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Atwal S, Browne D. Screen Time and Mental Health in Canadian Youth: An Examination of Nationally Representative Data. Psychol Rep 2024; 127:1678-1704. [PMID: 36409547 DOI: 10.1177/00332941221139995] [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] [Indexed: 08/01/2023]
Abstract
As screens have become ubiquitous in modern-day society, investigating the effects of high screen time on mental health is highly warranted. In the past decade, many studies have determined that higher levels of screen time engagement are associated with adverse mental health outcomes like anxiety and depression. However, the nature of the relationship between screen time and mental health requires further investigation to gain a better understanding of its mechanisms and properties. The purpose of this study is to utilize a nationally representative data set to (1) examine how factors like sex, age, and socioeconomic status moderate the relationship between screen time and mental health in Canadian youth and (2) determine whether this relationship supports the Goldilocks hypothesis or an exposure-response curve. It was hypothesized that (1) young, female, lower socioeconomic status individuals will be more strongly associated with poor mental health, and that (2) mental health will peak at low screen time usage, therefore, supporting an exposure-response curve. A series of moderation analyses concluded that young, male, lower socioeconomic status individuals strongly moderated the relationship between screen time and poor mental health compared to their counterparts. Furthermore, three out of the four mental health (presence of mood disorder, presence of anxiety disorder, and depression severity) measures peaked at an average of 12 hours and 19 minutes of screen time per week, hence, supporting the exposure-response curve.
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Affiliation(s)
- Simrat Atwal
- University of Waterloo Department of Psychology, Waterloo, ON, CA
| | - Dillon Browne
- University of Waterloo Department of Psychology, Waterloo, ON, CA
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Overman ML, Vrijkotte T, Sánchez Castro YM, Harskamp-van Ginkel MW, Hunsberger M, Renders CM, Kremers SPJ, Chinapaw MJM. The cross-sectional association of parental psychosocial status with children's Body Mass Index z-score and the mediating role of children's energy balance behaviors - the ABCD Study. PLoS One 2024; 19:e0302147. [PMID: 38683830 PMCID: PMC11057752 DOI: 10.1371/journal.pone.0302147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/28/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE Investigate the cross-sectional association between the psychosocial status of mothers and fathers and the BMI z-scores of their 10 to 12-year-old children. Explore whether this association is mediated by children's diet, physical activity, screen time and sleep. Analyze the moderating effect of the educational levels of both the mother and father on the association. DESIGN In a cross-sectional study design, children's height and weight were measured following a standardized protocol. Parents completed the validated Depression Anxiety and Stress questionnaire, while diet quality, sports participation, time spent in bed and screen time were assessed through child-report using previously validated questions. PARTICIPANTS The data for this study were obtained from the Amsterdam Born Children and their Development study, involving children aged 10 to 12 years and both of their parents (N = 1315). RESULTS The majority, 80%, of the parents were highly educated and born in the Netherlands, and 68% of the children had a healthy BMI. Maternal or paternal psychosocial status was not significantly associated with children's BMI z-score (maternal β -0.0037; 95% CI: -0.008 to 0.0007, paternal β 0.0028; 95% CI: -0.007 to 0.002). Screen time mediated the association between paternal psychosocial status and children's BMI z-score (β = 0.010, 95% CI: 0.002; 0.020). Children's diet, physical activity, and sleep did not mediate the association between paternal psychosocial status and children's BMI z-score. Parental educational level was not a moderator. CONCLUSIONS This research is unique in including four energy balance behaviors and including both mothers and fathers' psychosocial status. Children withfathers experiencing poorer psychosocial status engaged in more screen time which partly explained their higher BMI z-score.
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Affiliation(s)
- Meredith L. Overman
- Department of Health Promotion, Maastricht University, Maastricht, Netherlands
- Institute of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht, Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands
| | - Tanja Vrijkotte
- Amsterdam Public Health research institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Yolanda M. Sánchez Castro
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands
| | - Margreet W. Harskamp-van Ginkel
- Amsterdam Public Health research institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Monica Hunsberger
- School of Public Health and Community Medicine, Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Carry M. Renders
- Amsterdam Public Health research institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Stef P. J. Kremers
- Department of Health Promotion, Maastricht University, Maastricht, Netherlands
- Institute of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht, Netherlands
| | - Mai J. M. Chinapaw
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands
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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.
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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
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Lee H, Oldewage-Theron W, Lyford C, Shine S. Nutrition and health challenges among low-income families of young children in the post COVID-19 era: a qualitative study. Nutr Res Pract 2023; 17:1185-1200. [PMID: 38053831 PMCID: PMC10694413 DOI: 10.4162/nrp.2023.17.6.1185] [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: 02/06/2023] [Revised: 04/17/2023] [Accepted: 08/12/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND/OBJECTIVES In the United States, one in every 5 children is obese with greater likelihood in low-income households. The coronavirus disease 2019 (COVID-19) pandemic may have accelerated disparities in child obesity risk factors, such as poor dietary intake and increased sedentary behaviors, among low-income families because of financial difficulties, social isolation and other struggles. This study reveals insights into nutrition and health challenges among low-income families of young children in West Texas to better understand needs and develop interventions. SUBJECTS/METHODS In-depth individual interviews were performed via Zoom among 11 families of children under the age of 3. A semi-structured interview guide was developed to explore 3 areas: changes in (1) dietary intake and (2) sedentary behaviors and (3) families' preferences regarding a parent nutrition education program. Each interview was audio-recorded, transcribed, and coded using MaxQDA software. RESULTS Eating together as a family become challenging because of irregular work schedules during the COVID-19 pandemic. Most parents stated that their children's dietary habits shifted with an increased consumption of processed foods. Many parents are unable to afford healthful foods and have utilized food and nutrition assistance programs to help feed their families. All families reported that their children's screen time substantially increased compared to the pre-pandemic times. Moreover, the majority of parents did not associate child screen time with an obesity risk, so this area could be of particular interest for future interventions. Meal preparation ideas, remote modality, and early timing were identified as key intervention strategies. CONCLUSIONS Online nutrition interventions that emphasize the guidelines for child screen time and regular meal routines will be effective and promising tools to reach low-income parents for early childhood health promotion and obesity prevention.
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Affiliation(s)
- Hyunjung Lee
- Department of Nutrition, Texas A&M University, College Station, TX 77843, USA
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX 79409, USA
| | | | - Conrad Lyford
- Department of Agriculture and Applied Economics, Texas Tech University, Lubbock, TX 79409, USA
| | - Stephanie Shine
- Department of Human Development and Family Sciences, Texas Tech University, Lubbock, TX 79409, USA
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Griffith SF. Parent beliefs and child media use: Stress and digital skills as moderators. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2023. [DOI: 10.1016/j.appdev.2023.101535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Nowicka P, Ek A, Jurca-Simina IE, Bouzas C, Argelich E, Nordin K, García S, Vasquez Barquero MY, Hoffer U, Reijs Richards H, Tur JA, Chirita-Emandi A, Eli K. Explaining the complex impact of the Covid-19 pandemic on children with overweight and obesity: a comparative ecological analysis of parents' perceptions in three countries. BMC Public Health 2022; 22:1000. [PMID: 35581642 PMCID: PMC9113066 DOI: 10.1186/s12889-022-13351-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 05/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Covid-19 pandemic has changed children's eating and physical activity behaviours. These changes have been positive for some households and negative for others, revealing health inequalities that have ramifications for childhood obesity. This study investigates the pandemic's impact on families of children aged 2-6 years with overweight or obesity. METHODS Drawing on interviews conducted as part of a randomised controlled trial (RCT) for childhood obesity, thematic analysis was used to examine how parents of pre-schoolers perceived changes in their eating, screentime and physical activity behaviours between the first and second waves of Covid-19. Parents (n = 70, representing 68 families) were interviewed twice during a period of 6 months in three countries with markedly different pandemic policies - Sweden, Romania, and Spain. The analysis is informed by Bronfenbrenner's ecological systems theory, which embeds home- and school-based influences within societal and policy contexts. RESULTS The findings show that, although all participants were recruited from an RCT for families of children with excess weight, they reported different responses to the pandemic's second wave, with some children engaging in healthier eating and physical activity, and others engaging in comfort eating and a more sedentary lifestyle. Differences in children's obesity-related behaviours were closely related to differences in parents' practices, which were, in turn, linked to their emotional and social wellbeing. Notably, across all sites, parents' feeding and physical activity facilitation practices, as well as their emotional and social wellbeing, were embedded in household resilience. In resilient households, where parents had secure housing and employment, they were better able to adapt to the challenges posed by the pandemic, whereas parents who experienced household insecurity found it more difficult to cope. CONCLUSIONS As the Covid-19 pandemic is turning into a long-term public health challenge, studies that address household resilience are crucial for developing effective prevention and treatment responses to childhood obesity.
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Affiliation(s)
- P Nowicka
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. .,Department of Food Studies, Nutrition and Dietetics, University of Uppsala, Uppsala, Sweden.
| | - A Ek
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - I E Jurca-Simina
- Department of Microscopic Morphology Genetics Discipline, Center of Genomic Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - C Bouzas
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
| | - E Argelich
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
| | - K Nordin
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - S García
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
| | - M Y Vasquez Barquero
- Department of Food Studies, Nutrition and Dietetics, University of Uppsala, Uppsala, Sweden
| | - U Hoffer
- Department of Food Studies, Nutrition and Dietetics, University of Uppsala, Uppsala, Sweden
| | - H Reijs Richards
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - J A Tur
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
| | - A Chirita-Emandi
- Department of Microscopic Morphology Genetics Discipline, Center of Genomic Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - K Eli
- Department of Food Studies, Nutrition and Dietetics, University of Uppsala, Uppsala, Sweden.,School of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK.,Warwick Medical School, University of Warwick, Coventry, UK
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Stockdale L, Holmgren HG, Porter CL, Clifford BN, Coyne SM. Varying trajectories of infant television viewing over the first four years of life: Relations to language development and executive functions. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2022. [DOI: 10.1016/j.appdev.2022.101418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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McArthur BA, Volkova V, Tomopoulos S, Madigan S. Global Prevalence of Meeting Screen Time Guidelines Among Children 5 Years and Younger: A Systematic Review and Meta-analysis. JAMA Pediatr 2022; 176:373-383. [PMID: 35157028 PMCID: PMC8845032 DOI: 10.1001/jamapediatrics.2021.6386] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
IMPORTANCE Pediatric guidelines suggest that infants younger than 2 years avoid screen time altogether, while children aged 2 to 5 years receive no more than 1 hour per day. Although these guidelines have been adopted around the world, substantial variability exists in adherence to the guidelines, and precise estimates are needed to inform public health and policy initiatives. OBJECTIVE To derive the pooled prevalence via meta-analytic methods of children younger than 2 years and children aged 2 to 5 years who are meeting guidelines about screen time. DATA SOURCES Searches were conducted in MEDLINE, PsycINFO, and Embase up to March 2020. STUDY SELECTION Studies were included if participants were 5 years and younger and the prevalence of meeting (or exceeding) screen time guidelines was reported. DATA EXTRACTION AND SYNTHESIS Data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Two independent reviewers extracted all relevant data. Random-effects meta-analyses were used to derive the mean prevalence rates. MAIN OUTCOMES AND MEASURES Prevalence of meeting screen time guidelines. RESULTS From 63 studies, 95 nonoverlapping samples with a total of 89 163 participants were included. For children younger than 2 years, the pooled prevalence of meeting the screen time guideline (0 h/d) was 24.7% (95% CI, 19.0%-31.5%). Moderator analyses revealed that prevalence of meeting screen time guidelines varied as a function of year of data collection (increased over time), measurement method (higher when questionnaires compared with interview), and type of device use (higher when a combination of screen use activities compared with television/movies only). For children aged 2 to 5 years, the mean prevalence of meeting the screen time guideline (1 h/d) was 35.6% (95% CI, 30.6%-40.9%). Moderator analyses revealed that the prevalence of meeting screen time guidelines varied as a function of type of device use (higher when screen time was television/movies only compared with a combination of screen use activities). CONCLUSIONS AND RELEVANCE The findings of this meta-analysis indicate that only a minority of children 5 years and younger are meeting screen time guidelines. This highlights the need to provide support and resources to families to best fit evidence-based recommendations into their lives.
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Affiliation(s)
- Brae Anne McArthur
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada,Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Valeriya Volkova
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Suzy Tomopoulos
- Department of Pediatrics, New York University School of Medicine–Bellevue Hospital Center, New York
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada,Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
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Gago CM, Jurkowski J, Beckerman-Hsu JP, Aftosmes-Tobio A, Figueroa R, Oddleifson C, Mattei J, Kenney EL, Haneuse S, Davison KK. Exploring a theory of change: Are increases in parental empowerment associated with healthier weight-related parenting practices? Soc Sci Med 2022; 296:114761. [PMID: 35123371 PMCID: PMC8894077 DOI: 10.1016/j.socscimed.2022.114761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/25/2022] [Accepted: 01/27/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Parent health-related empowerment is defined as the process by which parents realize control over their life situation and take action to promote a healthier lifestyle. For decades, researchers have described the theoretical potential of empowerment in health promotion efforts, though few have empirically examined this hypothesized relationship. This study is one of the first to examine the relationship between parental empowerment and healthy weight parenting practices (i.e., food, physical activity, sleep, and media parenting), as a mechanism for early childhood health promotion in community settings. METHODS Low-income parents of preschool-aged children attending Head Start in Greater Boston between fall 2017 and spring 2019 were invited to complete a survey in the fall and spring of each academic school year (n = 578 with two surveys and n = 45 with four). Parental empowerment and healthy weight parenting practices were assessed using validated surveys. We used a multilevel difference-in-difference approach to estimate changes in healthy weight parenting practices score by changes in parental empowerment score. RESULTS Out of a possible score of four, the unadjusted mean (SD) score in fall was 3.20 (0.40) for empowerment and 3.01 (0.40) for parenting. An increase in parental empowerment was associated with an increase in healthier parenting practices (b = 0.14; 95% CI = 0.08, 0.20; p < 0.0001). CONCLUSIONS Parent empowerment may be an important target in interventions to prevent obesity in low-income children.
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Affiliation(s)
- Cristina M. Gago
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Janine Jurkowski
- Department of Health Policy, Management, and Behavior, State University of New York, Albany, NY, 12222, USA
| | | | | | - Roger Figueroa
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY, 14853, USA
| | - Carly Oddleifson
- School of Social Work, Boston College, Chestnut Hill, MA, 02467, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Erica L. Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
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Hish AJ, Wood CT, Howard JB, Flower KB, Yin HS, Rothman RL, Delamater AM, Sanders LM, Bian A, Schildcrout JS, Perrin EM. Infant Television Watching Predicts Toddler Television Watching in a Low-Income Population. Acad Pediatr 2021; 21:988-995. [PMID: 33161116 PMCID: PMC8096856 DOI: 10.1016/j.acap.2020.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/26/2020] [Accepted: 11/01/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study examines the development of active television (TV) watching behaviors across the first 2 years of life in a racially and ethnically diverse, low-income cohort and identifies caregiver and child predictors of early TV watching. METHODS We used longitudinal data from infants enrolled in the active control group (N = 235; 39% Latino; 29% Black; 15% White) of Greenlight, a cluster randomized multisite trial to prevent childhood obesity. At preventive health visits from 2 months to 2 years, caregivers were asked: "How much time does [child's first name] spend watching television each day?" Proportional odds models and linear regression analyses were used to assess associations among TV introduction age, active TV watching amount at 2 years, and sociodemographic factors. RESULTS Sixty-eight percent of children watched TV by 6 months, and 88% by 2 years. Age of TV introduction predicted amount of daily active TV watching at 2 years, with a mean time of 93 minutes if starting at 2 months; 64 minutes if starting at 4 or 6 months; and 42 minutes if starting after 6 months. Factors predicting earlier introduction included lower income, fewer children in household, care away from home, male sex, and non-Latino ethnicity of child. CONCLUSIONS Many caregivers report that their infants actively watch TV in the first 6 months of life. Earlier TV watching is related to sociodemographic factors yet predicts more daily TV watching at 2 years even controlling those factors. Interventions to limit early TV watching should be initiated in infancy.
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Affiliation(s)
| | - Charles T Wood
- Department of Pediatrics, Duke University (CT Wood, JB Howard, and EM Perrin), Vienna, Austria; Duke Center for Childhood Obesity Research, Duke University School of Medicine (CT Wood, JB Howard, and EM Perrin), Durham, NC
| | - Janna B Howard
- Department of Pediatrics, Duke University (CT Wood, JB Howard, and EM Perrin), Vienna, Austria; Duke Center for Childhood Obesity Research, Duke University School of Medicine (CT Wood, JB Howard, and EM Perrin), Durham, NC
| | - Kori B Flower
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine (KB Flower)
| | - H Shonna Yin
- Department of Pediatrics, School of Medicine/Bellevue Hospital Center, New York University (HS Yin), New York, NY
| | - Russell L Rothman
- Center for Health Services Research, Vanderbilt University Medical Center (RL Rothman), Nashville, Tenn
| | - Alan M Delamater
- University of Miami School of Medicine (AM Delamater), Miami, Fla
| | - Lee M Sanders
- Department of Pediatrics, Center for Policy, Outcomes and Prevention, Stanford University (LM Sanders), Stanford, Calif
| | - Aihua Bian
- Department of Biostatistics, Vanderbilt University School of Medicine (A Bian and JS Schildcrout), Nashville, Tenn
| | - Jonathan S Schildcrout
- Department of Biostatistics, Vanderbilt University School of Medicine (A Bian and JS Schildcrout), Nashville, Tenn
| | - Eliana M Perrin
- Department of Pediatrics, Duke University (CT Wood, JB Howard, and EM Perrin), Vienna, Austria; Duke Center for Childhood Obesity Research, Duke University School of Medicine (CT Wood, JB Howard, and EM Perrin), Durham, NC.
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Byrne R, Terranova CO, Trost SG. Measurement of screen time among young children aged 0-6 years: A systematic review. Obes Rev 2021; 22:e13260. [PMID: 33960616 PMCID: PMC8365769 DOI: 10.1111/obr.13260] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 12/16/2022]
Abstract
The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.
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Affiliation(s)
- Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Caroline O. Terranova
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Stewart G. Trost
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
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Lin YC, Tsai MC, Strong C, Hsieh YP, Lin CY, Lee CSC. Exploring Mediation Roles of Child Screen-Viewing between Parental Factors and Child Overweight in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061878. [PMID: 32183186 PMCID: PMC7143561 DOI: 10.3390/ijerph17061878] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/06/2020] [Accepted: 03/11/2020] [Indexed: 11/16/2022]
Abstract
Children's screen-viewing behavior is influenced by parents' own screen-viewing hours and the parental rules set for screen-viewing time. However, whether childhood obesity is associated with these three factors has not been widely investigated in Chinese populations. We examined the relationships between parental rules, parental screen-viewing, child screen-viewing and child overweight. Questionnaires were distributed to 1300 parents who had children studying in two elementary schools in an eastern Taiwanese City (Yi-Lan). We collected the data (the final response rate was 77.7%) on children's health states, the length of screen-viewing time, and whether parental rules of screen-viewing time have been set (n = 1005). Models using structural equation modeling, with controlling of age, gender, and physical activity of the participants, were carried out, to examine the mediated effect of child screen-viewing. The results of model testing showed that child screen-viewing could be a mediator in the associations between parental rule and child overweight (parental rule: coefficient = -0.18, p < 0.001); and between parent screen-viewing and child overweight (parent screen-viewing: coefficient = 0.072, p < 0.001). These findings suggested that parental factors (rules and little screen viewing time) effectively decreased the level of children's screen-viewing time, and the child screen-viewing time could mediate the association between parental factors and child overweight in the Chinese population.
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Affiliation(s)
- Yi-Ching Lin
- Department of Early Childhood and Family Education, College of Education, National Taipei University of Education, Taipei 10671, Taiwan;
| | - Meng-Che Tsai
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
| | - Carol Strong
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
| | - Yi-Ping Hsieh
- Department of Social Work, College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND 58202, USA;
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong;
- Correspondence: ; Tel.: +852-2766-6755
| | - Clara S. C. Lee
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong;
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Jang M, Owen B, Lauver DR. Different types of parental stress and childhood obesity: A systematic review of observational studies. Obes Rev 2019; 20:1740-1758. [PMID: 31475448 DOI: 10.1111/obr.12930] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/23/2019] [Accepted: 07/10/2019] [Indexed: 12/11/2022]
Abstract
Different types of parental stress may influence children's health behaviors and weight. The aim of this review was to systematically examine the relationships between parental stress and child obesity. We reviewed 27 studies published through December 2018 and classified parental stress as parents' general stress, parenting role stress, and life event stress. There were positive relationships of parents' general stress and parenting role stress with child obesity among families with younger children and in longitudinal studies. The relationship between life event stress and child obesity differed by measures. We found that parenting role stress may be associated with unhealthy parenting practices. Contextual factors such as children's and parents' sex, race or ethnicity, socioeconomic status, and family structure appeared to play a moderating role in the relationship between parents' stress and child obesity, which warrant cautious interpretation. Our recommendations for future research include clarifying further the types of parental stress that influence child obesity, evaluating long-term relationship between parental stress and child obesity, and identifying possible mediating factors to support the relationship between parents' stress and child obesity. Researchers may also consider developing stress management programs for parents to address child obesity.
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Affiliation(s)
- Myoungock Jang
- University of Wisconsin-Madison School of Nursing, Madison, Wisconsin
| | - Brenda Owen
- University of Wisconsin-Madison School of Nursing, Madison, Wisconsin
| | - Diane R Lauver
- University of Wisconsin-Madison School of Nursing, Madison, Wisconsin
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Lindsay AC, Moura Arruda CA, Machado MM, Greaney ML. "If You Let Them, They Will Be on It 24 Hours a Day": Qualitative Study Conducted in the United States Exploring Brazilian Immigrant Mothers' Beliefs, Attitudes, and Practices Related to Screen Time Behaviors of Their Preschool-Age Children. JMIR Pediatr Parent 2019; 2:e11791. [PMID: 31518308 PMCID: PMC6715394 DOI: 10.2196/11791] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 12/03/2018] [Accepted: 12/09/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The increasing prevalence of excessive screen time (ST) among children is a growing public health concern, with evidence linking it to an increased risk of overweight and obesity among children. OBJECTIVE This study aimed to explore the beliefs, attitudes, and practices of Brazilian immigrant mothers living in the United States related to their preschool-age children's ST behaviors. METHODS A qualitative study comprising 7 focus group discussions (FGDs) was conducted with Brazilian immigrant mothers living in the United States. All FGDs were audio-recorded and professionally transcribed verbatim. The Portuguese transcripts were analyzed using thematic analysis. RESULTS In total, 37 women participated in the FGDs. Analyses revealed that although most mothers expressed concerns for their preschool-age children's ST, nearly all viewed ST as an acceptable part of their children's daily lives. Furthermore, mothers perceived that ST has more benefits than disadvantages. The mothers' positive beliefs about (eg, educational purposes and entertainment) and perceived functional benefits of ST (eg, ability to keep children occupied so tasks can be completed and facilitation of communication with family outside the United States) contributed to their acceptance of ST for their preschool-age children. Nevertheless, most mothers spoke of needing to balance their preschool-age children's ST with other activities. Mothers reported using several parenting practices including monitoring time and content, setting limits and having rules, and prompting their children to participate in other activities to manage their preschool-age children's ST. CONCLUSIONS This study provides new information on the beliefs, attitudes, and practices of Brazilian immigrant mothers living in the United States related to their preschool-age children's ST. Study findings revealed several potentially modifiable maternal beliefs and parenting practices that may provide important targets for parenting- and family-based interventions aimed at limiting preschool-age children's ST.
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Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA, United States
| | | | - Márcia Mt Machado
- Department of Community Health, School of Medicine, Federal University of Ceara, Fortaleza, Brazil
| | - Mary L Greaney
- Department of Kinesiology, University of Rhode Island, Kingston, RI, United States
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Nobari TZ, Whaley SE, Blumenberg E, Prelip ML, Wang MC. Severe housing-cost burden and obesity among preschool-aged low-income children in Los Angeles County. Prev Med Rep 2018; 13:139-145. [PMID: 30591855 PMCID: PMC6305808 DOI: 10.1016/j.pmedr.2018.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 11/29/2018] [Accepted: 12/11/2018] [Indexed: 11/28/2022] Open
Abstract
Despite high rates of housing-cost burden in the United States, little is known regarding its impact on childhood obesity. In this article, we determine whether low-income 2–5-year-olds living in housing-cost burdened households are more likely to be obese and examine the potential moderators and behavioral and psychosocial mediators of this relationship. We used data from a triennial survey (2011, 2014) of a random sample of Los Angeles County participants of the Special Supplemental Nutrition Program for Women, Infants and Children (n = 2307). Logistic regression was used to examine the association between child's obesity status (Body Mass Index for age and sex ≥ 95th percentile) and severe housing-cost burden (finding it very difficult to pay for housing). Mother's depressive symptoms and child's diet and screen time were tested for mediation. We found that 16% of children lived in severe housing-cost burdened households. Severe housing-cost burden was associated with an increase in the odds of childhood obesity [aOR (95%CI) = 1.33 (1.00, 1.78)] and household size moderated this relationship. Child's diet and screen time and mother's depressive symptoms were not mediators. Given the high and vacillating rates of early childhood obesity and the increasing burden of housing costs in low-income populations, there is an urgency to better understand the role of housing-cost burden in epidemiologic investigations of early childhood obesity. Children in severe housing-cost burdened households had more chronic stressors. Severe housing-cost burden was associated with greater odds of childhood obesity. Child's behavior and mother's mental well-being were not mediators of the relationship.
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Affiliation(s)
- Tabashir Z Nobari
- UCLA Fielding School of Public Health, Department of Community Health Sciences, 650 Charles E. Young Drive South, Los Angeles, CA 90095, USA.,Public Health Foundation Enterprises WIC Program, 12781 Schabarum Ave., Irwindale, CA 91706, USA
| | - Shannon E Whaley
- Public Health Foundation Enterprises WIC Program, 12781 Schabarum Ave., Irwindale, CA 91706, USA
| | - Evelyn Blumenberg
- UCLA Luskin School of Public Affairs, Department of Urban Planning, 3250 Public Affairs Buliding, Box 951656, Los Angeles, CA 90095, USA
| | - Michael L Prelip
- UCLA Fielding School of Public Health, Department of Community Health Sciences, 650 Charles E. Young Drive South, Los Angeles, CA 90095, USA
| | - May C Wang
- UCLA Fielding School of Public Health, Department of Community Health Sciences, 650 Charles E. Young Drive South, Los Angeles, CA 90095, USA
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Sigmund E, Sigmundová D, Badura P, Madarasová Gecková A. Health-related parental indicators and their association with healthy weight and overweight/obese children's physical activity. BMC Public Health 2018; 18:676. [PMID: 29855285 PMCID: PMC5984306 DOI: 10.1186/s12889-018-5582-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 05/22/2018] [Indexed: 11/10/2022] Open
Abstract
Background Although it is accepted that parents play a key role in forming children’s health behaviours, differences in parent-child physical activity (PA) have not previously been analysed simultaneously in random samples of families with non-overweight and overweight to obese preschool and school-aged children. This study answers the question which of the health-related parental indicators (daily step count (SC), screen time (ST), and weight status and participation in organized leisure-time PA) help their children achieve the step count recommendations. Methods A nationally representative sample comprising 834 families including 1564 parent-child dyads who wore the Yamax Digiwalker SW-200 pedometer for at least 8 h a day on at least four weekdays and both weekend days and completed a family log book (anthropometric parameters, SC, and ST). Logistic regression analyses were used to investigate whether parental achievement of the daily SC recommendation (10,000 SC/day), non-excessive ST (< 2 h/day), weight status, and active participation in organized PA were associated with children’s achievement of their daily SC (11,500 SC/day for pre-schoolers and 13,000/11,000 SC/day for school-aged boys/girls). Results While living in a family with non-overweight parents helps children achieve the daily SC recommendation (mothers in the model: OR = 3.50, 95% CI = 2.29–5.34, p < 0.001; fathers in the model: OR = 2.41, 95% CI = 1.37–4.26, p < 0.01) regardless of their age category, gender, or ST, for families with overweight/obese children, only the mother’s achievement of the SC recommendations and non-excessive ST significantly (p < 0.05) increase the odds of their children reaching the daily SC recommendation. The active participation of children in organized leisure-time PA increases the odds of all children achieving the daily SC recommendations (OR = 1.80–2.85); however, for overweight/obese children this remains non-significant. The participation of parents in organized leisure-time PA does not have a significant relationship to the odds of their overweight/obese or non-overweight children achieving the daily SC recommendations. Conclusions The mother’s health-related behaviours (PA and ST) significantly affect the level of PA of overweight/obese preschool and school-aged children. PA enhancement programmes for overweight/obese children cannot rely solely on the active participation of children in organized leisure-time PA; they also need to take other family-based PA, especially at weekends, into account.
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Affiliation(s)
- E Sigmund
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, 77111, Olomouc, Czech Republic.
| | - D Sigmundová
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, 77111, Olomouc, Czech Republic
| | - P Badura
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, 77111, Olomouc, Czech Republic
| | - A Madarasová Gecková
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, 77111, Olomouc, Czech Republic.,Department of Health Psychology, Faculty of Physical Culture, Safarik University, Košice, Slovakia.,Graduate School, Košice Institute for Society and Health, Safarik University, Košice, Slovakia
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17
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Chang FC, Chiu CH, Chen PH, Miao NF, Chiang JT, Chuang HY. Computer/Mobile Device Screen Time of Children and Their Eye Care Behavior: The Roles of Risk Perception and Parenting. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2018; 21:179-186. [PMID: 29293374 DOI: 10.1089/cyber.2017.0324] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This study assessed the computer/mobile device screen time and eye care behavior of children and examined the roles of risk perception and parental practices. Data were obtained from a sample of 2,454 child-parent dyads recruited from 30 primary schools in Taipei city and New Taipei city, Taiwan, in 2016. Self-administered questionnaires were collected from students and parents. Fifth-grade students spend more time on new media (computer/smartphone/tablet: 16 hours a week) than on traditional media (television: 10 hours a week). The average daily screen time (3.5 hours) for these children exceeded the American Academy of Pediatrics recommendations (≤2 hours). Multivariate analysis results showed that after controlling for demographic factors, the parents with higher levels of risk perception and parental efficacy were more likely to mediate their child's eye care behavior. Children who reported lower academic performance, who were from non-intact families, reported lower levels of risk perception of mobile device use, had parents who spent more time using computers and mobile devices, and had lower levels of parental mediation were more likely to spend more time using computers and mobile devices; whereas children who reported higher academic performance, higher levels of risk perception, and higher levels of parental mediation were more likely to engage in higher levels of eye care behavior. Risk perception by children and parental practices are associated with the amount of screen time that children regularly engage in and their level of eye care behavior.
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Affiliation(s)
- Fong-Ching Chang
- 1 Department of Health Promotion and Health Education, National Taiwan Normal University , Taipei, Taiwan
| | - Chiung-Hui Chiu
- 2 Graduate Institute of Information and Computer Education, National Taiwan Normal University , Taipei, Taiwan
| | - Ping-Hung Chen
- 3 Graduate Institute of Mass Communication, National Taiwan Normal University , Taipei, Taiwan
| | - Nae-Fang Miao
- 4 Department of Nursing, Taipei Medical University , Taipei, Taiwan
| | - Jeng-Tung Chiang
- 5 Department of Statistics, National Chengchi University , Taipei, Taiwan
| | - Hung-Yi Chuang
- 6 Department of Public Health, Kaohsiung Medical University , Kaohsiung, Taiwan
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18
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Määttä S, Kaukonen R, Vepsäläinen H, Lehto E, Ylönen A, Ray C, Erkkola M, Roos E. The mediating role of the home environment in relation to parental educational level and preschool children's screen time: a cross-sectional study. BMC Public Health 2017; 17:688. [PMID: 28865436 PMCID: PMC5581928 DOI: 10.1186/s12889-017-4694-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 08/22/2017] [Indexed: 01/24/2023] Open
Abstract
Background Previous studies suggest that preschoolers from low socioeconomic backgrounds engage in more screen time. Still, the factors in the social and physical home environment driving these differences in preschool children’s screen time are poorly understood. This study examines potential home environment mediators in the associations between parental educational level and preschoolers’ screen time. Methods A total of 864 children aged 3–6 years and their parents participated in a cross-sectional DAGIS study in 2015–2016. Parents recorded their children’s screen time in a diary (N = 823). For the analyses, the daily average screen time at home was calculated. Parental questionnaires (N = 808) assessed educational level and eight social and physical environment factors in the home (i.e., descriptive norm for children’s screen time, parental screen use in front of children, parental importance for limiting children’s screen time, parental attitude toward societal pressures for children’s screen time, access to screens at home, parental self-efficacy for limiting children’s screen time, satisfaction of children’s screen time, and rules for limiting children’s screen time). Parental education was grouped into low, middle, and high education. The associations were tested by conducting mediation analyses adjusted by season and children’s sex and age. The significant mediators in the single-mediator models were included in the final multiple-mediator models. Results Of the potential eight mediators, the following four had a significant indirect association: descriptive norm for children’s screen time, parental screen use in front of children, parental importance for limiting children’s screen time, and parental attitude toward societal pressures for children’s screen time. Parents with high education had lower descriptive norm and used fewer screens in front of children compared to parents with middle or low education, and in turn, these factors were associated with less screen time among children from parents with a higher education level. Parents with high education placed greater importance on limiting children’s screen time and felt less societal pressures about children’s screen time compared to parents with low education, and in turn, these factors were associated with less screen time among children from parents with a higher education level. Conclusions Our study recognized multiple modifiable mediators in the associations between parental education and preschool children’s screen time. When aiming to diminish socioeconomic status differences in preschool children’s screen time, the focus should be on parental role models, attitudes, and norm related to children’s screen time.
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Affiliation(s)
- Suvi Määttä
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland.
| | - Riikka Kaukonen
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, -00014, Helsinki, FI, Finland
| | - Elviira Lehto
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland
| | - Anna Ylönen
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland
| | - Carola Ray
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, -00014, Helsinki, FI, Finland
| | - Eva Roos
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland.,Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, -00014, Helsinki, FI, Finland.,Clinicum, Department of Public Health, University of Helsinki, P.O. Box 66, -00014, Helsinki, FI, Finland
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19
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Lindsay AC, Greaney ML, Wallington SF, Mesa T, Salas CF. A review of early influences on physical activity and sedentary behaviors of preschool-age children in high-income countries. J SPEC PEDIATR NURS 2017; 22. [PMID: 28407367 DOI: 10.1111/jspn.12182] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Revised: 03/09/2017] [Accepted: 03/11/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE Promoting physical activity (PA) is a key component of preventing and controlling childhood obesity. Despite well-documented benefits of PA, globally, rates of PA among young children have declined over the past decades, and most children are not accruing sufficient PA daily. Helping children develop the foundation for PA habits early in life is critical for the promotion of health in childhood and prevention of chronic diseases later in life, and will ultimately promote longer and healthier lives for individuals and the general population. The purpose of this review is to provide a synthesis of current evidence on influences on PA and sedentary behaviors of preschool-age children in high-income countries. DESIGN AND METHODS A systematic review of three databases was performed. Studies conducted in high-income countries and published from 2000 onward that addressed influences on PA and sedentary behaviors of preschool-age children were identified and reviewed. Additionally, reference lists of identified articles and relevant published reviews were reviewed. Studies that met the following inclusion criteria were considered: (a) sample included preschoolers (age ≤5 years); (b) PA and/or sedentary behaviors or factors associated with PA and/or sedentary behaviors was assessed; (c) published in English; (d) used either quantitative or qualitative methods; and (e) conducted in a high-income country. Data were extracted from selected studies to identify influences on PA and sedentary behaviors of preschool-age children and organized using the social-ecological model according to multiple levels of influence. RESULTS Results from included studies identify multiple factors that influence PA and sedentary behaviors of young children in high-income countries at the various levels of the social-ecological model including intrapersonal, interpersonal, environmental, organizational, and policy. PRACTICE IMPLICATIONS Given pediatric nurses' role as primary care providers, and their frequent and continued contact with parents and their children throughout childhood through well-child visits, immunization, and minor acute illnesses, they are well positioned to promote and support the development of early healthful PA habits of children starting in early childhood.
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Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
- Health Studies & Department of Kinesiology, University of Rhode Island, Kingston, RI, USA
| | - Mary L Greaney
- Department of Kinesiology, University of Rhode Island, Kingston, RI, USA
| | - Sherrie F Wallington
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Tatiana Mesa
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Carlos F Salas
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
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Sigmundová D, Sigmund E, Badura P, Vokáčová J, Trhlíková L, Bucksch J. Weekday-weekend patterns of physical activity and screen time in parents and their pre-schoolers. BMC Public Health 2016; 16:898. [PMID: 27576897 PMCID: PMC5004262 DOI: 10.1186/s12889-016-3586-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 08/25/2016] [Indexed: 11/18/2022] Open
Abstract
Background This study focuses on the comparison of weekday/weekend parent-child behavioural patterns (step count (SC) and screen time (ST)) and answers the question of whether achieving the recommendations for daily SC (10,000) in parents also helps their preschool children achieve the recommended daily SC (11,500). Methods The participants (278 parents aged 30–45 and their 194 children aged 4–7) were randomly recruited from 10 Czech public kindergartens. The participants recorded SC (pedometer Yamax Digiwalker SW-200) and ST duration (proxy-report) for seven consecutive days (≥8 h/day) during September–October 2014 and April–May 2015. Differences between weekdays/weekends SC or ST were tested using a paired t-test. The odds of achieving the recommended daily SC for children were estimated using general logistic regression separately for weekdays and weekends. Results Only the mothers were found to have a significantly lower SC at weekends than on weekdays. All of the participants showed significantly more ST at weekends than on weekdays (daughters: 78.6 vs. 45.7 min/day, p < 0.001; sons: 78.8 vs. 55.8 min/day; mothers: 93.0 vs. 68.3 min/day; and fathers: 116.6 vs. 87.5 min/day). Daughters and sons were significantly more likely to achieve daily SC recommendation if a) the SC on weekdays during the daily routine in kindergarten exceeded the median of kindergarten SC or b) at weekends if their mother (OR: 9.67, 95 % CI: 3.57–26.23) exceeded 10,000 steps a day. Conclusions Especially at weekends, preschoolers have higher odds of meeting the recommended 11,500 steps per day when their mother reaches 10,000 steps per day and this is independent of the amount of parents’ ST. Moreover, physical activity in kindergarten helps preschool children meet the 11,500 recommended steps per day on weekdays. Therefore, interventions to promote physical activity in preschoolers should focus on kindergartens and encourage involvement of their families.
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Affiliation(s)
- Dagmar Sigmundová
- Faculty of Physical Culture, Palacký University, Tr. Miru 117, 77111, Olomouc, Czech Republic.
| | - Erik Sigmund
- Faculty of Physical Culture, Palacký University, Tr. Miru 117, 77111, Olomouc, Czech Republic
| | - Petr Badura
- Faculty of Physical Culture, Palacký University, Tr. Miru 117, 77111, Olomouc, Czech Republic
| | - Jana Vokáčová
- Faculty of Physical Culture, Palacký University, Tr. Miru 117, 77111, Olomouc, Czech Republic
| | - Lucie Trhlíková
- Faculty of Physical Culture, Palacký University, Tr. Miru 117, 77111, Olomouc, Czech Republic
| | - Jens Bucksch
- Department of Prevention and Health Promotion, Bielefeld University, School of Public Health, PO Box 100131, D-33501, Bielefeld, Germany
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21
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Sigmund E, Badura P, Vokacova J, Sigmundová D. Parent-Child Relationship of Pedometer-Assessed Physical Activity and Proxy-Reported Screen Time in Czech Families with Preschoolers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13070740. [PMID: 27455293 PMCID: PMC4962281 DOI: 10.3390/ijerph13070740] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 07/09/2016] [Accepted: 07/19/2016] [Indexed: 11/24/2022]
Abstract
This study focuses on determining the relationship between parents’ step count (SC) and screen time (ST) and children’s SC and ST on weekdays and at weekends. The participants (278 parents aged 30–45 and their 194 children aged 4–7) were recruited from 10 randomly selected Czech kindergartens. The participants recorded SC and ST duration over a week-long monitoring (≥8 h/day) during September–October 2014 and April–May 2015. The associations between parents’ SC and ST and children’s SC and ST were estimated using general linear regression for weekdays and weekends. Each 2500 SC increase in mothers’/fathers’ daily SC at weekdays (weekends) was associated with an extra 1143/903 (928/753) daily SC in children. Each 60 min of ST increase in mothers’/fathers’ ST at weekdays (weekends) was associated with an extra 7.6/7.6 (16.8/13.0) min of child daily ST. An increase of 2500 mothers’ daily SC was associated with reduction of 2.5 (7.5) min of ST in children at weekdays (weekends). This study reveals a significant relationship between parent-child SC/day, parent-child ST/day, and mothers’ ST and children’s SC at weekends. Weekend days seem to provide a suitable space for the promotion of joint physical activity in parents and their pre-schoolers.
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Affiliation(s)
- Erik Sigmund
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, Olomouc 77111, Czech Republic.
| | - Petr Badura
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, Olomouc 77111, Czech Republic.
| | - Jana Vokacova
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, Olomouc 77111, Czech Republic.
| | - Dagmar Sigmundová
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Tr. Miru 117, Olomouc 77111, Czech Republic.
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Sanders W, Parent J, Forehand R, Sullivan ADW, Jones DJ. Parental perceptions of technology and technology-focused parenting: Associations with youth screen time. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2016; 44:28-38. [PMID: 27795603 DOI: 10.1016/j.appdev.2016.02.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In the present study we propose a model linking parental perceptions of technology to technology-related parenting strategies to youth screen time, and, finally, to internalizing and externalizing problem behaviors. Participants were 615 parents drawn from three community samples of families with children across three developmental stages: young childhood, middle childhood, and adolescence. The model was tested at each stage with the strongest support emerging in the young childhood sample. One component of parental perceptions of technology, perceived efficacy, was related to technology-related parenting strategies across developmental stages. However, the association of these strategies to child screen time and, in turn, problem behaviors, diminished as children increased in age. Implications for intervention are considered.
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Affiliation(s)
| | | | | | - Alexandra D W Sullivan
- Harvard Medical School, Department of Psychiatry, Massachusetts General Hospital, United States
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23
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Davis RE, Cole SM, Blake CE, McKenney-Shubert SJ, Peterson KE. Eat, play, view, sleep: Exploring Mexican American mothers' perceptions of decision making for four behaviors associated with childhood obesity risk. Appetite 2016; 101:104-13. [PMID: 26944228 DOI: 10.1016/j.appet.2016.02.158] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 02/22/2016] [Accepted: 02/24/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This mixed methods study sought to understand who makes decisions about whether preschool-aged Mexican American children engage in eating, outdoor play, sleep, and screen time behaviors. METHODS Forty Mexican American mothers of children ages 3-4 participated in two interviews, during which both closed- and open-ended questions elicited perceptions of who made decisions for the four behaviors, as well as who was present, mealtime rules, and food choice values. Interviews were transcribed, coded for emergent themes, and compared across participants. RESULTS Participants generally perceived themselves to be primary decision makers for all four behaviors; however, food decisions often seemed to be made collaboratively with the child. Fathers were most likely to participate in evening television decisions. Other family members were rarely mentioned. Selecting foods that children liked was a strong food choice value, while cost was rarely mentioned. Participants appeared to have low perceived control over their child's behaviors relative to their perceived roles in decision making. CONCLUSIONS Mothers may be the primary audience for obesity prevention messages for preschool-aged, Mexican American children; however, health promotion programs may need to increase mothers' awareness of their control over children's behaviors. Understanding how children's behaviors are regulated is an important aspect of obesity prevention for low-income, Mexican American children.
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Affiliation(s)
- Rachel E Davis
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Room 529, Columbia, SC 29208, USA.
| | - Suzanne M Cole
- Department of Nutritional Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
| | - Christine E Blake
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Room 529, Columbia, SC 29208, USA.
| | | | - Karen E Peterson
- Department of Nutritional Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, I-1867, Ann Arbor, MI 48109-2029, USA.
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24
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Smith LJ, Gradisar M, King DL. Parental influences on adolescent video game play: a study of accessibility, rules, limit setting, monitoring, and cybersafety. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2015; 18:273-9. [PMID: 25965861 DOI: 10.1089/cyber.2014.0611] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Adolescents' video gaming is increasing at a rapid rate. Yet, little is known about what factors contribute toward more hours of gaming per week, as well as what factors may limit or protect adolescents from excessive gaming. The aim of the present study was to examine associations between adolescents' accessibility to video gaming devices, the locations played (i.e., bedroom, shared rooms), parental regulation of technology use, and the amount of hours spent video gaming during the week (weekdays vs. weekends). Adolescents (N=422; age 16.3±2.0 years, 41% male) completed an online questionnaire battery, including demographics, video gaming behaviors (e.g., hours played weekdays/weekends, time of day played, devices owned, locations played, etc.), and a questionnaire measuring aspects of parents' regulation of game playing (e.g., rules, limit setting, co-gaming). Accessibility to the adolescents' own devices, but not shared devices or device portability, was predictive of hours gaming on weekdays and weekends. Location (i.e., bedroom) was associated with increased gaming across the week. Parents discussing cybersafety was predictive of lower hours of gaming (weekdays and weekends). However, limit setting, monitoring, and co-gaming showed no significant effects. Adolescents' access to their own gaming equipped devices, as well as gaming in their bedrooms, were linked to increased hours of gaming. The findings suggest that in order to curb the increase in hours gaming, parents are advised to delay the ownership of adolescents' devices, encourage use in shared rooms, and discuss aspects of cybersafety with their teenage children.
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Affiliation(s)
- Lisa J Smith
- 1 School of Psychology, Flinders University , Adelaide, Australia
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25
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Gebremariam MK, Altenburg TM, Lakerveld J, Andersen LF, Stronks K, Chinapaw MJ, Lien N. Associations between socioeconomic position and correlates of sedentary behaviour among youth: a systematic review. Obes Rev 2015; 16:988-1000. [PMID: 26317685 DOI: 10.1111/obr.12314] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 07/24/2015] [Accepted: 07/24/2015] [Indexed: 10/23/2022]
Abstract
Existing research evidence indicates that children and adolescents of parents with a low socioeconomic position spend more time on sedentary behaviour than their counterparts. However, the mechanisms driving these differences remain poorly understood. The main aim of this systematic review was to summarize the evidence regarding the association between socioeconomic position and correlates of sedentary behaviour among youth (0-18 years) from developed countries. The literature search was conducted using MEDLINE, Embase, CINAHL and PsycINFO. A total of 37 studies were included. All but three studies examined screen-based sedentary behaviours only. Methodological quality ranged from low to moderate. Education was the most commonly used indicator of socioeconomic position, followed by income. Socioeconomic position was inversely related to the presence of a TV in the child's bedroom, parental modelling for TV viewing, parental co-viewing and eating meals in front of the TV. We found no/indeterminate evidence for an association between socioeconomic position and rules and regulations about screen time. The findings suggest possible factors that could be targeted in future intervention studies to decrease screen-based sedentary behaviour in lower socioeconomic groups in particular.
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Affiliation(s)
- M K Gebremariam
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - T M Altenburg
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - J Lakerveld
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - L F Andersen
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - K Stronks
- Department of Public Health, Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands
| | - M J Chinapaw
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - N Lien
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
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26
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Walton K, Simpson JR, Darlington G, Haines J. Parenting stress: a cross-sectional analysis of associations with childhood obesity, physical activity, and TV viewing. BMC Pediatr 2014; 14:244. [PMID: 25270356 PMCID: PMC4194416 DOI: 10.1186/1471-2431-14-244] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 09/26/2014] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Parents influence their children's obesity risk through feeding behaviours and modeling of weight-related behaviours. Little is known about how the general home environment, including parental stress, may influence children's weight. The objective of this study was to explore the association between parenting stress and child body mass index (BMI) as well as obesity risk factors, physical activity and television (TV) viewing. METHODS We used cross-sectional data from 110 parent-child dyads participating in a community-based parenting intervention. Child heights and weights were measured by trained research assistants. Parents (93% mothers) reported level of parenting stress via the Parenting Stress Index- Short Form (PSI-3-SF) as well as children's activity behaviours and TV viewing. This was an ethnically diverse (55% Hispanic/Latino, 22% Black), low-income (64% earning < $45,000/year) sample. RESULTS Level of parenting stress was not associated with children's risk of being overweight/obese. Children with highly stressed parents were less likely to meet physical activity guidelines on weekdays than children with normally stressed parents (OR = 0.33, 95% CI, 0.12-0.95). Parents experiencing high stress were less likely to set limits on the amount of TV their children watched (OR = 0.32, 95% CI, 0.11, 0.93). CONCLUSION Results suggest stress specific to parenting may not be associated with increased obesity risk among children. However, future interventions may need to address stress as a possible underlying factor associated with unhealthful behaviours among preschoolers.
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Affiliation(s)
- Kathryn Walton
- Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Road East, N1G 2 W1 Guelph, Ontario, Canada.
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27
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Leiner M, Peinado J, Villanos MT, Alvarado LA, Singh N, Dwivedi A. Psychosocial Profile of Mexican American Youths Who Play Aggressive Video Games. HISPANIC JOURNAL OF BEHAVIORAL SCIENCES 2014. [DOI: 10.1177/0739986314538603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The effects of video games on youths have been subject to debate. Some researchers have linked video games to behavioral and emotional problems, while others have found no adverse effects. The behavioral and emotional problems experienced by some gamers may be linked to certain types of video games. We hypothesized that Mexican American youths with lower socioeconomic status and who play “aggressive” video games have more emotional and behavioral problems than those who do not play such games. We examined a total of 579 youths using the Child Behavior Checklist and analyzing the games played within the last 6 months. Youths who played aggressive video games had higher scores and more emotional and behavioral problems compared with those who did not play aggressive video games.
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Affiliation(s)
- Marie Leiner
- Texas TechUniversityHealthSciences Center, El Paso, USA
| | - Jesus Peinado
- Texas TechUniversityHealthSciences Center, El Paso, USA
| | | | | | - Namrata Singh
- Texas TechUniversityHealthSciences Center, El Paso, USA
| | - Alok Dwivedi
- Texas TechUniversityHealthSciences Center, El Paso, USA
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Li K, Jurkowski JM, Davison KK. Social support may buffer the effect of intrafamilial stressors on preschool children's television viewing time in low-income families. Child Obes 2013; 9:484-91. [PMID: 24168754 PMCID: PMC3868299 DOI: 10.1089/chi.2013.0071] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Excessive television (TV) viewing in preschool children has been linked to negative outcomes during childhood, including childhood obesity. In a sample of low-income families, this study examined associations between intrafamilial factors and preschool children's TV-viewing time and the moderating effect of social support from nonfamily members on this association. METHODS In 2010, 129 mothers/female guardians of 2- to 5-year-old children enrolled at five Head Start centers in Rensselaer County, New York, completed a self-report survey. The survey assessed child TV-viewing time (including TV, DVDs, and videos) and intrafamilial risk factors, including maternal perceived stress, depressive symptoms, TV viewing, leisure-time physical activity (inactivity), and family functioning. Social support from nonfamily members (nonfamily social support) was also measured and examined as an effect modifier. RESULTS Children watched TV an average of 160 minutes per day. Moderate depressive symptoms (Personal Health Questionnaire depression scale scores ≥10), higher perceived stress, poorer family functioning, and higher maternal TV-viewing were significantly and independently associated with greater minutes of child TV viewing, controlling for covariates. In all instances, nonfamily social support moderated these associations, such that negative experiences within the family environment were linked with higher child TV-viewing time under conditions of low nonfamily social support, but not high nonfamily support. CONCLUSIONS Social support from nonfamily members may buffer potentially negative effects of intrafamilial factors on preschool children's TV-viewing time.
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Affiliation(s)
- Kaigang Li
- Department of Health Policy, Management and Behavior, The University at Albany School of Public Health, SUNY, Rensselaer, NY
| | - Janine M. Jurkowski
- Department of Health Policy, Management and Behavior, The University at Albany School of Public Health, SUNY, Rensselaer, NY
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