Program

Jan 11, 2011

OVERVIEW

Modifying the Home Television Watching Environment is
a program designed to reduce TV and computer screen time among young children at
or above the 75th percentile for Body Mass Index (BMI). A monitoring
device–TV Allowance–is installed on each television, computer, and video game
console in the family home. An experimental evaluation found reductions in
screen time and energy intake among children in the intervention group, compared
with the control group. There were impacts on BMI among children in families in
a lower socioeconomic status, but not among other children. There were no
statistically significant differences between the two study groups for physical
activity.

DESCRIPTION OF PROGRAM

Target population: Children four through seven years of age who are at or
above the 75th percentile for age- and sex-standardized Body Mass
Index (BMI)

Modifying the Home Television Watching Environment is
a program designed to reduce TV and computer screen time among young children at
or above the 75th percentile for Body Mass Index (BMI). A monitoring
device called “TV Allowance” is installed on each television, computer, and
video game console in the family home. TV Allowance both monitors and controls
the amount of time spent viewing TVs, computers, and video games. Each family
member is assigned a four-digit code in order to turn on these devices. Children
have their usage levels budgeted, where program staff reduce the child’s usage
time by 10% each month from the baseline usage level. Staff continue to reduce
the budgeted time until it is reduced by 50% of the baseline level. When study
children reach their budgeted time, they are not able to turn on these
electronic devices for the rest of the week. Other family members’ viewing times
are not budgeted. In cases where children are under-budget for their viewing
time, they can earn $0.25 for each half-hour they are under-budget–for a total
of $2.00 per week. Parents are asked to provide encouragement and praise when
their children reduce their viewing time and for engaging in physical activity.
A Star Chart is used to reward children for reducing their viewing time and for
engaging in physical activity. When children reach the 50% reduced viewing time
within six months, the Star Chart is suspended and substituted with monthly
newsletters, which provide families with tips on staying physically active.

EVALUATION(S) OF PROGRAM
<![if !supportLineBreakNewLine]>
<![endif]>

Epstein LH, Roemmich JN, Robinson JL, Paluch RA,
Winiewicz DD, Fuerch JH, Robinson TN. (2008). A Randomized Trial of the Effects
of Reducing Television Viewing and Computer Use on Body Mass Index in Young
Children. Archives of Pediatrics and Adolescent Medicine, 162(3):239-245.

Evaluated population: A total of 70 families participated in the study. Among the study children, 80%
had a BMI score above the 85th percentile (overweight and obese), and
44% had a BMI score above the 95th percentile (obese). The mean age
of study children was six years.

Approach: Families were recruited through newspaper advertisements, flyers, and direct
mailings. Families were then contacted, via telephone, for an initial screen; if
interested, families attended an orientation, where they completed a
questionnaire assessing the number of TVs, video game consoles, VCRs, DVDs, and
computers in the home.

To be eligible, children had to be between four and
seven years of age, have a BMI score either at or above the 75th
percentile, watch TV and/or play computer games at least 14 hours per week, have
no medical condition prohibiting physical activity, have unlimited access to TV,
and have family agreement allowing TV tracking devices for the duration of the
study. After stratifying families by child sex, families were randomly assigned
to either the intervention group (n=36) or the control group (n=34).

Screen time was monitored through a monitoring device
attached to each TV, video game console, and computer; BMI was calculated
through assessing height and weight; physical activity was assessed through an
activity monitor; energy intake was assessed through a self-report survey. The
study assessed children’s progress for up to two years.

Children assigned to the control group were given
unfettered access to TV and computer viewing. They received $2.00 per week for
participating in the study. Parents of the control group participants were sent
newsletters, providing parenting tips and age-appropriate child activities and
recipes.

Results: The
program was found to reduce screen time and energy intake but was not found to
increase physical activity.

There were significant impacts on BMI at the six- and
12-month follow-ups; however, impacts dissipated by the 24-month follow-up. A
subgroup analysis found greater decrease in BMI among children belonging to
families of lower socioeconomic status, and impacts were found at all follow-ups
for this subgroup.

SOURCES FOR MORE INFORMATION
<![if !supportLineBreakNewLine]>
<![endif]>

References:

Epstein LH, Roemmich JN, Robinson JL, Paluch RA,
Winiewicz DD, Fuerch JH, Robinson TN. (2008). A Randomized Trial of the Effects
of Reducing Television Viewing and Computer Use on Body Mass Index in Young
Children. Archives of Pediatrics and Adolescent Medicine, 162(3):239-245.

KEYWORDS: Children (3-11), Home-based, Parent/Family Component,
Nutrition, Health Status/Conditions, Other Physical Health

Program information last updated on 1/11/11.

Subscribe to Child Trends

Short weekly updates of recent research on children and youth.