Decreasing screen-based entertainment in young children: The Family@play study

Time spent in screen-based entertainment (SBE) has been shown to be associated with adverse health and cognitive outcomes even in young children. This project therefore aims to examine the feasibility, acceptability and potential efficacy of a program to reduce screen-based entertainment in young children. Twenty-thirty families will be recruited into the study and the intervention will be delivered to parents in intact groups over a 6-week period. That is, existing groups such as parents attending a particular swimming lesson class or local playgroup, will be approached to participate in the program to ensure a familiar support base amongst parent group. The intervention consists of six weekly one hour group-based sessions. In each session, participants will set a goal aimed to reduce their young child’s screen-based entertainment which they will implement during the week following the session. Each family will provide data (child height/weight, parent survey, objectively assessed physical activity) three times (baseline, completion of program, 10 weeks post intervention). Each data collection meeting will take approximately 15 minutes and will occur at a time and location convenient to the participant (such as their home, during or adjacent to their playgroup/lesson, or other time/location convenient). During the data collection visits, children will be weighed and measured following standardised protocols. Activity monitors to measure overall physical activity (accelerometer) and time in different postures such as sitting and standing (inclinometer) will be fitted to participating children. Parents will be provided with an information sheet about the monitors and a log sheet to complete during the time their child wears the monitors. Six sessions will be delivered across the intervention period at the physical location where each group was recruited. Intervention sessions will be scheduled either immediately before or after the groups' usual attendance time. Following baseline data collection, a computer generated program will be used to randomly select two of the four groups to participate in the program from August to September 2012. The remaining two groups will participate in an enhanced program (following feedback on the program from the first two groups) in February to March 2013. Sessions will focus on three primary components: a) non-selectively decreasing SBE by use of budgeting, removing SBE options from children's bedrooms; b) selectively reducing SBE by setting rules/boundaries around use, and limiting participation based on context (only when child is not eating); and c) displacing SBE with other activities such as reading, imaginary games, etc. Content for group sessions will include: clarification of parents' values regarding their! child's health and well being; factors which influence children's development/well-being/health; changing and influencing children's behaviours; review of baseline results of current SBE use in their child; consequences of excessive SBE use to health and other outcomes; benefits of lower levels of SBE, such as social interaction, language development; building motivation and skills to reduce SBE including self-monitoring, goal setting, outcome and efficacy expectancies; awareness of good/bad SBE content; self-efficacy (barrier identification and goal-setting to overcome barriers); and support strategies within each group. Group sessions will also discuss the home-based activities to be undertaken by families and will use an anticipatory guidance approach (where expected challenges are identified and options to manage these are discussed prior to them being encountered) to facilitate group-based problem solving to possible challenges. By peer-based problem solving, participant! s may be more open in discussing challenges and more willing to accept advice from their peers. SMS messaging will be used between group sessions to support adherence to goals. A weekly internet blog site will also be available to support adherence and allow participants to post comments. A healthy afternoon tea and childcare for children and siblings will be provided during the group session.