Use of television, videogames, and computer among children and adolescents in Italy

The degree of association between overweight and obesity with the use of electronic media among Bangladeshi adolescents

BACKGROUND

Electronic media usage is recently considered a modifiable risk factor for overweight and obesity among adolescents. The purpose of this present study was to evaluate the association of electronic media (EM) usage with overweight and obesity among school-going adolescents.

METHODS

This cross-sectional study was conducted from October to December 2019 among school-going adolescents (14-16 years old) residing in the Jashore Sadar Upazila, Jashore district of Bangladesh. A standardized questionnaire was used to collect information regarding the socio-economic status, time spent watching television, video games playing, computer, and smart mobile phone use through face-to-face interviews. Age- and sex-specific body mass index (BMI) cut-off values for overweight and obesity were determined for Asian adolescents by the International Obesity Task Force (IOTF). Multinomial logistic regression analysis was carried out to determine the association between electronic media use with overweight and obesity.

FINDINGS

The findings suggest that the overall prevalence of overweight and obesity was 13.5% and 25.2%, respectively. Among the total adolescent students, about 49.1% highly (above 3 hours per day) spent their time on EM use whereas 30.6% moderately (≥121 to 180 min/day) use EM. The regression analysis showed that spending high time using total screen-based electronic devices, television viewing, video game playing, computer use, and smartphone use were significantly associated with overweight (RRR: 7.36, 95% CI: 3.64-11.54; RRR: 4.58, 95% CI: 1.46-7.95; RRR: 4.45, 95% CI: 2.75-6.12; RRR: 3.18, 95% CI: 1.87-4.70; RRR: 2.15, 95% CI: 1.23-3.51) and obesity (RRR: 8.72, 95% CI: 4.64-12.54; RRR: 2.89, 95% CI: 1.31-5.21; RRR: 3.88, 95% CI: 1.74-5.13; RRR: 3.08, 95% CI: 1.32-4.86; RRR: 1.19, 95% CI: 0.93-1.48) in adolescents, respectively.

CONCLUSION

The results support the total time spent using electronic media was associated with an increased risk of being overweight and obesity. Finally, this study strongly suggests the proper use of electronic media may be necessary to reduce the risk of being overweight and obesity in early adolescents.

Development of a consensus statement on the role of the family in the physical activity, sedentary, and sleep behaviours of children and youth

BACKGROUND

Children and youth who meet the physical activity, sedentary, and sleep behaviour recommendations in the Canadian 24-Hour Movement Guidelines are more likely to have desirable physical and psychosocial health outcomes. Yet, few children and youth actually meet the recommendations. The family is a key source of influence that can affect lifestyle behaviours. The purpose of this paper is to describe the process used to develop the Consensus Statement on the Role of the Family in the Physical Activity, Sedentary, and Sleep Behaviours of Children and Youth (0-17 years) and present, explain, substantiate, and discuss the final Consensus Statement.

METHODS

The development of the Consensus Statement included the establishment of a multidisciplinary Expert Panel, completion of six reviews (three literature, two scoping, one systematic review of reviews), custom data analyses of Statistics Canada's Canadian Health Measures Survey, integration of related research identified by Expert Panel members, a stakeholder consultation, establishment of consensus, and the development of a media, public relations, communications and launch plan.

RESULTS

Evidence from the literature reviews provided substantial support for the importance of family on children's movement behaviours and highlighted the importance of inclusion of the entire family system as a source of influence and promotion of healthy child and youth movement behaviours. The Expert Panel incorporated the collective evidence from all reviews, the custom analyses, other related research identified, and stakeholder survey feedback, to develop a conceptual model and arrive at the Consensus Statement: Families can support children and youth in achieving healthy physical activity, sedentary and sleep behaviours by encouraging, facilitating, modelling, setting expectations and engaging in healthy movement behaviours with them. Other sources of influence are important (e.g., child care, school, health care, community, governments) and can support families in this pursuit.

CONCLUSION

Family is important for the support and promotion of healthy movement behaviours of children and youth. This Consensus Statement serves as a comprehensive, credible, and current synopsis of related evidence, recommendations, and resources for multiple stakeholders.

Association between psychological distress and elevated use of electronic devices among U.S. adolescents: Results from the youth risk behavior surveillance 2009-2017

OBJECTIVE

The purpose of this study was to provide updated information about the prevalence and temporal trends of elevated use of electronic devices (EUED) in leisure time (i.e., 3 h or more on an average school day) in nationally representative samples of U.S. adolescents in recent years and to determine whether there is a significant association between EUED and psychological distress.

METHODS

We used the national Youth Risk Behavior Survey (YRBS) data from 2009, 2011, 2013, 2015, and 2017 (N = 75,807). Propensity score matching was used to reduce selection bias due to potential confounding factors with EUED. Ordinal logistic regression analyses were performed for the matched samples to predict the association between EUED and psychological distress.

RESULTS

The prevalence of EUED in U.S. youth has substantially increased from 24.9% in 2009 to 43.1% in 2017 (p < .001). Boys had higher rates of EUED than girls only in 2009 and 2011 but not in 2013, 2015, and 2017. A significant association between EUED and psychological distress was identified throughout all the five survey years. The odds of having a higher level of psychological distress increased approximately 1.5 times among youth with EUED than those without.

CONCLUSIONS

The prevalence of U.S. youth with psychological distress and EUED has increased simultaneously in the past several years. Future longitudinal studies are warranted to examine causal and/or reciprocal relationship between the two.

Musculoskeletal pain and musculoskeletal syndromes in adolescents are related to electronic devices

OBJECTIVE

To evaluate television and simultaneous electronic devices use in adolescents with musculoskeletal pain and musculoskeletal pain syndromes.

METHODS

A cross-sectional study was performed in 299 healthy adolescents of a private school. All students completed a self-administered questionnaire, including: demographic data, physical activities, musculoskeletal pain symptoms, and use of simultaneous television/electronic devices (computer, internet, electronic games, and cell phones). Seven musculoskeletal pain syndromes were also evaluated: juvenile fibromyalgia, benign joint hypermobility syndrome, myofascial syndrome, tendinitis, bursitis, epicondylitis, and complex regional pain syndrome.

RESULTS

Inter-rater agreement between pretest and retest was 0.83. Musculoskeletal pain and musculoskeletal pain syndrome were found in 183/299 (61%) and 60/183 (33%), respectively. The median age (15 [10-18] vs. 14 [10-18] years, p=0.032) and years of education (10 [5-12] vs. 9 [5-12] years, p=0.011) were significantly higher in adolescents with musculoskeletal pain when compared with those without this condition. The frequencies of female gender (59% vs. 47%, p=0.019), cell phone use (93% vs. 81%, p=0.003), and simultaneous use of at least two electronic devices (80% vs. 67%, p=0.011) were significantly higher in the former group. Further comparisons between adolescents with and without musculoskeletal pain syndromes revealed that the frequency of female gender was significantly higher in the former group (75% vs. 25%, p=0.002), and with a significantly reduced median of weekends/holidays electronic games use (1.5 [0-10] vs. 3 [0-17]h/day, p=0.006).

CONCLUSIONS

A high prevalence of musculoskeletal pain/syndromes was observed in female adolescents. Musculoskeletal pain was mostly reported at a median age of 15 years, and students used at least two electronic devices. Reduced use of electronic games was associated with musculoskeletal pain syndromes.

Socioeconomic Correlates of Sedentary Behavior in Adolescents: Systematic Review and Meta-Analysis

Background

The body of evidence on associations between socioeconomic status (SES) and sedentary behaviors in adolescents is growing.

Objectives

The overall aims of our study were to conduct a systematic review and meta-analysis of this evidence and to assess whether (1) the associations between SES and sedentary behavior are consistent in adolescents from low-middle-income and from high-income countries, (2) the associations vary by domain of sedentary behavior, and (3) the associations vary by SES measure.

Methods

We performed a systematic literature search to identify population-based studies that investigated the association between SES and sedentary behavior in adolescents (aged 10–19 years). Only studies that presented risk estimates were included. We conducted meta-analyses using random effects and univariate meta-regression and calculated pooled effect sizes (ES).

Results

Data from 39 studies were included; this provided 106 independent estimates for meta-analyses. Overall, there was an inverse association between SES and sedentary behavior (ES 0.89; 95 % confidence interval [CI] 0.81–0.98). However, the direction of the association varied: in high-income countries, SES was inversely associated with sedentary behavior (ES 0.67; 95 % CI 0.62–0.73), whereas in low-middle-income countries, there was a positive association between SES and sedentary behavior (ES 1.18; 95 % CI 1.04–1.34). In high-income countries, the associations were strongest for screen time (ES 0.68; 95 % CI 0.62–0.74) and television (TV) time (ES 0.58; 95 % CI 0.49–0.69), whereas in low-middle-income countries, the associations were strongest for ‘other’ screen time (i.e., computer, video, study time, but not including TV time) (ES 1.38; 95 % CI 1.07–1.79). All indicators of SES were negatively associated with sedentary behavior in high-income countries, but only resources (income and assets indexes) showed a significant positive association in low-middle-income countries.

Conclusion

The associations between SES and sedentary behavior are different in high- and low-middle-income countries, and vary by domain of sedentary behavior. These findings suggest that different approaches may be required when developing intervention strategies for reducing sedentary behavior in adolescents in different parts of the world.

Electronic supplementary material

The online version of this article (doi:10.1007/s40279-016-0555-4) contains supplementary material, which is available to authorized users.

Socioeconomic position and sedentary behavior in Brazilian adolescents: A life-course approach

Socioeconomic position (SEP) is a potential correlate of sedentary behavior in adolescents. The aim of this study was to examine the associations between SEP and self-reported and objective measures of sedentary behavior in adolescents, using a life-course approach. Data from the 1993 Pelotas (Brazil) Birth Cohort Study were analyzed (N=5249). Cross-sectional and longitudinal associations between multiple SEP indicators (maternal education, family income, SEP composite, cumulative family income) at birth, 11, 15 and 18years, and five sedentary behavior outcomes (≥4h/day screen time; ≥4h/day TV; ≥2h/day computer; ≥2h/day video game; ≥12.7h/day objectively measured sedentary time) at 11, 15 and 18years, were examined. In cross-sectional analyses, higher SEP was positively associated with more screen time at ages 11 and 15years. There was a consistent and positive association between higher SEP with time spent using a computer, and with sedentary time assessed through accelerometry. SEP at birth had a positive and direct effect on screen, computer and total sedentary time at 18years. Participants in the highest cumulative income group had higher odds of high sedentary behavior in screen (OR: 2.40; 95% CI: 1.50-3.54), computer (OR: 7.35; 95% CI: 4.19-12.89) and total sedentary time (OR: 5.40; 95% CI: 3.53-10.35), respectively, compared with their counterparts with lower cumulative income. Our findings showed that SEP is an early determinant of sedentary behavior in adolescents.

Facilitating Factors and Barriers to the Use of Emerging Technologies for Suicide Prevention in Europe: Multicountry Exploratory Study

BACKGROUND

This study provides an analysis on the use of emerging technologies for the prevention of suicide in 8 different European countries.

OBJECTIVE

The objective of this study was to analyze the potentiality of using emerging technologies in the area of suicide prevention based on the opinion of different professionals involved in suicide prevention.

METHODS

Opinions of 3 groups of stakeholders (ie, relevant professionals in suicide field) were gathered using a specifically designed questionnaire to explore dimensions underlying perceptions of facilitating factors and barriers in relation to the use of emerging technologies for suicide prevention.

RESULTS

Goal 1 involved facilitating factors for the use of emerging technologies in suicide prevention. Northern European countries, except for Belgium, attach greater relevance to those that optimize implementation and benefits. On the other hand, Southern European countries attach greater importance to professionally oriented and user-centered facilitating factors. According to different stakeholders, the analysis of these facilitating factors suggest that professionals in the field of social work attach greater relevance to those that optimize implementation and benefits. However, professionals involved in the area of mental health, policy makers, and political decision makers give greater importance to professionally oriented and user-centered facilitating factors. Goal 2 was related to barriers to the usability of emerging technologies for suicide prevention. Both countries and stakeholders attach greater importance to barriers associated with resource constraints than to those centered on personal limitations. There are no differences between countries or between stakeholders. Nevertheless, there is a certain stakeholders-countries interaction that indicates that the opinions on resource constraints expressed by different stakeholders do not follow a uniform pattern in different countries, but they differ depending on the country.

CONCLUSIONS

Although all countries and stakeholders agree in identifying resource constraints as the main barrier to the use of emerging technologies, factors facilitating their use in suicide prevention differ among countries and among stakeholders.

Video Gaming Disorder and Sport and Exercise in Emerging Adulthood: A Longitudinal Study

Among the negative consequences of video gaming disorder, decreased participation in sport and exercise has received little attention. This study aimed to assess the longitudinal association between video gaming disorder and the level of sport and exercise in emerging adult men. A questionnaire was completed at baseline and 15-month follow-up by a representative national sample of 4,933 respondents. The seven items of the Game Addiction Scale were used to construct a latent variable representing video gaming disorder. Level of sport and exercise was also self-reported. Cross-lagged path modeling indicated a reciprocal causality between video gaming disorder and the level of sport and exercise, even after adjusting for a large set of confounders. These findings support the need for better promotion of sport and exercise among emerging adults in order to contribute to the prevention of video gaming disorder, and to raise the level of sport and exercise activity in addicted gamers.

The problematic use of Information and Communication Technologies (ICT) in adolescents by the cross sectional JOITIC study

Background

The emerging field of Information and Communications Technology (ICT) has brought about new interaction styles. Its excessive use may lead to addictive behaviours.

The objective is to determine the prevalence of the problematic use of ICT such as Internet, mobile phones and video games, among adolescents enrolled in mandatory Secondary Education (ESO in Spanish) and to examine associated factors.

Methods

Cross sectional, multi-centric descriptive study. Population: 5538 students enrolled in years one to four of ESO at 28 schools in the Vallès Occidental region (Barcelona, Spain). Data collection: self-administered socio-demographic and ICT access questionnaire, and validated questionnaires on experiences related to the use of the Internet, mobile phones and video games (CERI, CERM, CERV).

Results

Questionnaires were collected from 5,538 adolescents between the ages of 12 and 20 (77.3 % of the total response), 48.6 % were females. Problematic use of the Internet was observed in 13.6 % of the surveyed individuals; problematic use of mobile phones in 2.4 % and problematic use in video games in 6.2 %.

Problematic Internet use was associated with female students, tobacco consumption, a background of binge drinking, the use of cannabis or other drugs, poor academic performance, poor family relationships and an intensive use of the computer.

Factors associated with the problematic use of mobile phones were the consumption of other drugs and an intensive use of these devices.

Frequent problems with video game use have been associated with male students, the consumption of other drugs, poor academic performance, poor family relationships and an intensive use of these games.

Conclusions

This study offers information on the prevalence of addictive behaviours of the Internet, mobile phones and video game use.

The problematic use of these ICT devices has been related to the consumption of drugs, poor academic performance and poor family relationships.

This intensive use may constitute a risk marker for ICT addiction.

Parental influences on adolescent video game play: a study of accessibility, rules, limit setting, monitoring, and cybersafety

Adolescents' video gaming is increasing at a rapid rate. Yet, little is known about what factors contribute toward more hours of gaming per week, as well as what factors may limit or protect adolescents from excessive gaming. The aim of the present study was to examine associations between adolescents' accessibility to video gaming devices, the locations played (i.e., bedroom, shared rooms), parental regulation of technology use, and the amount of hours spent video gaming during the week (weekdays vs. weekends). Adolescents (N=422; age 16.3±2.0 years, 41% male) completed an online questionnaire battery, including demographics, video gaming behaviors (e.g., hours played weekdays/weekends, time of day played, devices owned, locations played, etc.), and a questionnaire measuring aspects of parents' regulation of game playing (e.g., rules, limit setting, co-gaming). Accessibility to the adolescents' own devices, but not shared devices or device portability, was predictive of hours gaming on weekdays and weekends. Location (i.e., bedroom) was associated with increased gaming across the week. Parents discussing cybersafety was predictive of lower hours of gaming (weekdays and weekends). However, limit setting, monitoring, and co-gaming showed no significant effects. Adolescents' access to their own gaming equipped devices, as well as gaming in their bedrooms, were linked to increased hours of gaming. The findings suggest that in order to curb the increase in hours gaming, parents are advised to delay the ownership of adolescents' devices, encourage use in shared rooms, and discuss aspects of cybersafety with their teenage children.

Condições de vida, inatividade física e conduta sedentária de jovens nas áreas urbana e rural

RESUMO Introdução: Poucas evidências destacam aspectos das condições de vida em adolescentes residentes nas áreas urbana e rural. Objetivo: Verificar indicadores das condições de vida associados às prevalências do nível de atividade física abaixo das recomendações (NAFAR) e da exposição ao comportamento sedentário (ECS) em escolares de áreas urbanas e rurais de Sergipe, Brasil. Métodos: Realizou-se um estudo transversal de base escolar. Compuseram a amostra 3.992 escolares, com idade variando de 14 a 19 anos. Resultados: A prevalência de adolescentes com NAFAR foi de 77,5% (urbana 76%; rural 80%) e ECS de 46,7 % (urbana 50,2%; rural 41,2%). Em áreas urbanas, verificou-se a associação da ECS com o território, período de estudo, escolaridade materna, situação ocupacional do adolescente e renda familiar. O NAFAR associou-se com o fato de residir com o pai e com o trabalho do pai. Em áreas rurais, a ECS associou-se ao período de estudo, situação ocupacional do adolescente e a renda familiar. O NAFAR associou-se à situação ocupacional do adolescente. Conclusão: Os resultados mostraram que o NAFAR e a ECS estiveram relacionados a diferentes indicadores de condições de vida, sugerindo intervenções variadas considerando o local de residência.

Characteristics associated with media use in early adolescence

This study aimed to identify socioeconomic and behavioral characteristics associated with media use in early adolescence. The sample was comprised of 1,680 adolescents (884 girls and 796 boys) aged 13, attending private and public schools in Porto, Portugal, during 2003/2004. Adolescents completed questionnaires pertaining to demographic, social and behavioral characteristics, including the time spent watching television and playing computer games on week and weekend days. Logistic and proportional ordinal regressions showed that attending public schools, sleeping less time, using tobacco and presenting low levels of physical activity were factors associated with high media use. In boys living with one of their parents as well as living with younger and older parents were also associated with high media use. Besides the association with less healthier behaviours, we also found higher media use among adolescents from lower social classes and less structured families, which may increase their exposure to negative influence of the media.

Factors influencing the television viewing practices of Indian children

OBJECTIVES

To study the effect of socio-demographic factors, parental regulations and maternal television usage on the television viewing practices of Indian schoolchildren.

METHODS

Mothers of 6-12 y old children were interviewed using a pre-tested questionnaire at the pediatric outpatient. The television viewing practices of 405 schoolchildren with maternal television viewing and parental television rules were analyzed. Specific television viewing practices considered harmful in the present study were- viewing television >2 h, viewing television just prior to sleep (at bedtime), predominantly viewing general adult channels and using television as an aid to sleep.

RESULTS

35.8 % (n = 145) of the children viewed television for >2 h on schooldays. 20 % (n = 81) used television as sleep-aid. 28.1 % (n = 114) children had televisions in the room they slept. The frequency of parental television rules were with respect to: duration of viewing- 77.5 % (n = 314), timing of viewing- 63.7 % (n = 258), content- 35.6 % (n = 144). The children of families with the rule needing of parental permission to switch on the television [present in 34.8 % (n = 141) children] had lower harmful television viewing practices: duration of television viewing on schooldays >2 h (23.4 %, n = 33, P < 0.001); television viewed just before sleep (39 %, n = 55, P < 0.001); use of television as sleep-aid (12.1 %, n = 17, P = 0.003). 26.7 % (n = 108) of the mothers viewed television for >2 h. Linear regression analysis showed association between average television duration of children and average maternal television duration on schooldays (Beta = 0.246, t = 5.09, P < 0.001). Binary logistic regression analysis showed that harmful television viewing practices were significantly more in children with television in bedroom [OR = 7.49(4.19-13.38), P < 0.001]. It was reduced significantly by the parental rules on content viewed [OR = 0.41(0.23-0.72), P = 0.002]; need of permission to switch on television [OR = 0.31(0.18-0.53), P < 0.001] and a higher maternal education [OR = 0.29 (0.14-0.59), P = 0.001].

CONCLUSIONS

Lower maternal education, increased maternal television usage, presence of television in bedroom resulted in harmful television viewing practices among Indian children. The parental rules that were effective in countering these were the rule on content viewed and needing parental permission to switch on television.

Patterns of sedentary behavior and compliance with public health recommendations in Spanish adolescents: the AFINOS study

The aims of the present study were: (i) describe patterns of sedentary behavior in Spanish adolescents; and (ii) determine the proportion of adolescents that do not meet the public health recommendations for sedentary behavior. This study comprised 1,724 Spanish adolescents (882 girls), aged 13 to 16 years. Patterns of sedentary behavior (TV viewing, use of computer games, console games and surfing the Internet) were assessed using the HELENA sedentary behavior questionnaire. The total proportion of adolescents watching TV, using computer and console games, and surfing the internet for more than two hours daily was 24%, 9%, 7%, and 17%, respectively, on weekdays, and 50%, 22%, 16%, and 35%, respectively, on weekends. Over 63% of the adolescents from the study did not meet the recommendation for sedentary behavior (< 2 hours daily screen time) on weekdays and 87% did not comply with this recommendation on weekends. Since sedentary behavior plays a key role in adolescent health, public health interventions in Spain that take these factors into consideration are needed.

[Access and use of new information and telecommunication technologies among teenagers at high school, health implications. JOITIC Study]

OBJECTIVE

To determine ICT accessibility and use among the adolescents attending High School and to analyse related factors.

DESIGN

Cross-sectional multicentric study.

SETTING

High Schools participating in the Community Health «Salut i Escola» Programme.

PARTICIPANTS

5,538 students from first to fourth degree at 28 centres in the area of Barcelona.

MAIN MEASUREMENTS

Self administered questionnaire including sociodemographic information, ICT use and accessibility.

RESULTS

Missing answers were below 1% in all items except in school performance (3,13%); 48,6% were female, mean age 14years (range 11-20); 15,5% foreigners; 23% reported low school performance; 75,2% took extracurricular activities; 88,9% refers a good relationship with their parents. ICT access is homogeneously massive: 98% had a computer at home, 44,8% used it for two or more hours daily. 98,6% could access Internet, 47,2% without parental control. 90% owned a mobile phone (83% in first grade, 95% in fourth); 45,6% owned one before 12years old. Girls use it for social relationships and boys for playing. 68,4% played videogames, 36,5% for three or more hours a week and 66,8% without parental control. Their use decreases with age. The ICT parental control is associated with better school performance.

CONCLUSIONS

Our high scholars gain access to the ICT at younger ages and they use them in almost every aspect of their lives. There have been detected some gender differences in their use, as well as in the age of the users and between the type of school.

Differences in children and adolescents' ability of reporting two CVS-related visual problems

The present study examined whether children and adolescents can correctly report dry eyes and blurred distance vision, two visual problems associated with computer vision syndrome. Participants are 913 children and adolescents aged 6-17. They were asked to report their visual problems, including dry eyes and blurred distance vision, and received an eye examination, including tear film break-up time (TFBUT) and visual acuity (VA). Inconsistency was found between participants' reports of dry eyes and TFBUT results among all 913 participants as well as for all of four subgroups. In contrast, consistency was found between participants' reports of blurred distance vision and VA results among 873 participants who had never worn glasses as well as for the four subgroups. It was concluded that children and adolescents are unable to report dry eyes correctly; however, they are able to report blurred distance vision correctly. Three practical implications of the findings were discussed.

PRACTITIONER SUMMARY

Little is known about children's ability to report their visual problems, an issue critical to diagnosis and treatment of children's computer vision syndrome. This study compared children's self-reports and clinic examination results and found children can correctly report blurred distance vision but not dry eyes.

A place for play? The influence of the home physical environment on children's physical activity and sedentary behaviour

The home environment is an important influence on the sedentary behaviour and physical activity of children, who have limited independent mobility and spend much of their time at home. This article reviews the current evidence regarding the influence of the home physical environment on the sedentary behaviour and physical activity of children aged 8–14 years. A literature search of peer reviewed articles published between 2005 and 2011 resulted in 38 observational studies (21 with activity outcomes, 23 with sedentary outcomes) and 11 experimental studies included in the review. The most commonly investigated behavioural outcomes were television watching and moderate to vigorous physical activity. Media equipment in the home and to a lesser extent the bedroom were positively associated with children’s sedentary behaviour. Physical activity equipment and the house and yard were not associated with physical activity, although environmental measures were exclusively self-reported. On the other hand, physical activity equipment was inversely associated with sedentary behaviours in half of studies. Observational studies that investigated the influence of the physical and social environment within the home space, found that the social environment, particularly the role of parents, was important. Experimental studies that changed the home physical environment by introducing a television limiting device successfully decreased television viewing, whereas the influence of introducing an active video game on activity outcomes was inconsistent. Results highlight that the home environment is an important influence on children’s sedentary behaviour and physical activity, about which much is still unknown. While changing or controlling the home physical environment shows promise for reducing screen based sedentary behaviour, further interventions are needed to understand the broader impact of these changes. Future studies should prioritise investigating the influence of the home physical environment, and its interaction with the social environment, on objectively measured sedentary time and home context specific behaviours, ideally including technologies that allow objective measures of the home space.

General and specific approaches to media parenting: a systematic review of current measures, associations with screen-viewing, and measurement implications

BACKGROUND

Parent-focused interventions may help to reduce youth screen-viewing (SV). This review synthesized current information on the links between parenting styles, parenting practices, and youth SV with a focus on measurement.

METHODS

A systematic review of electronic databases was conducted.

RESULTS

In all, 29 of 1189 studies met the inclusion criteria. Parenting practices were divided into rule and nonrule-based practices. Seven rules: (1) Limits on total time (n studies=23); (2) limits on time of day (n=7); (3) content restriction (n=11); (4) mealtime rules (n=2); (5) parental supervision (n=3); (6) contingent screentime (n=3); and (7) no-TV policy (n=1) were reported. Two nonrule-based practices were reported: Co-viewing (n=6) and encouragement to view (n=2). Three studies (10.3%) provided information on parenting styles. Only 12 studies (41.4%) provided information on the reliability/validity of the outcome measure, 15 (51.7%) studies provided information on the reliability/validity of the parenting measure, and 6 (20.7%) provided information on the reliability/validity of both outcome and exposure measures.

CONCLUSIONS

There is mixed evidence that parenting styles and media-related parenting practices are associated with youth SV. The assessment of parental influence of youth media use is hampered by the diversity of measures that have been used. There is a need for new measures that assess a range of media parenting practices that are relevant to multiple forms of SV.

Factors associated with media use among adolescents: a multilevel approach

BACKGROUND

During the last few years, several studies have reported a high screen time use among adolescents that can be related to negative health effects. The aims of this study were to describe screen time use among secondary school students and to identify individual- and school-level factors associated with media use.

METHODS

A cross-sectional study based on a self-reported questionnaire was performed among a representative sample of 2675 secondary school students (13-19 years old). Adolescents reported the amount of time spent viewing television, playing videogames and using the computer as well as other health-related behaviours and attitudes. Multilevel analysis was carried out and prevalence ratios were calculated to determine the association between media use and related factors.

RESULTS

Around 50% of the students reported watching television for ≥2 h/day during weekdays. Boys reported playing videogames for ≥2 h/weekday much more often than girls (14.6 and 1.5%, respectively). 68.2% of boys and 61.7% of girls reported using the computer for ≥2 h/weekday. In the multilevel analysis, the main factors associated with screen-related sedentary behaviours were attending schools from a low socio-economic status neighbourhood, eating unhealthy food and not reading books frequently.

CONCLUSION

The prevalence of adolescents reporting an excessive use of media devices is high, especially among students attending schools from deprived areas. Interventions to reduce screen time among adolescents may be necessary to reduce the risk of some metabolic and cardiovascular diseases such as being overweight and obesity in late adolescence or early adulthood.

Youth and New Media

The prevalence of digital media use among children and adolescents is indisputable. One medium to which children and adolescents dedicate a sizeable portion of their time is that of the digital game. Accordingly, digital game play continues to grow as a context for cognitive development. We showcase new research and practice addressing the impact of this very popular activity on children’s and adolescents’ learning. Our goal is to stimulate new research and interest in examining the positive ramifications of digital play for development among today’s youth.

Electronic screen use and mental well-being of 10-12-year-old children

BACKGROUND

Today's children spend a great deal of time viewing electronic screen material, but the consequences of such behaviors, if any, are unknown. This study sought to identify (i) the magnitude of total daily electronic screen time and (ii) the relations between electronic screen use and mental well-being indicators, in a sample of 10-12-year-old children.

METHODS

We analysed cross-sectional, population-based data of 10-12-year-old children from the 2007 Youth in Iceland school survey (n = 10,829, response rate: 81.7%, boys: 50.5%). Logistic regression models with odds ratios and 95% confidence intervals were conducted to assess the odds of each selected mental well-being indicator, depending on the number of daily hours spent on each electronic screen-based activity. All analyses were conducted separately for boys and girls and adjusted for family structure.

RESULTS

The prevalence of self-reported screen use of 4 hours per day or more ranges from 2.8% to 6.6% among boys and from 1.0% to 3.8% among girls. All five screen-based activities were significantly associated with all seven well-being indicators (P < 0.001) with symptoms being more common with increased time spent on screen use.

CONCLUSIONS

This study is the first of its kind to demonstrate a dose-response relationship between electronic screen use and mental well-being in 10-12-year-old children. Further research is needed to assess the validity and potential implications of these findings.

Low diversity and low frequency of participation in leisure activities compromise working memory efficiency in young adults

People perform leisure activities (LA) every day; pursuits that entail applying cognitive, physical and social abilities. As in old age, doing LA during early and middle adulthood is related to a reduced risk of dementias, probably by generating a cognitive reserve. As it is possible that a relation between doing LA and working memory (WM) efficiency exists in young adults, we assessed whether the diversity and frequency of LA are related to WM efficiency in this population. Ninety-three healthy young subjects solved the n-back task at two levels of difficulty (2, 3), and answered an LA questionnaire on the activities in which they had participated in the month prior to the experiment. Subjects were classified separately on their scores for (1) diversity (high/low) and (2) frequency (high/low) in order to test the relation between each variable and WM efficiency. Though no differences were found, a subsequent analysis of the average of diversity and frequency ratios of LA performance taken together-the diversity/frequency index-showed that low diversity plus low frequency was significantly associated with reduced WM efficiency at this age; results that suggest that frequent participation in diverse LA during youth is related to WM efficiency.

Physical activity, sedentary behaviors and dietary habits among Saudi adolescents relative to age, gender and region

BACKGROUND

Few lifestyle factors have been simultaneously studied and reported for Saudi adolescents. Therefore, the purpose of the present study was to report on the prevalence of physical activity, sedentary behaviors and dietary habits among Saudi adolescents and to examine the interrelationships among these factors using representative samples drawn from three major cities in Saudi Arabia.

METHODS

This school-based cross-sectional study was conducted during the years 2009-2010 in three cities: Al-Khobar, Jeddah and Riyadh. The participants were 2908 secondary-school males (1401) and females (1507) aged 14-19 years, randomly selected using a multistage stratified sampling technique. Measurements included weight, height, sedentary behaviors (TV viewing, playing video games and computer use), physical activity using a validated questionnaire and dietary habits.

RESULTS

A very high proportion (84% for males and 91.2% for females) of Saudi adolescents spent more than 2 hours on screen time daily and almost half of the males and three-quarters of the females did not meet daily physical activity guidelines. The majority of adolescents did not have a daily intake of breakfast, fruit, vegetables and milk. Females were significantly (p < 0.05) more sedentary, much less physically active, especially with vigorous physical activity, and there were fewer days per week when they consumed breakfast, fruit, milk and diary products, sugar-sweetened drinks, fast foods and energy drinks than did males. However, the females' intake of French fries and potato chips, cakes and donuts, and candy and chocolate was significantly (p < 0.05) higher than the males'. Screen time was significantly (p < 0.05) correlated inversely with the intake of breakfast, vegetables and fruit. Physical activity had a significant (p < 0.05) positive relationship with fruit and vegetable intake but not with sedentary behaviors.

CONCLUSIONS

The high prevalence of sedentary behaviors, physical inactivity and unhealthy dietary habits among Saudi adolescents is a major public health concern. There is an urgent need for national policy promoting active living and healthy eating and reducing sedentary behaviors among children and adolescents in Saudi Arabia.

Associations between media consumption habits, physical activity, socioeconomic status, and glycemic control in children, adolescents, and young adults with type 1 diabetes

OBJECTIVE

To evaluate the relationship between media consumption habits, physical activity, socioeconomic status, and glycemic control in youths with type 1 diabetes.

RESEARCH DESIGN AND METHODS

In the cross-sectional study, self-report questionnaires were used to assess media consumption habits, physical activity, and socioeconomic status in 296 children, adolescents, and young adults with type 1 diabetes. Clinical data and HbA(1c) levels were collected. Risk factors were analyzed by multiple regression.

RESULTS

Youths with type 1 diabetes (aged 13.7 ± 4.1 years, HbA(1c) 8.7 ± 1.6%, diabetes duration 6.1 ± 3.3 years) spent 2.9 ± 1.8 h per day watching television and using computers. Weekly physical activity was 5.1 ± 4.5 h. Multiple regression analysis identified diabetes duration, socioeconomic status, and daily media consumption time as significant risk factors for glycemic control.

CONCLUSIONS

Diabetes duration, socioeconomic status, and daily media consumption time, but not physical activity, were significant risk factors for glycemic control in youths with type 1 diabetes.

Physical activity and sedentary behaviours in Greek-Cypriot children and adolescents: a cross-sectional study

Background

There are no data on physical activity and sedentary behaviours of Greek-Cypriot children and adolescents, and no study to date examined the association between these two behaviours in this population. The purpose of this study was to document the prevalence of physical activity and sedentary behaviours among Greek-Cypriot adolescents and examine the association between physical activity and a range of sedentary behaviours. Logistic regression analyses were performed to examine the association between physical activity and sedentary behaviours.

Methods

A cross-sectional study among 1,966 Greek-Cypriot children and adolescents was conducted in 2008/2009. Data were collected by means of a questionnaire across primary, middle, high and technical/vocational schools.

Results

Overall 52.3% and 52.4% of the participants met physical activity and television viewing guidelines respectively. Boys and younger children were more likely to meet guidelines. Boys who attended sports clubs for two or more times per week were more likely to be physically active (OR = 3.4), and those who listened to music for one or less than one hour per day were less likely to be physically active (OR = 0.6). Girls who attended sports clubs for two or more times per week and who watched television for two or less than two hours per day were more likely to be physically active, (OR = 3.0 and OR = 1.5 respectively). Girls who reported travelling by car/bus/motorbike for one or less than one hour per day were more likely to actively travel to school (OR = 1.8).

Conclusions

Findings from this study provide limited support for the displacement hypothesis whereby sedentary behaviours displace physically active time. About 50.0% of Greek children and adolescents in Cyprus meet existing physical activity and television viewing guidelines. Encouraging children to attend sports clubs for at least two times per week may markedly improve their physical activity levels.