Beyond Screen Time: Assessing Recreational Sedentary Behavior among Adolescent Girls

Adherence to Combined Healthy Movement Behavior Guidelines among Adolescents: Effects on Cardiometabolic Health Markers

Background: The combined movement behavior guidelines for adolescents recommend ≥60 min of moderate to vigorous physical activity, ≤2 h of screen time, and 8–10 h of sleep. Considering that the information available on this topic in the young Latin American population is rare, this study aimed to identify the proportion of a sample of Brazilian adolescents meeting individual guidelines as well as the combination of the three healthy movement behavior guidelines. In addition, another objective of the study was to examine the effects of compliance with these guidelines on cardiometabolic health markers. Methods: This is a cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire with structured questions was applied to collect data on physical activity, screen time, and sleep duration. Cardiometabolic health was assessed by the calculation of a continuous risk score, including twelve markers related to body fat, blood pressure, plasma lipids and lipoproteins, glycemia, and insulin. Results: Only 4.8% (4.3–5.4) of the adolescents met the three healthy movement behavior guidelines, while 9.3% (8.4–10.4) of the sample did not meet any of the guidelines. No significant difference between sexes was found in the simultaneous compliance of the three movement guidelines. Adolescents who did not meet any of the movement guidelines were twice as likely to have higher cardiometabolic risk (OR = 2.05 (1.41–3.17)) than their peers who met all three guidelines. Conclusions: Considering the high proportion of adolescents who did not meet the movement behavior guidelines and the negative effects on cardiometabolic health, it is suggested that future policies and interventions should consider an integrated and holistic approach aimed at simultaneous actions of maximizing physical activity, minimizing screen time, and ensuring sufficient sleep duration.

Adherence to 24-Hour Movement Guidelines among Spanish Adolescents: Differences between Boys and Girls

Background: The 24-Hour Movement Guidelines for adolescents recommend ≥60 min/day of moderate-to-vigorous physical activity (PA), ≤ 2 h/day of screen time, and 8–10 h/day of sleep. Since little information is available on the 24-Hour Movement Guidelines in Spanish adolescents, this study aims to estimate the proportion of Spanish adolescents meeting individual and combinations of these 24-Hour Movement Guidelines. Moreover, another aim of this study is to examine gender differences in compliance with 24-Hour Movement Guidelines. Methods: A final sample of 1465 Spanish adolescents (44.50% girls; 13.08 ± 0.86) participated in this cross-sectional study. The 24-Hour Movement Guidelines were measured during weekdays and the weekend days by self-reported questionnaires. Results: Although most adolescents met sleep duration guidelines (81.3%), only 38% and 15.8% met physical activity and screen time guidelines, respectively. Only 5.4% of these adolescents met all three 24-Hour Movement Guidelines, whereas 10.2% of this sample did not meet any of these guidelines. Although boys reported greater compliance with physical activity recommendations and girls with screen time recommendations, no significant gender differences were found in the compliance of all three 24-Hour Movement Guidelines. Conclusion: Given that 94.4% of Spanish adolescents did not meet 24-Hour Movement Guidelines, promoting all these three movement behaviours in both boys and girls is an urgent public health priority.

National Adolescent School-based Health Survey - PeNSE 2015: Sedentary behavior and its correlates

OBJECTIVE

To investigate the association between sedentary behavior (SB) and sociodemographic, social support, behavioral, and health variables among Brazilian adolescents.

METHODS

The 2015 National Adolescent School-based Health Survey (PeNSE) was a cross-sectional study consisting of 102,072 Brazilian ninth-graders (mainly aged 13-15 years). SB was defined as the time (in hours) watching television, using a computer, playing video games, talking to friends, or doing other activities in a sitting position. For analysis purposes, SB was categorized into different cut-offs as per the sample distribution quartiles: >2 versus <2 (25th percentile); >4 versus <4 (50th 26 percentile) and >6 versus <6 (75th 27 percentile). We employed Poisson univariate and multivariate regression analyses with robust variance and hierarchical entry of variables for each cut-off point.

RESULTS

The prevalence rates of each SB cut-off point were 68.15% (CI: 67.44-68.86), 44.15% (CI: 43.40-44.90) and 24.97% (CI:24.37-25.57) for >2, >4 and >6 hours, respectively. The following characteristics were positively and significantly associated with each SB cut-off point in the final models: females, current employment, higher household economic status and higher maternal schooling, lower levels of parents checking homework, tobacco and alcohol use, soft drink and fruit consumption, and regular, poor or very poor self-assessed health status. Conversely, students who self-declared brown were less likely to be classified as a SB cut-off point. Significant associations with age, report of close friends, and physical activity varied by different SB cut-off points.

CONCLUSION

Understanding the SB correlates in their different dimensions contributes to the identification of subgroups of adolescents with higher SB prevalence, which is crucial in the development and improvement of public policies. The demographic and behavioral characterization of these groups can guide the development of future intervention strategies, considering the school and family contexts of these adolescents.

Perception of neighborhood safety and screen time in adolescents from Curitiba, Brazil

OBJECTIVE

To analyze the association between perceptions of neighborhood safety (PNS) and screen time among adolescents and to assess the moderating effects of sex, age and socioeconomic status.

METHODS

A cross-sectional study with school survey was conducted in Curitiba, Brazil. First, six schools (three public and three private) were intentionally selected. Next, one class within each educational level (from the sixth year of elementary school to the third year of high school) was randomly selected. PNS was assessed using a NEWS-Y scale, and daily screen time was defined as the time spent watching TV/videos/DVDs, playing video games and using the Internet. Multinomial logistic regression models were used to test the association between PNS and screen time, adjusting for the confounding variables.

RESULTS

The sample included 776 adolescents (boys and girls), aged between 11 and 18 years old. Perceived crime was associated with time playing video games among older teenagers (p < 0.05). Pedestrian and traffic safety was inversely associated with time playing video games among adolescents with high socioeconomic status (p < 0.05).

CONCLUSION

The association between PNS and screen time is complex among adolescents and varies according to sociodemographic variables and the screen time outcome (TV/videos/DVDs, video games and the Internet).

Factors Associated with Screen Time in Iranian Children and Adolescents: The CASPIAN-IV Study

BACKGROUND

Prolonged screen time is frequent in children and adolescents. Implementing interventions to reduce physical inactivity needs to assess related determinants. This study aims to assess factors associated with screen time in a national sample of children and adolescents.

METHODS

This nationwide study was conducted among 14,880 students aged 6-18 years. Data collection was performed using questionnaires and physical examination. The World Health Organization-Global School Health Survey questionnaire was used. Logistic regression analysis was used to examine the relationship between demographic variables, socioeconomic status (SES), family structure, physical activity, unhealthy eating habits, body mass index, and mental distress with screen time.

RESULTS

The participation rate was 90.6% (n = 13,486), 50.8% were male, and 75.6% lived in urban areas. Mean (standard deviation) age of participants was 12.47 (3.36) years. The SES, eating junk foods, urban residence, and age had significant association with screen time, watching television (TV), and computer use (P < 0.05). With increasing number of children, the odds ratio of watching TV reduced (P < 0.001). Statistically, significant association existed between obesity and increased time spent watching TV (P < 0.001). Girls spent less likely to use computer and to have prolonged screen time (P < 0.001). Participants in the sense of worthlessness were less likely to watch TV (P = 0.005). Screen time, watching TV, and using computer were higher in students with aggressive behaviors (P < 0.001); screen time was higher in those with insomnia.

CONCLUSIONS

In this study, higher SES, unhealthy food habits, and living in urban areas, as well as aggressive behaviors and insomnia increased the risk of physical inactivity.

Relationship between attention-deficit/hyperactivity disorder and sedentary behavior in adolescence: a cross-sectional study

Existing studies reveal that high levels of sedentary behavior are associated with more inattention and hyperactivity problems. Since most previous studies used screen time as an indicator of sedentary behavior and assessed symptoms of attention-deficit/hyperactivity disorder (ADHD) by short screening measures which do not allow to distinguish between subtypes of ADHD, the current study aimed to investigate association between different types of sedentary behavior and symptoms and subtypes of ADHD. The current cross-sectional study analyzed data of 913 students (46.1% girls) aged 13-17 years (M = 15.0, SD = 0.6). Using a self-administered questionnaire, screen-based and non-screen-based sedentary behavior and ADHD symptoms were assessed. Linear and logistic regression analyses were conducted. All analyses were adjusted for age, gender, moderate to vigorous physical activity and body mass index. Screen time was related to the total ADHD score (p < 0.001) as well as to the subscales inattention (p ≤ 0.016) and hyperactivity/impulsivity (p ≤ 0.008). Sedentary time without screens was virtually not associated with ADHD. As far as ADHD symptoms are considered as a correlate of sedentary behavior, the type of activity which is pursued sedentarily seems to matter: screen time, but not other non-screen-based sedentary activities should be considered as being a risk factor for ADHD.

[Prevalence of excessive screen time and associated factors in adolescents]

OBJECTIVE

To determine the prevalence of excessive screen time and to analyze associated factors among adolescents.

METHODS

This was a cross-sectional school-based epidemiological study with 2,874 high school adolescents with age 14-19 years (57.8% female) from public and private schools in the city of João Pessoa, PB, Northeast Brazil. Excessive screen time was defined as watching television and playing video games or using the computer for more than two hours per day. The associated factors analyzed were: sociodemographic (gender, age, economic class, and skin color), physical activity and nutritional status of adolescents.

RESULTS

The prevalence of excessive screen time was 79.5% (95%CI: 78.1-81.1) and it was higher in males (84.3%) compared to females (76.1%; p<0,001). In multivariate analysis, adolescent males, aged 14-15 years old, of higher economic classes had higher chances of exposure to excessive screen time. The level of physical activity and nutritional status of adolescents were not associated with excessive screen time.

CONCLUSIONS

The prevalence of excessive screen time was high and varied according to sociodemographic characteristics of adolescents. It is necessary to develop interventions to reduce the excessive screen time among adolescents, particularly in subgroups with higher exposure.