Effect of parent-focused interventions for screen use on developmental outcomes in young children: a systematic review and meta-analysis.

introductionParents are a key target for interventions promoting healthy screen use in young children, but no review has evaluated the effect of such parent-focused interventions on developmental outcomes in early childhood. The objective of this study was to conduct a systematic review and meta-analyses of the effects of parent-focused interventions for screen use on young children's social-emotional, cognitive, and physical development, as well as proximal indicators of development including sleep and physical activity. A secondary objective was to assess their impact on children's screen use.

methodsEight databases were searched with publication dates between 2007 and March 2025. Randomised controlled trials of parent-focused interventions targeting screen use in children (birth-5.99 years) were included if they reported outcomes related to both child screen use and development. Stata was used to undertake meta-analyses using multilevel random effects models to estimate effects for outcomes with data from at least three papers.

resultsIn total, 10 studies (11 papers) were eligible for inclusion, with eight studies (n = 1,776 participants) providing sufficient data to be included in meta-analyses of at least one outcome. Interventions targeted screen use duration (n = 8 studies), screen use before bed (n = 1 study) and screen content (n = 1 study; 2 papers). Interventions achieved reductions in social-emotional problems (ES=-0.32 (95%CI:-0.51,-0.12)), externalizing behaviors (ES=-0.31 (95%CI:-0.56,-0.05)) and screen time (ES=-0.92 (95%CI:-1.66,-0.18)). Few interventions (n = 2) targeted aspects of screen use other than duration (e.g. content quality and timing). Larger effects were achieved for interventions that were underpinned by a theory and incorporated a range of established behavior change techniques, compared to interventions that did not incorporate these aspects. Few studies explored intervention effects on physical activity, body mass index, cognitive development and/or motor skills, and heterogenous sleep outcomes were reported, making it difficult to draw definitive conclusions regarding these outcomes.

conclusionsFew parent-focused interventions for screen use were identified and most targeted screen use duration. Future intervention studies may consider targeting aspects of screen use other than duration (e.g. content quality), and evaluating their feasibility and acceptability for parents, compared to interventions targeting screen use duration. The protocol was prospectively registered on PROSPERO (ID: CRD420250654905).