The Overflow Effects of Movement Behaviour Change Interventions for Children and Adolescents: A Systematic Review and Meta-Analysis of Randomised Controlled Trials,Sports Medicine

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The Overflow Effects of Movement Behaviour Change Interventions for Children and Adolescents: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
Sports Medicine ( IF 9.3 ) Pub Date : 2024-09-18 , DOI: 10.1007/s40279-024-02113-1
Jie Feng _{1,

2} , Wendy Yajun Huang _{1,

3} , Chen Zheng ₄ , Jiao Jiao ₁ , Asaduzzaman Khan ₅ , Mehwish Nisar ₅ , Stephen Heung-Sang Wong ₂

Affiliation

Background

Considering the finite time within a 24-h day, the distribution of time spent on movement behaviours has been found to be associated with health outcomes.

Objectives

This systematic review and meta-analysis aimed to summarise and evaluate the overflow effects of interventions targeting a single behaviour (physical activity, sedentary behaviour/screen time, or sleep) on other non-targeted behaviours among children and adolescents.

Methods

Six databases (MEDLINE [Ovid], PsycINFO [ProQuest], EMBASE [Ovid], PubMed, Web of Science and SPORTDiscus [EBSCO]) were searched for relevant studies published before 13 May, 2024. Randomised controlled trials and clustered randomised controlled trials that targeted a single behaviour and also assessed the effects on non-targeted behaviours, comprised of healthy children under the age of 18 years, were included. Movement behaviours can be measured either objectively or subjectively. The revised Cochrane risk-of-bias tool for randomised trials was adopted to evaluate the risk of bias.

Results

A total of 102 studies with 45,998 participants from 21 countries were identified, and 60 of them with 26,183 participants were incorporated into the meta-analysis. The meta-analysis demonstrated that physical activity interventions led to a reduction in the proportion of each day spent in sedentary behaviour (mean difference = − 0.95% of wear time, 95% confidence interval − 1.44, − 0.45, I² = 39%). Sedentary behaviour interventions resulted in increased standing time (mean difference = 3.87%, 95% confidence interval 1.99, 5.75, I² = 0%). Interventions targeting screen time did not yield changes in physical activity or sleep. The findings on the effectiveness of sleep interventions on non-targeted behaviours and of physical activity interventions on sleep were inconclusive.

Conclusions

Overall, the findings suggested that interventions aimed at increasing physical activity or reducing sedentary behaviour had overflow effects on non-targeted behaviours, but the effect sizes were small. Additional evidence is needed to reach definitive conclusions regarding the impact of behaviour change interventions on sleep and of the overflow effects of sleep interventions.

中文翻译：

儿童和青少年运动行为改变干预措施的溢出效应：随机对照试验的系统回顾和荟萃分析

背景

考虑到一天 24 小时内的有限时间，运动行为所花费的时间分布与健康结果相关。

目标

这项系统回顾和荟萃分析旨在总结和评估针对儿童和青少年单一行为（身体活动、久坐行为/屏幕时间或睡眠）的干预措施对其他非目标行为的溢出效应。

方法

检索了六个数据库（MEDLINE [Ovid]、PsycINFO [ProQuest]、EMBASE [Ovid]、PubMed、Web of Science 和 SPORTDiscus [EBSCO]）以查找 2024 年 5 月 13 日之前发表的相关研究。针对单一行为，还评估了对非目标行为（包括 18 岁以下健康儿童）的影响。运动行为可以客观或主观地测量。采用修订后的随机试验 Cochrane 偏倚风险工具来评估偏倚风险。

结果

共确定了 102 项研究，涉及来自 21 个国家的 45,998 名参与者，其中 60 项研究，涉及 26,183 名参与者被纳入荟萃分析。荟萃分析表明，体力活动干预可以减少每天久坐行为的比例（平均差 = − 0.95% 佩戴时间，95% 置信区间 − 1.44，− 0.45， I ² = 39%）。久坐行为干预导致站立时间增加（平均差 = 3.87%，95% 置信区间 1.99、5.75， I ² = 0%）。针对屏幕时间的干预措施并没有改变身体活动或睡眠。关于睡眠干预对非目标行为和体力活动干预对睡眠的有效性的研究结果尚无定论。