Evaluation of a multi-component intervention to reduce screen-time in adolescents:

INTERVENTION: The ‘Switch‐off 4 Healthy Minds’ intervention will run for two full school terms, in 2014, and will aim to promote and improve psychological wellbeing in adolescents. The intervention will include a range of evidence‐based and innovative strategies to reduce sedentary behaviour in adolescents. The eHealth intervention will include push notifications and text messages promoting a reduction in screen‐time. Participants will receive 25 push prompt messages throughout the intervention. Participants will receive these prompts once weekly and will have the opportunity to choose how the messages will be delivered. Delivery methods such as: Facebook, Twitter, Email, Snap Chat and SMS have been chosen due to their popularity in the age group of (i.e.11‐12 years). The push‐prompt messages (i.e., text messages) will be designed to address the consequences of excessive screen‐time and the importance of self‐management. The intervention is grounded in self‐determination theory and strategies have been designed to influence motivation to limit screen time and potential environmental determinants. An information session will be delivered by a member of research team during school hours. The session will outline the intervention and requirements of the students. Students will be given the opportunity to ask any questions during this session. The intervention will also include a range of strategies for parents to manage their children’s screen‐time: (a) screen‐time behavioural contract, (b) newsletters focusing on: household screen‐time rules, consequences of excessive screen‐time, strategies to manage parent/child conflict arising from screen‐time rules and home challenges to reduce screen‐time. The intervention period will last for 6 months which includes baseline and follow‐up assessments. Attendance at workshops will be monitored using class attendance lists. Other strategies used to monitor adherance to the program will be included in the process evaluations conducted at 6‐months. Process evaluation questionnaires will determine how many newsletters were read, number of text messages received and satisfaction of the intervention in relation to the different methods of delivery. CONDITION: Obesity Physical inactivity Psychological well‐being Sedentary behaviour PRIMARY OUTCOME: Recreational screen‐time will be the primary outcome and will be measured using the Adolescent Sedentary Activity Questionnaire (ASAQ) (Hardy et al, 2007). INCLUSION CRITERIA: Eight Catholic schools located in the Hunter region will be eligible to participate in the study. All students in year 7 at the study schools will be invited to complete a screen‐time eligibility questionnaire. Students who report greater than or equal to 2 hours/day in screen‐based recreation will be invited to participate in the study. SECONDARY OUTCOME: Physical Self‐Description Questionnaire: Physical self‐concept will be measured using a modified version of the Physical Self‐Description Questionnaire (Marsh et al, 1994 & Marsh 1996). Physical activity will be assessed using GeneACTIV accelerometers (student's normal physical activity at home). Psychological distress will be measured using the Kessler 10 Questionnaire (K‐10) (Slade et al, 2011). Psychological well‐being will be will be measured using the Strengths and Difficulties Questionnaire (SDQ) total difficulties score (Goodman, 1997 & Mellor, 2005). Social cognitive and environmental mediators of sedentary behaviour change will be assessed using the Motivation to Limit Screen‐time questionnaire (Lubans et al., 2013) and Screen‐time rules will be used from a survey developed by Ramirez et al. (2011) will be adapted for the study. Weight and height will be measured in a private location using a portable medical scale and stadiometer. Body mass index and age/gender adjusted z‐scores will be calculated.