.1001/archpediatrics.2011.122.CrossRefGoogle Scholar
- Yıldırım, M., Verloigne, M., de Bourdeaudhuij, I., Androutsos, O., Manios, Y., Felso, R., et al. (2011). Study protocol of physical activity and sedentary behaviour measurement among schoolchildren by accelerometry–cross-sectional survey as part of the ENERGY-project. BMC Public Health, 11, 182. https://doi.org/10.1186/1471-2458-11-182.CrossRefPubMedPubMedCentralGoogle Scholar