Interventions to Reduce Screen Time in Preschool‐Aged Children: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

BACKGROUND: The impact of interventions aimed at reducing screen use in preschool-aged children is unclear. This systematic review and meta-analysis aimed to evaluate interventions to reduce screen time among preschool-aged children and examine the characteristics of effective interventions. METHODS: Electronic databases were searched for randomized controlled trials evaluating screen time interventions for children aged 0-5 years. Studies were assessed on achievement of predefined screen time reduction objectives. Narrative synthesis summarized these outcomes in relation to intervention characteristics, followed by a meta-analysis of the pooled effect sizes and moderator influences. RESULTS: Sixty-five studies met the inclusion criteria and 43 had sufficient data to support meta-analyses. The majority of the interventions targeted children aged 2-5 years (77%) focusing on caregiver-child pairs (57%). Interventions were delivered across various settings including preschools (29%), healthcare (12%), or online (20%). The majority of the interventions met their screen time reduction objectives (62%). Characteristics most prevalent among the interventions that met screen time reduction objectives included delivery within the healthcare setting, delivery by research teams, and with caregivers as sole recipients. The meta-regression suggested that the interventions to reduce screen time were associated with a small but statistically significant effect (g = 0.16, 95% CI [0.01, 0.31], p = 0.036). Interventions targeting children aged 0-2 years had a higher proportion of successful studies, whereas meta-analysis indicated that interventions for 2- to 5-year-olds produced larger effect sizes (B = 0.31, p = 0.038). CONCLUSION: Interventions to reduce screen time in preschool-aged children show larger effects in slightly older preschoolers.