A translational research intervention to reduce screen behaviours and promote physical activity among children: Switch-2-Activity

Translational or implementation research that assesses the effectiveness of strategies to promote health behaviours among children that have been previously tested under 'ideal' conditions is rarely reported. Switch-2-Activity aimed to examine the effectiveness of an abbreviated programme delivered by teachers targeting children's television viewing, computer use, physical activity and potential mediators of behaviour change. Fifteen schools from disadvantaged areas in Melbourne, Australia agreed to participate in the study (43% school-level response rate). Out of the 1566 Grades 5 and 6 (9-12 year old) children invited to take part in the study, 1048 (67% response rate) provided informed consent. Schools were randomized to either an intervention or wait-list control condition. Teachers delivered six lessons, which included strategies such as self-monitoring, behavioural contracting and budgeting of screen time. Children completed a self-report survey at baseline and post-intervention examining screen-based behaviours, physical activity, self-efficacy and behavioural capability. Teachers reported implementation of and attitudes to the programme. Seventy-one per cent of teachers delivered at least four of the six lessons. Most teachers reported that the materials were easy to follow and deliver; however, many teachers reported modifying the materials in some way. Among boys, there were favourable small intervention effects on weekend screen time [(coefficient -0.62, 95% 95% confidence interval: -1.15, -0.10, p = 0.020)]. The intervention also had significant positive effects on children's self-efficacy for reducing television viewing and on behavioural capability (television viewing styles). Future studies that assess the translation of efficacious programmes and that test whether such programmes are equally effective in different settings (e.g. in the family setting) are urgently required.