Screen time and child behaviour and health-related quality of life: Effect of family context

Screen Use Time and Its Association With Mental Health Issues in Young Adults in India: Protocol for a Cross-Sectional Study

BACKGROUND

Screen use time has increased in the past decade owing to the increased availability and accessibility of digital devices and the internet. Several studies have shown an association between increased screen use time and mental health issues such as anxiety and depression. However, studies in the young adult population-a demographic with high screen use-and in low- and middle-income country settings are limited.

OBJECTIVE

This protocol describes a study that aims to measure self-reported screen use times and patterns in young adults (18-24 y) in India and assess if increased screen use time is associated with poorer mental well-being.

METHODS

This protocol describes a cross-sectional study of a pan-India, web-based convenience sample of young adults (18-24 y) with access to digital devices with a screen and a minimum of secondary school education. Participants will be recruited through people in the professional networks of the investigators, which includes pediatricians. The survey will also be distributed via the social media pages of our organization (X [X Corp], Instagram [Meta], Facebook [Meta], etc). Sociodemographic details will be collected through a questionnaire designed by the authors; screen use time and patterns will be assessed using an adaptation of the Screen Time Questionnaire to include data on different apps and websites used on digital devices; and mental health parameters will be gauged using the Warwick-Edinburgh Mental Well-Being Scale, Generalized Anxiety Disorder Scale, Perceived Stress Scale, and Patient Health Questionnaire. For statistical analysis, we will consider the following variables: (1) the primary independent variable is screen use time; (2) other independent variables include age, gender, residence: rural or urban, educational qualifications, employment status, stress associated with familial financial status, average sleep time, number of people living in a house or rooms in that house, BMI, substance use, and past psychiatric history; and (3) dependent variables include mental well-being, depression, anxiety, and perceived stress. To quantify the association between screen use time and mental health, we will perform a Bayesian multivariate multiple regression analysis that models the possibility of multiple alternative hypotheses while accounting for relevant sociodemographic covariables.

RESULTS

The survey instrument has been designed, and feedback has been obtained from the domain experts and members of our organization whose profile is similar to the potential study participants. The final data received after this study has been conducted will be analyzed and shared. As of January 2023, we have not yet initiated the data collection.

CONCLUSIONS

Based on the findings of this study, we will be able to establish a correlation between device- and use-specific screen use time and various mental health parameters. This will provide a direction to develop screen use time and mental health guidelines among young adults.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/39707.

Adherence to 24-h movement behaviour guidelines in families with multiple children

BACKGROUND

In 2019, the World Health Organization (WHO) launched the first global movement guidelines for children that combined sleep, physical activity and screen time. Our previous research showed that adherence to age-specific guidelines for screen time was challenging for families with children in different age groups. We aimed to determine whether families with children in different age-based movement guideline categories have poorer adherence to the broader 24-h movement guidelines than those with all children in the same age category.

METHODS

Data were from the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health (seventh survey, 2015) and the women's three youngest children (aged ≤12) (Mothers and their Children's Health sub-study, 2016/2017). The sample was 1787 women (families) with 4064 children (mean age 7.2 [SD 2.9]). Whether children in the family were in the same or different age-based category was determined by matching children's ages in a family against age-based guideline categories for the 24-h movement behaviours. The association between children in the family being in the same or different age-based guideline category on adherence to 24-h movement guidelines, both collectively and individually, was analysed by adjusted logistic regression (binary and multinomial).

RESULTS

Families with children in the same age guideline categories had double the odds of having all children meet 24-h movement guidelines (adjusted odds ratio [OR] 1.95 [95% confidence interval, CI: 1.32, 2.86]). Families with children in the same age categories on the screen guideline had higher odds of all children meeting (2.25 [1.73, 2.93]) and lower odds of some meeting/some failing the screen guideline (0.18 [0.14, 0.25]), than families with all children in different age categories. Families with children in the same age categories on the physical activity guideline had lower odds of all children meeting (0.57 [0.43, 0.75]) or some meeting/some failing the physical activity guideline (0.08 [0.06, 0.12]). No associations were found for sleep guidelines.

CONCLUSIONS

Families with multiple children may need practical advice and strategies on how to adhere to guidelines when children span age categories. This could form part of public health strategies that raise awareness of the guidelines and may improve guideline adherence.

Cross-sectional and prospective associations between screen time and childhood neurodevelopment in two Brazilian cohorts born 11 years apart

BACKGROUND

The aim of this study was to investigate the associations between screen time from ages 2 to 4 years and child neurodevelopment at age 4.

METHODS

The participants were from the 2004 (N = 3787) and 2015 (N = 3604) Pelotas (Brazil) birth cohort studies. Childhood neurodevelopment was assessed at age 4 using the Battelle Development Inventory. The time children spent on screen devices was reported by their guardians at ages 2 and 4 years. Linear regression models were used to investigate the association of: (i) time spent on television at ages 2 and 4 years; (ii) time spent on other screens at age 4; and (iii) total screen time at age 4 (television + other screens) with childhood neurodevelopment at age 4.

RESULTS

Average daily screen time among children born in 2004 and those born in 2005 aged 4 years were 3.4 (SD: 2.4) and 4.4 h (SD: 2.9), respectively. Overall, few associations of very small magnitude between screen time and child neurodevelopment were observed. Television time at 2 years of age was statistically associated with lower neurodevelopment at 4 years of age in the 2015 cohort (β = -0.30, 95%CI = -0.55; -0.05). Conversely, television time (β = 0.17, 95%CI = 0.07, 0.26) and total screen time (β = 0.22, 95%CI = 0.13, 0.31) at age 4 were associated with higher neurodevelopment at age 4 in the 2004 cohort.

CONCLUSIONS

The findings of this study suggest that the amount of time spent on screen devices might not be associated with neurodevelopment of children under 5 years of age. The small magnitude and inconsistencies in the direction of associations did not find evidence to support the current guidelines for screen time at this age. Therefore, more studies, especially those with longitudinal data, are important to comprehend the true effect of screen time on neurodevelopment and other health outcomes.

Managing Screen Use in the Under-Fives: Recommendations for Parenting Intervention Development

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.

Associations of excessive screen time and early screen exposure with health-related quality of life and behavioral problems among children attending preschools

BACKGROUND

Both excessive screen time and early screen exposure have been linked to children's health outcomes, but few studies considered these two exposures simultaneously. The aim of this study was to explore the independent and interactive associations of excessive screen time and early screen exposure with health-related quality of life (HRQOL) and behavioral problems among Chinese children attending preschools.

METHODS

A cross-sectional study of 4985 children aged between 3 and 6 years was conducted in Chengdu, China. Each parent has finished an online questionnaire regarding their children's screen use, HRQOL, and behavioral problems. Children with screen time over 1 h/day were considered as having excessive screen time. Early screen exposure was defined if the children had started using screen-based media before the age of 2 years. HRQOL was assessed by the Pediatric Quality of Life Inventory version 4.0 (PedsQL 4.0), while behavioral problems were confirmed with the 48-item Conners' Parent Rating Scale (CPRS-48).

RESULTS

Of the 4985 children (2593 boys and 2392 girls) included, the mean age was 4.6 (SD: 1.0) years. After adjustment for confounders and early screen exposure, excessive screen time was significantly associated with worse HRQOL scores in all dimensions and summary scales, as well as each type of behavioral problems (all p values < 0.05). We also found that compared to children with later initiation of screen exposure, those with screen use before the age of 2 years had significantly lower emotional functioning score (β: - 2.13, 95%CI: - 3.17, - 1.09) and psychosocial health summary score (β: - 0.82, 95%CI: - 1.54, - 0.10) of HRQOL, as well as higher risks of conduct problems, learning problems, psychosomatic problems, impulsive-hyperactive, and hyperactivity index, which were independent of excessive screen use. Furthermore, there were significant interactive effects of excessive screen time and early screen exposure on emotional functioning domain of HRQOL scores and conduct problems.

CONCLUSION

Excessive screen time and early screen exposure are two independent and interactive factors to children's HRQOL and behavioral problems. Our findings support current guidelines to limit screen exposure in children. Appropriate screen use may represent an important intervention target to improve children's HRQOL and reduce their behavioral problems.

Associations between Leisure Preferences, Mindfulness, Psychological Capital, and Life Satisfaction

This study intended to explore which leisure preferences contribute to mindfulness, psychological capital, and life satisfaction and assess whether mindfulness, psychological capital, and life satisfaction are associated with different leisure preferences. This study applied the Satisfaction with Life Scale (SWLS), the Psychological Capital Questionnaire (PCQ-12), the Mindful Attention Awareness Scale (MAAS), and the instrument to evaluate the prevalence of leisure preferences. A sample consisted of 586 participants, 104 males and 478 females. The mean age of participants was 42.06, SD = 13.29. The results show that respondents who did not spend free time watching television scored higher on life satisfaction, mindfulness, and psychological capital. Participants who preferred attending events scored higher on life satisfaction and psychological capital. Participants who preferred spending time with family as a leisure preference scored significantly higher on life satisfaction, mindfulness, and psychological capital, including PsyCap overall, PsyCap work, PsyCap relationship, and PsyCap health. The findings also reveal that time spent with family is significantly associated with life satisfaction. Besides, males’ life satisfaction was significantly associated with time spent in nature, while females’ satisfaction was associated with spending time with family and participating in events. Males’ mindfulness was significantly associated with book reading, and females’ mindfulness was associated with not watching television. Males’ psychological capital was significantly associated with spending time with family and book reading, and females’ psychological capital was associated with not watching television but spending time with family, participating in events, and spending time in nature. The findings also showed that mindfulness mediated the link between watching television and life satisfaction, and psychological capital mediated links between spending time with family, participating in events, and life satisfaction. The findings demonstrate that life satisfaction is also significantly associated with spending time with family as a leisure preference. This study also revealed a significant negative association between age and spending time with friends or family, evidencing the possible loneliness of elderly respondents. Due to limitations of this study, including sample size and characteristics, cultural context, and research design, the research findings would preferably be regarded thoughtfully.

A Computational Model of Similarity Analysis in Quality of Life Research: An Example of Studies in Poland

Due to the multidimensional structure of the results of similarity studies, their analysis is often difficult. Therefore, a compact and transparent presentation of these results is essential. The purpose of the present study is to propose a graphical representation of the results of similarity analysis in studies on the quality of life. The results are visualized on specific diagrams (maps), where a large amount of information is presented in a compact form. New similarity maps obtained using a computational method, correspondence analysis, are shown as a convenient tool for comparative studies on the quality of life of different groups of individuals. The usefulness of this approach to the description of changes of the quality of life after the retirement threshold in different domains is demonstrated. The World Health Organization Quality of Life-BREF questionnaire was used to evaluate individuals in Poland. By analyzing clusters on the similarity maps, two groups (employees and retirees) were classified according to their quality of life in different domains. By comparing the structures of the classification maps containing the information about the whole system considered, it is clearly seen which factors are important in the comparative studies. For the considered problems, the uncertainty coefficients describing the effect size and preserving the information on the symmetry of the variables that were used for the creation of the contingency tables were evaluated.