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Lutz MR, Orr CJ, Shonna Yin H, Heerman WJ, Flower KB, Sanders LM, Rothman RL, Schildcrout JS, Bian A, Kay MC, Wood CT, Delamater AM, Perrin EM. Television Time, Especially During Meals, Is Associated With Less Healthy Dietary Practices in Toddlers. Acad Pediatr 2024; 24:741-747. [PMID: 37802249 DOI: 10.1016/j.acap.2023.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/23/2023] [Accepted: 09/30/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND While several studies examine the relationship between screen time and dietary practices in children and teenagers, there is limited research in toddlers. This study evaluates the association between television (TV) exposure and dietary practices in 2-year-old children. METHODS We conducted a cross-sectional, secondary data analysis from the Greenlight Intervention Study. Toddlers' daily TV watching time, mealtime TV, and dietary practices were assessed by caregiver report at the 24-month well-child visit. Separate regression models were used and adjusted for sociodemographic/household characteristics and clinic site. RESULTS Five hundred and thirty-two toddlers were included (51% Latino; 30% non-Latino Black; 59% ≤$20,000 annual household income). Median daily TV watching time was 42 minutes (interquartile range: 25, 60); 25% reported the TV was "usually on" during mealtimes. After adjustment, toddlers who watched more TV daily had higher odds of consuming sugar-sweetened beverages, fast food, and more junk food; those watching less TV had higher odds of consuming more fruits/vegetables. Those with the TV "usually on" during mealtimes were more likely to consume sugar-sweetened beverages (aOR 3.72 [95% confidence interval {CI} 2.16-6.43]), fast food (aOR 2.83 [95%CI 1.54-5.20]), and more junk food (aOR 4.25 [95%CI 2.71-6.65]). CONCLUSIONS Among toddlers from primarily minoritized populations and of lower socioeconomic status, those who watched more TV daily and usually had the TV on during meals had significantly less healthy dietary practices, even after adjusting for known covariates. This study supports the current American Academy of Pediatrics screen time guidelines and underscores the importance of early counseling on general and mealtime TV.
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Affiliation(s)
- Melissa R Lutz
- Department of Pediatrics (MR Lutz and EM Perrin), Johns Hopkins University School of Medicine, Baltimore, Md.
| | - Colin J Orr
- Department of Pediatrics (CJ Orr and KB Flower), University of North Carolina, Chapel Hill.
| | - Hsiang Shonna Yin
- Departments of Pediatrics and Population Health (HS Yin), New York University Grossman School of Medicine.
| | - William J Heerman
- Department of Pediatrics (WJ Heerman and RL Rothman), Vanderbilt University Medical Center, Nashville, Tenn.
| | - Kori B Flower
- Department of Pediatrics (CJ Orr and KB Flower), University of North Carolina, Chapel Hill.
| | - Lee M Sanders
- Departments of Pediatrics and Health Policy (LM Sanders), Stanford University, Calif.
| | | | - Jonathan S Schildcrout
- Department of Biostatistics (JS Schildcrout and A Bian), Vanderbilt University Medical Center, Nashville, Tenn.
| | - Aihua Bian
- Department of Biostatistics (JS Schildcrout and A Bian), Vanderbilt University Medical Center, Nashville, Tenn.
| | - Melissa C Kay
- Department of Pediatrics (CT Wood), Duke University School of Medicine, Durham, NC.
| | - Charles T Wood
- Department of Pediatrics (CT Wood), Duke University School of Medicine, Durham, NC.
| | - Alan M Delamater
- Mailman Center for Child Development (AM Delamater), University of Miami Miller School of Medicine, Fla.
| | - Eliana M Perrin
- Department of Pediatrics (MR Lutz and EM Perrin), Johns Hopkins University School of Medicine, Baltimore, Md; Division of General Pediatrics (EM Perrin), Department of Pediatrics, Schools of Medicine and Nursing.
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Mutlu N, Dinleyici M. Evaluation of Screen Time in Children Under Five Years Old. Cureus 2024; 16:e54444. [PMID: 38510895 PMCID: PMC10951682 DOI: 10.7759/cureus.54444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Due to the rapid advancement of technology, there has been a noteworthy increase in the diversity and abundance of activities involving children. The most effective methods to enhance and facilitate children's media interactions are to minimize, reduce, use with caution, and establish healthy patterns. We aimed to evaluate media exposure of children below five years of age. MATERIAL AND METHODS This is a prospective, observational, cross-sectional study that was conducted between December 2017 and September 2019 in Eskişehir, Türkiye. To assess the frequency of electronic device usage among children under the age of five, including televisions, laptops, tablets, and mobile phones, as well as its impact on their sleep patterns and physical measurements, and to evaluate families' understanding of the terms "screen time" and "back screen time," we developed a questionnaire. RESULTS We analyzed a total of 731 questionnaires: 334 (45.7%) were girls, 397 (54.3%) were boys, and the mean age was 33.55±16.37 months. Upon examining the technical equipment accessible to the children in our study, we found that 98.6% possessed a television, 96.9% owned a mobile phone, 54% had a laptop, 49.5% had a tablet, and 34.1% possessed a gaming console. The study revealed the following proportions of electronic devices in children's rooms: 13% televisions, 11.9% tablets, 7.4% laptops, and 7% mobile phones. There has been a substantial increase in the amount of time they spend watching television and playing computer games among children who have at least one sibling. There was a statistically significant disparity between the television viewing periods and the body mass index of children older than two years old. Additionally, we have seen a significant disparity in the presence of media devices in children's bedrooms and the subsequent impact on their sleep duration and patterns throughout both nighttime and daytime. Around 65.8% of parents did not know of the concept of screen time, while 88.4% of parents did not know of the concept of back screen time. DISCUSSION Parental compliance with the current guidelines for screen time is insufficient, among parents with children under the age of five, even though exposure to screens begins in the first months of life. Our analysis highlighted the necessity for parents to establish and enforce a unified and logical media usage policy for all children residing in the household. It is crucial to allocate sufficient time during the routine healthcare visit to discuss these recommendations.
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Affiliation(s)
- Nese Mutlu
- Department of Pediatrics, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, TUR
| | - Meltem Dinleyici
- Department of Social Pediatrics, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, TUR
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Sørensen SO, Gejl AK, Pedersen J, Rasmussen MG, Olesen LG, Kristensen PL, Grøntved A. Recreational screen media use among Danish children aged 6-11 years: influence of parental screen media habits and attitudes. Scand J Public Health 2023; 51:1173-1181. [PMID: 35708326 DOI: 10.1177/14034948221103463] [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: 11/15/2022]
Abstract
AIMS Little is known about the influence of parents' screen media habits and attitudes towards screen media on children's screen use. We investigated associations of parental screen use, their smartphone addiction and screen media attitudes, with children's recreational screen use. METHODS This study was based on a population-based cross-sectional survey sent between May 2019 and November 2020 to a random sample of 6820 Danish parent-child dyads who answered questions regarding their screen media habits. Children were 6-11 years of age and had to reside with the parent. Multivariable adjusted regression analyses were conducted (in October 2021) separately for screen media use on weekdays and weekend days. RESULTS The analyses included 5437 parents (41.0 years, 67.6% girls) and 5437 children (8.9 years, 48.2% girls). The adjusted relative odds of excessive amounts of screen use of children (>3 hours/weekday and >4 hours/weekend day) was 5.8 (95% confidence interval (CI) 4.6; 7.3) on weekdays and 7.2 (95% CI 5.9; 8.8) on weekend days comparing the fourth and first quartile of parental screen use. Children of parents in the fourth quartile of parental screen use had 2.1 (95% CI 1.7; 2.5) and 2.5 (95% CI 2.2; 3.0) greater odds of screen use before bedtime on all week and weekend days, respectively. Children of parents who had a positive attitude towards their child's screen use or were at high risk of smartphone addiction had significantly higher screen use and more frequent problematic screen use. CONCLUSIONS Parent's screen media habits and attitudes were strongly associated with their children's recreational screen use.
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Affiliation(s)
- Sarah Overgaard Sørensen
- Department of Sports Science and Clinical Biomechanics Research Unit for Exercise Epidemiology, University of Southern Denmark, Odense, Denmark
| | - Anne Kær Gejl
- Department of Sports Science and Clinical Biomechanics Research Unit for Exercise Epidemiology, University of Southern Denmark, Odense, Denmark
| | - Jesper Pedersen
- Department of Sports Science and Clinical Biomechanics Research Unit for Exercise Epidemiology, University of Southern Denmark, Odense, Denmark
| | - Martin Gillies Rasmussen
- Department of Sports Science and Clinical Biomechanics Research Unit for Exercise Epidemiology, University of Southern Denmark, Odense, Denmark
| | - Line Grønholt Olesen
- Department of Sports Science and Clinical Biomechanics Research Unit for Exercise Epidemiology, University of Southern Denmark, Odense, Denmark
| | - Peter Lund Kristensen
- Department of Sports Science and Clinical Biomechanics Research Unit for Exercise Epidemiology, University of Southern Denmark, Odense, Denmark
| | - Anders Grøntved
- Department of Sports Science and Clinical Biomechanics Research Unit for Exercise Epidemiology, University of Southern Denmark, Odense, Denmark
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Shrestha R, Khatri B, Majhi S, Kayastha M, Suwal B, Sharma S, Suwal R, Adhikari S, Shrestha J, Upadhyay MP. Screen time and its correlates among children aged 3–10 years during COVID-19 pandemic in Nepal: a community-based cross-sectional study. BMJ Open Ophthalmol 2022; 7:bmjophth-2022-001052. [PMID: 36161845 PMCID: PMC9402449 DOI: 10.1136/bmjophth-2022-001052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/05/2022] [Indexed: 11/23/2022] Open
Abstract
Objective This study aims to determine the prevalence of high screen time among schoolchildren aged 3–10 years in Bhaktapur, its correlates and the parents’ strategies to reduce screen time during the COVID-19 pandemic in Nepal. Methods and analysis This cross-sectional descriptive study was conducted during March 2021. A total of 630 households were selected for the study from 21 randomly selected clusters in Bhaktapur, Nepal. Correlates of high screen time were determined using a logistic model. P<0.002 was taken as significant. Results Among all the participants, the mean (SD) age was 7.0 (2.2) years, with 50.3% male participation. Few participants had online classes (n=24, 3.8%). The prevalence of high screen time among the participants was very high (55.2%, 95% CI=51.3% to 59.1%), which is even higher in boys (61.8%, 95% CI=58.0% to 65.6%). The median screen time before the COVID-19 pandemic was 1.0 hours (mean rank=275.8) which increased to 2.2 hours (mean rank=116.6) during the pandemic (p<0.001). Participants having smartphones were about seven times (adjusted OR=6.9, 95% CI=1.5 to 31.3, p=0.013) more likely to have high screen time than those who did not have the device. Most parents used to reprimand and urge their children to play outside to limit their screen usage. Conclusion During the COVID-19 pandemic, about one in two schoolchildren of 3–10 years had higher screen time than before the COVID-19 pandemic. Parents’ strategies to reduce screen time were not effective. An intervention study is recommended to design and test effective strategies to reduce screen time and its negative effects on children’s health.
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Affiliation(s)
- Rajan Shrestha
- Academic and Research Department, Hospital for Children Eye ENT and Rehabilitation Services, B P Eye Foundation, Bhaktapur, Nepal
| | - Bijay Khatri
- Academic and Research Department, Hospital for Children Eye ENT and Rehabilitation Services, B P Eye Foundation, Bhaktapur, Nepal
| | - Sangita Majhi
- Academic and Research Department, Hospital for Children Eye ENT and Rehabilitation Services, B P Eye Foundation, Bhaktapur, Nepal
| | - Manish Kayastha
- Academic and Research Department, Hospital for Children Eye ENT and Rehabilitation Services, B P Eye Foundation, Bhaktapur, Nepal
| | - Barsha Suwal
- Department of Ophthalmology, Hospital for Children Eye ENT and Rehabilitation Services, B P Eye Foundation, Bhaktapur, Nepal
| | - Samata Sharma
- Department of Ophthalmology, Hospital for Children Eye ENT and Rehabilitation Services, B P Eye Foundation, Bhaktapur, Nepal
| | - Rinkal Suwal
- Vision Therapy, Hospital for Children Eye ENT and Rehabilitation Services, B P Eye Foundation, Bhaktapur, Nepal
| | - Santoshi Adhikari
- Ethical Review, Monitoring and Evaluation Section, Nepal Health Research Council, Kathmandu, Nepal
| | - Junu Shrestha
- Central Department of Public Health, Tribhuvan University Institute of Medicine, Maharajgunj, Nepal
| | - Madan Prasad Upadhyay
- Hospital for Children Eye ENT and Rehabilitation Services, B P Eye Foundation, Bhaktapur, Nepal
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Rai J, Kuzik N, Carson V. Demographic, parental and home environment correlates of traditional and mobile screen time in preschool-aged children. Child Care Health Dev 2022; 48:544-551. [PMID: 34993994 DOI: 10.1111/cch.12958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/23/2021] [Accepted: 12/31/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Research on the correlates of screen time in young children, that could be targeted in future interventions to improve healthy development, has primarily focused on TV viewing with little consideration of mobile devices. The objectives of this study were to examine the associations between a range of demographic, parental, and home environment correlates and preschool-aged children's TV/video viewing, video/computer game playing, and total screen time across traditional and mobile devices. METHODS The results of this cross-sectional study are based on 106 preschool-aged children (3-5 years) and their parents recruited in 2018 in Edmonton, Alberta. Children's and parental demographic information, home characteristics, and information about parental and children's screen time use was measured using a parent questionnaire. Simple and multiple linear regression models were conducted. RESULTS Each additional hour/day of parental screen time was associated with 12 (95%CI = 5.2, 19.8) minutes/day of children's TV/video, 6 (95%CI = 1.5, 11.0), minutes/day of video/computer game playing, and 19 (95%CI = 8.9, 29.2) minutes/day of total screen time. Additionally, significant associations of technology interference and presence of electronics in the bedroom with children's screen time were attenuated in the multiple regression models. CONCLUSIONS Parental screen time appears important to target in future family-based screen time interventions and initiatives. Future studies should explore potential mediating or moderating variables between parental screen time and children's screen time.
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Affiliation(s)
- Jasmine Rai
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Nicholas Kuzik
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada.,Children's Hospital of Eastern Ontario (CHEO) Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
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Fitzpatrick C, Harvey E, Cristini E, Laurent A, Lemelin JP, Garon-Carrier G. Is the Association Between Early Childhood Screen Media Use and Effortful Control Bidirectional? A Prospective Study During the COVID-19 Pandemic. Front Psychol 2022; 13:918834. [PMID: 35832920 PMCID: PMC9271860 DOI: 10.3389/fpsyg.2022.918834] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
Individual differences in effortful control, a component of temperament, reflecting the ability to use attention and other cognitive processes to self-regulate emotion and behavior, contribute to child academic adjustment, social competence, and wellbeing. Research has linked excessive screen time in early childhood to reduced self-regulation ability. Furthermore, research suggests that parents are more likely to use screens with children who have more challenging temperaments, such as low levels of effortful control. Since screen time by children between the ages of 0 and 18 has increased during the COVID-19 pandemic, it remains timely to investigate the developmental pattern of association between child screen media use and effortful control. We hypothesize that higher levels of screen media intake at age 3.5 will be associated with lower effortful control at age 4.5 and that lower effortful control at 3.5 will contribute to more screen media intake at age 4.5. This study draws on participants followed longitudinally over the span of 2-years for an investigation of Canadian preschoolers' screen media use during the pandemic (N = 316, Wave 1). A follow-up with this sample was completed in 2021 (N = 265, Wave 2). Analyses using a cross-lagged panel model revealed stability in child screen time and effortful control between the ages of 3.5 and 4.5. Child screen time at age 3.5 significantly contributed to decreased effortful control scores at the age of 4.5, whereas effortful control at age 3.5 did not contribute to screen time at age 4.5. Our results partially confirmed our hypothesis and indicated that higher levels of screen time intake were detrimental to the development of effortful control. These results suggest that screen media use, an exceedingly frequent activity, may play an enduring role in development by shaping young children's temperaments.
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Affiliation(s)
- Caroline Fitzpatrick
- Faculty of Education, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of Childhood Education, University of Johannesburg, Johannesburg, South Africa
- Groupe de Recherche et d’Intervention sur les Adaptations Sociales de l’Enfance, Sherbrooke, QC, Canada
| | - Elizabeth Harvey
- Groupe de Recherche et d’Intervention sur les Adaptations Sociales de l’Enfance, Sherbrooke, QC, Canada
- Department of Education, Université Sainte-Anne, Church Point, NS, Canada
| | - Emma Cristini
- Faculty of Education, Université de Sherbrooke, Sherbrooke, QC, Canada
- Groupe de Recherche et d’Intervention sur les Adaptations Sociales de l’Enfance, Sherbrooke, QC, Canada
| | - Angélique Laurent
- Faculty of Education, Université de Sherbrooke, Sherbrooke, QC, Canada
- Groupe de Recherche et d’Intervention sur les Adaptations Sociales de l’Enfance, Sherbrooke, QC, Canada
| | - Jean-Pascal Lemelin
- Faculty of Education, Université de Sherbrooke, Sherbrooke, QC, Canada
- Groupe de Recherche et d’Intervention sur les Adaptations Sociales de l’Enfance, Sherbrooke, QC, Canada
| | - Gabrielle Garon-Carrier
- Faculty of Education, Université de Sherbrooke, Sherbrooke, QC, Canada
- Groupe de Recherche et d’Intervention sur les Adaptations Sociales de l’Enfance, Sherbrooke, QC, Canada
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Monteiro R, Fernandes S, Hutton JS, Huang G, Ittenbach RF, Rocha NB. Psychometric properties of the ScreenQ for measuring digital media use in Portuguese young children. Acta Paediatr 2022; 111:1950-1955. [PMID: 35648466 PMCID: PMC9546278 DOI: 10.1111/apa.16439] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/28/2022] [Accepted: 05/31/2022] [Indexed: 11/26/2022]
Abstract
AIM Digital media use is prevalent among children and linked to potential developmental and health risks, but validated measures of children's digital media use are lacking. The aim of this study was to validate the Portuguese version of the ScreenQ with three distinct children's age groups. METHODS Parents of children living in Portugal completed an online survey including the 16-item version of the ScreenQ and items related to home activities and digital media use. A combination of classical and modern theory (Rasch) methods was used for analysis. RESULTS A total of 549 mothers and 51 fathers of 325 girls and 322 boys from 6 months to 9 years and 11 months-old responded to the survey. Point-measure correlations were all positive and endorsement of item values were within acceptable ranges. Cronbach's coefficient α was acceptable for a new measure and test-retest reliability was high. Statistically significant correlations were found between ScreenQ total scores and relevant demographic, play-related, parenting, and digital media-use items. CONCLUSION The Portuguese version of the ScreenQ exhibited sound psychometric properties, including internal consistency and concurrent validity referenced to external items. Higher ScreenQ scores were correlated with higher digital media multitasking, lower parent-child interaction, and higher concerns regarding child's learning and behaviour.
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Affiliation(s)
- Rita Monteiro
- University of Vigo Ph.D. program in Educational and Behavioral Sciences Vigo Spain
- School of Health Polytechnic Institute of Porto Porto Portugal
| | - Sandra Fernandes
- Portucalense Institute for Human Development (INPP) Department of Psychology and Education Portucalense University Porto Portugal
| | - John S Hutton
- Division of General and Community Pediatrics Cincinnati Children’s Hospital University of Cincinnati College of Medicine Cincinnati
- Reading and Literacy Discovery Center Cincinnati Children’s Hospital University of Cincinnati College of Medicine Cincinnati
| | - Guixia Huang
- Division of Biostatistics and Epidemiology Cincinnati Children’s Hospital University of Cincinnati College of Medicine Cincinnati
| | - Richard F Ittenbach
- Division of Biostatistics and Epidemiology Cincinnati Children’s Hospital University of Cincinnati College of Medicine Cincinnati
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Wu Y, Amirfakhraei A, Ebrahimzadeh F, Jahangiry L, Abbasalizad-Farhangi M. Screen Time and Body Mass Index Among Children and Adolescents: A Systematic Review and Meta-Analysis. Front Pediatr 2022; 10:822108. [PMID: 35620148 PMCID: PMC9127358 DOI: 10.3389/fped.2022.822108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background There is no summative quantitative study that report the difference in BMI in high screen user children and adolescents or give a difference in screen time in children and adolescents with obesity vs. children and adolescents without obesity. In the current meta-analysis we systematically summarized the association between obesity and screen time and meta-analyzed the results. Methods A systematic search from Scopus, PubMed and Embase electronic databases. Studies that evaluated the association between screen time and obesity up to June 2021. Results Results revealed that those at the highest screen time category had 0.7 kg/m2 higher BMI (WMD = 0.703; CI = 0.128, 1.278; P < 0.016; I 2 = 95.8%). Moreover, children and adolescents with obesity had a mean value of 0.313 h higher screen time compared with children and adolescents without obesity (WMD: 0.313; OR = 0.219, 0.407; P < 0.001; I 2 = 96%). The results of subgrouping showed that study quality, continent and sample size could reduce the heterogeneity values. No evidence of publication bias was reported according to visual asymmetry of funnel plots and the results of Begg's and Egger's tests. Conclusion For the first time, the current systematic review and meta-analysis revealed a positive association between screen time and obesity among children and adolescents. Due to the cross-sectional design of the included studies, causal inference is impossible, therefore, further studies in separate analysis of both genders are suggested to better elucidate gender-specific results. Systematic Review Registration [www.ClinicalTrials.gov], identifier [CRD4202123 3899].
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Affiliation(s)
- Yiling Wu
- Department of Pediatrics, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Azita Amirfakhraei
- Department of Psychology, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran
| | - Farnoosh Ebrahimzadeh
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Leila Jahangiry
- Department of Health Education and Health Promotion, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran
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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: 43] [Impact Index Per Article: 21.5] [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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Determinants of Excessive Screen Time among Children under Five Years Old in Selangor, Malaysia: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063560. [PMID: 35329247 PMCID: PMC8951484 DOI: 10.3390/ijerph19063560] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 03/05/2022] [Accepted: 03/15/2022] [Indexed: 02/04/2023]
Abstract
Excessive screen time interferes with the health and development of children. However, the screen time situation among Malaysian children remains poorly understood. This study aims to identify the prevalence and determinants of excessive screen time among children under five years in Selangor, Malaysia, using the latest World Health Organization guidelines. In this cross-sectional study, 489 parent−child dyads were randomly selected from nine government health clinics in Petaling district, Selangor. Total screen time and factors were assessed using validated self-administered questionnaires and analysed using multiple logistic regression. The overall prevalence of excessive screen time was 91.4% with a median of 3.00 h. The majority of children utilized television (66%), followed by handheld devices (30%) and computers (4%). Determinants of screen time identified were Malay ethnicity, (aOR 3.56, 95% CI 1.65−7.68), parental age of ≥30 years (aOR 3.12, 95% CI 1.58−6.16), parental screen time >2 h a day (aOR 2.42, 95% CI 1.24−4.73), moderate self-efficacy to influence a child’s physical activity (aOR 2.29, 95% CI 1.01−5.20) and the positive perception on the influence of screen time on a child’s cognitive wellbeing (aOR 1.15, 95% CI 1.01−1.32). Parents play an important role in determining their child’s screen time. Future interventions should focus on addressing parental determinants to ensure age-appropriate screen time.
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Chong WW, Abd Rahman FN, Harun NA. Screen time of children with speech delay: a cross-sectional study in a tertiary center in Kuantan, Malaysia. Pediatr Int 2022; 64:e15105. [PMID: 35411977 DOI: 10.1111/ped.15105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 11/11/2021] [Accepted: 12/22/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Studies suggest excessive screen time (use of smartphones, televisions, computers and/or video games) is linked to speech and language delay. This study explored the sociodemographic characteristics of children with speech delay in Kuantan, Malaysia, and the association of screen time with speech and other developmental delays. METHODS This cross-sectional study was conducted between July and November 2019 at the child psychiatry and speech therapy clinics, at Kuantan Hospital, Pahang, Malaysia. Parents of children with speech delay aged <72 months provided information on their children's and their own screen times. Speech and other developmental skills were assessed using the Schedule of Growing Skills II with scores reported as developmental quotient (DQ) level. RESULTS The study included 91 children (67 boys, 24 girls) of whom 54.9% had primary speech delay and 45.1% had neurodevelopmental disorders; their mean age was 39.9 ± 11.52 months. The children's mean screen time was 2.26 ± 1.98 h daily, with 36.3% exceeding 2 h. Higher children's screen time was moderately correlated with higher parental screen time (rs = 0.479, P < 0.01). Household income was positively correlated with screen times of the children and the parents (rs = 0.243, P = 0.02 and rs = 0.390, p < 0.01, respectively). Parents who intended to reduce their children's screen time reported higher screen time in their children (t(89) = 2.322, P = 0.023). Children's age was positively correlated with the number of types of screen media (rs = 0.225, P = 0.032). The mean speech DQ was 54.76 ± 24.06%. Lower speech DQ was associated with lower DQs in other skills (P < 0.01). No significant correlation was shown between children's and parents' screen time with DQs of speech and other skills (P > 0.05). CONCLUSION The correlation between parent and child screen time provides an opportunity for possible intervention, where necessary. Larger studies are required to examine this correlation further.
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Affiliation(s)
- Wei Wei Chong
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.,Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
| | - Fairuz Nazri Abd Rahman
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Noorul Amilin Harun
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
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12
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Tezol O, Yildiz D, Yalcin S, Oflu A, Erat Nergiz M, Caylan N, Cıcek S, Foto Ozdemır D. Excessive screen time and lower psychosocial well-being among preschool children. Arch Pediatr 2021; 29:61-66. [PMID: 34758931 DOI: 10.1016/j.arcped.2021.10.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/02/2021] [Accepted: 10/03/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Too much screen time is a common and severe threat to child health and excessive screen exposure exists in the early childhood population in Turkey. We aimed to investigate the associations between excessive screen time and psychosocial well-being in a sample of Turkish preschool children. METHODS Mothers and their healthy children aged 2-5 years who applied to general pediatric outpatient clinics for well-child examinations were enrolled in this descriptive cross-sectional study. Children with a daily screen time of less than 1 h (low) or more than or equal to 4 h (excessive) were included. Psychosocial well-being was assessed using the parent version of the Strengths and Difficulties Questionnaire. RESULTS In all, 220 mother-child pairs participated in this study. Emotional symptoms, conduct problems, peer relationship problems, and total difficulties scores were significantly higher in the children with excessive screen time (p<0.05), while the hyperactivity-inattention and prosocial scores were not different between the low and excessive screen time groups (p>0.05). After adjusting for potential confounders, the children with excessive screen time had significantly increased odds ratios for having conduct and peer relationship problems (OR [95% CI]: 2.62 [1.11-6.19], p = 0.028 and 2.57 [1.25-5.26], p = 0.010, respectively). CONCLUSION Turkish preschool children with excessive screen time were significantly more likely to have poor psychosocial well-being. Preschool children with behavioral problems should be evaluated for excessive screen time.
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Affiliation(s)
- O Tezol
- Faculty of Medicine, Department of Pediatrics, Mersin University Hospital, Ciftlikkoy Campus, Yenişehir, Mersin 33110, Turkey.
| | - D Yildiz
- Department of Pediatrics, Dr. Sami Ulus Training and Research Hospital, Ankara, Turkey
| | - S Yalcin
- Faculty of Medicine, Department of Social Pediatrics, Hacettepe University, Ankara, Turkey
| | - A Oflu
- Faculty of Medicine, Department of Pediatrics, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - M Erat Nergiz
- Department of Pediatrics, Yıldırım Beyazıt University Yenimahalle Training and Research Hospital, Ankara, Turkey
| | - N Caylan
- Department of Child and Adolescent Health, Ministry of Health, Ankara, Turkey
| | - S Cıcek
- Department of Pediatrics, Etimesgut Şehit Sait Ertürk Hospital, Ankara, Turkey
| | - D Foto Ozdemır
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
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13
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Wiltshire CA, Troller-Renfree SV, Giebler MA, Noble KG. Associations among average parental educational attainment, maternal stress, and infant screen exposure at 6 months of age. Infant Behav Dev 2021; 65:101644. [PMID: 34509711 PMCID: PMC8627439 DOI: 10.1016/j.infbeh.2021.101644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 01/02/2023]
Abstract
Evidence suggests that increased use of screens early in life may have negative developmental consequences for children. However, little is known concerning parental factors that predict initial screen exposure in infancy. The primary goal of this study was to examine whether parental educational attainment and maternal stress were associated with infant screen exposure by 6 months of age. A diverse sample of mothers (N = 93) was recruited prenatally. In a follow-up visit when the infants were six months of age (N = 82), we examined factors that may be associated with initial infant exposure to screens. First, mothers reported whether they had already exposed their infants to screens. Thereafter, those mothers who reported already having exposed their infants to screens were further queried to determine the extent of infant screen use. Results demonstrated that among infants exposed to screens, mothers reported an average of nearly 3 h of daily screen use. Average parental educational attainment, but not maternal stress, was significantly associated with initial infant exposure. Of those families who endorsed screen exposure by 6 months, 70 % reported a screen in the room where the child sleeps, nearly half reported using screens to help calm the infant, and about a third reported using a screen at least sometimes during meals, when going to sleep, and while waiting. Parental education around infant screen use behaviors may be important to help promote child development and outcomes.
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Affiliation(s)
- Cynthia A Wiltshire
- The University of Texas at El Paso, United States; Teachers College, Columbia University, United States
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14
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Yalçin SS, Tezol Ö, Çaylan N, Erat Nergiz M, Yildiz D, Çiçek Ş, Oflu A. Evaluation of problematic screen exposure in pre-schoolers using a unique tool called "seven-in-seven screen exposure questionnaire": cross-sectional study. BMC Pediatr 2021; 21:472. [PMID: 34696746 PMCID: PMC8546938 DOI: 10.1186/s12887-021-02939-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background Screen media exposure has been increasing in the preschool years. Risky aspects of screen exposure have many potential negative effects on children’s health. We aimed to evaluate problematic screen exposure in Turkish preschool children by using a unique tool called the “Seven-in-Seven Screen Exposure Questionnaire” and to investigate factors associated with problematic screen exposure. Methods A questionnaire form was designed including general descriptive questions in the first part. In the second part, a questionnaire we designed called the “Seven-in-Seven Screen Exposure Questionnaire” was conducted to evaluate problematic screen exposure characteristics. The questionnaire included seven items: daily screen time, viewing with parent(s), setting screen limits, screen exposure during meals and in the hour before bedtime, age of onset of screen exposure, and viewing low-quality content. The total problematic screen exposure score (range 0–13) was generated by summing scores from the seven items. Total scores are classified into two categories: low (< 7) and high (≥ 7). Logistic regression was performed to search for independent parameters associated with problematic screen exposure. Results One thousand two hundred forty-five mother-child pairs participated in this study. The median age of the children was 3.9 (IQR: 2.9–4.7) years and 51% were males. Overall, 280 children (22.5%) had a problematic screen exposure score of ≥7 (high). The median problematic screen exposure score was 4 (IQR: 3–6). Maternal age of < 30 years; paternal age of ≥30 years; maternal educational level of ≤12 years; the age of 24–48 months; home-based daycare; postponing eating, toileting, or sleeping while using a screen; and using touchscreen devices were found to be associated with an increased risk of having a high problematic screen exposure score. Conclusion Developing national scales to monitor problematic screen use in children would be more effective than monitoring screen time alone. All of the screen use characteristics not recommended in children would be evaluated using problematic screen exposure scales. The “Seven-in-Seven Screen Exposure Questionnaire” may serve as an example for further studies.
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Affiliation(s)
- S Songül Yalçin
- Department of Pediatrics, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
| | - Özlem Tezol
- Department of Pediatrics, Mersin University, Faculty of Medicine, Mersin, Turkey
| | - Nilgün Çaylan
- Department of Child and Adolescents Health, Ministry of Health, Ankara, Turkey
| | - Meryem Erat Nergiz
- Department of Pediatrics, Yıldırım Beyazıt University, Yenimahalle Research Hospital, Ankara, Turkey
| | - Deniz Yildiz
- Department of Pediatrics, Dr. Sami Ulus Child Hospital, Ankara, Turkey
| | - Şeyma Çiçek
- Department of Pediatrics, Etimesgut Şehit Sait Ertürk Hospital, Ankara, Turkey
| | - Ayşe Oflu
- Department of Pediatrics, Afyon Health Sciences University, Faculty of Medicine, Afyon, Turkey
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15
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Júdice PB, Rosa GB, Magalhães JP, Hetherington-Rauth M, Correia IR, Henriques-Neto D, Sardinha LB. A hierarchy of correlates impacting adults' sensor-based physical activity and sedentary time. J Sports Sci 2021; 39:2821-2828. [PMID: 34378495 DOI: 10.1080/02640414.2021.1964749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Investigation into correlates across all levels of the socio-ecological model predictive of objectively measured physical activity has rarely been assessed in adults. While considering a diversity of correlates, we determined which correlates best predict sensor-based moderate-to-vigorous physical activity (MVPA) and sedentary-time (ST) in adults. A Chi-squared Automatic Interaction Detection algorithm was used to hierarchize the correlates associated with high ST (≥66.6thpercentile) and sufficient MVPA (≥150 min/week) in 865 adults. The main correlate predictive of being active was currently partaking in sport/exercise. The following relevant correlates were being male for the exercisers and having trees in the neighbourhood for the non-exercisers. The final correlate to boost male exercisers' MVPA was having lots of shops in the neighbourhood and not having television in the bedroom for women. The primary correlate for high ST was job activity level, with individuals having highly active jobs being less likely to exhibit high levels of ST; being single, male, and a former athlete also increased the chances of being highly sedentary. To increase adults' MVPA, promotion of sport participation, neighbourhood landscape planning, shop availability, as well as limiting television in the bedroom must be prioritized. For counteracting ST, increasing workplace activity level is warranted.
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Affiliation(s)
- Pedro B Júdice
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,CIDEFES - Centro de Investigação em Desporto, Educação Física e Exercício e Saúde, Faculty of Physical Education and Sport, Lusofona University, Lisbon, Portugal
| | - Gil B Rosa
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - João P Magalhães
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Megan Hetherington-Rauth
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Inês R Correia
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Duarte Henriques-Neto
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
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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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17
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Anitha FS, Narasimhan U, Janakiraman A, Janakarajan N, Tamilselvan P. Association of digital media exposure and addiction with child development and behavior: A cross-sectional study. Ind Psychiatry J 2021; 30:265-271. [PMID: 35017810 PMCID: PMC8709520 DOI: 10.4103/ipj.ipj_157_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 03/24/2021] [Accepted: 06/09/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Media exposure which was traditionally restricted only to television has now broadened to include various handheld devices and constant internet access. Although high quality educational and interactive screen time is beneficial, excessive addiction and early introduction of such media use has various deleterious consequences. AIM To estimate the exposure of media among Indian children and its influence on early child development and behaviour. SETTINGS AND DESIGN A tertiary care hospital based cross-sectional study. MATERIALS AND METHODS We included 613 children between 18 months and 12 years who visited the paediatric out-patient department for a well or a sick visit. Their media exposure was extensively analysed along with Problematic Media Use Measure Short Form (PMUM-SF). They were screened for behaviour problems using the Child Behaviour Checklist (CBCL) and Strengths and Difficulties Questionnaire (SDQ) accordingly. Those under five years were also subjected to a screening using Ages and Stages Questionnaire (ASQ3). RESULTS The most common gadget used was television followed immediately by smartphones. The average daily screen time was 2.11 hours, Mean+SD=2.11+1.53, 95% CI 2.11+ 0.12, found in (40.1%) of the study population. The prevalence of screen addiction was 28.1%, majority being boys. Increased screen time and media addiction were significantly associated with concerns in communication, problem-solving and personal-social domains, as well as conduct, hyperactivity and pervasive developmental disorder (PDD) problems. CONCLUSION We conclude that media exposure among children should be enquired as a routine. This helps to curtail unhealthy digital media practices at the earliest to ensure a digital safe environment for children.
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Affiliation(s)
- Fatima Shirly Anitha
- Department of Paediatrics, Karthikeyan Child Development Unit, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Udayakumar Narasimhan
- Department of Paediatrics, Karthikeyan Child Development Unit, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Abhinayaa Janakiraman
- Department of Paediatrics, Karthikeyan Child Development Unit, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Nivetha Janakarajan
- Department of Paediatrics, Karthikeyan Child Development Unit, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Priyadharshini Tamilselvan
- Department of Paediatrics, Karthikeyan Child Development Unit, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
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18
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Karssen LT, Vink JM, de Weerth C, Hermans RCJ, de Kort CPM, Kremers SP, Ruiter ELM, Larsen JK. An App-Based Parenting Program to Promote Healthy Energy Balance-Related Parenting Practices to Prevent Childhood Obesity: Protocol Using the Intervention Mapping Framework. JMIR Form Res 2021; 5:e24802. [PMID: 33988510 PMCID: PMC8164123 DOI: 10.2196/24802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/02/2021] [Accepted: 03/15/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The family environment plays an important role in the development of children's energy balance-related behaviors. As a result, parents' energy balance-related parenting practices are important targets of preventive childhood obesity programs. Families with a lower socioeconomic position (SEP) may benefit from participating in such programs but are generally less well reached than families with a higher SEP. OBJECTIVE This paper describes the application of the Intervention Mapping Protocol (IMP) for the development of an app-based preventive intervention program to promote healthy energy balance-related parenting practices among parents of children (aged 0-4 years) with a lower SEP. METHODS The 6 steps of the IMP were used as a theory- and evidence-based framework to guide the development of an app-based preventive intervention program. RESULTS In step 1, behavioral outcomes for the app-based program (ie, children have a healthy dietary intake, sufficient sleep, and restricted screen time and sufficient physical activity) and sociocognitive (ie, knowledge, attitudes, and self-efficacy) and automatic (ie, habitual behaviors) determinants of energy balance-related parenting were identified through a needs assessment. In step 2, the behavioral outcomes were translated into performance objectives. To influence these objectives, in step 3, theory-based intervention methods were selected for each of the determinants. In step 4, the knowledge derived from the previous steps allowed for the development of the app-based program Samen Happie! through a process of continuous cocreation with parents and health professionals. In step 5, community health services were identified as potential adopters for the app. Finally, in step 6, 2 randomized controlled trials were designed to evaluate the process and effects of the app among Dutch parents of infants (trial 1) and preschoolers (trial 2). These trials were completed in November 2019 (trial 1) and February 2020 (trial 2). CONCLUSIONS The IMP allowed for the effective development of the app-based parenting program Samen Happie! to promote healthy energy balance-related parenting practices among parents of infants and preschoolers. Through the integration of theory, empirical evidence, and data from the target population, as well as the process of continued cocreation, the program specifically addresses parents with a lower SEP. This increases the potential of the program to prevent the development of obesity in early childhood among families with a lower SEP. TRIAL REGISTRATION Netherlands Trial Register NL6727, https://www.trialregister.nl/trial/6727; Netherlands Trial Register NL7371, https://www.trialregister.nl/trial/7371.
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Affiliation(s)
- Levie T Karssen
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Jacqueline M Vink
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Carolina de Weerth
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Roel C J Hermans
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, Netherlands
- Netherlands Nutrition Centre, The Hague, Netherlands
| | - Carina P M de Kort
- Institute of Health Studies, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Stef Pj Kremers
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, Netherlands
| | - Emilie L M Ruiter
- Academic Collaborative Centre AMPHI, Primary and Community Care, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Junilla K Larsen
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
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Mansor E, Ahmad N, Raj D, Mohd Zulkefli NA, Mohd Shariff Z. Predictors of Parental Barriers to Reduce Excessive Child Screen Time Among Parents of Under-Five Children in Selangor, Malaysia: Cross-sectional Study. J Med Internet Res 2021; 23:e25219. [PMID: 33847590 PMCID: PMC8080141 DOI: 10.2196/25219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/13/2020] [Accepted: 03/04/2021] [Indexed: 01/22/2023] Open
Abstract
Background Globally, there is an increasing prevalence of excessive screen time exposure among young children, including in Malaysia. Parents are advised to limit this exposure, but there are barriers for many of them to follow this recommendation. To date, there is a lack of research on the factors that cause these parental barriers. Objective This study aimed to determine the parental barrier toward the reduction of excessive child screen time and its predictors among parents of children aged younger than 5 years in the Petaling District, Selangor, Malaysia. Methods A cross-sectional study was conducted from April 2019 to June 2020 among 789 parent-child dyads attending child health clinics in the Petaling District. Validated self-administered questionnaires were used to capture information on sociodemographic, parental, child-related, and environmental factors and parental barriers. Stratified sampling with probability proportionate to size was employed. Data were analyzed using SPSS Statistics version 25 (IBM Corp). Descriptive analysis and bivariable analysis were performed before multiple linear regression was used to identify predictors of parental barriers. Results The overall mean score of parental barriers was 3.51 (SD 0.83), indicating that the average numbers of barriers experienced by parents were more than 3. The multivariable analysis showed that the predictors of parental barriers included monthly household income (adjusted β=–.03, 95% CI –0.05 to –0.02), parents who worked in public sectors (adjusted β=.18, 95% CI 0.06 to 0.29), positive parental attitude on screens (adjusted β=.68, 95% CI 0.58 to 0.79), low parent self-efficacy to influence child’s physical activity (adjusted β=–.32, 95% CI –0.43 to –0.20), and child screen time (adjusted β=.04, 95% CI 0.02 to 0.06). Conclusions The strongest predictor of parental barriers to reduce excessive child screen time was the positive parental attitude on screen time which could contribute to their abilities to limit child screen time. Thus, future intervention strategies should aim to foster correct parental attitudes toward screen time activities among young children.
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Affiliation(s)
- Elliza Mansor
- Department of Community Health, Faculty of Medicine and Health Sciences, Serdang, Malaysia.,Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Norliza Ahmad
- Department of Community Health, Faculty of Medicine and Health Sciences, Serdang, Malaysia
| | - Diana Raj
- Department of Community Health, Faculty of Medicine and Health Sciences, Serdang, Malaysia.,Ministry of Health Malaysia, Putrajaya, Malaysia
| | | | - Zalilah Mohd Shariff
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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20
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Krogh MT, Egmose I, Stuart AC, Madsen EB, Haase TW, Væver MS. A longitudinal examination of daily amounts of screen time and technoference in infants aged 2-11 months and associations with maternal sociodemographic factors. Infant Behav Dev 2021; 63:101543. [PMID: 33652202 DOI: 10.1016/j.infbeh.2021.101543] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 11/28/2022]
Abstract
This study aimed to examine longitudinal developmental patterns in the daily amounts of screen time and technoference in infants aged 2, 4, 7, and 11 months and to examine associations with maternal sociodemographic factors across all age groups. The results showed that the amount of screen time varied between 6 and 17 min a day, while interruptions in mother-infant interactions due to maternal use of digital technology occurred between 5 and 6 times a day. There was a significant increase in infant screen time from 2 to 4 months, from 4-7 months, and from 7-11 months, and in technoference from 2 to 4 months and from 4-7 months. Maternal age and household income were not associated with infant screen time, but maternal educational level was negatively associated with infant screen time throughout the first year. No associations were found between technoference and maternal age, maternal educational level, or household income. Future research focusing on infant screen time and technoference should aim at including samples that reflect the general population, include measures of screen time and technoference that do not rely on parental report, and include measures of the effects of early infant screen time and technoference on later development.
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Affiliation(s)
- Marianne Thode Krogh
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark.
| | - Ida Egmose
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark
| | - Anne Christine Stuart
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark
| | - Eva Back Madsen
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark
| | - Tina Wahl Haase
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark
| | - Mette Skovgaard Væver
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark
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21
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Corkin MT, Peterson ER, Henderson AM, Waldie KE, Reese E, Morton SM. Preschool screen media exposure, executive functions and symptoms of inattention/hyperactivity. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2021. [DOI: 10.1016/j.appdev.2020.101237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Salunkhe S, Bharaswadkar R, Patil M, Agarkhedkar S, Pande V, Mane S. Influence of electronic media on speech and language delay in children. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2021. [DOI: 10.4103/mjdrdypu.mjdrdypu_636_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Alotaibi T, Almuhanna R, Alhassan J, Alqadhib E, Mortada E, Alwhaibi R. The Relationship between Technology Use and Physical Activity among Typically-Developing Children. Healthcare (Basel) 2020; 8:healthcare8040488. [PMID: 33212768 PMCID: PMC7712844 DOI: 10.3390/healthcare8040488] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 12/25/2022] Open
Abstract
Objectives: This study aimed to investigate the relationship between technology use and physical activity level and to measure the association between sociodemographic characteristics of the participants, technology use, and physical activity level among Saudi children. Materials and Methods: This cross-sectional study was conducted among 458 parents of typically-developing Saudi children (6–12 years). A translated validated questionnaire used for data collection consisted of three parts: Children’s Physical Activity Questionnaire (CPAQ), Questionnaire on the Impact of Technology on Children (used to investigate the impact of technology on children’s physical activity) and sociodemographic questions (e.g, children’s age and sex, age, educational level, marital status of parents and monthly income). Data were analyzed using Pearson correlation and Mann-Whitney U test to assess the relationship between technology use and physical activity level. A chi-squared test was used to assess the relationship between technology use and sociodemographic variables. Statistical significance was set at p < 0.05. Results: Mean age of the sampled children was (8.44 ± 2.07). Data analysis revealed that high use of technology was significantly associated with low level of activity. Pearson’s correlation analysis showed a negative relationship between a high level of activity and technology use (r = −0.138, p = 0.047). Ownership of a device was significantly associated with higher technology time consumption. Regression analysis revealed that age of the child, educational level of the parents, screen time use, and owning electrical devices significantly predicted the level of practicing physical activity among children of sampled parents (p < 0.05). Conclusions: practicing inadequate physical activity among children could be influenced by educational level of parents, screen time use, and owning electrical devices. Therefore, parental involvement is required to reduce time of exposure to technology screens among children.
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Affiliation(s)
- Thekra Alotaibi
- Rehabilitation Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11466, Saudi Arabia; (T.A.); (R.A.); (J.A.); (E.A.)
| | - Rifan Almuhanna
- Rehabilitation Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11466, Saudi Arabia; (T.A.); (R.A.); (J.A.); (E.A.)
| | - Johara Alhassan
- Rehabilitation Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11466, Saudi Arabia; (T.A.); (R.A.); (J.A.); (E.A.)
| | - Ethar Alqadhib
- Rehabilitation Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11466, Saudi Arabia; (T.A.); (R.A.); (J.A.); (E.A.)
| | - Eman Mortada
- Health Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11466, Saudi Arabia;
| | - Reem Alwhaibi
- Rehabilitation Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11466, Saudi Arabia; (T.A.); (R.A.); (J.A.); (E.A.)
- Correspondence:
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Kang AW, Ash TR, Tovar A, Gans KM, Minkel J, Mena NZ, Risica PM. Exploring Parenting Contexts of Latinx 2-to-5-Year Old Children's Sleep: Qualitative Evidence Informing Intervention Development. J Pediatr Nurs 2020; 54:93-100. [PMID: 32801064 DOI: 10.1016/j.pedn.2020.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/12/2020] [Accepted: 07/16/2020] [Indexed: 11/15/2022]
Abstract
PURPOSE Poor sleep quality is associated with childhood obesity, and Latinx children have the highest prevalence of obesity in the United States. Parents are key agents to ensuring good sleep quality among children, but limited research has examined sleep parenting among Latinx working parents who may have added responsibilities. DESIGN AND METHODS Working Latinx parents of 2-to-5-year old children participated in in-depth interviews exploring parenting and familial contexts of child sleep. Main topics in the interview guide included sleep-related parenting practices, social support, cultural influences, and intervention service delivery and content preferences. Thematic analysis was used to analyze data. RESULTS Twenty parents completed the interview. The following themes emerged: Sleep parenting, sleep knowledge, impact of familial structures, family commitments, child temperament, and broader contextual factors on sleep, and intervention content and design ideas. Across participants, employment was reported to be a barrier to effective sleep parenting. Parents also reported engaging in practices that may interfere with sleep quality such as using screen time as a distraction and reducing naptime during the weekends to increase the amount of family time. Family-level factors such as co-parenting and spousal support were reported to facilitate sleep parenting. Participants also indicated the need for more sleep parenting knowledge and a preference for mobile platforms and social media to deliver information. CONCLUSIONS Results not only fill critical gaps in the literature, but also highlight the variability in parents' approaches to sleep parenting and an urgent need for intervention/programming efforts to target Latinx parent's sleep knowledge and parenting.
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Affiliation(s)
- Augustine W Kang
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA.
| | - Tayla R Ash
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Kim M Gans
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA; Department of Human Development and Family Studies, University of Connecticut, Storrs, CT, USA
| | - Jared Minkel
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Noereem Z Mena
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA
| | - Patricia M Risica
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA; Department of Epidemiology, Brown School of Public Health, Providence, RI, USA
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Tomaz SA, Hinkley T, Jones RA, Watson ED, Twine R, Kahn K, Norris SA, Draper CE. Screen Time and Sleep of Rural and Urban South African Preschool Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155449. [PMID: 32751089 PMCID: PMC7432324 DOI: 10.3390/ijerph17155449] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 01/10/2023]
Abstract
This study aimed to investigate the extent to which preschool children meet guidelines for screen time (<1 h/day) and sleep (10-13 h/24-h) and explored home factors that affect these behaviors. Parents of preschoolers across income settings in South Africa (urban high-income n = 27, urban low-income n = 96 and rural low-income n = 142) completed a questionnaire. Urban high-income children had higher rates of exceeding screen time guidelines (67.0%) than children from urban low-income (26.0%) and rural low-income (3.5%) settings. Most children (81.0%) met sleep guidelines on weekdays and on weekends (75.0%). More urban high-income children met the sleep guideline, in comparison to both low-income settings. Fewer urban high-income parents (50.0%) thought that screen time would not affect their preschooler's health, compared to urban low-income (90.4%) and rural low-income (81.7%) parents. Weeknight bedtime was positively correlated with both weekday screen time (p = 0.001) and weekday TV time (p = 0.005), indicating that more time on screens correlated with later bedtimes. Meeting screen time and sleep guidelines differs across income settings, but it is evident that parents of preschoolers across all income settings would benefit from greater awareness about guidelines.
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Affiliation(s)
- Simone A. Tomaz
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town 7700, South Africa
- Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, Scotland, UK
- Correspondence: (S.A.T.); (C.E.D.)
| | - Trina Hinkley
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong 3125, Australia;
| | - Rachel A. Jones
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong 2500, Australia;
| | - Estelle D. Watson
- Centre for Exercise Science and Sports Medicine, School of Therapeutic Sciences, University of Witwatersrand, Johannesburg 2000, South Africa;
| | - Rhian Twine
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa; (R.T.); (K.K.)
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa; (R.T.); (K.K.)
| | - Shane A. Norris
- South African MRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa;
| | - Catherine E. Draper
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town 7700, South Africa
- South African MRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa;
- Correspondence: (S.A.T.); (C.E.D.)
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Klakk H, Wester CT, Olesen LG, Rasmussen MG, Kristensen PL, Pedersen J, Grøntved A. The development of a questionnaire to assess leisure time screen-based media use and its proximal correlates in children (SCREENS-Q). BMC Public Health 2020; 20:664. [PMID: 32397984 PMCID: PMC7216486 DOI: 10.1186/s12889-020-08810-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 04/29/2020] [Indexed: 11/14/2022] Open
Abstract
Background The screen-media landscape has changed drastically during the last decade with wide-scale ownership and use of new portable touchscreen-based devices plausibly causing changes in the volume of screen media use and the way children and young people entertain themselves and communicate with friends and family members. This rapid development is not sufficiently mirrored in available tools for measuring children’s screen media use. The aim of this study was to develop and evaluate a parent-reported standardized questionnaire to assess 6–10-year old children’s multiple screen media use and habits, their screen media environment, and its plausible proximal correlates based on a suggested socio-ecological model. Methods An iterative process was conducted developing the SCREENS questionnaire. Informed by the literature, media experts and end-users, a conceptual framework was made to guide the development of the questionnaire. Parents and media experts evaluated face and content validity. Pilot and field testing in the target group was conducted to assess test-retest reliability using Kappa statistics and intraclass correlation coefficients (ICC). Construct validity of relevant items was assessed using pairwise non-parametric correlations (Spearman’s). The SCREENS questionnaire is based on a multidimensional and formative model. Results The SCREENS questionnaire covers six domains validated to be important factors of screen media use in children and comprises 19 questions and 92 items. Test-retest reliability (n = 37 parents) for continuous variables was moderate to substantial with ICC’s ranging from 0.67 to 0.90. For relevant nominal and ordinal data, kappa values were all above 0.50 with more than 80% of the values above 0.61 indicating good test-retest reliability. Internal consistency between two different time use variables (from n = 243) showed good correlations with rho ranging from 0.59 to 0.66. Response-time was within 15 min for all participants. Conclusions SCREENS-Q is a comprehensive tool to assess children’s screen media habits, the screen media environment and possible related correlates. It is a feasible questionnaire with multiple validated constructs and moderate to substantial test-retest reliability of all evaluated items. The SCREENS-Q is a promising tool to investigate children screen media use.
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Affiliation(s)
- Heidi Klakk
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230, Odense M, Denmark. .,Research Center for Applied Health Science, University College Lillebælt, 5230, Odense M, Denmark.
| | - Christian Tolstrup Wester
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230, Odense M, Denmark
| | - Line Grønholt Olesen
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230, Odense M, Denmark
| | - Martin Gillies Rasmussen
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230, Odense M, Denmark
| | - Peter Lund Kristensen
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230, Odense M, Denmark
| | - Jesper Pedersen
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230, Odense M, Denmark
| | - Anders Grøntved
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230, Odense M, Denmark
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Aglipay M, Vanderloo LM, Tombeau Cost K, Maguire JL, Birken CS. The Digital Media Environment and Cardiovascular Risk in Children. Can J Cardiol 2020; 36:1440-1447. [PMID: 32353533 DOI: 10.1016/j.cjca.2020.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/01/2020] [Accepted: 04/16/2020] [Indexed: 12/16/2022] Open
Abstract
Children today are exposed to multiple forms of digital media including traditional (eg, televisions, computers) and newer mobile devices (eg, smartphones, tablets, etc). As the digital media environment evolves, it is important that health care providers and policymakers adapt to develop, implement, and evaluate strategies to ameliorate its effects on health. In this article we provide an overview of the literature on the relationship between the digital media environment and cardiovascular risk factors in childhood. Existing evidence on the relationship between digital media environment and cardiovascular risk in infants, children, and youth are reported. Potential mechanisms underpinning the relationship between the digital media environment and cardiovascular disease risk in children such as the displacement of movement behaviours, food and beverage marketing to children, and eating while viewing were explored. National and international guidelines aimed at addressing the digital media environment are highlighted, and suggestions for future research and guideline development are provided. Action-oriented professional recommendations for health care providers, families, and children are urgently needed. As the prevalence of screen use in childhood continues to exceed those of past generations, concern about the effects and strategies to reduce harm including cardiovascular outcomes must remain a top public health priority.
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Affiliation(s)
- Mary Aglipay
- Department of Pediatrics, St Michael's Hospital, Toronto, Ontario, Canada
| | - Leigh M Vanderloo
- The Hospital for Sick Children Research Institute, Child Health Evaluative Sciences, Toronto, Ontario, Canada
| | - Katherine Tombeau Cost
- The Hospital for Sick Children Research Institute, Neurosciences and Mental Health, Toronto, Ontario, Canada
| | - Jonathan L Maguire
- Department of Pediatrics, St Michael's Hospital, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Ontario, Canada
| | - Catherine S Birken
- The Hospital for Sick Children Research Institute, Child Health Evaluative Sciences, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Ontario, Canada.
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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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Jusienė R, Urbonas V, Laurinaitytė I, Rakickienė L, Breidokienė R, Kuzminskaitė M, Praninskienė R. Screen Use During Meals Among Young Children: Exploration of Associated Variables. ACTA ACUST UNITED AC 2019; 55:medicina55100688. [PMID: 31615125 PMCID: PMC6843261 DOI: 10.3390/medicina55100688] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 10/08/2019] [Accepted: 10/08/2019] [Indexed: 01/03/2023]
Abstract
Background and Objectives: There is evidence that eating meals or snacks while watching TV is an obesogenic factor. Moreover, the patterns of TV and other screen use during meals begin early and persist. However, there are only a few studies to date which address the prevalence and predictors of young children’s exposure to screen during mealtimes. Thus, the present study aimed to investigate the prevalence and the associated factors of screen use during meals in early childhood. Materials and Methods: A cross sectional survey was conducted in Lithuania. Data of 847 children aged 2 to 5 years old (51.5% boys) were analyzed in this study. Parents completed the Child Behavior Checklist (CBCL/1½-5) and reported their children’s daily screen time, exposure to background TV, screen use during child’s meals, child and parental height and weight, and sociodemographic data. Results: More than half of children were exposed to screen during meals: 33.7% occasionally, several times per week or per month, and 22%—daily or during every meal. Overall daily screen time, background TV, consumption of junk food, child age, and emotional and behavioral problems were related to mealtime screen use (all associations significant at p < 0.01). Longer daily screen time (OR 1.01; 95% CI 1.00–1.01), more background TV (OR 1.26; 95% CI 1.10–1.45), and elder child age (OR 1.02; 95% CI 1.00–1.03) were significant predictors of occasional use of screen during meals. Also, longer daily screen time (OR 0.99; 95% CI 0.98–0.99), background TV (OR 0.78; 95% CI 0.66–0.91) together with no siblings’ status of a child (OR 0.42; 95% CI 0.25–0.69) increased the probability that children were fed in front of screens daily. Conclusions: This study confirmed the unfavorable associations among screen use during meals, daily screen time and junk food consumption in early childhood. In addition, first-time parents should get particular health providers’ attention as they are more likely to use screens during child’s mealtime.
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Affiliation(s)
- Roma Jusienė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, LT-01513 Vilnius, Lithuania.
| | - Vaidotas Urbonas
- Institute of Psychology, Faculty of Philosophy, Vilnius University, LT-01513 Vilnius, Lithuania.
- Clinic of Children's Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, LT-08406 Vilnius, Lithuania.
| | - Ilona Laurinaitytė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, LT-01513 Vilnius, Lithuania.
| | - Lauryna Rakickienė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, LT-01513 Vilnius, Lithuania.
| | - Rima Breidokienė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, LT-01513 Vilnius, Lithuania.
| | - Monika Kuzminskaitė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, LT-01513 Vilnius, Lithuania.
| | - Rūta Praninskienė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, LT-01513 Vilnius, Lithuania.
- Pediatric Neurology Department, Children's Hospital, Affiliate of Vilnius University Hospital Santaros Clinics, LT-08406 Vilnius, Lithuania.
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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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McDonald JA, Sroka C, Olivares E, Marin M, Gurrola M, Sharkey JR. Patterns of Screen Time Among Rural Mexican-American Children on the New Mexico-Mexico Border. Prev Chronic Dis 2018; 15:E113. [PMID: 30218553 PMCID: PMC6157263 DOI: 10.5888/pcd15.180070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The prevalence of obesity is 26% among Hispanic children and teenagers and 47% among Hispanic adults. One contributor to obesity is sedentary behavior, such as using electronic screen devices (ie, screens). Low-income and Hispanic youths spend more time using such devices than other youths. METHODS We interviewed 202 parents of Mexican-origin children aged 6 to 10 years in 2 rural communities near the US-Mexico border to determine screen use among children. We tested for associations between covariates and heavy screen use (≥4 hours/day) and calculated adjusted odds ratios (AORs) to identify independent, modifiable risk factors for such use. RESULTS More than two-thirds (68.3%) of households had an annual income of less than $24,000, 89.1% spoke primarily Spanish, and 92.1% had internet access. The percentage of children with heavy screen use was 14.9% on weekdays and 25.2% on weekends. Smartphones were used by 62.4% of children, desktops or laptops by 60.9%; homework was the most common reason for use of these devices. One in 3 children used them for social media. Increased odds of heavy screen use were associated with having a television on while the child ate (weekday AOR = 3.02; 95% confidence interval [CI], 1.08-8.45 and weekend AOR = 2.38; 95% CI, 1.04-5.40) and using electronics to entertain (weekend AOR = 2.94; 95% CI, 1.15-7.51). More than 3 family meals per week (AOR = 0.40; 95% CI, 0.17-0.94 compared with ≤3 meals) and 2 or 3 family activities per week (AOR = 0.33; 95% CI, 0.12-0.87 compared with ≤1 activity) were associated with decreased odds of heavy weekend use. CONCLUSION Even in low-income, Spanish-speaking communities, children have access to electronic devices, social media, and the internet, and a substantial fraction of them are heavy users. Efforts to reduce screen time might focus on understanding and changing the social norms that promote it.
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Affiliation(s)
- Jill A McDonald
- Department of Public Health Sciences, College of Health and Social Services, New Mexico State University, Las Cruces, New Mexico.,Southwest Institute for Health Disparities Research, College of Health and Social Services, New Mexico State University, Las Cruces, New Mexico.,Department of Public Health Sciences and Southwest Institute for Health Disparities Research, College of Health and Social Services, New Mexico State University, PO Box 30001, Las Cruces, NM 88003-8001.
| | - Christopher Sroka
- Economics, Applied Statistics and International Business Department, College of Business, New Mexico State University, Las Cruces, New Mexico
| | - Elizabeth Olivares
- Southwest Institute for Health Disparities Research, College of Health and Social Services, New Mexico State University, Las Cruces, New Mexico
| | - Merranda Marin
- Southwest Institute for Health Disparities Research, College of Health and Social Services, New Mexico State University, Las Cruces, New Mexico.,Department of Family and Child Science, College of Agricultural, Consumer and Environmental Sciences, New Mexico State University, Las Cruces, New Mexico
| | - Maria Gurrola
- Southwest Institute for Health Disparities Research, College of Health and Social Services, New Mexico State University, Las Cruces, New Mexico.,School of Social Work, New Mexico State University, Las Cruces, New Mexico
| | - Joseph R Sharkey
- Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, College Station, Texas
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Ahluwalia N, Frenk SM, Quan SF. Screen time behaviours and caffeine intake in US children: findings from the cross-sectional National Health and Nutrition Examination Survey (NHANES). BMJ Paediatr Open 2018; 2:e000258. [PMID: 30019017 PMCID: PMC6045721 DOI: 10.1136/bmjpo-2018-000258] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 05/10/2018] [Accepted: 06/06/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Screen time (ST) behaviours, for example, television (TV) watching and computer use, among youth are associated with unhealthy eating, and these patterns track over time. A positive association between ST and TV watching with consumption of caffeinated foods and beverages has been described in national samples of children in a few European countries. The association of ST behaviours with caffeine intake has not been previously reported. We examined whether ST behaviours were associated with caffeine intake on a given day (% consumers and amount consumed) in a nationally representative sample of US children. METHODS Data on 3421 children (ages 6-11 years) from the cross-sectional National Health and Nutrition Examination Survey 2007-2012 were used. Time spent on TV watching and computer use was determined using questionnaires. Dietary intake was assessed using a 24-hour recall by trained interviewers. Caffeine intake (mg) was estimated by using updated food and nutrient databases. Caffeine consumption was examined in relation to time spent (≥2 vs<2 hours/day) on ST behaviours. RESULTS Children who watched TV ≥2 hours/day had significantly higher (~45% more) caffeine intake. Total ST or computer use was not associated with caffeine consumption in school-aged children. CONCLUSION TV watching was positively associated with caffeine intake in school-aged children, suggesting the need for continued monitoring of ST and caffeine intake behaviours in children and adolescents as well as examining the correlates of these behaviours to inform nutrition and health policies.
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Affiliation(s)
- Namanjeet Ahluwalia
- Division of National Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention (CDC), Hyattsville, Maryland, USA
| | - Steven M Frenk
- Division of National Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention (CDC), Hyattsville, Maryland, USA
| | - Stuart F Quan
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Adams EL, Marini ME, Stokes J, Birch LL, Paul IM, Savage JS. INSIGHT responsive parenting intervention reduces infant's screen time and television exposure. Int J Behav Nutr Phys Act 2018; 15:24. [PMID: 29544506 PMCID: PMC5855973 DOI: 10.1186/s12966-018-0657-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 02/23/2018] [Indexed: 11/25/2022] Open
Abstract
Background Sedentary behaviors, including screen time, in childhood have been associated with an increased risk for overweight. Beginning in infancy, we sought to reduce screen time and television exposure and increase time spent in interactive play as one component of a responsive parenting (RP) intervention designed for obesity prevention. Methods The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study is a randomized trial comparing a RP intervention with a safety control intervention. Primiparous mother-newborn dyads (N = 279) were randomized after childbirth. Research nurses delivered intervention content at infant ages 3, 16, 28, and 40 weeks and research center visits at 1 and 2 years. As one component of INSIGHT, developmentally appropriate messages on minimizing screen time, reducing television exposure in the home, and promoting parent-child engagement through interactive play were delivered. Mothers self-reported their infant’s screen time at ages 44 weeks, 1, 1.5, 2 and 2.5 years; interactive play was reported at 8 and 20 weeks and 2 years. Results More RP than control parents reported their infants met the American Academy of Pediatrics’ no screen time recommendation at 44 weeks (53.0% vs. 30.2%) and at 1 year on weekdays (42.5% vs. 27.6%) and weekends (45.5% vs. 26.8%), but not after age 1 year. RP mothers and RP children had less daily screen time than controls at each time point (p ≤ 0.01). Fewer RP than control group mothers reported the television was ever on during infant meals (p < 0.05). The frequency of tummy time and floor play did not differ by study group; approximately 95% of infants spent time in restrictive devices (i.e. swing) at 8 and 20 weeks. At 2 years of age, there were no study group differences for time children spent in interactive play. Conclusion From infancy to early childhood, the INSIGHT RP intervention reduced screen time and television exposure, but did not increase the frequency or amount of interactive play. Trial registration clinicaltrials.gov NCT01167270. Registered on 21 July 2010. Electronic supplementary material The online version of this article (10.1186/s12966-018-0657-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elizabeth L Adams
- Center for Childhood Obesity Research, Penn State University, 129 Noll Laboratory, University Park, PA, 16802, USA.,Department of Nutritional Sciences, Penn State University, University Park, PA, USA
| | - Michele E Marini
- Center for Childhood Obesity Research, Penn State University, 129 Noll Laboratory, University Park, PA, 16802, USA
| | - Jennifer Stokes
- Pediatrics and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Leann L Birch
- Department of Foods and Nutrition, University of Georgia, Athens, GA, USA
| | - Ian M Paul
- Pediatrics and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Jennifer S Savage
- Center for Childhood Obesity Research, Penn State University, 129 Noll Laboratory, University Park, PA, 16802, USA. .,Department of Nutritional Sciences, Penn State University, University Park, PA, USA.
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Poitras VJ, Gray CE, Janssen X, Aubert S, Carson V, Faulkner G, Goldfield GS, Reilly JJ, Sampson M, Tremblay MS. Systematic review of the relationships between sedentary behaviour and health indicators in the early years (0-4 years). BMC Public Health 2017; 17:868. [PMID: 29219092 PMCID: PMC5773886 DOI: 10.1186/s12889-017-4849-8] [Citation(s) in RCA: 172] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background The purpose of this systematic review was to examine the relationships between sedentary behaviour (SB) and health indicators in children aged 0 to 4 years, and to determine what doses of SB (i.e., duration, patterns [frequency, interruptions], and type) were associated with health indicators. Methods Online databases were searched for peer-reviewed studies that met the a priori inclusion criteria: population (apparently healthy, 1 month to 4.99 years), intervention/exposure and comparator (durations, patterns, and types of SB), and outcome/health indicator (critical: adiposity, motor development, psychosocial health, cognitive development; important: bone and skeletal health, cardiometabolic health, fitness, risks/harm). The quality of the evidence was assessed by study design and outcome using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Results Due to heterogeneity, meta-analyses were not possible; instead, narrative syntheses were conducted, structured around the health indicator and type of SB. A total of 96 studies were included (195,430 participants from 33 countries). Study designs were: randomized controlled trial (n = 1), case-control (n = 3), longitudinal (n = 25), longitudinal with additional cross-sectional analyses (n = 5), and cross-sectional (n = 62). Evidence quality ranged from “very low” to “moderate”. Associations between objectively measured total sedentary time and indicators of adiposity and motor development were predominantly null. Associations between screen time and indicators of adiposity, motor or cognitive development, and psychosocial health were primarily unfavourable or null. Associations between reading/storytelling and indicators of cognitive development were favourable or null. Associations between time spent seated (e.g., in car seats or strollers) or in the supine position, and indicators of adiposity and motor development, were primarily unfavourable or null. Data were scarce for other outcomes. Conclusions These findings continue to support the importance of minimizing screen time for disease prevention and health promotion in the early years, but also highlight the potential cognitive benefits of interactive non-screen-based sedentary behaviours such as reading and storytelling. Additional high-quality research using valid and reliable measures is needed to more definitively establish the relationships between durations, patterns, and types of SB and health indicators, and to provide insight into the appropriate dose of SB for optimal health in the early years. Electronic supplementary material The online version of this article (10.1186/s12889-017-4849-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Veronica J Poitras
- Healthy Active Living and Obesity Research Group, RI #1, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
| | - Casey E Gray
- Healthy Active Living and Obesity Research Group, RI #1, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Xanne Janssen
- University of Strathclyde, School of Psychological Science and Health, G1 1QE, Glasgow, Scotland, UK
| | - Salome Aubert
- Healthy Active Living and Obesity Research Group, RI #1, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Valerie Carson
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada
| | - Gary S Goldfield
- Healthy Active Living and Obesity Research Group, RI #1, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - John J Reilly
- University of Strathclyde, School of Psychological Science and Health, G1 1QE, Glasgow, Scotland, UK
| | - Margaret Sampson
- Healthy Active Living and Obesity Research Group, RI #1, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.,Library and Media Services, Children's Hospital of Eastern Ontario, Ottawa, ON, K1H 8L1, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, RI #1, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
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Paudel S, Jancey J, Subedi N, Leavy J. Correlates of mobile screen media use among children aged 0-8: a systematic review. BMJ Open 2017; 7:e014585. [PMID: 29070636 PMCID: PMC5665287 DOI: 10.1136/bmjopen-2016-014585] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 08/15/2017] [Accepted: 09/21/2017] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE This study is a systematic review of the peer-reviewed literature to identify the correlates of mobile screen media use among children aged 8 years and less. SETTING Home or community-based studies were included in this review while child care or school-based studies were excluded. PARTICIPANTS Children aged 8 years or less were the study population. Studies that included larger age groups without subgroup analysis specific to the 0-8 years category were excluded. Eight electronic databases were searched for peer-reviewed English language primary research articles published or in press between January 2009 and March 2017 that have studied correlates of mobile screen media use in this age group. OUTCOME MEASURE Mobile screen media use was the primary outcome measure. Mobile screen media use refers to children's use of mobile screens, such as mobile phones, electronic tablets, handheld computers or personal digital assistants. RESULTS Thirteen studies meeting the inclusion criteria were identified of which a total of 36 correlates were examined. Older children, children better skilled in using mobile screen media devices, those having greater access to such devices at home and whose parents had high mobile screen media use were more likely to have higher use of mobile screen media devices. No association existed with parent's age, sex and education. CONCLUSION Limited research has been undertaken into young children's mobile screen media use and most of the variables have been studied too infrequently for robust conclusions to be reached. Future studies with objective assessment of mobile screen media use and frequent examination of the potential correlates across multiple studies and settings are recommended. TRIAL REGISTRATION NUMBER This review is registered with PROSPERO International Prospective Register of Ongoing Systematic Reviews (registration number: CRD42015028028).
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Affiliation(s)
- Susan Paudel
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Narayan Subedi
- Department of Community Medicine and Public Health, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Justine Leavy
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), School of Public Health, Curtin University, Perth, Western Australia, Australia
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A qualitative study conducted in the USA exploring Latino fathers' beliefs, attitudes and practices related to their young children's eating, physical activity and sedentary behaviours. Public Health Nutr 2017; 21:403-415. [PMID: 28994358 DOI: 10.1017/s1368980017002579] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Increasing evidence documents fathers' influential role in their children's eating, physical activity (PA) and sedentary behaviours (SB). We aimed to expand limited existing research examining fathers' influence in these areas by exploring Latino fathers' beliefs, attitudes and practices related to eating, PA and SB of their young children. DESIGN Seven focus group discussions were conducted in Spanish with Latino fathers (n 28) of children aged 2-8 years. Audio recordings were transcribed and translated verbatim without identifiers. Data were analysed using thematic analysis to identify key concepts and themes using NVivo 11 software. RESULTS Fathers expressed positive beliefs and attitudes about the importance of healthy eating for their young children, themselves and their families. Nevertheless, the majority reported familial practices including eating out, getting take-out, etc. that have been linked to increased obesity risk among Latino children. Fathers were more involved and engaged in children's PA than eating and feeding. However, several fathers reported engaging predominantly in sedentary activities with their children, appeared permissive of children's sedentary habits and struggled to set limits on children's screen-time. CONCLUSIONS We provide new information on Latino fathers' beliefs and child feeding and PA practices that may provide important targets for interventions aimed at promoting healthful eating and PA behaviours of Latino children. Future research should further quantify the influence of Latino fathers' parenting styles and practices on development of children's eating, PA and SB. This information is needed to identify risk factors amenable to interventions and to design culturally appropriate parenting and family-based interventions targeting Latino children's home environment and designed to meet this ethnic group's specific needs.
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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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