Excessive use of mobile devices and children's physical health

The utility of behavioral biometrics in user authentication and demographic characteristic detection: a scoping review

BACKGROUND

Objective measures of screen time are necessary to better understand the complex relationship between screen time and health outcomes. However, current objective measures of screen time (e.g., passive sensing applications) are limited in identifying the user of the mobile device, a critical limitation in children's screen time research where devices are often shared across a family. Behavioral biometrics, a technology that uses embedded sensors on modern mobile devices to continuously authenticate users, could be used to address this limitation.

OBJECTIVE

The purpose of this scoping review was to summarize the current state of behavioral biometric authentication and synthesize these findings within the scope of applying behavioral biometric technology to screen time measurement.

METHODS

We systematically searched five databases (Web of Science Core Collection, Inspec in Engineering Village, Applied Science & Technology Source, IEEE Xplore, PubMed), with the last search in September of 2022. Eligible studies were on the authentication of the user or the detection of demographic characteristics (age, gender) using built-in sensors on mobile devices (e.g., smartphone, tablet). Studies were required to use the following methods for authentication: motion behavior, touch, keystroke dynamics, and/or behavior profiling. We extracted study characteristics (sample size, age, gender), data collection methods, data stream, model evaluation metrics, and performance of models, and additionally performed a study quality assessment. Summary characteristics were tabulated and compiled in Excel. We synthesized the extracted information using a narrative approach.

RESULTS

Of the 14,179 articles screened, 122 were included in this scoping review. Of the 122 included studies, the most highly used biometric methods were touch gestures (n = 76) and movement (n = 63), with 30 studies using keystroke dynamics and 6 studies using behavior profiling. Of the studies that reported age (47), most were performed exclusively in adult populations (n = 34). The overall study quality was low, with an average score of 5.5/14.

CONCLUSION

The field of behavioral biometrics is limited by the low overall quality of studies. Behavioral biometric technology has the potential to be used in a public health context to address the limitations of current measures of screen time; however, more rigorous research must be performed in child populations first.

SYSTEMATIC REVIEW REGISTRATION

The protocol has been pre-registered in the Open Science Framework database ( https://doi.org/10.17605/OSF.IO/92YCT ).

Development of a Protocol for Objectively Measuring Digital Device Use in Youth

INTRODUCTION

Screen time is predominantly measured using questionnaires assessing a limited range of activities. This project aimed to develop a coding protocol that reliably identified screen time, including device type and specific screen behaviors, from video-camera footage.

METHODS

Screen use was captured from wearable and stationary PatrolEyes video cameras in 43 participants (aged 10-14 years) within the home environment (May-December 2021, coding in 2022, statistical analysis in 2023). After extensive piloting, the inter-rater reliability of the final protocol was determined in 4 coders using 600 minutes of footage from 18 participants who spent unstructured time on digital devices. Coders independently annotated all footage to determine 8 device types (e.g., phone, TV) and 9 screen activities (e.g., social media, video gaming) using Observer XT (behavioral coding software). Reliability was calculated using weighted Cohen's κ for duration per sequence (meets criteria for total time in each category) and frequency per sequence (meets criteria for total time in each category and order of use) for every coder pair on a per-participant and footage type basis.

RESULTS

Overall reliability of the full protocol was excellent (≥0.8) for both duration per sequence (κ=0.89-0.93) and the more conservative frequency per sequence (κ=0.83-0.86) analyses. This protocol reliably differentiates between different device types (κ=0.92-0.94) and screen behaviors (κ=0.81-0.87). Coder agreement ranged from 91.7% to 98.8% across 28.6-107.3 different instances of screen use.

CONCLUSIONS

This protocol reliably codes screen activities in adolescents, offering promise for improving the understanding of the impact of different screen activities on health.

Smartphone use affects gait performance, spinal kinematics and causes spinal musculoskeletal discomfort in young adults

BACKGROUND

Smartphone use may lead to alterations in spinal kinematics and musculoskeletal discomfort.

OBJECTIVES

The aim of this study was to evaluate the effect of smartphone use on spinal kinematics, and to examine the relationship between smartphone addiction, spinal discomfort, and gait parameters.

DESIGN

Cross-Sectional Study.

METHODS

The study included 42 healthy adults aged 18-30 years. A photographic method was used for spinal kinematic evaluation in sitting, standing and at the end of a 3-min walk. GAITRite electronic walkway was used for spatiotemporal gait parameters. Smartphone addiction was evaluated with the Smartphone Addiction Scale - Short Version (SAS-SV). The Cornell Musculoskeletal System Discomfort Questionnaire (CMDQ) was used to evaluate feelings of discomfort and pain.

RESULTS

There was an increase in head, cervical, and thoracic flexion angles while sitting, standing, and at the end of a 3-min walk. Similarly, an increase in thoracolumbar and lumbar flexion angles was observed only in the sitting position (p < 0.05). While using a smartphone during walking, cadence, walking speed, step length decreased, while step duration and double support duration increased (p < 0.05). A statistically significant correlation was determined between the SAS-SV and CMDQ scores (p < 0.05).

CONCLUSION

The study showed that smartphone use has an impact on spinal kinematics during sitting, standing and at the end of a 3 min-walk, as well as on the spatiotemporal parameters of gait. This study suggest that smartphone addiction should be taken into consideration due to its potential to cause musculoskeletal discomfort and there may be a need to raise public awareness on this matter.

Maternal COVID-19 Distress and Chinese Preschool Children's Problematic Media Use: A Moderated Serial Mediation Model

Introduction

Maternal distress increased during the COVID-19 pandemic, significantly impacting children's media use. The purpose of this study was to explore the influence mechanism of maternal COVID-19 distress on preschoolers' problematic media us through a moderated mediation model; specifically, we examined the possible mediating roles of parenting stress and negative instrumental use of media in parenting and the moderating role of supportive co-parenting.

Methods

An online survey was conducted in a sample of 1357 children (M_age = 4.01, SD = 1.06; 47.4% boys) and their parents from six public kindergartens in Shanghai, China. The mothers provided information by completing measures on their levels of distress related to COVID-19, parenting stress levels, digital parenting practices, and perception of supportive co-parenting from their partners. Additionally, both parents rated their children's problematic media use.

Results

(1) maternal COVID-19 distress was significantly and positively related to children's problematic media use; (2) this relationship was sequentially mediated by parenting stress and parents' negative instrumental use of media in parenting; and (3) supportive co-parenting moderated the serial mediation path by reducing the effect of maternal COVID-19 distress on parenting stress.

Conclusion

The findings provide some support and guidance for preventing children's problematic media use and enhancing parental adaptation during the COVID-19 pandemic or in potentially adverse situations.

Problematic Media Use among Children up to the Age of 10: A Systematic Literature Review

INTRODUCTION

Digital screen media use has significantly grown in all age groups and at an increasingly young age, including toddlers, schoolers, and primary school children. Although there is evidence that excessive early childhood media exposure can lead to several negative developmental outcomes, no systematic review on Problematic Media Use (PMU) of children under 10 years old have been provided. The aim of the present systematic review was to identify (i) the main instruments used to measure children's PMU across different studies; (ii) the risk and protective factors which might increase or reduce children's PMU; and (iii) the negative outcomes associated with children's PMU.

METHODS

This study was conducted following the systematic review guidelines proposed in the PRISMA statement. A total of 35 studies published between 2012-2022 and with a mean sample age between 0 and 10 years old were ultimately included in this literature review.

RESULTS

Use of media for more than 2 h a day, male gender, and higher age increased the risk of developing PMU among children. PMU led to several negative consequences for children's development and well-being (e.g., more problematic behaviors, sleep problems, higher depressive symptoms, lower emotional intelligence, and lower academic achievements). Children who experienced negative psychological symptoms, a dysfunctional parent-child relationship, and difficulties in school context were more prone to develop PMU. However, an authoritative parenting style and restrictive parental mediation reduced the risk of developing PMU among children. Finally, self-report measures specifically designed to get the younger children's perspective are still few and not so widely used.

CONCLUSIONS

Overall, this research field is still in its infancy and needs further investigation. Likely, a dysfunctional family system can lead children to experience emotional distress and negative psychological symptoms, which they try to manage by escaping into the virtual world, thus increasing the risk of developing PMU. As the children's PMU is closely affected by the family environment, future prevention interventions should target both children and their parents to improve their self-regulatory and mentalizing capabilities, as well as parental mediation strategies and general parenting practices.

Prevalence, determinants and consequences of problematic smartphone use among preschoolers (3-5 years) from Dhaka, Bangladesh: A cross-sectional investigation

The problematic smartphone use (PSU) has been becoming a challenging health issue for preschoolers aged 3-5 years as it has severe adverse effect on their psychological, physical, and cognitive development. The scarcity of scientific research on this issue in the context of Bangladesh motivated the authors for conducting this cross-sectional study to explore the prevalence of PSU with its influential factors and adverse effects on preschooler's psychological and physical development based on primary data collected from 400 mothers. The multivariable ordinal logistic regression (OLR) was used to compute the adjusted likelihoods. The estimated prevalence of PSU was approximately 86 %, where about 29 % were severely problematic user. The likelihood of preschoolers' PSU was observed to increase with >1 h/day usage of smartphone by children (Adjusted Odds Ratio (AOR): 3.92). Other important factors were parental smartphone use, education, profession, family income, and mother's age. Both of moderate and severe PSU had adverse effect on preschoolers' health- severe PSU was found to increase the likelihood of psychological and physical problems by 6.03 and 3.29 times, respectively. The preschoolers with PSU reported to suffer from many physical and mental health problems such as attention deficit and hyperactivity disorder (ADHD), emotional instability, aggressiveness, depression, lack of control, impaired vision and hearing, obesity, body imbalance, and lack of brain development. It is now prime time to undertake strategic policies considering the findings for limiting the preschoolers' usage of smartphone, which will make Bangladesh susceptible to protect its future generation from harmful effects of PSU.

Thoracic Spine Pain in High School Adolescents: A One-Year Longitudinal Study

Thoracic spine pain (TSP) is a common condition in the general adult population, with a similar prevalence in children and adolescents. An in-depth understanding of risk factors can assist in the identification of potential targets for effective prevention strategies. This study aimed to determine the incidence of TSP and ongoing TSP and identify its predictors in high school students. This longitudinal study was conducted in 2017 (baseline-T1), and follow-up surveys were completed in 2018 (T2). The variable "thoracic spine pain" was observed using the Nordic questionnaire, and associated variables were observed through the Baecke questionnaire and the Strengths and Difficulties Questionnaire. Statistical association methods were used for bivariate and multivariate logistic regression analysis. Among the participants, the one-year prevalence (ongoing TSP) was 38.4%, and the one-year incidence (new TSP) was 10.1%. Significant risk factors for ongoing TSP were adolescent females (RR = 2.14), in the age group of 15 to 18 years (RR = 1.41), clinical mental health problems (RR = 3.07), borderline mental health problems (RR = 2.02), mental health problems, sitting while using a tablet (RR = 1.93), distance of the eye from cell phone screen of or more than 20 cm (RR = 1.69), distance of the eye from the PC screen of or more than 30 cm (RR = 1.53), cell phone mobile use duration of or more than 3 h (RR = 1.60), tablet use time of or more than 3 h (RR = 2.08), and semi-lying prone position while using the cell phone (RR= 1.47), and these were also significant predictors of TSP episodes. Significant risk factors for new TSP were adolescent female sex (RR = 1.88), level, clinical mental health problems (RR = 4.26), borderline mental health problems (RR = 2.07), semi-lying prone position while using cell phone (RR = 1.71) or tablet (RR = 2.31), and mobile phone use duration equal to or greater than 3 h (RR = 1.72). We conclude that there is a high prevalence of TSP in high school students, which is associated with the female sex, mental health problems, and use of electronic devices for an inappropriate duration in an improper position.

Unpacking the relation between children's use of digital technologies and children's well-being: A scoping review

Over the last decade, a substantial number of studies have addressed children's use of technologies and their impact on well-being. Nonetheless, there is still a lack of clarity on the operationalisation of technology use, well-being, and the relation between the two. This scoping review intended to shed lights on Digital Technologies Use, its operationalisation, and the relation between Digital Technologies Negative Use (DTNU) and children's well-being. For the scope of the special issue we focused on negative use. Results showed two conceptualisations of DTNU: compulsive/addictive use of devices and the Internet (e.g., Internet addiction) and negative online experiences/risky behaviours (e.g., cyberbullying). Well-being in relation to DTNU was mainly studied in terms of psycho/social dimensions (e.g., depression), and a gap in cognitive well-being studies was identified. Study designs were largely quantitative, and, in most studies, well-being was considered as a predictor of DTNU. Also, research with children under 12 years was lacking. Future research on DTNU should look at: how dimensions of addiction and negative online experiences relate; provide more evidence on cognitive well-being; explore the interplay of well-being multiple components relying on integrative conceptual frameworks. The recent notion of digital well-being should also be explored considering the results of this review.

The relationship between screen time exposure and the presence of anxiety-related disorders among adolescents during the COVID-19 pandemic: A cross-sectional study

Background

The Coronavirus Disease 2019 (COVID-19) pandemic prompted rules and laws such as lockdown, which contributed to staying at home and participating in sedentary activities such as using smartphones, tablets, televisions, gaming devices, and computers. As a result of the increased use of digital screen time, a worldwide issue has arisen among various age groups, especially adolescents, which may have affected their psychological well-being, increasing their susceptibility to anxiety-related disorders.

Objective

This study aimed to assess the relationship between screen time exposure and the presence of anxiety-related disorders among adolescents during the COVID-19 pandemic.

Methods

A quantitative descriptive cross-sectional design using convenience sampling was used in this study. The online self-administered questionnaire, including the Arabic-translated version of the Screen for Child Anxiety-related Disorders (SCARED-C), was distributed through social media using Google forms between February and April 2021. The Chi-Squared test was used for data analysis.

Results

Of 625 participants, majority were females (n = 527, 84.3%) than males (n = 98, 15.7%). A significant difference between screen time and the presence of an anxiety-related disorder among adolescents during the COVID-19 pandemic (p = .021) was noted. More than half of the participants (n = 410, 65.6%) scored above 25 in the SCARED-C test, indicating the presence of an anxiety-related disorder regardless of the type. Of those, more than a quarter (n = 176, 28.2%) used screens for more than 8 hours a day.

Conclusion

The results indicated a relationship between screen time exposure and the presence of anxiety-related disorders among adolescents during the pandemic. In particular, adolescents are more susceptible to the adverse effects of increased exposure to screen time, which is constantly on the rise. Therefore, nurses and other healthcare professionals can play a significant role in providing guidance and advice to parents, caregivers, and adolescents themselves on how to limit screen time exposure. The findings can also be useful for future studies to build on and develop screen time management interventions and guidelines.

A New Contemporary Profession as Game Boosters: The Behavioural Emergence of Intellectual Opportunism

This study investigates the emergence of intellectual opportunism for game boosters in mobile social networks. It shows the supply and demand for upgrading game levels in mobile social networks. These supply and lucrative demand highlight a new temporary profession as game boosters. Game boosters facilitate framed newbie gamers who want to play at a higher game level without playing for a long time. This emergence of professionally game boosters is due to economic opportunism, promising their potential future incomes. Moreover, opportunistic mobile social networks (OMSNs) support the muscular appearance of the game booster profession. On the other hand, this study demonstrates that mobile social networks exploit hedonistic human needs by reflecting their behaviour and social relationships when building efficient and trustworthy business contracts. This study presents uniqueness supported by critical reasoning. First, it shows that the game booster phenomenon has emerged as a contemporary profession in society, promising future cash inflows above the average salaries of typical jobs. Second, this research demonstrates the sequential logic of economic opportunities, intellectual opportunism, and mobile social networks, constructing game boosters’ income generating. Nevertheless, this study acknowledges that the game booster profession has low integrity due to its members’ inconsistent and unprincipled virtues.

Spine Posture, Mobility, and Stability of Top Mobile Esports Athletes: A Case Series

Professional esports athletes spend a long time in the same sitting posture during training and competition. Mobile esports may exacerbate potential postural problems because of the closer and unsupported arms and because athletes spend more time in a forward-/flexed-head posture. Prolonged sitting in these postures carries significant health risks and may lead to musculoskeletal problems and injuries. The objective of this retrospective study is to assess the posture, mobility, and stability of the spine for professional mobile esports athletes. We collected spine-assessment data from 48 athletes participating in a top-tier league on a real-time-strategy battle-arena online game. The spinal assessment was conducted using the SpinalMouse® under upright standing and trunk flexion in addition to the Matthiass test. Measurements were converted into Idiag Scores by the SpinalMouse® software. The Idiag Posture, Idiag Mobility, and Idiag Stability scores were 62.50 (IQR: 21), 63.50 (IQR: 19.5), and 54.50 (IQR: 14.5), respectively, and were significantly lower (p < 0.001) than the reference normative value (100). Age was found to have a weak positive correlation with the posture score (ρ = 0.29, p = 0.048). Although career duration appeared to lower the scores, the association was insignificant (p > 0.05). The scores also had no significant association with body height, body mass, body mass index, and esports team (p > 0.05). It was anticipated that mobile-based esports would attenuate the biomechanics of the spine and increase the likelihood of musculoskeletal problems, such as neck and back pain.

Influences of Smartphone and Computer Use on Health-Related Quality of Life of Early Adolescents

This study explored the daily amount of time that early adolescents spent using smartphones and computers, and their influences on health-related quality of life of early adolescents. A total of 650 early adolescents were recruited. The 36-Item Short Form Health Survey was used to measure their health-related quality of life. The early adolescents reported their average daily time spent using smartphones and computers over the course of the previous week; the majority of early adolescents (71%) spent approximately 1 h a day or less using computers on average or reported no computer use, and 98.8% indicated that they used smartphones for less than 1 h to more than 4 h per day on average. The results showed that the average daily time spent using smartphones was significantly negatively associated with two scales in the physical domain and four scales in the mental domain of health-related quality of life of early adolescents, whereas the average daily time spent using computers was significantly negatively associated with two scales in the mental domain (p < 0.05). Therefore, early adolescents who spent more time using smartphones and computers have significantly poorer outcomes in the physical and mental domains of their health-related quality of life.

Smartphone use and addiction during the coronavirus disease 2019 (COVID-19) pandemic: cohort study on 184 Italian children and adolescents

Background

The lives of many children and adolescents are today increasingly influenced by new technological devices, including smartphones. The coronavirus disease 2019 (COVID-19) pandemic occurred in a time of outstanding scientific progress and global digitalization. Young people had relevant adverse psychological and behavioral effects due to the COVID-19 pandemic, mainly related to infection control measures, which led them to spend more time at home and with major use of technological tools. The goal this study proposes is to evaluate health and social outcomes of smartphone overuse among Italian children and adolescents during the COVID-19 pandemic, analyzing patterns and aims of utilization, as well as the eventual presence and degree of addiction.

Methods

This study was based on a self-report and anonymous questionnaire, which was administered to 184 Italian school-age (6–18 years) children and adolescents during the second wave of the COVID-19 pandemic. The test was electronically (email, whatsapp) explained and sent by pediatricians either directly to older children (middle and high school), or indirectly, through the help of teachers, to younger ones (primary school). All participants spontaneously and voluntarily joined the present study. The survey was made by 4 sections, and designed to know and outline modalities (frequency, patterns and aims) of smartphone use, adverse outcomes, and related parental behaviors, also in order to reveal the eventual occurrence and degree of addiction. The same information, related to the pre-epidemic period, was also investigated and analyzed.

Results

The data obtained revealed a significantly greater adhesion to the questionnaire by females, likely reflecting higher attention and interest than boys to initiatives relating to health education. Our study showed more frequent smartphone use among Italian children and adolescents during the COVID-19 pandemic, compared to the pre-epidemic period. This may be related to the social distancing measures adopted during the months under investigation. The present survey also outlined the changing patterns and aims in the use of smartphones among young people, which allowed to limit some effects of the crisis. Indeed, they were used for human connection, learning and entertainment, providing psychological and social support. Finally, it was observed a significant increase of overuse and addiction. This led to many clinical (sleep, ocular and musculoskeletal disorders), psychological (distraction, mood modification, loss of interest) and social (superficial approach to learning, isolation) unfavorable outcomes.

Conclusions

Pediatricians and health care professionals should be aware of the potential risks related to inappropriate use of smartphones. They should monitor, in cooperation with parents, possible associated adverse effects, in order to early recognize signs and symptoms suggestive, or at high risk, for addiction. They must carry out, as well, the necessary interventions to prevent and/or lower the detrimental impact of smartphone overuse on children and adolescents’ health, oriented to sustain adequate physical and psychological development as well as social relationships.

Association of digital media exposure and addiction with child development and behavior: A cross-sectional study

BACKGROUND

Media exposure which was traditionally restricted only to television has now broadened to include various handheld devices and constant internet access. Although high quality educational and interactive screen time is beneficial, excessive addiction and early introduction of such media use has various deleterious consequences.

AIM

To estimate the exposure of media among Indian children and its influence on early child development and behaviour.

SETTINGS AND DESIGN

A tertiary care hospital based cross-sectional study.

MATERIALS AND METHODS

We included 613 children between 18 months and 12 years who visited the paediatric out-patient department for a well or a sick visit. Their media exposure was extensively analysed along with Problematic Media Use Measure Short Form (PMUM-SF). They were screened for behaviour problems using the Child Behaviour Checklist (CBCL) and Strengths and Difficulties Questionnaire (SDQ) accordingly. Those under five years were also subjected to a screening using Ages and Stages Questionnaire (ASQ3).

RESULTS

The most common gadget used was television followed immediately by smartphones. The average daily screen time was 2.11 hours, Mean+SD=2.11+1.53, 95% CI 2.11+ 0.12, found in (40.1%) of the study population. The prevalence of screen addiction was 28.1%, majority being boys. Increased screen time and media addiction were significantly associated with concerns in communication, problem-solving and personal-social domains, as well as conduct, hyperactivity and pervasive developmental disorder (PDD) problems.

CONCLUSION

We conclude that media exposure among children should be enquired as a routine. This helps to curtail unhealthy digital media practices at the earliest to ensure a digital safe environment for children.

Adverse Childhood Experiences and Problematic Media Use: Perceptions of Caregivers of High-Risk Youth

Youth with a history of adverse childhood experiences (ACEs) are more likely to develop risky health behaviors. With the increase of media use in the general population, it is likely that these high-risk youth are developing maladaptive behaviors associated with media use (i.e., problematic media use). The goals of this article are (1) to describe symptoms of problematic media use in high-risk youth and (2) to determine whether ACEs are related to problematic media use in this population. Data were collected through online questionnaires from 348 parents or legal guardians of children ages 5 to 18 years, the majority of whom had been adopted. Parents and guardians reported on the child's history of ACEs and completed the Problematic Media Use Measure-Short Form (PMUM-SF). Almost half of the participants reported that their child had a history of four or more ACEs (48.9%). Caregivers of foster or adopted children reported more symptoms of problematic media use than those reporting on their biological children. After adjusting for covariates, the number of ACEs predicted problematic media use above and beyond variance explained by demographic factors or screen time amount. Children with a history of ACEs had higher problematic media use compared to children without ACEs.

Quality over quantity? Using sibling comparisons to examine relations between sleep quality, sleep duration, and delinquency

RATIONALE

A growing body of research suggests that adolescents with problematic sleep patterns are more likely to engage in externalizing and delinquent behaviors. Few studies, however, have examined the role of between- and within-family effects on this association to establish whether poor sleep is related to delinquency after controlling for familial confounding.

OBJECTIVE

The current study examines the relationship between self-reported restless sleep, sleep duration, and delinquency from ages 16-19 in a population-based sample of U.S. youth.

METHODS

Data from full siblings from the Children and Young Adult sample of the National Longitudinal Survey of Youth (1979) (CNLSY) are analyzed. Negative binomial regression models and sibling comparisons are estimated to assess between- and within-family effects of sleep on delinquency during ages 16-17. Sibling comparison cross-lagged models are then fitted to the data to examine whether sibling differences in sleep are related to sibling differences in changes in delinquency from ages 16-19.

RESULTS

Siblings with higher levels of self-reported restless sleep were more likely to report higher levels of delinquency at ages 16-17, net of observable covariates and unobservable familial confounders. Sibling differences in restless sleep at ages 16-17 were also associated with increases in delinquency at ages 18-19 after controlling for familial confounding and temporal stability in both sleep and delinquent behavior.

CONCLUSIONS

Findings suggest that perhaps sleep quality, rather than sleep duration, should be the primary target for intervention/prevention programming efforts for adolescent delinquency.

Screen media use by Portuguese children in 2009 and 2016: a repeated cross-sectional study

BACKGROUND

Few studies have examined how access to mobile media is disrupting more traditional forms of media use.

AIM

To examine screen-time in 2009/10 and 2016/17 among children aged 3-6 years and assess potential socio-economic determinants of adherence to screen-time recommendations.

SUBJECTS AND METHODS

Two independent cross-sectional studies included 6874 Portuguese children. Screen-time (including television, computer, tablet, and smartphone) and proxy measures to calculate socioeconomic position (SEP) were parent-reported using a standardised questionnaire. Screen-time and adherence to screen-time recommendations were calculated for both periods. Determinants of excessive screen-time were identified using adjusted logistic regression models.

RESULTS

In 2009/10 screen-time averaged 107 min/day for pre-school children and 149 min/day for school-aged children. In 2016/17 values were 142 min/day and 173 min/day, respectively. Screen-time allocated to television was the highest, independently of children's age. In 2016/17, mobile media use was common among pre-school (37 min/day) and school-aged children (43 min/day). Exceeding the recommended screen-time was more prevalent in boys than girls (adjusted odds ratio (aOR) between 1.02 and 1.59) and in children whose parents had lower education levels or were unemployed (aOR between 1.00 and 2.23).

CONCLUSION

Screen-time was high among pre-school children, emphasising the need for earlier interventions, particularly among those from lower-SEP who had higher risk of exceeding the screen-time recommendations.

The association of adolescents' television viewing with Body Mass Index percentile, food addiction, and addictive phone use

Television (TV) viewing remain a popular forms of screen time for adolescents. Greater TV viewing is associated with a number of negative consequences for adolescent health. In a changing media landscape, it is important to understand adolescents' overall and commercial TV exposure, and how TV viewing is linked to health risks (e.g., obesity, food addiction, and phone addiction). The purpose of this study was to: 1) examine differences by age, gender, race/ethnicity, and parental education in overall TV and commercial TV viewing and 2) investigate whether adolescents who watch more overall TV and commercial TV programming were more likely to have a higher BMI percentile, more addictive eating, and more addictive phone use. A sample of 190 adolescents (13-16 years of age) completed Time-Use Diaries (TUDs) in 2015-2017. We found that girls had more overall weekday TV time than males. No other gender differences were detected for weekend TV time or commercial TV time. Higher BMI percentile was not correlated with greater overall or commercial TV viewing. However, we did identify a positive association between overall TV viewing and commercial TV viewing with addictive-eating and addictive phone use. This effect was mainly driven by boys. To our knowledge, this is the first study to investigate patterns of television viewing and addictive-like eating and addictive phone use. We conclude that adolescents, particularly boys, with higher TV viewing may be more likely to present with problems with addictive eating behavior and phone use. Our findings add to the research on the behavioral health correlates of TV viewing among adolescents.

Gender Differences in Parental Impact on Problematic Smartphone Use among Korean Adolescents

This study aimed to examine the effective parental impact in preventing problematic smartphone use in adolescents by identifying the parent-related factors. A secondary analysis of cross-sectional data from a Korean national survey was conducted. Data from 2758 male and 2419 female adolescents, aged 10 to 19 years, were analyzed; the respondents were divided into normal and risk groups based on their standardized smartphone addiction diagnostic scale scores. Parent-related factors of smartphone addiction were analyzed using a logistic regression model. Among both male and female adolescents, mobile messenger usage, and family environment emerged as significant predictors of problematic smartphone use. In addition, for male adolescents, smartphone use frequency and parent’s awareness of content use were significant predictors. The findings indicated the importance of parental roles in preventing problematic smartphone use in adolescents. Parents should create a healthy family environment by avoiding smartphone overuse and modeling the appropriate usage of smartphones.

PROBLEMATIC INTERNET USE AND HEALTH OUTCOMES: DOES TRAIT SELF-CONTROL MATTER?

Problematic internet use is prevalent among university students, and it has been associated with increased adverse health outcomes. The results of existing research are mixed regarding the effects of problematic internet use on health outcomes. To resolve this ambiguity, we drew upon the self-control theory and person-situation interaction model to propose trait self-control as a moderator in the relationship between problematic internet use and adverse health outcomes. The study participants comprised 273 students from both public and private universities in Nigeria. Results reveal that problematic internet use is a significant predictor of adverse health outcomes. However, we find no evidence to support our postulated Hypothesis that trait selfcontrol moderates the effects of problematic internet use on adverse health outcomes. Implications, limitations, and potential for future research are highlighted.  

Parents' Beliefs About the Benefits and Detriments of Mobile Screen Technologies for Their Young Children's Learning: A Focus on Diverse Latine Mothers and Fathers

Young children’s use of mobile screens is increasing despite the American Academy of Pediatrics’ recommendations to limit screen use. Research on TV has found that maternal beliefs about the effects of screens on children’s learning and parental socioeconomic status influence children’s media consumption. However, few studies have explored parents’ beliefs about mobile screens and whether there are differences in beliefs by socioeconomic status, particularly within the largest ethnic minoritized group — Latines. Because Latines are a socioeconomically and linguistically heterogenous group, but are often represented by low-income mothers in research, it is important to understand whether there are socioeconomic and linguistic differences on how and why Latine mothers AND fathers permit their children to use mobile screens. This study used in-depth, semi-structured interviews to understand how and why Latine mothers (low-income = 10, middle-to-high income = 10) and fathers (low-income = 10, middle-to-high income = 10) permitted their children (0–4 years) to use mobile screens. Specifically, we discussed their beliefs about how mobile screens support and hinder their children’s learning and how their children used them. Results from qualitative content analysis showed that mothers and fathers, across income, education levels, and language use, believed that they, as parents, were the key decision-makers in determining the extent to which mobile screens supported and hindered their young children’s learning. They described mediation strategies of selecting appropriate content, setting time limits, and monitoring use, to ensure that their children primarily benefited from device use. However, two distinctions were noted. Parents with a high school diploma or beyond stressed the importance of co-using devices with their children. This was not mentioned by less formally educated parents. Additionally, low-income parents with diverse educational levels, mentioned the importance of continuously monitoring device use to avoid their children encountering inappropriate content. Findings can inform work seeking to promote optimal media habits among Latine families.

Social inequalities in traditional and emerging screen devices among Portuguese children: a cross-sectional study

BACKGROUND

Children are often exposed to too much screen time but few studies have explored the use of old and new digital media among young children. This study assesses screen time, including traditional and mobile devices, in pre-school and elementary school-aged children, according to their gender, age, and socioeconomic position (SEP).

METHODS

A total of 8430 children (3 to 10 years; 50.8% boys) from the north, center and south-central Portugal were included in the present study. Data was collected by a parental questionnaire during 2016/2017. Children's screen time (by media device, weekdays and at the weekend; calculated by mean minutes per day) were reported by parents. Analysis were carried to compare screen time by children's age, gender and family SEP (classified using father's educational degree).

RESULTS

Daily screen time was high both in children aged 3 to 5 and 6 to 10 years - 154 min/day (95% CI: 149.51-158.91) and 200.79 min/day (95% CI: 197.08-204.50), respectively - and the majority of children, independently of their gender, exceed the recommended 2 h/day of screen viewing. Children are still primarily engaging in screen time through television but the use of mobile devices, particularly tablets, were already high among 3 year-old children and increased with age. SEP was a negative predictor of screen time in the linear regression analysis, including after adjustment.

CONCLUSIONS

Considering the negative health impacts of excessive screen time, recognizing subgroups at risk of excessive screen time and identifying how each device is used according to age is fundamental to enable appropriate future interventions. The screen time in children aged 3-10 years is longer than the recommended, particularly among boys and in those children from lower SEP. Parents and policymakers should have in mind that children spend most of their screen time watching television but mobile devices are becoming extremely popular starting at a young age.

Possible Effects of Social Media Use on Adolescent Health Behaviors and Perceptions

Social media use is one of the most popular leisure activities among adolescents. Concomitant to this is a growing concern regarding problematic social media use and its relationship with health behaviors. To further increase the body of research into this phenomenon, our study explored the relationship between problematic social media use and physical activity levels, sleep peculiarities, and life satisfaction in Lithuanian children and adolescents. The study was conducted in April to June 2018 during the Health Behaviour in School-aged Children survey in Lithuania, a collaborative project of the World Health Organization. The sample comprised 4,191 school children (mean age 13.9 ± 1.69 years). The findings show that problematic social media use associates with about two times higher odds for worse sleep quality and lower life satisfaction. Problematic social media use was related to lower levels of vigorous physical activity in girls, but the possible effect on moderate physical activity was in boys and was inverse-boys with problematic social media use reported higher levels of moderate physical activity. Overall, in our study, girls with problematic social media use tended to have more negative health perceptions than boys. The results suggest that problematic social media use is an independent risk factor for negative health behaviors. This study adds to the accumulating knowledge that problematic social media use among adolescents may lead to worse health perceptions and, likely, further negative health outcomes.

Adolescents' Addictive Phone Use: Associations with Eating Behaviors and Adiposity

Concerns have been raised about excessive or "addictive" phone use among adolescents, and the impact that addictive phone use (APU) can have on adolescent development and health. Most research on the physical health correlates of smartphone use has been limited to sleep health, whereas other outcomes, such as eating behaviors and obesity risk have not received as much attention. To address this gap in the literature, we examined the association between APU and emotion regulation difficulties, impulsivity, maladaptive eating behaviors, and adiposity in a sample of 111 adolescents. We found that APU is associated with greater emotion regulation difficulties, dysregulated eating, restrained eating, food addiction, and higher percent body fat. Further, we found that emotion regulation difficulties mediated the association between APU and dysregulated eating, restrained eating, and food addiction. Findings suggest that addictive phone use may confer increased risk for obesogenic eating behaviors and food addiction via challenges in regulating emotions.