Evaluating the effectiveness of interventions to reducing screen time in children: meta-analysis of randomized controlled trials

Purpose The purpose of this paper is to evaluate the impact of interventions focused on reducing screen time in children. Design/methodology/approach Studies that aim to investigate the effects of interventions aimed at reducing the time spent in front of the screen (i.e. screen time). A Random-effects model was used to calculate the pooled standard mean differences. The outcome was to evaluate the screen time in children in the 0–18 age range. A subgroup analysis was performed to reveal the extent to which the overall effect size varied by subgroups (participant age, duration of intervention and follow). Findings For the outcome, the meta-analysis included 21 studies, and the standard difference in mean change in screen time in the intervention group compared with the control group was −0.16 (95% confidence interval [CI], −0.21 to −0.12) (p < 0.001). The effect size was found to be higher in long-term (=7 months) interventions and follow-ups (p < 0.05). Originality/value Subgroup analysis showed that a significant effect of screen time reduction was observed in studies in which the duration of intervention and follow-up was =7 months. As the evidence base grows, future researchers can contribute to these findings by conducting a more comprehensive analysis of effect modifiers and optimizing interventions to reduce screen time.

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Considering the methodological limitations in the evidence base of antidepressants for depression: a reanalysis of a network meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-024886 ◽

2019 ◽

Vol 9 (6) ◽

pp. e024886 ◽

Cited By ~ 24

Author(s):

Klaus Munkholm ◽

Asger Sand Paludan-Müller ◽

Kim Boesen

Keyword(s):

Systematic Review ◽

Clinical Study ◽

Effect Size ◽

Meta Analysis ◽

Evidence Base ◽

Risk Of Bias ◽

Depression Symptom ◽

Meta Analyses ◽

The Impact ◽

Clinical Study Reports

ObjectivesTo investigate whether the conclusion of a recent systematic review and network meta-analysis (Ciprianiet al) that antidepressants are more efficacious than placebo for adult depression was supported by the evidence.DesignReanalysis of a systematic review, with meta-analyses.Data sources522 trials (116 477 participants) as reported in the systematic review by Ciprianiet aland clinical study reports for 19 of these trials.AnalysisWe used the Cochrane Handbook’s risk of bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to evaluate the risk of bias and the certainty of evidence, respectively. The impact of several study characteristics and publication status was estimated using pairwise subgroup meta-analyses.ResultsSeveral methodological limitations in the evidence base of antidepressants were either unrecognised or underestimated in the systematic review by Ciprianiet al. The effect size for antidepressants versus placebo on investigator-rated depression symptom scales was higher in trials with a ‘placebo run-in’ study design compared with trials without a placebo run-in design (p=0.05). The effect size of antidepressants was higher in published trials compared with unpublished trials (p<0.0001). The outcome data reported by Ciprianiet aldiffered from the clinical study reports in 12 (63%) of 19 trials. The certainty of the evidence for the placebo-controlled comparisons should be very low according to GRADE due to a high risk of bias, indirectness of the evidence and publication bias. The mean difference between antidepressants and placebo on the 17-item Hamilton depression rating scale (range 0–52 points) was 1.97 points (95% CI 1.74 to 2.21).ConclusionsThe evidence does not support definitive conclusions regarding the benefits of antidepressants for depression in adults. It is unclear whether antidepressants are more efficacious than placebo.

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Retrospective observational study of the impact on emergency admission of telehealth at scale delivered in community care in Liverpool, UK

BMJ Open ◽

10.1136/bmjopen-2019-028981 ◽

2019 ◽

Vol 9 (7) ◽

pp. e028981

Author(s):

Cees van Berkel ◽

Peter Almond ◽

Carol Hughes ◽

Maurice Smith ◽

Dave Horsfield ◽

...

Keyword(s):

Observational Study ◽

Subgroup Analysis ◽

Intervention Group ◽

Average Treatment Effect ◽

Retrospective Observational Study ◽

Control Group ◽

Chronic Obstructive ◽

Emergency Admissions ◽

Percentage Decrease ◽

The Impact

ObjectiveTo assess the effect of a real world, ongoing telehealth service on the use of secondary healthcare.DesignA retrospective observational study with anonymous matched controls.SettingPrimary and community healthcare. Patients were recruited over 4 years in 89 general practices in Liverpool, UK and remotely managed by a dedicated clinical team in Liverpool Community Health.Participants5154 patients with chronic obstructive pulmonary disease, heart failure or diabetes were enrolled in the programme, of whom 3562 satisfied the inclusion criteria of this study.InterventionAt least 9 weeks of telehealth including vital sign collection, questionnaires, education, support and informal coaching by clinical staff.Primary outcomeReduction in the number of emergency admissions in the 12 months after start, compared with the year before start. Secondary subgroup analysis to improve future targeting and personalisation of the service.ResultThe average number of emergency admissions for the intervention group at baseline is 0.35, 95% CI 0.32 to 0.38. The differential decrease in emergency admissions in the intervention group in comparison with the control group, the average treatment effect, is 0.08, 95 CI 0.05 to 0.11, corresponding to an average percentage decrease of 22.7%. In subgroup analysis, a score is calculated that can be used prospectively to predict individual benefit from the intervention. Patients with an above median score (37%) are predicted average reduction in emergency admissions of 0.15, 95% CI 0.09 to 0.2, corresponding to a percentage decrease in admissions of 25.3%.ConclusionThe telehealth intervention has a positive impact across a wide cohort of patients with different diseases. Prospective scoring of patients and allocation to targeted telehealth interventions is likely to improve the effectiveness and efficiency of the service.

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Music intervention affects the quality of life on Alzheimer’s disease: a meta-analysis

10.37766/inplasy2021.12.0055 ◽

2021 ◽

Author(s):

Lingyan Zuo ◽

Fengting Zhu ◽

Rui Wang ◽

Hongyan Shuai ◽

Xin Yu

Keyword(s):

Meta Analysis ◽

Intervention Group ◽

Original Data ◽

Controlled Study ◽

Control Group ◽

Music Intervention ◽

Significant Difference ◽

Review Question ◽

Intervention Modality ◽

The Impact

Review question / Objective: Inclusion criteria: population: 1) A randomized controlled study on the impact of music intervention on the QOL of patients with AD; 2) The participants in this study is patients with AD; 3) There is no significant difference among age, gender and education background in sorted groups before analysis which make these groups comparable; intervention: 1)Intervention Modality Music-based intervention; comparison: 1) All data were sorted into two groups: the music intervention group and the control group without any music intervention; outcome: 1) The indicators evaluated in the literature included the score of QOL-AD or WHOQOL-BERF scale, at least one of the two scales summarized in selected publications; language: 1) Only articles published in English and Chinese were considered. Exclusion criteria: 1) The participants were not diagnosed with AD; 2) Non-musical intervention;3) Non-RCTs; 4) No specific values for outcome variables; 5) Articles lacking original data; 6) Repeat published reports; 7) Full text could not be obtained.

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Effects of reflexology on premenstrual syndrome: a systematic review and meta-analysis

BioPsychoSocial Medicine ◽

10.1186/s13030-019-0165-0 ◽

2019 ◽

Vol 13 (1) ◽

Cited By ~ 1

Author(s):

Marzieh Hasanpour ◽

Mohammad Mehdi Mohammadi ◽

Habib Shareinia

Keyword(s):

Systematic Review ◽

Premenstrual Syndrome ◽

Treatment Time ◽

Psychological Symptoms ◽

Meta Analysis ◽

Intervention Group ◽

Care Program ◽

Cochrane Library ◽

Control Group ◽

The Impact

Abstract Background Premenstrual syndrome (PMS) refers to a set of somatic and psychological symptoms that occur cyclically in the luteal phase of a menstrual cycle. There is no report of final result of reflexology on PMS. Therefore, the present study aimed to determine the effect of reflexology on PMS through a systematic review and meta-analysis study. Method The present study was a systematic review and meta-analysis that was conducted by searching in 8 electronic databases including PubMed, EMBASE, Cochrane Library, Web of Science, ProQuest, Scopus, Google Scholar, and SID until December 28, 2018. In this regard, interventional studies, which examined the impact of reflexology on women with premenstrual syndrome, were included. These studies were published during 1993 to 2018. The Cochrane Collaboration’s Risk of Bias Tool was used to assess the quality of studies. Meta-analysis was performed by the help of CMA 2 software. Results Nine out of 407 studies finally remained after screening, and quantitative and quantitative analyses were performed on them. The total number of research samples was 475. The mean treatment time with reflexology was 40.55 min per session that was performed in 6 to 10 sessions of treatment in 66.67% of studies. According to the meta-analysis and based on the random effects model, the reflexology could decrease the severity of PMS in the intervention group compared to the control group (SMD = − 2.717, 95% CI: − 3.722 to − 1.712). Meta-regression results indicated that the duration of intervention sessions (β = − 0.1124, 95% CI − 0.142 to − 0.084, p < 0.001) had a significant impact on the severity of PMS. Reflexology could also significantly affect somatic (SMD = − 1.142, 95% CI: − 1.481 to − 0.803) and psychological (SMD = − 1.380, 95% CI: − 2.082 to − 0.677) symptoms arising from PMS. Conclusion In general, results of the present study indicated that the reflexology could relieve PMS symptoms, so that overall scores, somatic and psychological symptoms of PMS decreased by applying the reflexology intervention. Furthermore, an increase in the length of reflexology time in each session increased its efficiency. Reflexology can be used as an effective intervention in a patient care program by nurses and its efficiency can be enhanced by increasing intervention time in each reflexology treatment session.

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Tailored Web-Based Smoking Interventions and Reduced Attrition: Systematic Review and Meta-Analysis

Journal of Medical Internet Research ◽

10.2196/16255 ◽

2020 ◽

Vol 22 (10) ◽

pp. e16255

Author(s):

Amika Shah ◽

Michael Chaiton ◽

Dolly Baliunas ◽

Robert Schwartz

Keyword(s):

Systematic Review ◽

Smoking Cessation ◽

Passive Control ◽

Controlled Trial ◽

Meta Analysis ◽

Intervention Group ◽

Control Group ◽

Web Based ◽

The Impact

Background The increasing number of internet users presents an opportunity to deliver health interventions to large populations. Despite their potential, many web-based interventions, including those for smoking cessation, face high rates of attrition. Further consideration of how intervention features impact attrition is needed. Objective The aim of this systematic review is to investigate whether tailored web-based smoking cessation interventions for smokers are associated with reduced rates of attrition compared with active or passive untailored web-based interventions. The outcomes of interest were dropout attrition at 1-, 3-, 6-, and 12-month follow-ups. Methods Literature searches were conducted in May 2018 and updated in May 2020 on MEDLINE (Medical Literature Analysis and Retrieval System Online), PsycINFO (Psychological Information), EMBASE (Excerpta Medica dataBASE), CINAHL (Cumulated Index to Nursing and Allied Health Literature), Scopus, and the Cochrane Tobacco Addiction Group Specialized Register with the following search terms: smoking cessation, tailored, or web- or internet-based. Included studies were published in English before or in May 2020 using a randomized controlled trial design. Studies were restricted to those with web-based delivery, a tailored intervention group, an untailored control group, and a reported outcome of smoking cessation. Studies were assessed for methodological quality using the Cochrane Risk of Bias tool. Two reviewers independently extracted the study characteristics and the number of participants lost to follow-up for each treatment group. Results A total of 13 studies were included in the systematic review, of which 11 (85%) were included in the meta-analysis. Tailoring had no statistically significant effect on dropout attrition at 1-month (risk ratio [RR]=1.02, 95% CI 0.95-1.09; P=.58; I2=78%), 3-month (RR=0.99, 95% CI 0.95-1.04; P=.80; I2=73%), 6-month (RR=1.00, 95% CI 0.95-1.05; P=.90; I2=43%), or 12-month (RR=0.97, 95% CI 0.92-1.02; P=.26; I2=28%) follow-ups. Subgroup analyses suggested that there was a statistically significant effect of tailoring between the active and passive subgroups at 1-month (P=.03), 3-month (P<.001), and 6-month (P=.02) follow-ups but not at 12-month follow-up (P=.25). Conclusions The results suggest that tailoring of web-based smoking cessation interventions may not be associated with reduced rates of dropout attrition at 1-, 3-, 6-, or 12-month follow-ups. Significant differences between studies that include untailored active and passive control groups suggest that the role of tailoring may be more prominent when studies include a passive control group. These findings may be because of variability in the presence of additional features, the definition of smokers used, and the duration of smoking abstinence measured. Future studies should incorporate active web-based controls, compare the impact of different tailoring strategies, and include populations outside of the Western countries.

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Effects of Virtual Reality-Based Physical And Psychological Exercise On Depression In Stroke Patients : A Meta-Analysis

10.21203/rs.3.rs-982395/v1 ◽

2021 ◽

Author(s):

Hebing Liu ◽

Zhaohua Cheng ◽

Shuo Wang ◽

Yong Jia ◽

Chen Li

Keyword(s):

Virtual Reality ◽

Controlled Trial ◽

Meta Analysis ◽

Depression Scale ◽

Control Group ◽

Stroke Patients ◽

Depth Study ◽

Health Related ◽

Mean Differences ◽

The Impact

Abstract Background: Virtual Reality (VR) has been widely used in health-related fields. The aim of this study was to assess the effectiveness of virtual reality-based physical and psychological exercise on depression.Methods: A total of 752 patients with stroke from 11 randomized controlled trial (RCT) studies were included in this meta-analysis and the studies derived from 6 electronic databases searched from database inception to August 2021. For continuous results, the standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated to synthesize the effects.Results: The meta-analysis showed that compared with control group, VR-based interventions significantly decreased the depression scale score (SMD = −0.71, 95% CI: −1.32, −0.10) in the subjects. The results showed that the the patient age and total intervention time had a significant impact on the outcome of depression. The smaller the age and longer the intervention duration, the greater the impact on the outcome of depression.Conclusions: The current meta-analysis indicated the virtual reality-based physical and psychological exercise has a significant effect on depression in stroke patients compared to controls. The study showed an outstanding reduction in depression for aged under 60 participants and intervention longer than 8 weeks. At the same time, clinical studies of different ages and different intervention time also need further in-depth study.

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Does strawberry supplementation ameliorate markers of cardiovascular and metabolic health? A systematic review and meta-analysis

Nutrition & Food Science ◽

10.1108/nfs-10-2021-0295 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Reihaneh Mousavi ◽

Morteza Arab-Zozani ◽

Elaheh Foroumandi ◽

Majid Karandish ◽

Leila Maghsoumi-Norouzabad ◽

...

Keyword(s):

Risk Factors ◽

Meta Analysis ◽

Intervention Group ◽

Health Sector ◽

Density Lipoprotein ◽

High Sensitivity ◽

Metabolic Health ◽

Control Group ◽

Content Type

Purpose This study aims to identify the effect of strawberry supplementation on some metabolic, inflammatory and oxidative parameters in adults with cardiovascular (CV) risk factors. Design/methodology/approach A systematic literature search was performed up to November 2020 using PubMed, Embase, Cochrane, Web of Sciences and Scopus databases. The pooled mean difference (MD) with 95% confidence interval (CI) was used to analyze the data by random-effects model. I2 statistics and Cochrane risk of bias tool were used for investigating heterogeneity and quality of included studies, respectively. Findings In total, 13 randomized controlled trials with 488 participants were included. Strawberry supplementation significantly reduced diastolic blood pressure (MD = −2.1, 95% CI [−3.7, −0.42], P = 0.01), low-density lipoprotein cholesterol (−0.16, −0.30, −0.02, P = 0.03), high-sensitivity C-reactive protein (CRP) (−0.76, −1.4, −0.05, P < 0.001) and CRP (−0.31, −0.43, −0.18, P = 0.04). Leptin levels were raised in control group compared with participants who had received strawberry (0.65, 0.09 and 1.2, P = 0.02). The results of subgroup analysis based on the follow-up duration and supplementation dose showed that consumption of strawberry for more than eight weeks and 50 g day−1 can significantly decrease some other CV risk factors compared to control group. Further, both higher follow-up duration and supplementation dose were more effective in increasing leptin levels of control group compared to intervention group. Originality/value The use of some useful plant foods such as strawberries by the pharmaceutical industry and the community health sector can greatly help improve people’s CV and metabolic health.

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The Effect of Probiotics on Symptoms, Gut Microbiota and Inflammatory Markers in Infantile Colic: A Systematic Review, Meta-Analysis and Meta-Regression of Randomized Controlled Trials

Journal of Clinical Medicine ◽

10.3390/jcm9040999 ◽

2020 ◽

Vol 9 (4) ◽

pp. 999 ◽

Cited By ~ 1

Author(s):

Karolina Skonieczna-Żydecka ◽

Katarzyna Janda ◽

Mariusz Kaczmarczyk ◽

Wojciech Marlicz ◽

Igor Łoniewski ◽

...

Keyword(s):

Gut Microbiota ◽

Lactobacillus Reuteri ◽

Meta Analysis ◽

Intervention Group ◽

Intestinal Microbiome ◽

Infantile Colic ◽

Breastfed Infants ◽

Mean Differences ◽

Meta Analyses ◽

The Impact

Immaturity in digestive-tract motor function and altered intestinal microbiome may play roles in pathogenesis of infantile colic. We assessed the impact of probiotic therapy on crying duration day, in newborns experiencing colic attacks. The PubMed, Embase, Cinnahl, Web of Science databases, and a clinical trials registry (ClinicalTrials.gov) were searched from inception until 12/02/2020. Random-effects meta-analyses were used to derive standardized mean differences/differences in means and risk ratios. We included 16 studies, which involved 1319 newborns aged up to 6 months. Lactobacillus reuteri strain DSM17938 was administered predominantly (n = 10). Probiotic intervention reduced the duration of crying (standardized mean difference = −2.012, 95% confidence interval: −2.763 to −1.261, z = −5.25, p < 0.0001). The probability of at least a 50% reduction in crying duration was at least 1.98 times higher in the intervention group than in controls (Z = 4.80, p < 0.0001). The effects of the intervention were not significantly affected by the risk of bias assessment, percentage of breastfed infants, and duration of the study. In 11 studies, data concerning gut microbiota composition and function and/or immunological markers were given. Probiotics significantly shortened the crying duration, but a causal relationship between the modulatory effect of probiotics on microbiota and the immune system has not been confirmed.

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Tailored Web-Based Smoking Interventions and Reduced Attrition: Systematic Review and Meta-Analysis (Preprint)

10.2196/preprints.16255 ◽

2019 ◽

Author(s):

Amika Shah ◽

Michael Chaiton ◽

Dolly Baliunas ◽

Robert Schwartz

Keyword(s):

Systematic Review ◽

Smoking Cessation ◽

Passive Control ◽

Controlled Trial ◽

Meta Analysis ◽

Intervention Group ◽

Control Group ◽

Web Based ◽

The Impact

BACKGROUND The increasing number of internet users presents an opportunity to deliver health interventions to large populations. Despite their potential, many web-based interventions, including those for smoking cessation, face high rates of attrition. Further consideration of how intervention features impact attrition is needed. OBJECTIVE The aim of this systematic review is to investigate whether tailored web-based smoking cessation interventions for smokers are associated with reduced rates of attrition compared with active or passive untailored web-based interventions. The outcomes of interest were dropout attrition at 1-, 3-, 6-, and 12-month follow-ups. METHODS Literature searches were conducted in May 2018 and updated in May 2020 on MEDLINE (Medical Literature Analysis and Retrieval System Online), PsycINFO (Psychological Information), EMBASE (Excerpta Medica dataBASE), CINAHL (Cumulated Index to Nursing and Allied Health Literature), Scopus, and the Cochrane Tobacco Addiction Group Specialized Register with the following search terms: smoking cessation, tailored, or web- or internet-based. Included studies were published in English before or in May 2020 using a randomized controlled trial design. Studies were restricted to those with web-based delivery, a tailored intervention group, an untailored control group, and a reported outcome of smoking cessation. Studies were assessed for methodological quality using the Cochrane Risk of Bias tool. Two reviewers independently extracted the study characteristics and the number of participants lost to follow-up for each treatment group. RESULTS A total of 13 studies were included in the systematic review, of which 11 (85%) were included in the meta-analysis. Tailoring had no statistically significant effect on dropout attrition at 1-month (risk ratio [RR]=1.02, 95% CI 0.95-1.09; P=.58; I2=78%), 3-month (RR=0.99, 95% CI 0.95-1.04; P=.80; I2=73%), 6-month (RR=1.00, 95% CI 0.95-1.05; P=.90; I2=43%), or 12-month (RR=0.97, 95% CI 0.92-1.02; P=.26; I2=28%) follow-ups. Subgroup analyses suggested that there was a statistically significant effect of tailoring between the active and passive subgroups at 1-month (P=.03), 3-month (P<.001), and 6-month (P=.02) follow-ups but not at 12-month follow-up (P=.25). CONCLUSIONS The results suggest that tailoring of web-based smoking cessation interventions may not be associated with reduced rates of dropout attrition at 1-, 3-, 6-, or 12-month follow-ups. Significant differences between studies that include untailored active and passive control groups suggest that the role of tailoring may be more prominent when studies include a passive control group. These findings may be because of variability in the presence of additional features, the definition of smokers used, and the duration of smoking abstinence measured. Future studies should incorporate active web-based controls, compare the impact of different tailoring strategies, and include populations outside of the Western countries.

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Effects of a documentary on consumer perception of the environmental impact of meat consumption

British Food Journal ◽

10.1108/bfj-02-2020-0138 ◽

2020 ◽

Vol 123 (1) ◽

pp. 177-189

Author(s):

Andreas Bschaden ◽

Eduardo Mandarano ◽

Nanette Stroebele-Benschop

Keyword(s):

Environmental Impact ◽

Intervention Group ◽

Meat Consumption ◽

Self Report ◽

Control Group ◽

Content Type ◽

Consumption Frequency ◽

One Year ◽

The Impact

PurposeMeat consumption causes a large amount of global greenhouse gas emissions and other environmental problems. Studies showed that consumers underestimate the environmental impact of meat consumption compared to other food-related behaviours. A video intervention was conducted to investigate the effect of information on consumers' perception and behaviour.Design/methodology/approachTwo didactically different videos about meat and the environment and a control video were shown to 189 participants. Ratings about the environmental impact of different food-related behaviours as well as participants' meat consumption frequency were obtained directly before, one week later and one year after the screening by self-report questionnaires.FindingsMean rating of the environmental impact of meat consumption was second to the least important of the different food consumption patterns. In the first intervention group, the rating increased significantly (p = 0.001) after having watched the video. There was no such effect in the second intervention or the control group. Self-reported meat consumption frequency did not change significantly in any of the groups. No long-term differences between the groups could be found.Research limitations/implicationsThe results suggest that there is still a lack of knowledge concerning the environmental impact of meat consumption. Providing information can affect awareness, depending on the type of information delivery. The circumstances under which information encourages behaviour change need to be further explored.Originality/valueThis is the first study that investigated the impact of different videos about environmental impacts of meat consumption on consumer perceptions and behaviour.

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