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Background Excessive screen time (ST) is linked to adverse physical and mental development in children, with habits forming in preschool and solidifying over time. Previous studies on interventions to reduce ST in preschoolers aged 0–7 years have shown inconsistent results. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate intervention effectiveness and identify potential moderators.  Methods We searched CNKI (Chinese), Wanfang Data (Chinese), SinoMed, Ebscohost, Web of Science, EMBASE, PubMed, and Cochrane Library for RCTs (January 1, 2000–December 31, 2024) targeting ST reduction in preschool children. Study quality was assessed using the Cochrane Risk of Bias Assessment tool and Jadad scale. Effect size were reported as standardized mean difference (SMD) with 95% confidence intervals (CI). Subgroup analyses (e.g., sample size, child age, gender, intervention duration) were conducted, with statistical tests (e.g., the chi-square test) comparing subgroup differences. Results A total of 41 studies with 14,514 participants were included in the meta-analysis. The overall summary of random effects showed a small, beneficial impact of ST interventions compared to controls (SMD = 0.26, 95% CI: 0.12 to 0.39). Subgroup analysis showed that the intervention effect was moderated by child age (χ 2  = 6.25, P  = 0.04), intervention duration (χ 2  = 7.38, P  = 0.007), target behavior of the intervention (χ 2  = 6.72, P  = 0.01) and intervention recipient (χ 2  = 10.5, P  = 0.01). Conclusion Despite heterogeneity in study methods and results, overall interventions to reduce ST in early childhood show significant reductions, suggesting that this may be an opportune time to intervene. Future research should explore strategies for implementing large-scale interventions and sustaining long-term intervention effects, investigate the potential impact of different theoretical frameworks on intervention outcomes, and examine the role of caregivers in supporting behavior change. These findings provide a robust foundation for developing evidence-based strategies to promote healthy ST habits in young children.

Purpose This study investigated the risk factors associated with insufficient engagement of Chinese early school-aged children in outdoor activities, including play and physical activities. Methods Data were gathered from two waves of parent-proxy surveys. The analysis involved 1612 children (46.15% girls; mean age = 7.83 years) who had participated in outdoor activities. Responses were analyzed using Generalized Estimating Equations to identify relevant correlates impacting children’s outdoor play or outdoor physical activities. Children were assessed on their outdoor activities’ levels, and variables were analyzed for their impact on these levels. Results Maternal outdoor activity (< 1 h/day) and less clear requirements for outdoor activity are correlated with children’s outdoor play time (< 2 h/day) ( p  < 0.05). The number of outdoor playfields was also significantly associated with insufficient outdoor play, particularly on weekends ( p  < 0.05). For outdoor physical activities (< 1 h/day), the male gender of the child was a protective factor (OR = 0.33, p  < 0.001), while paternal outdoor activity time (< 1 h/day) and unclear outdoor activity requirements were risk factors ( p  < 0.01). Conclusions The risk factors of insufficient engagement of Chinese early school-aged children in outdoor pursuits included the lack of time parents spend on outdoor activities, their unclear requirements, and the limited availability of outdoor spaces. Specifically, mothers’ outdoor activities time is linked to children’s outdoor play, while the male gender of the child and fathers’ outdoor activities are associated with children’s outdoor physical activities participation.

ObjectivesSeveral studies have found that inappropriate workstations are associated with musculoskeletal disorders. The present cross-sectional study aimed to identify the risk factors of non-specific neck pain (NP) and low back pain (LBP) among computer-using workers.DesignObservational study with a cross-sectional sample.SettingThis study surveyed 15 companies in Zhejiang province, China.ParticipantsAfter excluding participants with missing variables, 417 office workers, including 163 men and 254 women, were analyzed.Outcome measuresDemographic information was collected by self-report. The standard Northwick Park Neck Pain Questionnaire and Oswestry Low Back Pain Disability Index, along with other relevant questions, were used to assess the presence of potential occupational risk factors and the perceived levels of pain. Multinomial logistic regression analysis, adjusted for age, sex, body mass index, education, marital status and neck/low back injury, was performed to identify significant risk factors.ResultsCompared with low-level NP, the computer location (monitor not in front of the operator, but on the right or left side) was associated with ORs of 2.6 and 2.9 for medium- and high-level NP, respectively. For LBP, the computer location (monitor not in front) was associated with an OR of 3.2 for high-level pain, as compared with low-level pain, in females. Significant associations were also observed between the office temperature and LBP (OR 5.4 for high vs low), and between office work duration ≥5 years and NP in female office workers (OR 2.7 for medium vs low).ConclusionsNot having the computer monitor located in front of the operator was found to be an important risk factor for NP and LBP in computer-using female workers. This information may not only enable the development of potential preventive strategies but may also provide new insights for designing appropriate workstations.

Background Previous studies have shown that prolonged time spent on screen-based sedentary behavior was significantly associated with lower health status in children, independent of physical activity levels. The study aimed to explore the individual and environmental correlates of screen time (ST) among 8–19-year-old students in China. Methods The study surveyed ST using a self-administered questionnaire in Chinese students aged 8–19 years; 1063 participants were included in the final analysis. Individual and environmental correlates of ST were assessed using a mixed-effects model (for continuous outcome variables) and multiple logistic regression model (for binary outcome variables). Results Prolonged ST was observed in 14.7% of boys and 8.9% of girls. Of the ST, weekend and mobile phone/tablet use represented 80% and 40%, respectively. A positive relationship was observed between media accessibility and ST in both boys and girls ( p < 0.05), whereas the presence of parents/others while using screens was a negative factor for longer ST ( p < 0.05). Among the assessed correlates, access to a television (TV) in students’ bedrooms was associated with prolonged total and weekend ST ( p < 0.05 and p < 0.001, respectively). However, spending time on a mobile phone/tablet or a computer rather than viewing a TV, along with increased media accessibility, increased ST. Conclusions These results indicate that greater media accessibility was positively associated and the presence of parents/others was negatively associated with prolonged ST in both Chinese boys and girls. Development of new and effective strategies against prolonged ST are required, especially for small screen device-based ST on weekends.

Background Executive function plays a crucial role in children’s cognitive development, academic performance, as well as their physical and mental health. This study aims to assess the impact of exergaming on executive functions in pediatric populations. Methods The criteria of inclusion were randomized controlled trials of exergaming intervention and evaluation of executive function in children aged 4–12 years. A meta-analysis was performed in databases of China National Knowledge Infrastructure (in Chinese), Wan Fang (in Chinese), Web of Science, Embase, and PubMed, from January 2010 to February 2023, following the PRISMA guidelines. Risk of bias was assessed by the Jadad scale, the Cochrane risk of bias assessment tool, funnel plot, and regression-based Egger test. The Review Manager 5.3 was used to analyze the included articles using a random-effects model, and the effects were calculated as standardized mean difference (SMD). Results Eleven experimental studies with children (n = 508) were included. Exergaming was found to have a positive impact on children’s cognitive flexibility (SMD = 0.34, 95%CI [0.17,0.52], P < 0.01 ), inhibitory control (SMD = 0.57, 95%CI [0.31,0.83], P < 0.01 ), and working memory (SMD = 0.26, 95%CI [0.02,0.51], P < 0.05 ). The publication bias were observed. Conclusions Exergaming has the potential to improve executive functions in children. More studies with rigorous designs are warranted to explore the specific effects of exergaming intervention. This study was registered on the PROSPERO (CRD42023401526).

Background With the advent of the electronic age, the prolonged screen time (ST) of preschoolers in China is relatively high and is on the rise, which is likely to affect preschoolers’ physical and mental health. This study aimed to explore the factors influencing ST in preschoolers, especially the role of parental factors, and to provide a basis for the prevention, control, and intervention of ST in preschoolers in China. Methods A questionnaire was completed by the parents of 1,546 preschoolers from four kindergartens in Pinghu City, Zhejiang Province, China, and a multivariate logistic regression model was used to analyze the correlates of excessive ST in preschoolers. Results A total of 43.8% of preschoolers aged 3 to 6 years, of which 50.3% were boys and 49.7% were girls, had > 1 h/day of ST. Older preschoolers, greater screen accessibility, greater frequency of eating in front of a screen, longer ST of parents, and unclear rules of screen-based behavior were the risk factors for ST being > 1 h/day ( P  < 0.05). After additional adjusting of maternal correlates, the relationship between the ST of fathers and ST of preschoolers was still significant ( P  < 0.01), and the dose–effect relationship was also observed ( P  < 0.001). Conclusion Prolonged parental ST (especially of fathers) and lack of rules for screen behavior were independent risk factors for prolonged preschoolers’ ST in this study.

Background: Existing evidence regarding how time spent on various types of sedentary behavior (SB) in relation to physical fitness (PF) and academic performance (AP) in children and adolescents is limited. This cross-sectional study aimed to explore the associations of SB types with PF and AP among 8–19-year-old Chinese students. Methods: A total of 1164 students were recruited from five schools in Zhejiang province, China. Children’s SB was assessed by a valid questionnaire and AP was represented by scores on four courses. PF was measured by Chinese National Student PF Standard battery. The associations were assessed using linear mixed-effects models adjusted for age, school, grade, and class. Results: Students’ screen-based SB was observed to be negatively associated with PF in girls (p < 0.05). Screen-based SB was inversely associated with AP in both girls and boys (p < 0.001). The significant interaction between weekdays and weekends, and SB on AP was observed in girls (p < 0.001). On weekends, screen-based SB ≥ 6 h/day (<3 h/day as reference group) was significantly and negatively associated with AP (p < 0.01 for both sex). Conclusions: Longer screen-based SB, especially on weekends, was related to poorer AP in 8–19-year-old Chinese students. Our findings suggest that restrictions on any type of screen-based SB for leisure on weekends are beneficial to AP in Chinese students.

Studies on the relationship between television (TV) viewing and bone mineral density (BMD) in adults are limited. The purpose of this study was to examine whether longer duration of TV viewing increased the risk of lower BMD in Chinese women. A total of 626 female adults were voluntarily recruited into the study. Anthropometric measurements were obtained using standard procedures. Body composition including total body and regional BMD was estimated using dual-energy X-ray absorptiometry. The duration of TV viewing was categorized into 4 groups: <1 h, 1 to <2 h, 2 to <3 h, and ≥3 h. Multiple linear regression models were applied to analyze the associations between duration of TV viewing and total and regional BMD in all subjects and in subjects stratified by age of 45 years, respectively. After adjusting for age, BMI, alcohol use, smoking, education, income, urbanicity, leisure time physical activity, occupational physical activity, and menopause, the significant trend of pelvic BMD across categories of TV viewing was observed in all subjects ( p  < 0.05). Further analysis revealed that women aged <45 years, the 1 to <2 h group, the 2 to <3 h group, and the ≥3 h group were significantly associated with lower total body and regional BMD compared to women aged <45 years in the <1 h group. We concluded that the duration of TV viewing was negatively associated with BMD in Chinese women, especially in those aged 18–44 years. It might be sensible to reduce TV viewing time to prevent bone loss in young women.

Background/Objectives: Twenty-four-hour movement behaviors, including physical activity, sedentary time, and sleep, are associated with a range of health outcomes. However, the relationship between the combinations of these behaviors and dietary outcomes in young populations remains unclear. We conducted a systematic review to explore how combined movement behaviors are linked to dietary outcomes in children and adolescents. Methods: We searched MEDLINE, Embase, and PsycINFO from January 2017 to July 2024, including studies that were (1) written in English, (2) published in peer-reviewed journals, (3) quantitatively analyzed two or three movement behaviors with dietary outcomes, and (4) focused on populations aged between 0 and 18 years. Results: Ten cross-sectional studies met these criteria. The majority of studies (6 out of 10) assessed all three movement behaviors, although sleep was less frequently examined, appearing in only 4 of the studies. Our findings indicated that adhering to all movement recommendations was consistently associated with healthier dietary patterns, including a higher consumption of fruits, vegetables, nuts, fish, and cereals, and a lower intake of sweets and pastries. Additionally, adhering to physical activity and sedentary time guidelines was linked to improved dietary habits in children, including more fruit and vegetable intake and less sugary drink and snack consumption. Conversely, higher sedentary time and inadequate sleep were linked to poorer dietary outcomes, particularly lower fruit intake and hydration. Conclusions: This review suggests that meeting movement behavior guidelines correlates with healthier dietary outcomes in children and adolescents. However, given the limited number of studies and their cross-sectional design, further high-quality research, including longitudinal and intervention studies, is needed to clarify causal relationships.

Background: Modern-day technology is appealing to children. Few studies, however, have conducted longitudinal analyses of a school-based exergaming program’s effect on physical activity (PA) behaviors and fitness in children. Therefore, this study examined the longitudinal effect of an 8-month school-based exergaming intervention on children’s objectively-measured PA and cardiorespiratory fitness (CRF). Materials and Methods: Eighty-one fourth grade students ( X ¯ age = 9.23 ± 0.62; 39 girls; 54.3% African American, 30.9% Non-Hispanic White, 14.8% other) participated in this study from 2014–2015. The intervention school’s children participated in a once-weekly 50-min exergaming intervention during recess throughout the school year, while the control school continued regular recess. Children’s in-school PA and sedentary behavior (SB) were measured with ActiGraphGT3X+ accelerometers, with CRF assessed via the half-mile run. All measurements were taken at baseline, mid-intervention (four months) and post-intervention (eight months). Repeated-measures two-way ANCOVAs using age and race as covariates were conducted to examine between-school differences over time for SB, light PA (LPA), moderate-to-vigorous PA (MVPA), and CRF. Results: Significant time by group interactions were observed for LPA, F(1, 79) = 7.82, η2 = 0.09, p < 0.01, and MVPA, F(1, 79) = 4.58, η2 = 0.06, p < 0.05, as LPA increased among the control group, while MVPA increased among intervention group. Children in both groups experienced decreased SB during the intervention (intervention: −7.63 min; control: −17.59 min), but demonstrated lower CRF over time (intervention: +46.73 s; control: +61.60 s). Conclusions: Observations suggested that school-based exergaming implementation may be effective in increasing children’s MVPA and decreasing their SB over the course an academic year (i.e., ~eight months). More research is needed, however, to discern how modifications to school-based exergaming might also promote improved CRF in children.