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5MinuteConsult Journal Club

Put the Screen Down so the Children Up and Move


JAMA Pediatr 2022 May 23;e221519. doi:10.1001/jamapediatrics.2022.1519

Study Summary

This is a randomized controlled trial of families who self-reported parental recreational screen use >2.4 hours per day to determine the influence of limiting screen time on sleep and activity levels in their children.

Families assigned to the screen reduction intervention had to turn in their portable devices (i.e., smartphones, tablets) for 2 weeks. Adults who were not able to do so due to their jobs required at least 1 adult had to relinquish their smartphone. In exchange, they received a non–smart phone with their SIM cards, allowing calls and text messages during the intervention. All intervention participants were instructed to reduce their recreational screen use to 3 hours or less per week for 2 weeks. Reminder signs were placed around their home to remind them of the 3-hour limit. The control group families were instructed to carry on as usual.

97% of the families in the intervention group were compliant with the screen use reduction during the intervention. The mean change in leisure non-sedentary activity of the children in the intervention group was 44.8 (SD 63.5) minutes per day vs in the control group was 1.0 (55.1) minute per day (intention-to-treat between-group mean difference, 45.8 minutes per day; 95% CI, 27.9-63.6 minutes per day; P < .001). No significant between-group mean differences were observed for the electroencephalography-based sleep outcomes.


A recreational screen reduction intervention resulted in a substantial increase in children's physical activity.


Could you limit your recreational screen time to 3 hours or less per week? Most (so-called Smart) phones come with a “Screen Time” tracker. Looking at mine right now shows I have had over 4 hours of “Social” screen time use during the last 5 days. YIKES.

This may be one of the greatest parenting challenges of the 21st century. The “go outside and play” mantra has long ago disappeared. Too much “play” can be accomplished by looking, rather than doing. While they paid the families who participated in this study ~$75.50, would that be adequate incentive for the adults in the house to put down the phone? Doubtful.

Regaining control of technology requires willpower. But the reward will likely be lower rates of obesity, heart disease and diabetes, and longer life expectancy in our children. That is one set of powerful outcomes that no pill can accomplish.

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Contributed by Frank J. Domino, July 6, 2022