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Screen Time Weight-loss Intervention Targeting Children at Home (SWITCH): process evaluation of a randomised controlled trial intervention.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Ni Mhurchu, Cliona 
Marsh, Samantha 
Epstein, Leonard H 
Olds, Tim 

Abstract

BACKGROUND: The Screen Time Weight-loss Intervention Targeting Children at Home (SWITCH) trial tested a family intervention to reduce screen-based sedentary behaviour in overweight children. The trial found no significant effect of the intervention on children's screen-based sedentary behaviour. To explore these null findings, we conducted a pre-planned process evaluation, focussing on intervention delivery and uptake. METHODS: SWITCH was a randomised controlled trial of a 6-month family intervention to reduce screen time in overweight children aged 9-12 years (n = 251). Community workers met with each child's primary caregiver to deliver the intervention content. Community workers underwent standard training and were monitored once by a member of the research team to assess intervention delivery. The primary caregiver implemented the intervention with their child, and self-reported intervention use at 3 and 6 months. An exploratory analysis determined whether child outcomes at 6 months varied by primary caregiver use of the intervention. RESULTS: Monitoring indicated that community workers delivered all core intervention components to primary caregivers. However, two thirds of primary caregivers reported using any intervention component "sometimes" or less frequently at both time points, suggesting that intervention uptake was poor. Additionally, analyses indicated no effect of primary caregiver intervention use on child outcomes at 6 months, suggesting the intervention itself lacked efficacy. CONCLUSIONS: Poor uptake, and the efficacy of the intervention itself, may have played a role in the null findings of the SWITCH trial on health behaviour and body composition. TRIAL REGISTRATION: The trial was registered in the Australian and New Zealand Clinical Trials Registry (no. ACTRN12611000164998 ); registration date: 10/02/2011.

Description

Keywords

Body Composition, Child, Child Health Services, Family, Female, Health Behavior, Humans, Male, New Zealand, Patient Education as Topic, Pediatric Obesity, Process Assessment, Health Care, Television, Treatment Outcome, Video Games

Journal Title

BMC Public Health

Conference Name

Journal ISSN

1471-2458
1471-2458

Volume Title

16

Publisher

Springer Science and Business Media LLC
Sponsorship
Medical Research Council (MR/K023187/1)
Medical Research Council (MC_UU_12015/6)
Wellcome Trust (087636/Z/08/Z)
Economic and Social Research Council (ES/G007462/1)