Is The Use of Screen Time as a Reward Associated

with Differing Participation in Physical Activity and

Screen Time?By: Tyler Kybartas

Committee:

Emily H Guseman, Kinesiology and Health

Mark Byra, Kinesiology and Health

Christine Wade, Family and Consumer Sciences

Outline Literature Review

Purpose

Methods

Results

Discussion

Conclusion

Obesity in Children

32% of children and adolescents in the US are overweight or obese (Ogden et al., 2012)

Consequences of pediatric obesity (Stamatakis et al., 2013; Thorp et al., 2011) Chronic disease risk

Socioemotional difficulties

Possible causes Sedentary habits

Physical activity

Physical Activity

Current recommendations (US Department of Health and Human Services) One hour moderate to vigorous activity (MVPA) on each day

of the week

Vigorous physical activity and muscle/bone strengthening on at least three of those days

Prevalence of those meeting recommendations (NHANES; Troiano et al., 2008)

42% aged 6-11 y

8% of adolescents

Screen Time

Screen time Screen time is the main contributor to sedentary time

Televisions, computers, video games, and cell phone usage

Less than 2 hours a day is recommended (Huhman et al., 2012; Kozub & Farmer, 2011)

Many children exceed this recommendation

Rewards and Motivation (Goldfield, 2012; He et al., 2010; Ryan & Deci, 2000; Deci, Koestner, & Ryan, 1999; Deci, 1992; Deci, Benware, & Landy, 1972)

The use of rewards Role of motivation

Possible shift from extrinsic to intrinsic motivation How does this shift occur?

Decreasing Excessive Media Usage While Increasing Physical Activity: A Single-Subject Research Study (Larwin & Larwin, 2008)

Subject: 14 year old girl; poor exercise motivation; excessive ST

5 week intervention with 2 follow ups (5 weeks and 1 Year)

Phase 1

2 weeks

1 mile TM = 1 h ST

Phase 2

3 weeks

1.5 miles TM = 1.5 h ST

Findings: Decreased ST & increased PA at follow-up (5 weeks and 1 Year)

Implications: use of ST as a reward could be a key factor to a positive behavior shift to increase exercise and decrease ST

Purpose

The purpose of this study was to determine whether the use of screen time as a reward is associated with habitual physical activity among Wyoming children

Methods - Subjects

Boys and girls ages 5-18 y Recruited from a local pediatric clinic

Recruitment Annual well-child visits

Methods - Assessments

Lifestyle survey

Data Analysis – Subject Characteristics

Subject Characteristics Age, gender

Independent samples t-test (rewards groups)

Frequencies Percent playing sports, percent in season

Main outcome: ANCOVA (sex)

Results

Participant Characteristics

49 Participants completed the survey

2 Exclusions-incomplete survey

3 Exclusions-Statistical outliers (MVPA ± 3 SD)

44 Total participants included

17 Males

12 Females

15 Unknown

Results – Screen Time

    + Rewards - Rewards Total Sample    n=16 n=28 n=44Television (h/day)

Total 2.08 (1.51) 2.61 (2.40) 2.42 (2.12)Video Games (h/day)

Total 1.11 (1.16) 0.81 (1.18) 0.92 (1.17)Computer (h/day)

Total 0.69 (0.75) 0.76 (1.10) 0.74 (0.98)Total Screen Time (h/day)

3.88 (1.89) 4.19 (3.29) 4.08 (2.84)Meeting recommendations (n) 4 5 9  Percent  25.0% 17.9% 20.5%

Table 4-3. Differences in screen time behaviors by reward group. Values are mean (SD) unless otherwise indicated.

Results – Physical Activity

    + Rewards - Rewards Total Sample

    n=16 n=28 n=44

Physical Activity (h/day)

Weekdays 1.73 (0.88) 1.34 (0.84) 1.49 (0.87)

Weekends 2.53 (1.56) 1.53 (0.90) 1.89 (1.27)

Total 1.96 (0.89)* 1.39 (0.80)* 1.60 (0.87)

Meeting recommendations (n) 14 20 34

Percent 87.50% 74.07% 77.27%

Table 4-4. Differences in physical activity patterns between reward groups. Values are mean (SD) unless otherwise indicated.

Results

Figure 4-1. MVPA differences between reward groups adjusted for sex.

*

Discussion

There was a significant difference in PA levels but not ST levels between the two reward groups

ST as a reward may increase extrinsic, and later intrinsic, motivation to exercise

ST and PA

80% of children exceeded the ST recommendation in this study

77% of children met the PA recommendation in the sample

Only 18.8% met both PA and ST recommendations

20.4% met neither PA nor ST recommendations

Sedentary time and PA are independent predictors of health (Eisenmann et al., 2008; Hamilton, Hamilton, & Zderic, 2007; Healy, et al., 2008; Rosenberg et al., 2008)

High childhood ST increases the likelihood of becoming overweight or obese (Huhman et al., 2012; Kozub & Farmer, 2011)

ST and PA Inverse relationship between ST and PA

Results inconsistent with other findings (Huhman et al., 2012; Maher et al., 2012; Olds et al., 2012; Sandercock et al., 2012; Serrano-Sanchez et al., 2011)

Results consistent with Laurson and colleagues in 2008

Rural states

Number, size, and access to state and national parks

Urban versus rural play (Burdette & Whitaker, 2005; Lederbogen et al., 2011)

ST as a reward for PA

Comparison to Larwin & Larwin’s 2008 case study

No difference in ST between the groups

Difference in PA levels

ST as a reward for PA may play a key role in increasing PA levels

Use of extrinsic rewards might promote a shift to intrinsic motivation to participate in PA

Shown previously (Hardman et al., 2011; Horne et al., 2009)

Conclusion

Limitations

Small sample

Unable to collect anthropometric data

Cannot extend our findings to potential impacts on obesity rates

Cross-sectional design

Self-reported measured of PA and ST

Future study

Randomized control trial comparing 3 groups (control, + rewards, - rewards)

Objective measures of PA and ST

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Questions