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Am Fam Physician. 2004;70(9):1784-1785

Television viewing has increased dramatically during the past 20 years. This increase has occurred despite studies showing that television viewing by children can lead to poor school performance, attenuated social behavior, higher rates of violence, and increased rates of childhood obesity. In response to the adverse effects of television viewing, many programs have been developed that target school-aged children’s television viewing habits. However, most television viewing habits are developed during preschool years. The American Academy of Pediatrics recommends that children younger than two years not watch television and that children two years and older be limited in their exposure to television and other media (to a maximum of two hours per day). Dennison and colleagues developed and evaluated an intervention to reduce television viewing by preschool children.

The trial was a randomized controlled study of 16 preschool or day care centers in a rural area. The centers were assigned randomly to an intervention group that participated in a seven-session program designed to reduce television viewing or to a control group that received a safety and injury prevention program. Participants in the study were children two and one half years through five and one half years who attended the study schools and centers. Before the intervention, parents were surveyed regarding their children’s television viewing habits and the amount of time spent playing video or computer games or surfing the Internet. The survey was repeated after the intervention. Height and weight were measured before, during, and after the intervention. The main outcomes measured were change in parent-reported child television or video viewing and measured growth variables.

There were 90 children who completed the study in the intervention group and 73 children in the control group. Before the intervention, the average time spent viewing television or videos was 11.9 hours per week in the intervention group and 14.0 hours per week in the control group. At the end of the intervention, the children in the intervention group had decreased television or video viewing by a little more than three hours per week, while children in the control group had increased their viewing by a little more than one and one half hours per week.

The percentage of children in the intervention group who watched television or videos for more then two hours per day decreased from 33 to 18 percent. The percentage of children in the control group who watched television or videos more than two hours per day increased from 41 to 47 percent. This overall difference of 21.5 percent was significant. There were no significant changes between the two groups with regard to height, weight, body mass index, standardized body mass index calculation, and triceps skin-fold.

The authors conclude that preschool intervention can reduce the amount of viewing of television and videos by young children. They add that this intervention did not change children’s growth or adiposity during the study. However, they point out that the issue should be addressed in a larger study of reduced television viewing and prevention of overweight or obesity in children.

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