1
|
Takahashi I, Obara T, Ishikuro M, Orui M, Noda A, Shinoda G, Nagami F, Hozawa A, Nishimura T, Tsuchiya KJ, Kuriyama S. Prospective associations of screen time at age 2 with specific behavioral subscales at age 3: a cohort study. J Public Health (Oxf) 2024:fdae240. [PMID: 39263935 DOI: 10.1093/pubmed/fdae240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/05/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND We aim to discover which, if any, of the subscales of internalizing and externalizing behavioral problems at age 3 are still associated with screen time (ST) at age 2 after adjusting for behavioral problems scores at age 2. METHODS This study was conducted under the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Information was gathered prospectively, with 7207 mother-child pairs included in the analysis. Children's ST was categorized in hours a day at age 2 (<1, 1-<2, 2-<4, ≥4). We assessed children's behavioral problems using the Child Behavior Checklist for Ages 1½-5 (CBCL) at ages 2 and 3. 'Having behavioral problems' was defined by them being within a clinical range for internalizing behaviors (withdrawn, somatic complaints, anxious/depressed and emotionally reactive) and externalizing behaviors (attention problems and aggressive behaviors) at age 3. Continuous scores on each of the behavioral problem scales at age 2 were used as covariates. RESULTS Greater ST for children at age 2 was associated with specific subscales for emotionally reactive and aggressive behaviors at age 3. CONCLUSIONS This study found that ST is prospectively associated with some behavioral scales but not others.
Collapse
Affiliation(s)
- Ippei Takahashi
- Division of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, 7F, Tohoku Medical Megabank Building 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
| | - Taku Obara
- Division of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, 7F, Tohoku Medical Megabank Building 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 7F, Tohoku Medical Megabank Building 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Mami Ishikuro
- Division of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, 7F, Tohoku Medical Megabank Building 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 7F, Tohoku Medical Megabank Building 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
| | - Masatsugu Orui
- Division of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, 7F, Tohoku Medical Megabank Building 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 7F, Tohoku Medical Megabank Building 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
| | - Aoi Noda
- Division of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, 7F, Tohoku Medical Megabank Building 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 7F, Tohoku Medical Megabank Building 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Genki Shinoda
- Division of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, 7F, Tohoku Medical Megabank Building 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 7F, Tohoku Medical Megabank Building 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
| | - Fuji Nagami
- Department of Public Relations and Planning, Tohoku Medical Megabank Organization, Tohoku University, 3F, Tohoku Medical Megabank Building 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 7F, Tohoku Medical Megabank Building 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
- Division of Epidemiology, Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
- Division of Personalized Prevention and Epidemiology, Graduate School of Medicine, Tohoku University, 7F, Tohoku Medical Megabank Building 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
| | - Tomoko Nishimura
- United Graduate School of Child Development, Hamamatsu University School of Medicine, 1-20-1 Handayama, Chuo-ku, Hamamatsu City, Shizuoka 431-3192, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, 1-20-1 Handayama, Chuo-ku, Hamamatsu City, Shizuoka 431-3192, Japan
| | - Kenji J Tsuchiya
- United Graduate School of Child Development, Hamamatsu University School of Medicine, 1-20-1 Handayama, Chuo-ku, Hamamatsu City, Shizuoka 431-3192, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, 1-20-1 Handayama, Chuo-ku, Hamamatsu City, Shizuoka 431-3192, Japan
| | - Shinichi Kuriyama
- Division of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, 7F, Tohoku Medical Megabank Building 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 7F, Tohoku Medical Megabank Building 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
- Division of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University, 7F, Tohoku Medical Megabank Building 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
| |
Collapse
|
2
|
Marriage JE, Keshavarzi M, Moore BCJ. An association between auditory responsiveness of children and duration of entertainment screen time in the early years of life. Int J Audiol 2024; 63:731-737. [PMID: 37750302 DOI: 10.1080/14992027.2023.2260097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE To examine whether the responsiveness of young children to simple sounds was associated with entertainment screen time (EST), opportunities for social interaction, and social and communication skills. DESIGN Parents completed a questionnaire covering, for years one and two, the number of times the child met with other children; the number of words the child spoke; and the daily amount of EST. Social, attention and communication skills were assessed. STUDY SAMPLE Participants were 118 children, aged 15 to 46 months. They were initially assessed behaviourally using simple sounds. Children who responded to such sounds were denoted the Responsive group. Children who did not were assessed using familiar songs and denoted the Unresponsive group. RESULTS The two groups did not differ significantly in mean age or the number of opportunities to meet other children. The Unresponsive group had significantly fewer words than the Responsive group at 12 and 24 months and had significantly higher EST than the Responsive group for years 1 and 2. The Unresponsive group showed lower social, attention and communication skills than the Responsive group. CONCLUSIONS High EST was associated with poorer auditory and social skills. Hence, it may be wise to limit the EST of young children.
Collapse
Affiliation(s)
| | - Mahmoud Keshavarzi
- Centre for Neuroscience in Education, Cambridge Hearing Group, Department of Psychology, University of Cambridge, Cambridge, UK
| | - Brian C J Moore
- Cambridge Hearing Group, Department of Psychology, University of Cambridge, Cambridge, UK
| |
Collapse
|
3
|
Borodovsky JT, Squeglia LM, Mewton L, Marsch LA. Longitudinal Use Patterns of Technology Subtypes During the Transition Into Early Adolescence: Results From the Adolescent Brain Cognitive Development Study. J Adolesc Health 2024:S1054-139X(24)00304-5. [PMID: 39140927 DOI: 10.1016/j.jadohealth.2024.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 06/15/2024] [Accepted: 06/17/2024] [Indexed: 08/15/2024]
Abstract
PURPOSE Adolescents encounter a complex digital environment, yet existing data on youth technology use rarely differentiates technology subtypes. This study maps the evolution and intricacies of youth engagement with technology subtypes. METHODS N = 11,868 participants in the Adolescent Brain Cognitive Development study followed from ages ∼9/10 to ∼13/14. We examined youths' self-reported hours per day (hr/day) of technology subtypes: TV/Movies, video games, YouTube, social media, video chat, and texting. We used descriptive statistics and multilevel logistic regression to assess cross-sectional and longitudinal use patterns of technology subtypes, agreement between child and parent reports on the child's technology use, and associations between each technology subtype and sociodemographics (child's biological sex, parent education, income, and marital status). RESULTS At age 9/10, ∼75% of youth reported minimal (<30 min/day) social technology use (social media, video chat, texting) and up to ∼1.5 hr/day of TV, video games, and YouTube. By age 13/14, TV trajectories were converging to >2 hr/day, but social technology trajectories "fanned out" into a wide range of usage rates. Child and parent reports were weakly correlated (rs range: 0.13-0.29). Using child-reported hours of technology use, increases in the subject-specific odds of using a technology >2 hr/day ranged from 25% (YouTube; 95% CI: 1.16-1.35) to 234% (social media; 95% CI: 3.14-3.55). Compared with males, females had ∼100-200% greater odds of >2 hr/day of social technologies, but ∼40-80% reduced odds of >2 hr/day of video games and YouTube. Higher parent education and income predicted significantly lower odds of >2 hr/day of use - regardless of technology subtype. DISCUSSION Distributions of youths' self-reported technology engagement are highly contingent on technology subtype, age, and biological sex. Future research on youth development and technology may benefit from considering youths' varied digital experiences.
Collapse
Affiliation(s)
- Jacob T Borodovsky
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire.
| | - Lindsay M Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Louise Mewton
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Syndey, Australia
| | - Lisa A Marsch
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire
| |
Collapse
|
4
|
Al-Mehmadi SO, Halawani AT, Sulaimani MT, Al-Mehmadi TO. Electronic device usage among preschool children and its association with mental health status in Saudi Arabian kindergartens. Saudi Med J 2024; 45:945-951. [PMID: 39218475 PMCID: PMC11376694 DOI: 10.15537/smj.2024.45.9.20240354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 07/09/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVES To estimate the prevalence of electronic device usage and its association with mental health status among preschool children aged 3-6 years. METHODS A cross-sectional study was conducted among preschool children aged 3-6 years in kindergartens in Makkah city in 2023-2024, using an electronic questionnaire. An Arabic version of the Strengths and Difficulties Questionnaire was used to assess mental health. RESULTS We recruited a total of 399 children. The prevalence of electronic device usage was 91.5%. The number of hours spent using electronic devices ranged from 0 to 12 hour (h)/day, with a mean of 3.1 h/day. We found a significant positive correlation between the number of hours spent using electronic devices and emotional problems (r=0.200, p<0.001), conduct problems (r=0.149, p=0.003), hyperactivity (r=0.279, p<0.001), peer problems (r=0.104, p=0.038), and total difficulty scores (r=0.263, p<0.001). We also found a significant negative correlation between the number of hours spent using electronic devices and the prosocial score (r= -0.128, p=0.011), and most of the included children had scores within the "close to average" category across all scales of mental health status. CONCLUSION There was a high prevalence of electronic device usage among preschool children, which exceeded the recommended time limit. A significant correlation was observed between electronic device use and mental health scores. Further longitudinal studies are required to understand the nature of this association and its implications for child development.
Collapse
Affiliation(s)
- Siham O Al-Mehmadi
- From the Department of Preventive Medicine (S. Al-Mehmadi), Saudi Board of Preventive Medicine Al-Madinah joint program, Makkah Healthcare Cluster, Makkah; from the Department of Preventive Medicine, (Halawani), Ministry of Health, Al-Madinah Health Cluster, Al-Madinah Al-Munawarah; from the Department of Preventive Medicine (Sulaimani) Saudi Board of Preventive Medicine Makkah joint program, Makkah Healthcare Cluster, Makkah; and from the Neonatal Intensive Care Unit (T. Al-Mehmadi), Maternity and Children Hospital, Makkah Healthcare Cluster, Makkah, Kingdom of Saudi Arabia
| | - Abdulrahman T Halawani
- From the Department of Preventive Medicine (S. Al-Mehmadi), Saudi Board of Preventive Medicine Al-Madinah joint program, Makkah Healthcare Cluster, Makkah; from the Department of Preventive Medicine, (Halawani), Ministry of Health, Al-Madinah Health Cluster, Al-Madinah Al-Munawarah; from the Department of Preventive Medicine (Sulaimani) Saudi Board of Preventive Medicine Makkah joint program, Makkah Healthcare Cluster, Makkah; and from the Neonatal Intensive Care Unit (T. Al-Mehmadi), Maternity and Children Hospital, Makkah Healthcare Cluster, Makkah, Kingdom of Saudi Arabia
| | - Mrnan T Sulaimani
- From the Department of Preventive Medicine (S. Al-Mehmadi), Saudi Board of Preventive Medicine Al-Madinah joint program, Makkah Healthcare Cluster, Makkah; from the Department of Preventive Medicine, (Halawani), Ministry of Health, Al-Madinah Health Cluster, Al-Madinah Al-Munawarah; from the Department of Preventive Medicine (Sulaimani) Saudi Board of Preventive Medicine Makkah joint program, Makkah Healthcare Cluster, Makkah; and from the Neonatal Intensive Care Unit (T. Al-Mehmadi), Maternity and Children Hospital, Makkah Healthcare Cluster, Makkah, Kingdom of Saudi Arabia
| | - Tamim O Al-Mehmadi
- From the Department of Preventive Medicine (S. Al-Mehmadi), Saudi Board of Preventive Medicine Al-Madinah joint program, Makkah Healthcare Cluster, Makkah; from the Department of Preventive Medicine, (Halawani), Ministry of Health, Al-Madinah Health Cluster, Al-Madinah Al-Munawarah; from the Department of Preventive Medicine (Sulaimani) Saudi Board of Preventive Medicine Makkah joint program, Makkah Healthcare Cluster, Makkah; and from the Neonatal Intensive Care Unit (T. Al-Mehmadi), Maternity and Children Hospital, Makkah Healthcare Cluster, Makkah, Kingdom of Saudi Arabia
| |
Collapse
|
5
|
Mekhail KT, Blom L, Rydström LL. Young children's screen habits and first-time parents' reflections on screen use in socioeconomically disadvantaged Swedish settings: a mixed methods study. BMC Public Health 2024; 24:2027. [PMID: 39075392 PMCID: PMC11285388 DOI: 10.1186/s12889-024-19557-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 07/22/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Despite WHO's recommendation of limited screen time for children < 2 years, they are worldwide established screen users. Several negative consequences are connected to excessive screen use among children. As parents are key actors in introducing screens to children, it is important to explore children's screen habits and parents' perspectives on screen in different populations, which could support the development of guidelines for healthier screen use. This study aimed to explore young children's screen use habits and describe first-time parents' reflections on children's screen use in socioeconomically disadvantaged Swedish settings. METHODS This mixed methods study was a part of larger studies within Stockholm County. The data were collected through semi-structured questionnaire-based interviews, among first-time parents (N = 386) of 15-18 months-olds at local Child Health Care centres during 2019-2022. Quantitative and qualitative data analyses conducted in parallel resulted in descriptive statistics and qualitative categories. RESULTS Most children (92.4%) used screens by the age of 15-18 months, commonly for a maximum of 30 min (48.5%) per day. Participants stated the most suitable age for starting screen use to be after (41.7%) or at (37.9%) the age of two years. Parents' reflections on screen use formed three main categories, each having two sub-categories: screen use patterns (screen-related time and reasons for screen use), perceived concerns with screen use (child development and social issues), and attitudes related to screen use (parents' attitudes towards screens and child's response to screens). CONCLUSIONS First-time parents in socioeconomically disadvantaged settings expressed awareness of possible negative screen-related effects and recommendations but did not always focus on long-term consequences when using screens in everyday life. Screens used as a short distraction, time spent together with screens, infants' contact with relatives overseas, and pedagogical children's programs and apps can be regarded as screen-related benefits. Encouraging parents' self-reflection on their screen use may be a way of contributing to healthier screen habits among young children. Future studies are suggested regarding parents' and children's excessive interest in screens and how to manage screen use as a family. TRIAL REGISTRATION Retrospectively registered 18 February 2020 (ISRCTN10336603) and 24 May 2021 (ISRCTN66190787) in ISRCTN registry.
Collapse
Affiliation(s)
- Kirsi Tiitinen Mekhail
- Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
- Department of Global Public Health (GPH), Karolinska Institutet, Stockholm, Sweden.
| | - Lisa Blom
- Department of Global Public Health (GPH), Karolinska Institutet, Stockholm, Sweden
| | - Lise-Lott Rydström
- Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
6
|
Tadpatrikar A, Sharma MK, Murthy P. Digital dilemmas and existing recommendations for healthy screen time use for children and adolescents. Asian J Psychiatr 2024; 99:104154. [PMID: 39047352 DOI: 10.1016/j.ajp.2024.104154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/06/2024] [Accepted: 06/27/2024] [Indexed: 07/27/2024]
Abstract
As technology continues to play an integral role in our daily lives, concerns regarding the appropriate and healthy use of screen time have prompted health organizations and authorities worldwide to establish guidelines and recommendations. This paper comprehensively summarizes existing recommendations and guidelines for screen time use from various countries, highlighting key similarities, differences, and emerging trends. However, there is a dire need to expand the existing repertoire of guidelines and recommendations to different age groups and strategies depending on user engagement for healthy screen time use.
Collapse
Affiliation(s)
- Ashwini Tadpatrikar
- SHUT Clinic (Service for Healthy Use of Technology), Department of Clinical Psychology, National Institute of Mental Health & Neuro Sciences, Bengaluru, Karnataka, India
| | - Manoj Kumar Sharma
- SHUT Clinic (Service for Healthy Use of Technology), Department of Clinical Psychology, National Institute of Mental Health & Neuro Sciences, Bengaluru, Karnataka, India.
| | - Pratima Murthy
- Department of Psychiatry,National Institute of Mental Health & Neuro Sciences, Bengaluru, Karnataka, India
| |
Collapse
|
7
|
Cooper DK, Alonzo JK, Goldson T, Jordan IR, Jatoi F, Mallozzi I, Lupini F. Black and Latiné parents' perspectives on supporting their children's emotional and physical health. JOURNAL OF MARITAL AND FAMILY THERAPY 2024; 50:630-648. [PMID: 38654393 DOI: 10.1111/jmft.12705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 03/21/2024] [Accepted: 03/27/2024] [Indexed: 04/25/2024]
Abstract
Informed by integrative models of cultural resilience, the purpose of this study was to (a) explore how parents are promoting their children's emotional and physical health, with a focus on race and ethnic-racial socialization strategies, and (b) identify the barriers and challenges parents are experiencing in supporting their children's health. Ethnically racially matched qualitative interviews were conducted with 33 parents (82% women, 64% Black, 36% Latiné). Results of thematic analysis revealed three overarching themes: (a) Strategies for Promoting Children's Physical and Emotional Health, (b) Challenges Promoting Children's Physical and Emotional Health, and (c) Impact of Racism on Parenting and Children's Health. Most parents believed that racism had an impact on their parenting decisions and their children's health; however, there were some differences in ethnic-racial socialization practices between Black and Latiné parents. Findings have implications for culturally relevant parenting approaches to support children's emotional and physical health.
Collapse
Affiliation(s)
- Daniel K Cooper
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Jayxa K Alonzo
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Tracey Goldson
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Isabel R Jordan
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Fatima Jatoi
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Isabella Mallozzi
- Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Francesca Lupini
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| |
Collapse
|
8
|
Chakranon P, Huang JP, Au HK, Lin CL, Chen YY, Mao SP, Lin WY, Zou ML, Estinfort W, Chen YH. The importance of mother-child interaction on smart device usage and behavior outcomes among toddlers: a longitudinal study. Child Adolesc Psychiatry Ment Health 2024; 18:79. [PMID: 38943161 PMCID: PMC11214231 DOI: 10.1186/s13034-024-00772-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 06/21/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND In recent years, smart devices have become an integral part of daily life. However, longitudinal studies, particularly those regarding the relationship between toddlers' smart device usage and behavioral outcomes, are limited. Understanding the impact of parent-child interactions on this relationship is crucial for enhancing toddlers' developmental outcomes. Accordingly, this study examined the influence of early screen time and media content exposure on toddlers' behaviors, as well as the positive effects of mother-child interactions on this influence. METHODS We used relevant data related to 277 children born between November 2016 and July 2020 and who were part of an ongoing prospective follow-up study conducted across five hospitals in Taipei City, Taiwan. We analyzed (1) data from maternal reports regarding children's behavior by using the Child Behavior Checklist (for ages 11/2-5 years), (2) assessments of mother-child interactions by using the Brigance Parent-Child Interactions Scale, and (3) self-reported parental data covering the first 3 postpartum years. Statistical analyses involved group-based trajectory modeling and multiple linear regression. RESULTS A considerable increase in screen time between the ages of 1 and 3 years was associated with less favorable behavioral outcomes at age 3. These outcomes included somatic complaints [adjusted beta coefficient (aβ) = 2.17, 95% confidence interval (CI) = 0.39-3.95, p-value = 0.01], withdrawal (aβ = 2.42, 95% CI = 0.15-4.69, p-value = 0.04), and aggressive behavior (aβ = 6.53, 95% CI = 0.25-12.81, p-value = 0.04). This association was particularly evident among children with lower levels of mother-child interaction. Nevertheless, positive mother-child interactions mitigated most of the adverse effects. Additionally, increased exposure to games and cartoons was associated with poorer behavioral outcomes in all children except for those experiencing positive mother-child interactions. CONCLUSION Early mother-child interactions play a crucial role in mitigating the risk of behavioral problems in toddlers who spend prolonged periods looking at screens and who are frequently exposed to game and cartoon content.
Collapse
Affiliation(s)
- Pairote Chakranon
- School of Public Health, College of Public Health, Taipei Medical University, New Taipei City, Taiwan
| | - Jian-Pei Huang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Heng-Kien Au
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chen-Li Lin
- Department of Obstetrics and Gynecology, Heping Fuyou Branch, Taipei City Hospital, Taipei, Taiwan
| | - Yi-Yung Chen
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Shih-Peng Mao
- Department of Obstetrics and Gynecology, Ministry of Health and Welfare, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Wen-Yi Lin
- Ph.D. Program in Medical Neuroscience, College of Medical Science and Technology, Taipei Medical University and National Health Research Institutes, New Taipei City, Taiwan
| | - Ming-Lun Zou
- School of Public Health, College of Public Health, Taipei Medical University, New Taipei City, Taiwan
| | - Wanda Estinfort
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, USA
| | - Yi-Hua Chen
- School of Public Health, College of Public Health, Taipei Medical University, New Taipei City, Taiwan.
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan.
- Research Center of Health Equity, College of Public Health, Taipei Medical University, New Taipei City, Taiwan.
- School of Public Health, College of Public Health, Taipei Medical University, 10F., Biomedical Technology Building, Shuang-Ho Campus, No. 301, Yuantong Rd., Zhonghe Dist., New Taipei City, Taiwan.
| |
Collapse
|
9
|
Tokala M, Weber J, Gilbert R, Dreyer Gillette ML, August KJ, Befort CA, Bates CR. Caregiver perceptions of child heath behaviors and weight during treatment for acute lymphoblastic leukemia. Pediatr Blood Cancer 2024; 71:e30984. [PMID: 38584336 DOI: 10.1002/pbc.30984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/07/2024] [Accepted: 03/18/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Changes in health behaviors and weight are common during the early phases of pediatric acute lymphoblastic leukemia treatment, and may negatively impact treatment tolerability. Given that ALL is most prevalent in children, caregivers play an essential role in shaping health behaviors during treatment. This study presents a qualitative analysis of semi-structured interviews with caregivers of youth in the early phases of ALL treatment. PROCEDURE Caregivers (N = 17, 95% female) of a child (M age = 6.76 years) diagnosed with ALL and on treatment for less than 1 year (M = 8.7 months since diagnosis) completed a semi-structured interview about perceptions of their child's nutrition, physical activity, sedentary time, and weight during ALL treatment. Thematic analysis followed Braun and Clark's six-step framework (2006). Two coders established reliability (alpha = .88) and used a multi-pass coding system to extract themes. RESULTS Caregivers' concerns around their child's weight during ALL treatment primarily centered around avoiding malnutrition. Weight gain during treatment was less of a concern and often viewed as protective. Caregivers reported encouraging their child to eat palatable, calorie-dense foods to mitigate risk for weight loss. Caregivers also expressed concern that children were less active and more sedentary due to treatment-related pain. Caregivers discussed health behaviors during treatment as being child-directed, rather than parent- or provider-directed. CONCLUSION Future interventions may consider strategies to engage in joint parent-child decisions and caregiver education around risks of excessive weight gain during treatment. Interventions should include anticipatory guidance and aim to support parents in developing skills to support their child's health behaviors during treatment.
Collapse
Affiliation(s)
- Meghan Tokala
- University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Jacee Weber
- Kansas City University College of Osteopathic Medicine, Kansas City, Missouri, USA
| | - Renee Gilbert
- University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Meredith L Dreyer Gillette
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA
- University of Missouri Kansas City School of Medicine, Kansas City, Missouri, USA
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
| | - Keith J August
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA
- University of Missouri Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Christie A Befort
- University of Kansas Medical Center, Kansas City, Kansas, USA
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- University of Kansas Cancer Center, Westwood, Kansas, USA
| | - Carolyn R Bates
- University of Kansas Medical Center, Kansas City, Kansas, USA
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- University of Kansas Cancer Center, Westwood, Kansas, USA
| |
Collapse
|
10
|
Owais S, Ospina MB, Ford C, Hill T, Savoy CD, Van Lieshout R. Screen Time and Socioemotional and Behavioural Difficulties Among Indigenous Children in Canada: Temps d'écran et difficultés socio-émotionnelles et comportementales chez les enfants autochtones du Canada. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024; 69:337-346. [PMID: 38151919 PMCID: PMC11032090 DOI: 10.1177/07067437231223333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
OBJECTIVES To describe screen time levels and determine their association with socioemotional and behavioural difficulties among preschool-aged First Nations, Métis, and Inuit children. METHOD Data were taken from the Aboriginal Children's Survey, a nationally representative survey of 2-5-year-old Indigenous children in Canada. Socioemotional and behavioural difficulties were defined using parent/guardian reports on the Strengths and Difficulties Questionnaire. Multiple linear regression analyses were conducted separately for First Nations, Métis, and Inuit participants, and statistically adjusted for child age, child sex, and parent/guardian education. Statistical significance was set at P < 0.002 to adjust for multiple comparisons. RESULTS Of these 2-5-year-old children (mean [M] = 3.57 years) 3,085 were First Nations (53.5%), 2,430 Métis (39.2%), and 990 Inuit (7.3%). Screen time exposure was high among First Nations (M = 2 h and 58 min/day, standard deviation [SD] = 1.89), Métis (M = 2 h and 50 min [SD = 1.83]), and Inuit children (M = 3 h and 25 min [SD = 2.20]), with 79.7% exceeding recommended guidelines (>1 h/day). After adjusting for confounders, screen time was associated with more socioemotional and behavioural difficulties among First Nations (total difficulties β = 0.15 [95% CI, 0.12 to 0.19]) and Métis (β = 0.16 [95% CI, 0.12 to 0.20]) but not Inuit children (β = 0.12 [95% CI, 0.01 to 0.23]). CONCLUSIONS Screen time exposure is high among Indigenous children in Canada, and is associated with more socioemotional and behavioural difficulties among First Nations and Métis children. Contributing factors could include enduring colonialism that resulted in family dissolution, lack of positive parental role models, and disproportionate socioeconomic disadvantage. Predictors of poor well-being should continue to be identified to develop targets for intervention to optimize the health and development of Indigenous children.
Collapse
Affiliation(s)
| | - Maria B. Ospina
- Department of Public Health Sciences, Queen's University, Kingston, Canada
| | - Camron Ford
- Bachelor of Medical Sciences Program, Western University, London, Canada
| | - Troy Hill
- McMaster Alumni Association, McMaster University, Hamilton, Canada
| | - Calan D. Savoy
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Ryan Van Lieshout
- McMaster University, Hamilton, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| |
Collapse
|
11
|
Wunsch K, Fiedler J, Hubenschmid S, Reiterer H, Renner B, Woll A. An mHealth Intervention Promoting Physical Activity and Healthy Eating in a Family Setting (SMARTFAMILY): Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e51201. [PMID: 38669071 PMCID: PMC11087865 DOI: 10.2196/51201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/27/2023] [Accepted: 02/27/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Numerous smartphone apps are targeting physical activity (PA) and healthy eating (HE), but empirical evidence on their effectiveness for the initialization and maintenance of behavior change, especially in children and adolescents, is still limited. Social settings influence individual behavior; therefore, core settings such as the family need to be considered when designing mobile health (mHealth) apps. OBJECTIVE The purpose of this study was to evaluate the effectiveness of a theory- and evidence-based mHealth intervention (called SMARTFAMILY [SF]) targeting PA and HE in a collective family-based setting. METHODS A smartphone app based on behavior change theories and techniques was developed, implemented, and evaluated with a cluster randomized controlled trial in a collective family setting. Baseline (t0) and postintervention (t1) measurements included PA (self-reported and accelerometry) and HE measurements (self-reported fruit and vegetable intake) as primary outcomes. Secondary outcomes (self-reported) were intrinsic motivation, behavior-specific self-efficacy, and the family health climate. Between t0 and t1, families of the intervention group (IG) used the SF app individually and collaboratively for 3 consecutive weeks, whereas families in the control group (CG) received no treatment. Four weeks following t1, a follow-up assessment (t2) was completed by participants, consisting of all questionnaire items to assess the stability of the intervention effects. Multilevel analyses were implemented in R (R Foundation for Statistical Computing) to acknowledge the hierarchical structure of persons (level 1) clustered in families (level 2). RESULTS Overall, 48 families (CG: n=22, 46%, with 68 participants and IG: n=26, 54%, with 88 participants) were recruited for the study. Two families (CG: n=1, 2%, with 4 participants and IG: n=1, 2%, with 4 participants) chose to drop out of the study owing to personal reasons before t0. Overall, no evidence for meaningful and statistically significant increases in PA and HE levels of the intervention were observed in our physically active study participants (all P>.30). CONCLUSIONS Despite incorporating behavior change techniques rooted in family life and psychological theories, the SF intervention did not yield significant increases in PA and HE levels among the participants. The results of the study were mainly limited by the physically active participants and the large age range of children and adolescents. Enhancing intervention effectiveness may involve incorporating health literacy, just-in-time adaptive interventions, and more advanced features in future app development. Further research is needed to better understand intervention engagement and tailor mHealth interventions to individuals for enhanced effectiveness in primary prevention efforts. TRIAL REGISTRATION German Clinical Trials Register DRKS00010415; https://drks.de/search/en/trial/DRKS00010415. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/20534.
Collapse
Affiliation(s)
- Kathrin Wunsch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Janis Fiedler
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Sebastian Hubenschmid
- Department of Computer and Information Science, University of Konstanz, Konstanz, Germany
| | - Harald Reiterer
- Department of Computer and Information Science, University of Konstanz, Konstanz, Germany
| | - Britta Renner
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| |
Collapse
|
12
|
Merín L, Toledano-González A, Fernández-Aguilar L, Nieto M, Del Olmo N, Latorre JM. Evaluation of the association between excessive screen use, sleep patterns and behavioral and cognitive aspects in preschool population. A systematic review. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02430-w. [PMID: 38565731 DOI: 10.1007/s00787-024-02430-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024]
Abstract
In this review, we analyzed the possible relationship between the excessive use of screens and sleep patterns, and how this may affect certain behavioral and cognitive factors in preschool children. The selection, extraction and synthesis of the data were conducted according to PRISMA guidelines. The search was carried out in the electronic databases Medline (PubMed), PsycINFO (American Psychological Association), Scopus and Web of Science (WOS). Of the 597 articles initially identified, 13 met the inclusion criteria. The risk of bias of the articles selected was evaluated using a specific scale created for this purpose. The results found indicate that excessive use of screens is associated with a negative impact on the duration and quality of sleep-in preschoolers, and this worsening of sleep in infancy is related with a greater probability of the appearance of internalizing and externalizing behavioral problems and certain cognitive problems. The results also suggest that sleep could play a mediating or moderating role as a bioregulatory system that attenuates or increases the onset of behavioral and cognitive difficulties in those children most exposed to digital devices.
Collapse
Affiliation(s)
- Llanos Merín
- Department of Psychology, Faculty of Education, University of Castilla-La Mancha, Albacete, Spain
| | - Abel Toledano-González
- Department of Psychology, Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
- Biomedicine Institute, University of Castilla La Mancha, Albacete, Spain
| | - Luz Fernández-Aguilar
- Biomedicine Institute, University of Castilla La Mancha, Albacete, Spain.
- Department of Psychology, Faculty of Law, University of Castilla-La Mancha, Albacete, Spain.
| | - Marta Nieto
- Biomedicine Institute, University of Castilla La Mancha, Albacete, Spain
- Department of Psychology, Faculty of Medicine, University of Castilla-La Mancha, Albacete, Spain
| | - Nuria Del Olmo
- Department of Psychobiology, Faculty of Psychology, National University of Distance Education, Madrid, Spain
| | - José M Latorre
- Biomedicine Institute, University of Castilla La Mancha, Albacete, Spain
- Department of Psychology, Faculty of Medicine, University of Castilla-La Mancha, Albacete, Spain
| |
Collapse
|
13
|
Brushe ME, Haag DG, Melhuish EC, Reilly S, Gregory T. Screen Time and Parent-Child Talk When Children Are Aged 12 to 36 Months. JAMA Pediatr 2024; 178:369-375. [PMID: 38436942 PMCID: PMC10913002 DOI: 10.1001/jamapediatrics.2023.6790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/20/2023] [Indexed: 03/05/2024]
Abstract
Importance Growing up in a language-rich home environment is important for children's language development in the early years. The concept of "technoference" (technology-based interference) suggests that screen time may be interfering with opportunities for talk and interactions between parent and child; however, limited longitudinal evidence exists exploring this association. Objective To investigate the longitudinal association between screen time and 3 measures of parent-child talk (adult words, child vocalizations, and conversational turns) when children are 12 to 36 months of age. Design, Setting, and Participants This Australian prospective cohort study used advanced speech recognition technology to capture young children's screen time and home language environment, on an average 16-hour day. Data were collected from 220 families once every 6 months in the family home when children were 12, 18, 24, 30, and 36 months of age, from January 1, 2018, to December 31, 2021. Statistical analysis took place from November 1, 2022, to July 31, 2023. Exposure Language Environment Analysis (LENA) technology provided automated counts of children's language environment and exposure to electronic noise. The exposure of interest was screen time, which was calculated based on manual coding of LENA electronic noise audio segments. Main Outcomes and Measures Three measures of parent-child talk were outcomes of focus: adult words, child vocalizations, and conversational turns. Separate models were run for each of the 3 outcomes and included adjustment for child sex, child age, maternal educational level, number of children at home, number of home activities, and primary caregiver's psychological distress. Results The study included 220 families (120 girls [54.6%]; mean [SD] gestational age of children, 39.3 [1.5] weeks; mean [SD] age of mother at childbirth, 31.3 [4.8] years). Adjusted linear mixed-effect models demonstrated that increases in screen time were associated with decreases in measures of parent-child talk. The largest decreases were seen at 36 months, when an additional minute of screen time was associated with a reduction of 6.6 (95% CI, -11.7 to -1.5) adult words, 4.9 (95% CI, -6.1 to -3.7) child vocalizations, and 1.1 (95% CI, -1.4 to -0.8) conversational turns. Conclusion and Relevance Findings of this study support the notion of technoference for Australian families, whereby young children's exposure to screen time is interfering with opportunities to talk and interact in their home environment. This finding has implications for interventions and supports aimed at promoting a language-rich home environment, with families needing support in understanding the potential association of screen time with opportunities for children and adults to talk and interact in their home environment.
Collapse
Affiliation(s)
- Mary E. Brushe
- Telethon Kids Institute, University of Western Australia, Adelaide, South Australia, Australia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Dandara G. Haag
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | | | - Sheena Reilly
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Tess Gregory
- Telethon Kids Institute, University of Western Australia, Adelaide, South Australia, Australia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
14
|
Kwon S, Armstrong B, Wetoska N, Capan S. Screen Time, Sociodemographic Factors, and Psychological Well-Being Among Young Children. JAMA Netw Open 2024; 7:e2354488. [PMID: 38441898 PMCID: PMC10915694 DOI: 10.1001/jamanetworkopen.2023.54488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/12/2023] [Indexed: 03/07/2024] Open
Abstract
Importance Young children's screen time increased during the COVID-19 lockdown in 2020, but it is unknown whether their screen time returned to prepandemic levels in 2021. Knowledge of the relationship between screen time and child development and health will inform prevention and intervention targets and strategies. Objective To evaluate screen time by family income and race and ethnicity in the prepandemic (ie, 2018, 2019) and pandemic (ie, 2020, 2021) periods and to examine the relationship between screen time and psychological well-being among young children in the US. Design, Setting, and Participants Cross-sectional population-based web or mail survey study of 2018-2021 National Survey of Children's Health participants aged 6 months to 5 years. Exposure Daily screen time (<1, 1, 2, 3, or ≥4 h/d) reported by participants' primary caregivers. Main outcomes and Measures Flourishing and externalizing behaviors, as indicators of psychological well-being. All analyses were weighted, accounting for the complex survey sample design. Results Of the 48 775 participants (50.7% female), the proportion of those with high screen time (defined as ≥1 h/d for children aged 6 months-1 year and ≥2 h/d for children aged 2-5 years) was 48.5% (95% CI, 46.3%-50.7%) in 2018, 49.2% (95% CI, 47.0%-51.5%) in 2019, 55.3% (95% CI, 53.4%-57.2%) in 2020, and 50.0% (95% CI, 48.3%-51.6%) in 2021. Among children living in poverty (federal poverty level <100%), the proportion of those with high screen time was 48.7% (95% CI, 42.8%-54.6%) in 2018, 52.0% (95% CI, 45.4%-58.6%) in 2019, 60.9% (95% CI, 55.4%-66.4%) in 2020, and 58.9% (53.7%-64.1%) in 2021. Adjusted odds ratio of flourishing was 0.66 (95% CI, 0.51-0.85), 0.81 (95% CI, 0.66-0.99), 0.68 (95% CI, 0.52-0.88), and 0.53 (95% CI, 0.42-0.69) for less than 1, 2, 3, and 4 or more hours per day vs 1 hour per day of screen time, respectively, among children aged 3 to 5 years. No association between screen time and flourishing was found among children aged 6 months to 2 years. An adjusted externalizing behavior score was higher by 0.2 points (95% CI, -0.1 to 0.5), 0.5 points (95% CI, 0.3 to 0.8), 1.3 points (95% CI, 1.0 to 1.6), and 2.1 points (95% CI, 1.7 to 2.5) for less than 1, 2, 3, and 4 or more hours per day vs 1 hour per day of screen time, respectively, among children aged 3 to 5 years. Conclusions and Relevance In this multiyear cross-sectional study of a representative sample of young children in the US, the increased prevalence of high screen time in 2020 returned to prepandemic levels in 2021; however, it remained elevated in children living in poverty. Two hours or more of daily screen time was associated with lower psychological well-being among preschool-aged children.
Collapse
Affiliation(s)
- Soyang Kwon
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Nina Wetoska
- Buehler Center for Health Policy and Economics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Selin Capan
- Buehler Center for Health Policy and Economics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| |
Collapse
|
15
|
Muth ND, Bolling C, Hannon T, Sharifi M. The Role of the Pediatrician in the Promotion of Healthy, Active Living. Pediatrics 2024; 153:e2023065480. [PMID: 38404207 PMCID: PMC11042797 DOI: 10.1542/peds.2023-065480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/27/2024] Open
Abstract
Few children and adolescents meet federal nutrition or physical activity recommendations, and many experience poor or inadequate sleep and negative health effects from screen use and social media. These lifestyle factors exacerbate physical and mental health risks for children and adolescents. This clinical report provides guidance to help pediatricians address the nutritional, physical activity, sleep, media and screen use, and social-emotional factors that affect child and adolescent health and wellness. The recommendations in this clinical report aim to promote health and wellness practices for infants, children, and adolescents across several domains of influence, including the individual, interpersonal, institutional, community, and public policy levels.
Collapse
Affiliation(s)
- Natalie D. Muth
- Children’s Primary Care Medical Group, Carlsbad, Californiaand Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California
| | - Christopher Bolling
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Tamara Hannon
- Division of Pediatric Endocrinology and Diabetology, Department of Pediatrics, Indiana University School of Medicine, Bloomington, Indiana
| | - Mona Sharifi
- Departments of Pediatrics and Biostatistics, Yale School of Medicine, New Haven, Connecticut
| | | | | |
Collapse
|
16
|
Jiang S, Ng JYY, Chong KH, Peng B, Ha AS. Effects of eHealth Interventions on 24-Hour Movement Behaviors Among Preschoolers: Systematic Review and Meta-Analysis. J Med Internet Res 2024; 26:e52905. [PMID: 38381514 PMCID: PMC10918543 DOI: 10.2196/52905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/04/2023] [Accepted: 01/18/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND The high prevalence of unhealthy movement behaviors among young children remains a global public health issue. eHealth is considered a cost-effective approach that holds great promise for enhancing health and related behaviors. However, previous research on eHealth interventions aimed at promoting behavior change has primarily focused on adolescents and adults, leaving a limited body of evidence specifically pertaining to preschoolers. OBJECTIVE This review aims to examine the effectiveness of eHealth interventions in promoting 24-hour movement behaviors, specifically focusing on improving physical activity (PA) and sleep duration and reducing sedentary behavior among preschoolers. In addition, we assessed the moderating effects of various study characteristics on intervention effectiveness. METHODS We searched 6 electronic databases (PubMed, Ovid, SPORTDiscus, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials) for experimental studies with a randomization procedure that examined the effectiveness of eHealth interventions on 24-hour movement behaviors among preschoolers aged 2 to 6 years in February 2023. The study outcomes included PA, sleep duration, and sedentary time. A meta-analysis was conducted to assess the pooled effect using a random-effects model, and subgroup analyses were conducted to explore the potential effects of moderating factors such as intervention duration, intervention type, and risk of bias (ROB). The included studies underwent a rigorous ROB assessment using the Cochrane ROB tool. Moreover, the certainty of evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) assessment. RESULTS Of the 7191 identified records, 19 (0.26%) were included in the systematic review. The meta-analysis comprised a sample of 2971 preschoolers, which was derived from 13 included studies. Compared with the control group, eHealth interventions significantly increased moderate to vigorous PA (Hedges g=0.16, 95% CI 0.03-0.30; P=.02) and total PA (Hedges g=0.37, 95% CI 0.02-0.72; P=.04). In addition, eHealth interventions significantly reduced sedentary time (Hedges g=-0.15, 95% CI -0.27 to -0.02; P=.02) and increased sleep duration (Hedges g=0.47, 95% CI 0.18-0.75; P=.002) immediately after the intervention. However, no significant moderating effects were observed for any of the variables assessed (P>.05). The quality of evidence was rated as "moderate" for moderate to vigorous intensity PA and sedentary time outcomes and "low" for sleep outcomes. CONCLUSIONS eHealth interventions may be a promising strategy to increase PA, improve sleep, and reduce sedentary time among preschoolers. To effectively promote healthy behaviors in early childhood, it is imperative for future studies to prioritize the development of rigorous comparative trials with larger sample sizes. In addition, researchers should thoroughly examine the effects of potential moderators. There is also a pressing need to comprehensively explore the long-term effects resulting from these interventions. TRIAL REGISTRATION PROSPERO CRD42022365003; http://tinyurl.com/3nnfdwh3.
Collapse
Affiliation(s)
- Shan Jiang
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Johan Y Y Ng
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Kar Hau Chong
- School of Health and Society and Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Bo Peng
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Amy S Ha
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| |
Collapse
|
17
|
Berg V, Arabiat D, Morelius E, Kervin L, Zgambo M, Robinson S, Jenkins M, Whitehead L. Young Children and the Creation of a Digital Identity on Social Networking Sites: Scoping Review. JMIR Pediatr Parent 2024; 7:e54414. [PMID: 38381499 PMCID: PMC10918551 DOI: 10.2196/54414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND There is limited understanding of the concept of the digital identity of young children created through engagement on social networking sites. OBJECTIVE The objective of this scoping review was to identify key characteristics of the concept of digital identity for children from conception to the age of 8 years on social networking sites. METHODS This scoping review was conducted using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The key databases searched were EBSCO, Web of Science, ProQuest ERIC, and Scopus. Gray literature sources (National Grey Literature Collection, ProQuest Dissertations and Theses, and Google Scholar) were also searched to identify unpublished studies. Articles were selected if they were published in English and reported data on the digital identity of children in relation to social networking sites. RESULTS The key terms used in the literature were sharenting, followed by digital footprints and children's identities. Our study revealed 2 approaches to the creation of digital identity: social digital identity and performative digital identity. The articles in this review most commonly used the term sharenting to describe the behavior parents engage in to create digital identities for children on social networking sites. Motivations to post information about children differed among parents; however, the most common reasons were to share with friends and family and create digital archives of childhood photos, termed social digital identity. The second motivation was categorized as performative digital identity. The risk of digital kidnapping and identity theft associated with the creation of digital identities also influenced parents' behaviors. CONCLUSIONS The creation of a digital identity for children is an emerging concept. Our review develops a deeper understanding of sharenting behaviors that can be used to better support parents and their children in creating a digital identity with children and awareness of the potential future impact. We recommend that future studies explore the perspectives of children as key stakeholders in the creation of their digital identity.
Collapse
Affiliation(s)
- Valeska Berg
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, Australia
- Australian Research Council Centre of Excellence for the Digital Child, Brisbane, Australia
| | - Diana Arabiat
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, Australia
- Australian Research Council Centre of Excellence for the Digital Child, Brisbane, Australia
- Faculty of Nursing, University of Jordan, Amman, Jordan
| | - Evalotte Morelius
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, Australia
- Australian Research Council Centre of Excellence for the Digital Child, Brisbane, Australia
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Lisa Kervin
- Australian Research Council Centre of Excellence for the Digital Child, Brisbane, Australia
- School of Education, University of Wollongong, Wollongong, Australia
| | - Maggie Zgambo
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, Australia
- Australian Research Council Centre of Excellence for the Digital Child, Brisbane, Australia
| | - Suzanne Robinson
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, Australia
| | - Mark Jenkins
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, Australia
| | - Lisa Whitehead
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, Australia
- Australian Research Council Centre of Excellence for the Digital Child, Brisbane, Australia
- Faculty of Nursing, University of Jordan, Amman, Jordan
- The Centre for Evidence Informed Nursing, Midwifery and Healthcare Practice: A JBI Affiliated Group, Joondalup, Australia
| |
Collapse
|
18
|
Moussi C, Tahan L, Habchy P, Kattan O, Njeim A, Abou Habib L, El Bitar W, El Asmar B, Chahine MN. School-Based Pre- and Post-Intervention Tests Assessing Knowledge about Healthy Lifestyles: A National School Health Awareness Campaign on Children Aged between 3 and 12 Years Old. CHILDREN (BASEL, SWITZERLAND) 2024; 11:213. [PMID: 38397325 PMCID: PMC10887629 DOI: 10.3390/children11020213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
In response to the diverse health challenges faced by today's youth and their extensive time spent in schools, we conducted a school health awareness campaign aimed at prioritizing well-being and academic performance. This analytical longitudinal study, spanning 27 schools in Lebanon, aimed to assess the impact of the awareness campaign on the health knowledge and practices of 5-, 8-, and 11-year-old students throughout pre- and post-intervention testing focused on general health and healthy habits, employing 11, 14, and 15 questions tailored to 5, 8, and 11 year olds, respectively. The questions covered various aspects, including sleep, personal and dental hygiene, nutrition, physical activity, addiction, security measures, and bullying. Out of the 7100 students who participated, 16.11% (1144 students) were evaluated before and after the campaign. The results indicated a significant increase in health awareness post-intervention across all age groups. For instance, in 5-year-olds, limited awareness decreased from 91.6% to 36.38%, while adequate awareness rose from 8.03% to 62.3%. Improvement varied across health knowledge topics, with security-related questions showing the highest enhancement. Factors such as governorate, normal-weight status, and close supervision influenced improvement. However, no significant correlations were found with school type, size, gender, age, nationality, parental factors, or comorbidities. The study concludes that the school health awareness campaign successfully heightened children's health awareness, advocating for the integration of regular health promotions into the standard educational curriculum.
Collapse
Affiliation(s)
- Charbel Moussi
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (C.M.); (L.T.); (P.H.); (O.K.); (A.N.)
| | - Léa Tahan
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (C.M.); (L.T.); (P.H.); (O.K.); (A.N.)
| | - Peter Habchy
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (C.M.); (L.T.); (P.H.); (O.K.); (A.N.)
| | - Ogarite Kattan
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (C.M.); (L.T.); (P.H.); (O.K.); (A.N.)
| | - Alain Njeim
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (C.M.); (L.T.); (P.H.); (O.K.); (A.N.)
| | - Leila Abou Habib
- Lebanese Association of the Knights of Malta (Order of Malta Lebanon), Vanlian Bldg, 6th Fl. City Rama Str. Dekwaneh, Beirut P.O. Box 11-4286, Lebanon; (L.A.H.); (W.E.B.); (B.E.A.)
| | - Wassim El Bitar
- Lebanese Association of the Knights of Malta (Order of Malta Lebanon), Vanlian Bldg, 6th Fl. City Rama Str. Dekwaneh, Beirut P.O. Box 11-4286, Lebanon; (L.A.H.); (W.E.B.); (B.E.A.)
- Department of Pediatrics, Bellevue Medical Center University Hospital, Mansourieh P.O Box 295, Lebanon
| | - Béchara El Asmar
- Lebanese Association of the Knights of Malta (Order of Malta Lebanon), Vanlian Bldg, 6th Fl. City Rama Str. Dekwaneh, Beirut P.O. Box 11-4286, Lebanon; (L.A.H.); (W.E.B.); (B.E.A.)
- Faculty of Medicine, Saint Joseph University, Beirut P.O. Box 17-5208, Lebanon
- Department of Cardiology, Hotel-Dieu de France Hospital, Achrafieh, Beirut P.O. Box 11-5190, Lebanon
| | - Mirna N. Chahine
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (C.M.); (L.T.); (P.H.); (O.K.); (A.N.)
- Lebanese Association of the Knights of Malta (Order of Malta Lebanon), Vanlian Bldg, 6th Fl. City Rama Str. Dekwaneh, Beirut P.O. Box 11-4286, Lebanon; (L.A.H.); (W.E.B.); (B.E.A.)
- Basic Sciences Department, Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon
- Foundation-Medical Research Institutes (F-MRI), Achrafieh, Beirut P.O. Box 64, Lebanon
- Foundation-Medical Research Institutes (F-MRI), 1211 Geneva, Switzerland
| |
Collapse
|
19
|
Harandian K, Necsa B, Barnett TA, Pagani LS. Family Meal Environment Differentially Conditions the Prospective Association between Early Childhood Screen Time and Key Social Relationships in Adolescent Girls. CHILDREN (BASEL, SWITZERLAND) 2024; 11:145. [PMID: 38397257 PMCID: PMC10886694 DOI: 10.3390/children11020145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024]
Abstract
Background: Despite screen time recommendations, children are increasingly spending time on electronic devices, rendering it an important risk factor for subsequent social and developmental outcomes. Sharing meals could offer a way to promote psychosocial development. This study examines the interaction between family meal environment and early childhood screen time on key adolescent social relationships. Methods: Participants are 1455 millennial children (49% boys) from the Quebec Longitudinal Study of Child Development birth cohort. Parents reported on child screen use at ages 2 and 6 years and family meal environment quality at age 6 years. Parents and children reported on parent-child relationships and peer victimization experiences, respectively, at age 13 years. Sex-stratified multiple regression estimated the direct association between screen time trends, family meal environment quality, and their interaction on later social relationship outcomes. Results: For girls, when preschool screen time increased, sharing family meals in high-quality environments was associated with more positive and less conflictual relationships with their mothers, whereas meals shared in low- and moderate-quality environments were associated with fewer instances of victimization by their peers. Non-linear associations were not significant for boys. Conclusion: Capitalizing on family meal environment represents a simple/cost-efficient activity that can compensate for some long-term risks associated with increased screen use, above and beyond pre-existing and concurrent individual and family characteristics. Public health initiatives may benefit from considering family meals as a complementary intervention strategy to screen use guidelines.
Collapse
Affiliation(s)
- Kianoush Harandian
- School of Psycho-Education, University of Montreal, Montreal, QC H3C 3J7, Canada; (K.H.); (B.N.)
- School Environment Research Group, University of Montreal, Montreal, QC H3C 3J7, Canada
| | - Beatrice Necsa
- School of Psycho-Education, University of Montreal, Montreal, QC H3C 3J7, Canada; (K.H.); (B.N.)
| | - Tracie A. Barnett
- Sainte-Justine’s Hospital Research Center, Montreal, QC H3T 1C5, Canada
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada
| | - Linda S. Pagani
- School of Psycho-Education, University of Montreal, Montreal, QC H3C 3J7, Canada; (K.H.); (B.N.)
- School Environment Research Group, University of Montreal, Montreal, QC H3C 3J7, Canada
- Sainte-Justine’s Hospital Research Center, Montreal, QC H3T 1C5, Canada
| |
Collapse
|
20
|
Shakya H, Acharya S, Pradhan S, KC D. High Problematic Screen Exposure among Children Aged 2-5 Years Visiting the Department of Pediatrics of a Tertiary Care Centre. JNMA J Nepal Med Assoc 2023; 61:927-930. [PMID: 38289758 PMCID: PMC10792710 DOI: 10.31729/jnma.8364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction The effects of problematic screen exposure in the early years have adverse effects on cognition, reasoning, executive, and social skills, and physical health. The study aimed to assess the prevalence of problematic screen exposure in children between 2 to 5 years of age visiting the Department of Paediatrics of a tertiary care centre. Methods A descriptive cross-sectional study was conducted among caregivers of children aged 2 to 5 years of age in a tertiary care centre from 16 July 2023 to 30 September 2023 after an ethical clearance from the Institutional Review Committee. This study excluded children with chronic disease and behavioural disorders. The problematic screen exposure was assessed using the Problematic Screen Exposure Score. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results Among 310 respondents, 216 (69.67%) (64.55-74.79, 95% Confidence Interval) children had a high problematic screen exposure score. The mean age of children was 3.46±1.033 with 89 (41.20%) children having their first exposure before 12 months of age, 131 (60.64%) exceeding daily usage of >2 hr, and 198 (91.66%) children viewing age-inappropriate media content. Conclusions The prevalence of high problematic screen exposure was comparable to that of the prevalence found in studies done in similar settings. Keywords children; preschool; screen time.
Collapse
Affiliation(s)
- Henish Shakya
- Department of Pediatrics, KIST Medical College and Teaching Hospital, Mahalaxmi, Lalitpur, Nepal
| | - Sharda Acharya
- Department of Pediatrics, KIST Medical College and Teaching Hospital, Mahalaxmi, Lalitpur, Nepal
| | - Shikhar Pradhan
- Department of Pediatrics, KIST Medical College and Teaching Hospital, Mahalaxmi, Lalitpur, Nepal
| | - Divya KC
- Department of Pediatrics, KIST Medical College and Teaching Hospital, Mahalaxmi, Lalitpur, Nepal
| |
Collapse
|
21
|
Morawska A, Mitchell AE, Tooth LR. Managing Screen Use in the Under-Fives: Recommendations for Parenting Intervention Development. Clin Child Fam Psychol Rev 2023; 26:943-956. [PMID: 37171529 PMCID: PMC10640456 DOI: 10.1007/s10567-023-00435-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 05/13/2023]
Abstract
The impact of excessive screen use on children's health and development is a public health concern and many countries have published recommendations to limit and guide the use of screen media in childhood. Despite this, international studies report that the majority of parents and children do not adhere to screen use recommendations. Existing research aiming to understand children' screen use has largely focused on older children, and on demographic and structural aspects of the child's environment. Parents play a central role in determining young children's screen use and identify numerous barriers to developing healthy screen use practices with their children. However, no clear models exist that incorporate key parenting factors in understanding children's screen use, which presents an impediment to intervention development. Likewise, while some evidence exists for interventions to improve children's screen use behaviours, most are focused on older children and parental involvement has generally been limited. In this paper, we overview key factors associated with screen use in young children (< 5 years) and summarise the existing evidence base for interventions designed to support healthy screen use. This paper proposes a conceptual model linking aspects of parenting and the socio-ecological environment to young children's screen use. Our proposed model could be used to design longitudinal studies of screen use predictors and outcomes, and inform intervention development. Finally, the paper provides key recommendations for future research, intervention development and testing.
Collapse
Affiliation(s)
- Alina Morawska
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, 13 Upland Road, St Lucia, Brisbane, Qld, 4072, Australia.
| | - Amy E Mitchell
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Leigh R Tooth
- School of Public Health, The University of Queensland, Brisbane, Australia
| |
Collapse
|
22
|
Yamamoto M, Mezawa H, Sakurai K, Mori C. Screen Time and Developmental Performance Among Children at 1-3 Years of Age in the Japan Environment and Children's Study. JAMA Pediatr 2023; 177:1168-1175. [PMID: 37721733 PMCID: PMC10507594 DOI: 10.1001/jamapediatrics.2023.3643] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/24/2023] [Indexed: 09/19/2023]
Abstract
Importance It is unclear whether increased television (TV) and DVD viewing in early childhood from age 1 year decreases development or whether poor development increases TV/DVD viewing. Objective To investigate the directional association between TV/DVD screen time and performance on developmental screeners in children aged 1 to 3 years. Design, Setting, and Participants This longitudinal cohort study analyzed data from 57 980 children and mothers from a national birth cohort, the Japan Environment and Children's Study. Data were collected in collaboration with 15 regional centers across Japan. The mothers were recruited between January 2011 and March 2014. Analyses using random intercept, cross-lagged panel models were performed for children aged 1, 2, and 3 years. Of 100 303 live births, children with missing developmental screening test scores and screen time data, those with congenital diseases or cerebral palsy, and those diagnosed with an autism spectrum disorder were excluded. Statistical analyses were conducted from October 2022 to July 2023. Exposures TV and DVD screen time. Main Outcomes and Measures Child development at ages 1, 2, and 3 years was assessed via the mother's or guardian's report using the Ages and Stages Questionnaire, third edition. Results Of 57 980 included children, 29 418 (50.7%) were male, and the mean (SD) maternal age at delivery was 31.5 (4.9) years. A negative association between screen time and developmental scores was observed. Increased TV/DVD screen times at age 1 and 2 years were associated with lower developmental scores at age 2 and 3 years, respectively (2 years: β = -0.05; 95% CI, -0.06 to -0.04; 3 years: β = -0.08; 95% CI, -0.09 to -0.06). An obverse association was observed from the Ages and Stages Questionnaires, third edition, score in the communication domain at age 1 and 2 years to subsequent screen time (2 years: γ = -0.03; 95% CI, -0.04 to -0.02; 3 years: γ = -0.06; 95% CI, -0.07 to -0.04). Conclusions and Relevance In this study, increased TV/DVD screen time from age 1 year negatively affected later development. To reduce the negative consequences of excessive media use, researchers and health care professionals should encourage family media management and recommend social support for parents who tend to rely on the media.
Collapse
Affiliation(s)
- Midori Yamamoto
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Hidetoshi Mezawa
- Medical Support Center for Japan Environment and Children’s Study, National Center for Child Health and Development, Tokyo, Japan
| | - Kenichi Sakurai
- Department of Nutrition and Metabolic Medicine, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Chisato Mori
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| |
Collapse
|
23
|
Shih P, Chiang TL, Lin PI, Lin MY, Guo YL. Attention-deficit hyperactivity disorder in children is related to maternal screen time during early childhood in Taiwan: a national prospective cohort study. BMC Psychiatry 2023; 23:736. [PMID: 37817111 PMCID: PMC10565960 DOI: 10.1186/s12888-023-05242-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 09/30/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND It is unclear to familial screen time in early childhood is associated with the subsequent diagnosis of attention-deficit and hyperactivity disorder (ADHD). Our study is to evaluate the association between screen time during early childhood in families and the incidence of ADHD. METHODS We conducted a population-based birth cohort study by using the Taiwan Birth Cohort Study, which recruited 24 200 mother-child pairs when children were 6 months old. Screen time exposure for children and parents were collected at the age of 18 and 36 months. Whether the child has ever been diagnosed with ADHD was determined at a follow-up interview at age 8. Factors including socioeconomic factors and screen time were analyzed using logistic regression to determine their association with the rate of ADHD. RESULTS A total of 16 651 term singletons were included in the final analysis. Of them, 382 (2.3%) were diagnosed as having ADHD before the age of 8 years. No significant relationship between children's or fathers' screen time and ADHD was noted. When compared to children whose mothers spent less time on screens, those whose mothers spent more than 3 h a day on screens when the child was 3 years old exhibited a higher incidence of ADHD (adjusted OR [aOR]: 1.31, 95% CI: 1.03-1.66). CONCLUSION Higher maternal screen time when the child was 3 years old was associated with an increased incidence of ADHD in this population-based study. However, children's screen time did not find related to ADHD. We found that it was the mother's screen time, who typically serves as the primary caregiver in our study participants, not the child's, that mattered. In addition to superficial screen use time, future research is needed to replicate the findings and clarify mechanisms underlying this association.
Collapse
Affiliation(s)
- Ping Shih
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ping-I Lin
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Mental Health Research Unit, South Western Sydney Local Health District, Liverpool, Australia
- Department of Mental Health, School of Medicine, Western Sydney University, Penrith, Australia
| | - Ming-Yu Lin
- Department of Industrial Education, National Taiwan Normal University, Taipei, Taiwan
- Ministry of Education, Taipei, Taiwan
| | - Yue Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan.
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.
- , Rm 339, 3F., No. 17, Xuzhou Rd., Zhongzheng Dist., Taipei City, 10055, Taiwan.
| |
Collapse
|
24
|
Krijger A, Schiphof-Godart L, Elstgeest L, van Rossum C, Verkaik-Kloosterman J, Steenbergen E, Ter Borg S, Lanting C, van Drongelen K, Engelse O, Kindermann A, Detmar S, Frenkel C, Raat H, Joosten K. Development and evaluation study of FLY-Kids: a new lifestyle screening tool for young children. Eur J Pediatr 2023; 182:4749-4757. [PMID: 37580556 PMCID: PMC10587277 DOI: 10.1007/s00431-023-05126-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/09/2023] [Accepted: 07/18/2023] [Indexed: 08/16/2023]
Abstract
Evaluating, discussing, and advising on young children's lifestyles may contribute to timely modification of unhealthy behaviour and prevention of adverse health consequences. We aimed to develop and evaluate a new lifestyle screening tool for children aged 1-3 years. The lifestyle screening tool "FLY-Kids" was developed using data from lifestyle behaviour patterns of Dutch toddlers, age-specific lifestyle recommendations, target group analyses, and a Delphi process. Through 10 items, FLY-Kids generates a dashboard with an overview of the child's lifestyle that can be used as conversation aid. FLY-Kids was completed by parents of children aged 1-3 years attending a regular youth healthcare appointment. Youth healthcare professionals (YHCP) then used the FLY-Kids dashboard to discuss lifestyle with the parents and provided tailored advice. Parents as well as YHCP evaluated the tool after use. Descriptive and correlation statistics were used to determine the usability, feasibility, and preliminary effect of FLY-Kids. Parents (N = 201) scored an average of 3.2 (out of 9, SD 1.6) unfavourable lifestyle behaviours in their children, while 3.0% complied with all recommendations. Most unfavourable behaviours were reported in unhealthy food intake and electronic screen time behaviour. Parents and YHCP regarded FLY-Kids as usable and feasible. The number of items identified by FLY-Kids as requiring attention was associated with the number of items discussed during the appointment (r = 0.47, p < 0.001). Conclusion: FLY-Kids can be used to identify unhealthy lifestyle behaviour in young children and guide the conversation about lifestyle in preventive healthcare settings. End-users rated FLY-Kids as helpful and user-friendly. What is Known: • A healthy lifestyle is important for optimal growth, development and overall health of young children (1-3 years). • Evaluating, discussing and advising on young children's lifestyles may contribute to timely modification of unhealthy behaviour and prevention of adverse health consequences. What is New: • The new lifestyle screening tool FLY-Kids generates a dashboard with an overview of young children's lifestyle that can be used as conversation aid between parents and youth healthcare professionals. • As parents and youth healthcare professionals rated FLY-Kids as helpful and user-friendly, and the number of items identified by FLY-Kids as requiring attention was associated with the number of items discussed during the appointment, FLY-Kids can be considered guiding the lifestyle discussion in preventive healthcare settings.
Collapse
Affiliation(s)
- Anne Krijger
- Department of Pediatrics and Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, PO Box 2060, 3000 CB, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Lieke Schiphof-Godart
- Department of Medical Informatics, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Liset Elstgeest
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Reinier Academy, Reinier de Graaf Hospital, Delft, The Netherlands
| | - Caroline van Rossum
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | | | - Elly Steenbergen
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Sovianne Ter Borg
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Caren Lanting
- Netherlands Organisation for Applied Scientific Research TNO, Unit Healthy Living, Child Health Expertise Group, Leiden, The Netherlands
| | | | - Ondine Engelse
- Dutch Knowledge Centre for Youth Health, Utrecht, The Netherlands
| | - Angelika Kindermann
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands
| | - Symone Detmar
- Netherlands Organisation for Applied Scientific Research TNO, Unit Healthy Living, Child Health Expertise Group, Leiden, The Netherlands
| | - Carolien Frenkel
- Association of Dutch Infant and Dietetic Foods Industries, The Hague, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Koen Joosten
- Department of Pediatrics and Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, PO Box 2060, 3000 CB, Rotterdam, The Netherlands.
| |
Collapse
|
25
|
Takahashi I, Obara T, Ishikuro M, Murakami K, Ueno F, Noda A, Onuma T, Shinoda G, Nishimura T, Tsuchiya KJ, Kuriyama S. Screen Time at Age 1 Year and Communication and Problem-Solving Developmental Delay at 2 and 4 Years. JAMA Pediatr 2023; 177:1039-1046. [PMID: 37603356 PMCID: PMC10442786 DOI: 10.1001/jamapediatrics.2023.3057] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/22/2023] [Indexed: 08/22/2023]
Abstract
Importance Whether some domains of child development are specifically associated with screen time and whether the association continues with age remain unknown. Objective To examine the association between screen time exposure among children aged 1 year and 5 domains of developmental delay (communication, gross motor, fine motor, problem-solving, and personal and social skills) at age 2 and 4 years. Design, Participants, and Setting This cohort study was conducted under the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Pregnant women at 50 obstetric clinics and hospitals in the Miyagi and Iwate prefectures in Japan were recruited into the study between July 2013 and March 2017. The information was collected prospectively, and 7097 mother-child pairs were included in the analysis. Data analysis was performed on March 20, 2023. Exposure Four categories of screen time exposure were identified for children aged 1 year (<1, 1 to <2, 2 to <4, or ≥4 h/d). Main Outcomes and Measures Developmental delays in the 5 domains for children aged 2 and 4 years were assessed using the Japanese version of the Ages & Stages Questionnaires, Third Edition. Each domain ranged from 0 to 60 points. Developmental delay was defined if the total score for each domain was less than 2 SDs from its mean score. Results Of the 7097 children in this study, 3674 were boys (51.8%) and 3423 were girls (48.2%). With regard to screen time exposure per day, 3440 children (48.5%) had less than 1 hour, 2095 (29.5%) had 1 to less than 2 hours, 1272 (17.9%) had 2 to less than 4 hours, and 290 (4.1%) had 4 or more hours. Children's screen time was associated with a higher risk of developmental delay at age 2 years in the communication (odds ratio [OR], 1.61 [95% CI, 1.23-2.10] for 1 to <2 h/d; 2.04 [1.52-2.74] for 2 to <4 h/d; 4.78 [3.24-7.06] for ≥4 vs <1 h/d), fine motor (1.74 [1.09-2.79] for ≥4 vs <1 h/d), problem-solving (1.40 [1.02-1.92] for 2 to <4 h/d; 2.67 [1.72-4.14] for ≥4 vs <1 h/d), and personal and social skills (2.10 [1.39-3.18] for ≥4 vs <1 h/d) domains. Regarding risk of developmental delay at age 4 years, associations were identified in the communication (OR, 1.64 [95% CI, 1.20-2.25] for 2 to <4 h/d; 2.68 [1.68-4.27] for ≥4 vs <1 h/d) and problem-solving (1.91 [1.17-3.14] for ≥4 vs <1 h/d) domains. Conclusions and Relevance In this study, greater screen time for children aged 1 year was associated with developmental delays in communication and problem-solving at ages 2 and 4 years. These findings suggest that domains of developmental delay should be considered separately in future discussions on screen time and child development.
Collapse
Affiliation(s)
- Ippei Takahashi
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Taku Obara
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Mami Ishikuro
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Keiko Murakami
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Fumihiko Ueno
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Aoi Noda
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Tomomi Onuma
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Genki Shinoda
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Tomoko Nishimura
- United Graduate School of Child Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kenji J. Tsuchiya
- United Graduate School of Child Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Shinichi Kuriyama
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| |
Collapse
|
26
|
Song K, Zhang JL, Zhou N, Fu Y, Zou B, Xu LX, Wang Z, Li X, Zhao Y, Potenza M, Fang X, Zhang JT. Youth Screen Media Activity Patterns and Associations With Behavioral Developmental Measures and Resting-state Brain Functional Connectivity. J Am Acad Child Adolesc Psychiatry 2023; 62:1051-1063. [PMID: 36963562 PMCID: PMC10509312 DOI: 10.1016/j.jaac.2023.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 01/31/2023] [Accepted: 03/15/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVE Screen media activity (SMA) consumes considerable time in youth's lives, raising concerns about the effects it may have on youth development. Disentangling mixed associations between SMA of youth and developmental measures should move beyond overall screen time and consider types and patterns of SMA. This study aimed to identify reliable and generalizable SMA patterns among youth and examine their associations with behavioral developmental measures and developing brain functional connectivity. METHOD Three waves of Adolescent Brain and Cognitive Development (ABCD) data were examined. The Lifespan Human Connectome Project in Development (HCP-D) was interrogated as an independent sample. ABCD participants included 11,876 children at baseline. HCP-D participants included 652 children and adolescents. Youth-reported SMA and behavioral developmental measures (neurocognitive performance, behavioral problems, psychotic-like experiences, impulsivity, and sensitivities to punishment/reward) were assessed with validated instruments. We identified SMA patterns in the ABCD baseline data using K-means clustering and sensitivity analyses. Generalizability and stability of the identified SMA patterns were examined in HCP-D data and ABCD follow-up waves, respectively. Relations between SMA patterns and behavioral and brain (resting-state brain functional connectivity) measures were examined using linear mixed effects modeling with false discovery rate (FDR) correction. RESULTS SMA data from 11,815 children (mean [SD] age = 119.0 [7.5] months; 6,159 [52.1%] boys) were examined; 3,151 (26.7%) demonstrated a video-centric higher-frequency SMA pattern, and 8,664 (73.3%) demonstrated a lower-frequency pattern. SMA patterns were validated in similarly aged HCP-D youth. Compared with the lower-frequency SMA pattern group, the video-centric higher-frequency SMA pattern group showed poorer neurocognitive performance (β = -.12, 95% CI [-0.08, -0.16], FDR-corrected p < .001), more total behavioral problems (β = .13, 95% CI [0.09, 0.18], FDR-corrected p < .001), and more psychotic-like experiences (β = .31, 95% CI [0.27, 0.36], FDR-corrected p < .001). The video-centric higher-frequency SMA pattern group demonstrated higher impulsivity, more sensitivity to punishment/reward, and altered resting-state brain functional connectivity among brain areas implicated previously in cognitive processes. Most of the associations persisted with age in the ABCD data, with more participants (n = 3,378, 30.4%) in the video-centric higher-frequency SMA group at 1-year follow-up. A social communication-centric SMA pattern was observed in HCP-D adolescents. CONCLUSION Video-centric SMA patterns are reliable and generalizable during late childhood. A higher-frequency video entertainment SMA pattern group showed altered resting-state brain functional connectivity and poorer developmental measures that persisted longitudinally. The findings suggest that public health strategies to decrease excessive time spent by children on video entertainment-related SMA are needed. Further studies are needed to examine potential video-centric/social communication-centric SMA bifurcation to understand dynamic changes and trajectories of SMA patterns and related outcomes developmentally. DIVERSITY & INCLUSION STATEMENT We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
Collapse
Affiliation(s)
- Kunru Song
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China, and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Jia-Lin Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China, and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Nan Zhou
- Faculty of Education, University of Macau, Macau, China
| | - Yu Fu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China, and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Bowen Zou
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China, and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Lin-Xuan Xu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China, and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Ziliang Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China, and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China, and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Yihong Zhao
- Yale University School of Medicine, New Haven, Connecticut; Columbia University School of Nursing, New York
| | - Marc Potenza
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, the Connecticut Mental Health Center, New Haven, Connecticut, the Connecticut Council on Problem Gambling, Wethersfield, Connecticut, the Connecticut Council on Problem Gambling, Wethersfield, Connecticut, and the Wu Tsai Institute, Yale University, New Haven, Connecticut
| | - Xiaoyi Fang
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Jin-Tao Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China, and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.
| |
Collapse
|
27
|
Brushe ME, Lynch JW, Melhuish E, Reilly S, Mittinty MN, Brinkman SA. Objectively measured infant and toddler screen time: Findings from a prospective study. SSM Popul Health 2023; 22:101395. [PMID: 37096246 PMCID: PMC10122061 DOI: 10.1016/j.ssmph.2023.101395] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/26/2023] Open
Abstract
Objective Screen time guidelines recommend no screens under two years due to the potential negative impacts on development. While current reports suggest many children exceed this, research relies on parent reports of their children's screen exposure. We objectively assess screen exposure during the first two years and how it differs by maternal education and gender. Methods This Australian prospective cohort study used speech recognition technology to understand young children's screen exposure over an average day. Data collection occurred every six months when children were 6, 12, 18 and, 24 months old (n = 207). The technology provided automated counts of children's exposure to electronic noise. Audio segments were then coded as screen exposure. Prevalence of screen exposure was quantified, and differences between demographics examined. Results At six months, children were exposed to an average of 1hr, 16 min (SD = 1hr, 36 min) of screens per day, increasing to an average of 2 h, 28 min (SD = 2 h, 4 min) by 24-months. Some children at six months were exposed to more than 3 h of screen time per day. Inequalities in exposure were evident as early as six months. Children from higher educated families were exposed to 1hr,43 min fewer screens per day, 95%CI (-2hr, 13 min, -1hr, 11 min) compared to lower educated households, with this difference remaining consistent as children age. Girls were exposed to an additional 12 min of screens 95%CI (-20 min, 44 min) per day compared to boys at six months, but this difference reduced to only 5 min by 24-months. Conclusion Using an objective measure of screen exposure, many families exceed screen time guidelines, the extent increasing with child's age. Furthermore, substantial differences between maternal education groups emerge as young as six months old. This highlights the need for education and supports for parents around screen use in the early years, balanced within the realities of modern life.
Collapse
Affiliation(s)
- Mary E. Brushe
- Telethon Kids Institute, Ground Floor, 108 North Terrace, Adelaide, SA, Australia
- School of Public Health, University of Adelaide, Level 4, Rundle Mall Plaza Building, 50 Rundle Mall, Adelaide, SA, Australia
- Corresponding author. Telethon Kids Institute, Ground Floor 108 North Terrace, Adelaide, SA, 5000, Australia.
| | - John W. Lynch
- School of Public Health, University of Adelaide, Level 4, Rundle Mall Plaza Building, 50 Rundle Mall, Adelaide, SA, Australia
- Population Health Sciences, Bristol Medical School, University of Bristol, Beacon House, Queens Road, Bristol, BS8 1QU, UK
| | - Edward Melhuish
- Menzies Health Institute Queensland, G40 Griffith Health Centre, Level 8.86 Gold Coast Campus, Griffith University, Gold Coast, QLD, Australia
| | - Sheena Reilly
- Department of Education, University of Oxford, 15 Norham Gardens, Oxford, OX2 6PY, UK
| | - Murthy N. Mittinty
- College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, SA, Australia
| | - Sally A. Brinkman
- School of Public Health, University of Adelaide, Level 4, Rundle Mall Plaza Building, 50 Rundle Mall, Adelaide, SA, Australia
- Education Futures, University of South Australia, Campus Central – City West, SA, 5001, Australia
| |
Collapse
|
28
|
Molleri N, Gomes Junior SC, Marano D, Zin A. Survey of the Adequacy of Brazilian Children and Adolescents to the 24-Hour Movement Guidelines before and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095737. [PMID: 37174254 PMCID: PMC10178683 DOI: 10.3390/ijerph20095737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/17/2023] [Accepted: 04/17/2023] [Indexed: 05/15/2023]
Abstract
The 24-Hour Movement Guidelines provide specific recommendations on movement behaviors for children and adolescents. The objective of this study was to verify the adequacy of children and adolescents to the guidelines for moderate to vigorous physical activity, recreational screen time, and sleep duration, and the overall adequacy to the guidelines, before and during the COVID-19 pandemic. A cross-sectional study was conducted with parents or guardians of children or adolescents from different regions of Brazil using a digital interview form including sociodemographic characteristics of families, moderate to vigorous physical activity, recreational screen time, and sleep duration before and during the pandemic. Statistically significant variation was observed in both groups in relation to moderate to vigorous physical activity and recreational screen time between the two periods evaluated. Overall adequacy to the guidelines before the pandemic was 19.28% for children from Group 1 (0-5 years old) and 39.50% for those from Group 2 (6 to 17 years old). During the pandemic, it corresponded to 3.58% in Group 1 and 4.94% in Group 2 (p-value between periods ≤0.001). This study showed the significant impact of pandemic restrictions on reducing overall compliance and physical activity, and increasing screen time among Brazilian children and adolescents.
Collapse
Affiliation(s)
- Natália Molleri
- National Institute of Women's, Child's and Adolescent's Health Fernandes Figueira, Rio de Janeiro 22250-020, Brazil
| | - Saint Clair Gomes Junior
- National Institute of Women's, Child's and Adolescent's Health Fernandes Figueira, Rio de Janeiro 22250-020, Brazil
| | - Daniele Marano
- National Institute of Women's, Child's and Adolescent's Health Fernandes Figueira, Rio de Janeiro 22250-020, Brazil
| | - Andrea Zin
- National Institute of Women's, Child's and Adolescent's Health Fernandes Figueira, Rio de Janeiro 22250-020, Brazil
| |
Collapse
|
29
|
Gangi DN, Aishworiya R, Hill MM, Nguyen DT, Ni R, Parikh C, Solis E, Ozonoff S. Case report: Transient symptoms of autism spectrum disorder in a 2-year-old boy. Clin Case Rep 2023; 11:e07345. [PMID: 37180323 PMCID: PMC10172454 DOI: 10.1002/ccr3.7345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/06/2023] [Accepted: 04/15/2023] [Indexed: 05/16/2023] Open
Abstract
Though early ASD diagnosis is highly stable, this case report describes a rare situation in which symptoms resolved without intervention over a 4 month period. We do not recommend delaying diagnosis in symptomatic children who meet criteria but when major behavioral changes are reported after diagnosis, reevaluation may be beneficial.
Collapse
Affiliation(s)
- Devon N. Gangi
- Department of Psychiatry & Behavioral SciencesMIND Institute, University of California‐DavisSacramentoCaliforniaUSA
| | - Ramkumar Aishworiya
- Department of Psychiatry & Behavioral SciencesMIND Institute, University of California‐DavisSacramentoCaliforniaUSA
- Khoo Teck Puat‐National University Children's Medical InstituteNational University Health SystemSingaporeSingapore
- Department of Pediatrics, Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Monique Moore Hill
- Department of Psychiatry & Behavioral SciencesMIND Institute, University of California‐DavisSacramentoCaliforniaUSA
| | - Dan Thu Nguyen
- Department of Psychiatry & Behavioral SciencesMIND Institute, University of California‐DavisSacramentoCaliforniaUSA
| | - Rachel Ni
- Department of Psychiatry & Behavioral SciencesMIND Institute, University of California‐DavisSacramentoCaliforniaUSA
| | - Chandni Parikh
- Department of Psychiatry & Behavioral SciencesMIND Institute, University of California‐DavisSacramentoCaliforniaUSA
| | | | - Sally Ozonoff
- Department of Psychiatry & Behavioral SciencesMIND Institute, University of California‐DavisSacramentoCaliforniaUSA
| |
Collapse
|
30
|
Bourke M, Haddara A, Loh A, Carson V, Breau B, Tucker P. Adherence to the World Health Organization's physical activity recommendation in preschool-aged children: a systematic review and meta-analysis of accelerometer studies. Int J Behav Nutr Phys Act 2023; 20:52. [PMID: 37101226 PMCID: PMC10132436 DOI: 10.1186/s12966-023-01450-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/06/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND The World Health Organization (WHO) recommend that preschool-aged children should engage in 180 min of total physical activity (TPA) including 60 min of moderate-to-vigorous physical activity (MVPA) each day. No systematic reviews or meta-analyses have pooled adherence to the recommendation across multiple studies. This study aimed to estimate the prevalence of preschool-aged children achieving the WHO's physical activity recommendation for young children, and determine if the prevalence differed between boys and girls. METHODS Primary literature searches were conducted on six online databases and a machine learning assisted systematic review was used to identify relevant studies. Studies written in English reporting on the prevalence of children aged 3-5 years achieving overall WHO physical activity recommendation or the individual TPA or MVPA aspects of the recommendation measured using accelerometers were eligible for inclusion. Random effects meta-analysis was used to determine the prevalence of preschools achieving the overall WHO recommendation and the individual TPA and MVPA aspect of the recommendation, and to determine difference in prevalence between boys and girls. RESULTS Forty-eight studies reporting on 20,078 preschool-aged children met the inclusion criteria. Based on the most commonly employed accelerometer cut-points across all aspects of the recommendation, 60% (95% Confidence Interval [CI] = 37%, 79%) of preschool-aged children adhered to the overall physical activity recommendation, 78% (95% CI = 38%, 95%) adhered to the TPA aspect of the recommendation, and 90% (95% CI = 81%, 95%) adhered to the MVPA aspect of the recommendation. There was substantial variability is prevalence estimates between different accelerometer cut-points. Girls were significantly less likely to achieve the overall recommendation and the MVPA aspect of the recommendation than boys were. CONCLUSIONS Although there was substantial variability in estimated prevalence of preschool-aged children adhering the WHO physical activity recommendation between various accelerometer cut-points, the weight of available evidence suggests that the majority of young children are adhering to the overall recommendation and the individual TPA and MVPA aspects of the recommendation. Large-scale, intercontinental surveillance studies are needed to further strengthen the evidence regarding the prevalence of preschool-aged children achieving physical activity recommendation globally.
Collapse
Affiliation(s)
- Matthew Bourke
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, ON, Canada.
| | - Ameena Haddara
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Aidan Loh
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Becky Breau
- Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, Canada
| | - Patricia Tucker
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
- Children's Health Research Institute, London, ON, Canada
| |
Collapse
|
31
|
Sugiyama M, Tsuchiya KJ, Okubo Y, Rahman MS, Uchiyama S, Harada T, Iwabuchi T, Okumura A, Nakayasu C, Amma Y, Suzuki H, Takahashi N, Kinsella-Kammerer B, Nomura Y, Itoh H, Nishimura T. Outdoor Play as a Mitigating Factor in the Association Between Screen Time for Young Children and Neurodevelopmental Outcomes. JAMA Pediatr 2023; 177:303-310. [PMID: 36689245 PMCID: PMC9871942 DOI: 10.1001/jamapediatrics.2022.5356] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Importance Whether the association between higher screen time in infancy and later suboptimal neurodevelopment can be mitigated by frequency of outdoor play is unknown. Objective To investigate whether higher screen time at age 2 years is associated with neurodevelopmental outcomes at age 4 years and whether this association is mediated by frequency of outdoor play at age 2 years 8 months. Design, Setting, and Participants Participants were a subsample of the Hamamatsu Birth Cohort Study for Mothers and Children (HBC Study, N = 1258). Children were born between December 2007 and March 2012 and followed up from 1 year 6 months to 4 years. The analysis was conducted from April 2021 to June 2022. Exposures Screen time longer than 1 hour a day at age 2 years was coded as higher screen time. Main Outcomes and Measures Standardized scores for communication, daily living skills, and socialization domains of the Vineland Adaptive Behavior Scale, second edition, at age 4 years were used (mean [SD], 100 [15]). The mediating factor was frequency of outdoor play at age 2 years 8 months, with 6 or 7 days per week coded as frequent outdoor play. Results Of 885 participants, 445 children (50%) were female; mean (SD) screen time per day was 2.6 (2.0) hours. Causal mediation analyses revealed that higher screen time at age 2 years was associated with lower scores in communication at age 4 years (nonstandardized coefficient b = -2.32; 95% CI, -4.03 to -0.60), but the association was not mediated by frequency of outdoor play. Higher screen time was also associated with lower scores in daily living skills (b = -1.76; 95% CI, -3.21 to -0.31); 18% of this association was mediated by frequency of outdoor play. Frequency of outdoor play was associated with socialization (b = 2.73; 95% CI, 1.06 to 4.39), whereas higher screen time was not (b = -1.34; 95% CI, -3.05 to 0.36). Conclusions and Relevance Higher screen time at age 2 years was directly associated with poorer communication at age 4 years. It was also associated with daily living skills, but frequency of outdoor play at age 2 years 8 months alleviated it, suggesting outdoor play mitigated the association between higher screen time and suboptimal neurodevelopment. Future research should specify the nature of the associations and intervention measures, enabling targeted interventions that reduce the potential risk in screen time.
Collapse
Affiliation(s)
- Mika Sugiyama
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Japan
| | - Kenji J Tsuchiya
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Japan.,Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yusuke Okubo
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Mohammad Shafiur Rahman
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Japan.,Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Satoshi Uchiyama
- Rupiro, the Center for Consultation of Child Development, Hamamatsu, Japan
| | - Taeko Harada
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Japan.,Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Toshiki Iwabuchi
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Japan.,Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Akemi Okumura
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Japan.,Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Chikako Nakayasu
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yuko Amma
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Haruka Suzuki
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Nagahide Takahashi
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Child and Adolescent Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Barbara Kinsella-Kammerer
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Queens College and Graduate Center, City University of New York, New York
| | - Yoko Nomura
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Queens College and Graduate Center, City University of New York, New York.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York
| | - Hiroaki Itoh
- Department of Obstetric and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomoko Nishimura
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Japan.,Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| |
Collapse
|
32
|
Fitzpatrick C, Binet MA, Harvey E, Barr R, Couture M, Garon-Carrier G. Preschooler screen time and temperamental anger/frustration during the COVID-19 pandemic. Pediatr Res 2023:10.1038/s41390-023-02485-6. [PMID: 36755186 PMCID: PMC9908303 DOI: 10.1038/s41390-023-02485-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/02/2022] [Accepted: 11/08/2022] [Indexed: 02/10/2023]
Abstract
BACKGROUND In the context of increased media use and family distress during the pandemic, we examine whether preschooler screen time at age 3.5 contributes to later expressions of anger/frustration at 4.5, while also considering the inverse association. METHODS Data are from a cohort of 315 Canadian preschool-aged children during the COVID-19 pandemic. Parent-reported measures included child h/day of screen time and child temperamental anger/frustration, both measured at 3.5 and 4.5 years of age. Indicators of family distress include use of childcare and child sleep, family income, parenting stress, and parent education, marital and employment status. We also consider child sex as a control variable. RESULTS A crossed-lagged panel model revealed continuity in screen time between the ages of 3.5 and 4.5 (ß = 0.68) and temperamental anger/frustration from 3.5 to 4.5 (ß = 0.60). Child screen time at age 3.5 predicted increased proneness to anger/frustration at age 4.5 (ß = 0.14). Anger/frustration at age 3.5 did not predict screen time at age 4.5. CONCLUSION Our results suggest that preschooler screen time during the pandemic may have undermined the ability to regulate negative emotions, a key component of social and academic competence. Supporting parents in implementing healthy media habits post pandemic may benefit young children's development. IMPACT Key message: this study observes prospective bidirectional associations between preschoolers screen time and temperamental displays of anger or frustration during the COVID-19 pandemic. What does it add: we provide evidence that preschool screen time at age 3.5 prospectively contributes to the tendency to react in anger/frustration at age 4.5. In contrast, greater proneness to anger/frustration did not predict later exposure to screen time. What is the impact: health practitioners should enquire about media use habits during well-child visits to foster children's healthy development during the preschool years.
Collapse
Affiliation(s)
- Caroline Fitzpatrick
- Université de Sherbrooke, Sherbrooke, QC, Canada. .,University of Johannesburg, Johannesburg, South Africa.
| | - Marie-Andrée Binet
- grid.86715.3d0000 0000 9064 6198Université de Sherbrooke, Sherbrooke, QC Canada
| | - Elizabeth Harvey
- grid.440011.00000 0001 2167 8636Université Sainte-Anne, Church Point, NS Canada
| | - Rachel Barr
- grid.213910.80000 0001 1955 1644Georgetown University, Washington, DC USA
| | - Mélanie Couture
- grid.86715.3d0000 0000 9064 6198Université de Sherbrooke, Sherbrooke, QC Canada
| | | |
Collapse
|
33
|
Prospective Associations Between Preschool Exposure to Violent Televiewing and Psychosocial and Academic Risks in Early Adolescent Boys and Girls. J Dev Behav Pediatr 2023; 44:e1-e11. [PMID: 36345124 DOI: 10.1097/dbp.0000000000001135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 08/29/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Risks of early exposure to media violence remain unclear. This study examines typical early childhood violent media exposure and subsequent psychosocial and academic risks. METHODS Our longitudinal birth cohort comprised 978 girls and 998 boys. Child-reported and teacher-reported measures of adjustment at age 12 years were linearly regressed on parent-reported televised violence exposure at ages 3.5 and 4.5 years while adjusting for individual/family confounders. RESULTS For girls, preschool violent televiewing was associated with increases in emotional distress (b = 0.31; 95% confidence interval [CI], 0.13-0.49) and decreases in classroom engagement (b = -0.97; 95% CI, -1.55 to -0.40), academic achievement (b = -2.60; 95% CI, -3.48 to -1.72), and academic motivation (b = -0.58; 95% CI, -1.09 to -0.07) at age 12 years. For boys, preschool violent televiewing was associated with increases in emotionally distressed (b = 0.33; 95% CI, 0.13-0.53), inattentive (b = 0.25; 95% CI, 0.06-0.45), conduct disordered (b = 0.11; 95% CI, 0.00-0.21), and socially withdrawn behavior (b = 0.23; 95% CI, 0.05-0.40), as well as decreases in classroom engagement (b = -0.84; 95% CI, -1.57 to -0.12), academic achievement (b = -1.19; 95% CI, -2.15 to -0.23), and academic motivation (b = -0.58; 95% CI, -1.13 to -0.03) at age 12 years. CONCLUSION Compared with no preschool exposure, violent televiewing is associated with distinct and enduring psychosocial risks by early adolescence. Acknowledging such risks remains a pertinent health literacy target for pediatric professionals, parents, and communities.
Collapse
|
34
|
Cui Z, Zou P, Lin Z, Cao Y, Luo Y. Gender Differences in Excessive Screen Time among Chinese High School Students in Henan Province. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:721. [PMID: 36613042 PMCID: PMC9819855 DOI: 10.3390/ijerph20010721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
In a technology-driven society, adolescents are particularly vulnerable to the effects of excessive screen time, and gender disparities are notable. However, evidence on the gender difference in excessive screen time among Chinese high school students is scarce. This study examined gender differences in excessive screen time and its impact on mental health and urinary incontinence among 15,055 high school-aged adolescents, including 7514 (49.9%) males and 7541 (50.1%) females with the mean age of 16.72 (SD 0.88) in Henan Province, China. A stratified two-stage cluster sampling design was applied. Mental Health Inventory of Middle School Students and International Consultation on Incontinence Questionnaire-Short Form was used to collect data about mental health and urinary incontinence status. The percentage of students reporting excessive screen time was 9.4%, predominantly male (15.3% versus 3.5%; p < 0.001). Physical disease, living on campus, and cigarette or alcohol consumption were common factors associated with excessive screen time in both genders. Students in their second or third year showed significantly lower rates of excessive screen time than their peers. In males, younger age, active sexual behavior, chronic constipation, and having a mother with a Ph.D. degree were factors associated with a higher probability of reporting excessive screen time, while females living in a rural-urban continuum or whose mothers have a junior college degree were associated with higher odds of reporting excessive screen times. Excessive screen time was significantly positively correlated with mental health problems and urinary incontinence (p < 0.05). Results suggests the need to address excessive screen time and to focus separately on the mechanisms influencing excessive screen time in males and females.
Collapse
Affiliation(s)
- Zhenti Cui
- School of Nursing, Sias University, Zhengzhou 451100, China
- Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Ping Zou
- Scholar Practitioner Program, School of Nursing, Faculty of Education and Professional Studies, Nipissing University, Toronto, ON M5T 1V4, Canada
| | - Zihan Lin
- Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Yingdong Cao
- School of Nursing, Sias University, Zhengzhou 451100, China
| | - Yan Luo
- Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| |
Collapse
|
35
|
Oppici L, Stell FM, Utesch T, Woods CT, Foweather L, Rudd JR. A Skill Acquisition Perspective on the Impact of Exergaming Technology on Foundational Movement Skill Development in Children 3-12 Years: A Systematic Review and Meta-analysis. SPORTS MEDICINE - OPEN 2022; 8:148. [PMID: 36525118 PMCID: PMC9756923 DOI: 10.1186/s40798-022-00534-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 11/11/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Sedentary, digital screen time in children represents a major concern due to its detrimental effect on children's development. Nowadays, however, advances in technology allow children to actively interact with a digital screen using their whole body (e.g., exergaming), providing potential for movement learning. Exergaming technology may prove valuable in supporting children's development of foundational movement skills (FMS). OBJECTIVE To examine the impact of exergaming technology on the development of FMS in children 3-12 years through a skill acquisition lens. METHODS Systematic review and meta-analysis were conducted following the PRISMA guidelines. Web of Science, PubMed, PsycINFO and SPORTDiscus databases were searched between 2007 and 2022. Studies were eligible if they conducted an exergaming intervention to improve FMS in typically developing children aged three to twelve with a control group, using a baseline and post-intervention assessment design. FMS outcomes were pooled with a random effects model. RESULTS Nine trials (4 RCTs, 2 cluster RCTs and 3 non-randomized trials) of varying methodological quality (2 had low, 6 had some concerns, and 1 had a high risk of bias) were included, with a total of 783 participants. FMS outcome measures across studies comprised object control skills, locomotor skills, coordination, agility, balance and balance-related skills. The meta-analysis included showed a small positive effect in favor of the exergaming intervention (r = 0.24 [95% confidence interval: 0.11-0.36]). CONCLUSION Our results indicate that screen-based technology that requires an active engagement of the child can promote the development of FMS. Considering that FMS are the foundation of a child's physical, mental, health and academic development, this finding could lead to a reshaping of the perception of digital screen-based technology and the role this should play in children's lives. We speculate that the observed benefits most likely depend upon the quality of information-movement coupling specificity and the motor learning strategies built into the exergame and/or the intervention design. We do not believe this is dependent on the type of FMS being performed or the amount of practice. We recommend therefore that future research should examine how practitioners (school teachers, coaches and parents) can facilitate the interaction between a child and exergaming technology.
Collapse
Affiliation(s)
- Luca Oppici
- grid.412285.80000 0000 8567 2092The Department of Teacher Education and Outdoor Studies, Norwegian School of Sport Sciences, Oslo, Norway
| | - Frederike Marie Stell
- grid.27593.3a0000 0001 2244 5164Institute of Communication and Media Research, German Sport University Cologne, Cologne, Germany
| | - Till Utesch
- grid.5949.10000 0001 2172 9288Institute of Educational Sciences, University of Münster, Münster, Germany
| | - Carl T. Woods
- grid.1019.90000 0001 0396 9544Institute for Health and Sport (IHES), Victoria University, Melbourne, Australia
| | - Lawrence Foweather
- grid.4425.70000 0004 0368 0654Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - James R. Rudd
- grid.412285.80000 0000 8567 2092The Department of Teacher Education and Outdoor Studies, Norwegian School of Sport Sciences, Oslo, Norway ,grid.477239.c0000 0004 1754 9964Western Norway University of Applied Sciences, Sogndal, Norway
| |
Collapse
|
36
|
Picca M, Manzoni P, Corsello A, Ferri P, Bove C, Braga P, Mariani D, Marinello R, Mezzopane A, Senaldi S, Macchi M, Cugliari M, Agostoni C, Milani GP. Persistence of Lockdown Consequences on Children: A Cross-sectional Comparative Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121927. [PMID: 36553370 PMCID: PMC9776603 DOI: 10.3390/children9121927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/28/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022]
Abstract
Lockdown during the COVID-19 pandemic had a significant psychological impact on children and adolescents. This study compared lockdown effects on children aged 1-10 years in 2020 and 2021. Two structured questionnaires were administered to 3392 parents in 2020, and 3203 in 2021. Outcomes considered for the data analysis included sleep changes, episodes of irritability, attention disturbances, distance learning and number of siblings. For data analysis, children were divided into two groups: pre-scholar (1-5 years old) and older ones. The lockdown was associated with a significant increase in sleep disturbances in 2020 and persisted after a year. The high prevalence of mood changes persisted unchanged in children under the age of 10 in 2020 and in 2021. Even if strengthened family ties seemed to mitigate the negative impact of lockdowns in 2020, this effect appeared absent or at least reduced in 2021. Irritability and rage in children were perceived to have increased in 2021 compared to 2020. A significant reduction in digital device use was observed in 2021 compared to 2020. Overall, the most harmful consequences of the lockdown in 2020 were still observed in 2021. Further studies are needed to analyze possible psychological effects that the generation who experienced the pandemic during early childhood may have, particularly in their future adolescence, in order to identify possible intervention practices to support families.
Collapse
Affiliation(s)
- Marina Picca
- SICuPP—Lombardia: Italian Primary Care Paediatrics Society—Lombardy, 20126 Milan, Italy
| | - Paola Manzoni
- SICuPP—Lombardia: Italian Primary Care Paediatrics Society—Lombardy, 20126 Milan, Italy
| | - Antonio Corsello
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Correspondence:
| | - Paolo Ferri
- Department of Human Sciences, State University Milano Bicocca, 20126 Milan, Italy
| | - Chiara Bove
- Department of Human Sciences, State University Milano Bicocca, 20126 Milan, Italy
| | - Piera Braga
- Department of Human Sciences, State University Milano Bicocca, 20126 Milan, Italy
| | - Danila Mariani
- SICuPP—Lombardia: Italian Primary Care Paediatrics Society—Lombardy, 20126 Milan, Italy
| | - Roberto Marinello
- SICuPP—Lombardia: Italian Primary Care Paediatrics Society—Lombardy, 20126 Milan, Italy
| | - Angela Mezzopane
- SICuPP—Lombardia: Italian Primary Care Paediatrics Society—Lombardy, 20126 Milan, Italy
| | - Silvia Senaldi
- SICuPP—Lombardia: Italian Primary Care Paediatrics Society—Lombardy, 20126 Milan, Italy
| | - Marina Macchi
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Marco Cugliari
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda–Ospedale Maggiore Policlinico, Pediatric Area, 20122 Milan, Italy
| | - Gregorio Paolo Milani
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda–Ospedale Maggiore Policlinico, Pediatric Area, 20122 Milan, Italy
| |
Collapse
|
37
|
Pfefferbaum B, Van Horn RL. Physical Activity and Sedentary Behavior in Children During the COVID-19 Pandemic: Implications for Mental Health. Curr Psychiatry Rep 2022; 24:493-501. [PMID: 36048321 PMCID: PMC9434093 DOI: 10.1007/s11920-022-01366-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE OF REVIEW This paper examines children's physical activity and sedentary behavior and associated psychological outcomes coincident with the COVID-19 pandemic. RECENT FINDINGS Generally, the research has found decreased physical activity and increased sedentary behavior, both of which are associated with various psychological outcomes. The research on sedentary behavior has focused on screen time with minimal consideration of other sedentary behaviors or of specific physical activities or the context in which these behaviors occurred. Changes in children's daily routines and activities have received little attention in the mass trauma research despite the fact that disasters disrupt individual, family, and community life. Thus, the current report contributes to an understanding of the breadth of mass trauma effects, underscores the importance of physical activity and sedentary behavior and their associations with health and psychological outcomes, and is a reminder to consider children's daily lives both during times of crisis and under usual circumstances.
Collapse
Affiliation(s)
- Betty Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Boulevard, WP 3217, P.O. Box 26901, Oklahoma City, OK 73126-0901 USA
| | - Richard L. Van Horn
- University of Oklahoma, 920 Stanton L. Young Boulevard, WP 3217, P.O. Box 26901, Oklahoma City, OK 73126-0901 USA
| |
Collapse
|
38
|
Moss S, Gu X. Home- and Community-Based Interventions for Physical Activity and Early Child Development: A Systematic Review of Effective Strategies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191911968. [PMID: 36231271 PMCID: PMC9565703 DOI: 10.3390/ijerph191911968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 06/09/2023]
Abstract
This systematic review examined the effects of home/family and community-based interventions on physical activity (PA) and developmental outcomes in early childhood. A search strategy was employed using four electronic databases (Academic Search Complete, CINAHL Complete, MEDLINE, and SPORTDiscus). Interventions investigating weight status (i.e., BMI), physical activity, sedentary behavior, and/or motor proficiency that took place in home, family, or community settings were assessed. Studies were eligible if they were peer-reviewed, available in English, published between 2011 and 2021, and if samples consisted of healthy young children (2-5 years old). There were 24 studies retained (8351 participants) spanning from the United States (n = 12), Australia (n = 3), Canada (n = 2), Switzerland (n = 2), Finland (n = 2), Netherlands (n = 1), and other Eastern European countries (n = 2). There were 19 studies that incorporated home/family-based approaches and 14 studies that incorporated community-based approaches. Studies ranged in intervention duration from 6 weeks to 24 months. It suggests that improving PA participation in young children was especially challenging to solicit improvement (only 25% of all studies found significant improvement in PA after intervention). Distributing educational material to parents/families, consistent, direct contact with parents, and encouraging community engagement were identified as effective strategies to promote physical activity, healthy weight status, and motor skills in young children.
Collapse
Affiliation(s)
- Samantha Moss
- Department of Kinesiology, State University of New York at Cortland, Cortland, NY 13090, USA
| | - Xiangli Gu
- Department off Kinesiology, University of Texas at Arlington, Arlington, TX 76019, USA
| |
Collapse
|
39
|
Rocka A, Jasielska F, Madras D, Krawiec P, Pac-Kożuchowska E. The Impact of Digital Screen Time on Dietary Habits and Physical Activity in Children and Adolescents. Nutrients 2022; 14:nu14142985. [PMID: 35889942 PMCID: PMC9317201 DOI: 10.3390/nu14142985] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Over the last few decades, the time children spend using electronic devices has increased significantly. The aim of the study was to evaluate the impact of screen time on dietary behaviors and physical activity in children and adolescents. Methods: An online survey was conducted among parents of preschool and school-aged children during the COVID-19 lockdown in Poland. There were 3127 surveys used in the analysis. Results: Survey responses referred to 1662 (53%) boys and 1465 (47%) girls, with a mean age of 12.1 ± 3.4 years. During a routine weekday, most children (71%) spent >4 h on educational activities using electronic devices, and 43% of children spent 1−2 h using devices for recreational purposes. The majority of children (89%) were exposed to screens during meals, and ate snacks between main meals (77%). There was an association between screen time and the exposure to screens during meals, and between screen time and time spent performing physical activity. Conclusions: This study revealed that the majority of children were exposed to screens during meals, which is a risk factor of obesity. The promotion of the judicious use of digital devices and healthy dietary habits associated with the use of screens may be an important component of obesity prevention strategies.
Collapse
Affiliation(s)
- Agata Rocka
- Students’ Scientific Group, Department of Pediatrics and Gastroenterology, Medical University of Lublin, Racławickie 1, 20-059 Lublin, Poland; (A.R.); (F.J.); (D.M.)
| | - Faustyna Jasielska
- Students’ Scientific Group, Department of Pediatrics and Gastroenterology, Medical University of Lublin, Racławickie 1, 20-059 Lublin, Poland; (A.R.); (F.J.); (D.M.)
| | - Dominika Madras
- Students’ Scientific Group, Department of Pediatrics and Gastroenterology, Medical University of Lublin, Racławickie 1, 20-059 Lublin, Poland; (A.R.); (F.J.); (D.M.)
| | - Paulina Krawiec
- Department of Pediatrics and Gastroenterology, Medical University of Lublin, Racławickie 1, 20-059 Lublin, Poland;
- Correspondence: ; Tel.: +48-8171-85420; Fax: +48-81-7431-353
| | - Elżbieta Pac-Kożuchowska
- Department of Pediatrics and Gastroenterology, Medical University of Lublin, Racławickie 1, 20-059 Lublin, Poland;
| |
Collapse
|
40
|
Raj D, Ahmad N, Mohd Zulkefli NA, Lim PY. ‘Stop & Play’ digital health education intervention in reducing excessive screen time among preschoolers from low socioeconomic families in Malaysia: A Cluster Randomized Control Trial (Preprint). J Med Internet Res 2022; 25:e40955. [PMID: 37140970 DOI: 10.2196/40955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 01/09/2023] [Accepted: 03/15/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND High prevalence of excessive screen time among preschool children is attributable to certain parental factors such as lack of knowledge, false perception about screen time, and inadequate skills. Lack of strategies to implement screen time guidelines, in addition to multiple commitments that may hinder parents from face-to-face interventions, demands the need to develop a technology-based parent-friendly screen time reduction intervention. OBJECTIVE This study aims to develop, implement, and evaluate the effectiveness of Stop and Play, a digital parental health education intervention to reduce excessive screen time among preschoolers from low socioeconomic families in Malaysia. METHODS A single-blind, 2-arm cluster randomized controlled trial was conducted among 360 mother-child dyads attending government preschools in the Petaling district, who were randomly allocated into the intervention and waitlist control groups between March 2021 and December 2021. This 4-week intervention, developed using whiteboard animation videos, infographics, and a problem-solving session, was delivered via WhatsApp (WhatsApp Inc). Primary outcome was the child's screen time, whereas secondary outcomes included mother's screen time knowledge, perception about the influence of screen time on the child's well-being, self-efficacy to reduce the child's screen time and increase physical activity, mother's screen time, and presence of screen device in the child's bedroom. Validated self-administered questionnaires were administered at baseline, immediately after the intervention, and 3 months after the intervention. The intervention's effectiveness was evaluated using generalized linear mixed models. RESULTS A total of 352 dyads completed the study, giving an attrition rate of 2.2% (8/360). At 3 months after the intervention, the intervention group showed significantly reduced child's screen time compared with the control group (β=-202.29, 95% CI -224.48 to -180.10; P<.001). Parental outcome scores also improved in the intervention group as compared with that in the control group. Mother's knowledge significantly increased (β=6.88, 95% CI 6.11-7.65; P<.001), whereas perception about the influence of screen time on the child's well-being reduced (β=-.86, 95% CI -0.98 to -0.73; P<.001). There was also an increase in the mother's self-efficacy to reduce screen time (β=1.59, 95% CI 1.48-1.70; P<.001) and increase physical activity (β=.07, 95% CI 0.06-0.09; P<.001), along with reduction in mother's screen time (β=-70.43, 95% CI -91.51 to -49.35; P<.001). CONCLUSIONS The Stop and Play intervention was effective in reducing screen time among preschool children from low socioeconomic families, while improving the associated parental factors. Therefore, integration into primary health care and preschool education programs is recommended. Mediation analysis is suggested to investigate the extent to which secondary outcomes are attributable to the child's screen time, and long follow-up could evaluate the sustainability of this digital intervention. TRIAL REGISTRATION Thai Clinical Trial Registry (TCTR) TCTR20201010002; https://tinyurl.com/5frpma4b.
Collapse
Affiliation(s)
- Diana Raj
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Norliza Ahmad
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Nor Afiah Mohd Zulkefli
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| |
Collapse
|
41
|
Kerbl R. Pädiatrie aktuell – Forschung kurz notiert. Monatsschr Kinderheilkd 2022; 170:493-495. [PMID: 35437334 PMCID: PMC9009163 DOI: 10.1007/s00112-022-01478-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Reinhold Kerbl
- Abteilung für Kinder und Jugendliche, LKH Hochsteiermark/Leoben, Vordernbergerstr. 42, 8700 Leoben, Österreich
| |
Collapse
|
42
|
Lin Y, Zhang X, Huang Y, Jia Z, Chen J, Hou W, Zhao L, Wang G, Zhu J. Relationships between screen viewing and sleep quality for infants and toddlers in China: A cross-sectional study. Front Pediatr 2022; 10:987523. [PMID: 36299700 PMCID: PMC9589267 DOI: 10.3389/fped.2022.987523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/20/2022] [Indexed: 11/30/2022] Open
Abstract
AIM Currently young children have more opportunity to access all kinds of media, while their sleep duration has been steadily decreasing. However, little is known about the relationships between screen viewing and sleep quality, and the reasons of screen viewing for children under three years old in China. This study aimed to describe the relationships between screen viewing and sleep quality of infants and toddlers in mainland China. METHODS A cross-sectional study was conducted. Eight hundred twenty-seven children were recruited at a health care unit from a university affiliated hospital in China, and the questionnaires were completed by their parents. An extended Brief Infant Sleep Questionnaire and a Screen Viewing Questionnaire were used to collect information on children's sleep quality and screen viewing. Multivariate linear regression models were used to assess the relationships between screen viewing and sleep quality among infants and toddlers, adjusted for sociodemographic variables. RESULTS Of the 827 children, 26.9% of the infants and 61.4% of the toddlers did not comply with the World Health Organization (WHO) guideline on screen time. Even after adjusting for the sociodemographic covariates for both infants and toddlers, negative relationships between screen time and total sleep time (P < 0.001), and screen time and nighttime sleep (P < 0.001) existed. TV viewing time was negatively related to infants' total sleep time (β = -0.15, P < 0.001) and toddlers' nighttime sleep (β = -0.1, P < 0.05). Smartphone viewing time was negatively related to toddlers' total sleep time (β = -0.12, P < 0.05) and daytime sleep (β = -0.22, P < 0.05). Parents who offered screen media for children when they needed to do house chores were more likely to report that their children had less total sleep time (β = -0.1, P < 0.05) and shorter longest sleep episode (β = -0.1, P < 0.05). CONCLUSION The majority of toddlers did not meet the WHO guidelines on screen time in China. Screen time was negatively related to total sleep time and nighttime sleep among infants and toddlers. Practical strategies, such as education programs on children's screen viewing, more outdoor exercises and indoor parent-child activities, providing other educational materials instead of screening, early sleep, restricted use of TVs and smartphones, and screen co-viewing, are needed to improve young children's sleep quality and promote their development.
Collapse
Affiliation(s)
- Yumin Lin
- Department of Nursing, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Xueqin Zhang
- Department of Obstetrics and Gynecology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Yinying Huang
- Department of Nursing, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Zhiwei Jia
- Department of Child Health, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Jing Chen
- Department of Child Health, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Wanling Hou
- Department of Nursing, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Lili Zhao
- Department of Nursing, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Guiyan Wang
- Department of Obstetrics and Gynecology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Jiemin Zhu
- Department of Nursing, School of Medicine, Xiamen University, Xiamen, China
| |
Collapse
|