Associations between parental rules, style of communication and children's screen time

Prospective relationship between family screen time rules, obesogenic behaviours, and childhood obesity

Family screen use rules (FSRs) could plausibly protect against the development of childhood obesity, although the mechanisms underlying these protective effects remain largely unexplored. This research aimed to investigate prospectively the associations between exposure to FSRs at age 24 months, obesogenic behaviours (excessive screen time and short sleep duration) at age 45 months, and obesity at age 54 months. Additionally, a model proposing the mediating role of obesogenic behaviours in the association between FSRs and childhood obesity was tested. Data were obtained from 5733 children and their mothers participating in the 'Growing Up in New Zealand' study. Logistic regressions examined the association between three FSRs (rules on quality, quantity and timing of screen time, and different numbers of FSRs), obesogenic behaviours, and childhood obesity. Structural equation modelling (SEM) was applied to assess the potential mediating roles of obesogenic behaviours in the association between FSRs and zBMI. Neither exposure to individual nor all three FSRs was significantly associated with lower odds of obesity. However, protective effects of FSRs were observed concerning obesogenic behaviours. Exposure to individual or all three FSRs correlated with reduced odds of not meeting screen time and sleep duration recommendations. SEM analysis indicated no direct association between FSRs and zBMI; nevertheless, a significant indirect association was identified through the mediation of obesogenic behaviours. These findings suggest the potential benefits of promoting the adoption of FSRs as a promising population-based strategy to enhance child health behaviours and mitigate the risk of childhood obesity.

The impact of parental migration on screen exposure among children aged 1-66 months in rural China

BACKGROUND

Screen exposure, particularly recreational screen exposure, is an integral part of children's lives. However, little is known about how family factors influence children's excessive screen exposure, especially in the context of 69 million left-behind children experiencing parent-child separation in China. This study mainly concentrates on the correlation between parental migration, type of caregiver, depression and disciplinary practices of the caregiver and children's screen exposure, including average daily screen time (on weekdays or weekends) and screen content (recreational activities or learning activities).

METHODS

For a cross-sectional study, we collected data of family basic features, parental migration status and children's screen use in the past week from caregivers of 1,592 children aged 1-66 months in Anhui province. Children were classified into left-behind children (LBC), previously left-behind children (PLBC) and never left-behind children (NLBC) based on their parental migration. Multiple linear regression and binary logistic regression were used to identified the association between family factors and children's screen exposure.

RESULTS

Overall, PLBC had higher rates of screen exposure, as well as higher average daily exposure times, than NLBC and LBC. The results of logistic regression showed that PLBC had a higher likelihood of excessive screen use compared to NLBC (60 min/day, OR = 1.40, p < 0.05; 120 min/day, OR = 1.76, p < 0.05). The higher the score of disciplinary practices, the less time children spent on screens for entertainment (B = -3.37, p < 0.01).

CONCLUSIONS

Our findings provide insights into the risks of children's screen exposure in different contexts of parental migration. The study emphasizes the urgent need to pay attention to PLBC's screen use and to strengthen caregivers' discipline and supervision over children's screen exposure.

Associations between media parenting practices and early adolescent screen use

BACKGROUND

To assess the prevalence of various media parenting practices and identify their associations with early adolescent screen time and problematic social media, video game, and mobile phone use.

METHODS

Cross-sectional data from Year 3 of the Adolescent Brain Cognitive Development (ABCD) Study (2019-2022) that included 10,048 adolescents (12-13 years, 48.3% female, 45.6% racial/ethnic minorities) in the US were analyzed using multiple linear regression analyses adjusting for potential confounders.

RESULTS

Parent screen use, family mealtime screen use, and bedroom screen use were associated with greater adolescent screen time and problematic social media, video game, and mobile phone use. Parental use of screens to control behavior (e.g., as a reward or punishment) was associated with higher screen time and greater problematic video game use. Parental monitoring of screens was associated with lower screen time and less problematic social media and mobile phone use. Parental limit setting of screens was associated with lower screen time and less problematic social media, video game, and mobile phone use.

DISCUSSION

Parent screen use, mealtime screen use, and bedroom screen use were associated with higher adolescent problematic screen use and could be limited in a family media use plan. Parental monitoring and limiting of screen time are associated with less problematic screen use.

IMPACT STATEMENT

Although the American Academy of Pediatrics provides guidance for screen use for children 5-18 years, there is a paucity of evidence-based guidance for media parenting practices, specifically for early adolescents. In a diverse sample of 10,048 early adolescents across the US, we found cross-sectional associations between parent, mealtime, and bedroom screen use and higher adolescent problematic screen use. Parental monitoring and limiting of adolescent screen time were cross-sectionally associated with less problematic screen use in our analytic sample and may be incorporated into a family media use plan.

Family and developmental correlates of adolescent involvement in decision making about screen use

Objective

Assess how child involvement in making rules about screen time relates to age, child prosocial functioning, and amount of screen use.

Methods

NORC's AmeriSpeak Panel was used to recruit a nationally representative sample of parents or guardians of school-aged children (age 5-17) in the United States (n = 2084). Parents completed survey that included measures of screen time, child involvement in rule making about screen use, family functioning, and dimensions of child psychosocial functioning.

Results

Across all age categories, most families had some form of rules about the allowable amount of screen-based digital media for uses other than schoolwork: 86% of elementary school-aged children (ages 5 to 10), 81% of middle school-aged children (ages 11-13), and 61% of high school aged children (ages 14-17). Across all age groups, having rules was associated with fewer hours of screen time (elementary school: B = -1.31, 95% CI = -1.80 to -0.81, p < 0.001; middle school: B = -1.40, 95% CI = -2.20 to -0.59, p < 0.001; high school: B = -0.97, 95% CI = -1.68 to -0.27, p = 0.007). Child involvement in making rules was significantly greater for high school students as compared to elementary school students (ß=0.12, p < 0.001), and not associated with high school- or middle-school aged child screen time. Across all age groups, child involvement in making rules was associated with higher levels of prosocial functioning (elementary school: ß=0.07, p < 0.001; middle school: ß=0.19, p = 0.001; high school: ß=0.21, p < 0.001).

Conclusions

Child involvement in making rules about screen use may be an opportunity to strengthen developmentally important competencies, as part of a broader autonomy-supportive approach to parenting.

Change in screen time of preschool children according to parental attitudes during the COVID-19 pandemic with an online survey

The relationship between the change in the screen time of preschool children according to both parent-child characteristics and parental attitudes was investigated in an online study involving 403 mothers. Mothers completed a questionnaire on baseline characteristics and Parent Attitude Scale. Multiple logistic regression and generalized linear models revealed the associations. Change in screen time was grouped as "increase" and "no increase". 70% stated an increase in the screen time during the pandemic period. The overprotective score was low in the group with increased screen time after adjusting parental age, education, and working status, family type, number of the children, the enrolled child's age, gender, daily screen time before the pandemic, and caregiver of the child. The child having longer screen time also had higher risk for the history of an increase in screen time in the lockdown period. This situation shows a need for parental guidance for healthy screen use.

Effect of school lockdown due to the COVID-19 pandemic on screen time among adolescents in Hungary: a longitudinal analysis

Introduction

Studies indicate that due to school lockdown during the Coronavirus Disease 2019 (COVID-19) pandemic, screen time increased more steeply than pre-pandemic years. The aim of our study was to examine changes in screen time and its components (screen time spent on videos, games, homework, and other activities) of adolescents affected by COVID-19 school closures compared to controls from pre-pandemic years and to assess the effect of family structure and family communication.

Methods

Two sets of ninth-grader boys and girls transitioning into 10th grade were included in the analysis. The 'pre-COVID classes' (controls) completed the baseline survey in February 2018 and the follow-up survey in March 2019. 'COVID classes' (cases) completed the baseline survey in February 2020 (1 month before the COVID-19-related school lockdowns) and the follow-up survey in March 2021. Linear mixed models stratified by sex were built to assess the change in screen time over one year adjusted for family structure and communication.

Results

Our study population consisted of 227 controls (128 girls, 99 boys) and 240 cases (118 girls, 122 boys). Without COVID-19, overall screen time did not change significantly for boys, but there was a decrease in screen time for gaming by 0.63 h, which was accompanied by an increase of 1.11 h in screen time for other activities (consisting mainly of social media and communication). Because of the pandemic, all components increased by 1.44-2.24 h in boys. Girls' screen time and its components remained stable without school lockdown, while it increased for videos and homework by 1.66-2.10 h because of school lockdown. Living in a single-parent household was associated with higher, while better family communication resulted in lower screen time.

Discussion

Our results indicate that COVID-19-related school lockdowns modified the age-specific increase in screen time for boys and girls as well. This trend, however, may be counterbalanced by improving communication between family members.

Investigating the effects of autonomy-supportive parenting practices on Italian young adolescent students' motivation to defend victims of bullying: findings on the mediating roles of reactance, depression, anxiety, and stress

This study investigated the effect of autonomy-supportive parenting practices on young adolescents' self-reported motivation to defend victims of bullying, and the possible mediating effects of factors such as reactance, anxiety, depression, and stress.

Methods

Data were collected from 578 Italian public school students ages 10-14 (M age = 11.8 years, 52% boys), who completed a survey in their classroom. The survey included self-report measures of parental orientation, motivation to defend victims of bullying, reactance, anxiety, depression, and stress.

Results

We found that autonomy-supportive parenting had a positive effect on autonomous motivation to defend, and that this effect was weakly mediated by reactance. Moreover, autonomy-supportive parenting had a negative effect on extrinsic motivation to defend, which was partially mediated by reactance. Reactance had a positive direct effect on extrinsic motivation to defend, but results also showed that anxiety, depression, and stress did not mediate the effect of autonomy-supportive parenting on motivation to defend. Additionally, autonomy-supportive parenting appeared to play a protective role, being associated with lower levels of reactance, anxiety, depression, and stress. Finally, gender differences were found in our sample, with extrinsic motivation to defend being more prevalent in boys, and autonomous motivation to defend being more prevalent in girls. Girls also reported higher levels of anxiety, depression, and stress, compared to boys.

Conclusion

Our findings show that autonomy-supportive parenting practices play a significant role in fostering young adolescents' motivation to defend victims of bullying, and that they are also linked with lower feelings of reactance, anxiety, depression, and stress. We argue that interventions aimed at contrasting bullying and cyberbullying among youths should seek to involve parents more and promote the adoption of more autonomy-supportive parenting practices, due to their consistently proven beneficial effects.

What happens when you are not on social networks? A survey among middle-school teens in Switzerland

AIM

The aim of the study was to describe the differences between users and non-users of social networks controlling for explanatory factors.

METHODS

Data were drawn from a survey on media and Internet use carried out among 2893 10th graders in Switzerland. Participants were asked whether they were active in 10 different social networks and divided into two groups: Not active (answering no to the 10 networks; n = 176) and Active (answering positively to at least one; n = 2717). The groups were compared on sociodemographic, health, and screen-related variables. All variables significant in the bivariate analysis were included in a backward logistic regression.

RESULTS

The backward logistic regression revealed that inactive participants were more likely to be males, younger, to live in an intact family, and to assess their screen time as below average, and less likely to practice extracurricular sport, to spend ≥4 h of screen time per day, to be around their smartphone at all times, to have parental rules about Internet content, or to discuss Internet use with parents.

CONCLUSION

Most young adolescents use social networks. However, this activity does not seem to be associated with academic problems. Therefore, the use of social networks should not be demonized but considered part of their social life.

The impact of media on children during the COVID-19 pandemic: A narrative review

Although mobile technologies are a fundamental part of daily life, several studies have shown increased use of electronic devices, TV, and gaming during childhood in conjunction with the COVID-19 pandemic. The virus affected almost every country, causing uncertainty about the future, social isolation, and distress. This narrative review has searched the scientific literature in the field focusing on children. A non-systematic literature review was conducted in May 2022. Various databases were employed to conduct the document research for this paper, such as "Google Scholar", "PubMed", "Web of Science". Keywords for the search included "screen time", "media", "digital use", "social media", "COVID-19", "pandemic", "lockdown", "children", "effect of media on children during COVID". It was found that both children and adolescents seem to have used technologies to confront struggles provoked by COVID-19, such as the onset or exacerbation of symptoms of anxiety, depression, and attention-deficit/hyperactivity disorder. However, moreover, other studies have suggested that increased media use can have positive effects on children depending on usage and monitoring by the parents.

Correlations between the screen time of children with special needs and their parent-child relationships, home participation, and occupational performance

This study aimed to examine the relationships between the screen time of children with special needs and of their parents with their home participation, occupational performance, and parent-child relationships according to sex and diagnosis. Parents of 150 children with special needs (age range, 4 to 6 years) such as autism spectrum disorder, cerebral palsy, and attention deficit hyperactivity disorder, as well as undiagnosed and developmentally risky children, were included. The Demographic Information Form, Screen Time Usage Form, Parent-Child Relationship Scale, Participation and Environment Measure for Children and Youth, and Short Child Occupational Profile were used for the data collection. There was a significant relationship between the screen time of girls and their parent-child relationships, home participation, and occupational performance. Moreover, we detected a relationship between the screen time of children with autism spectrum disorder and positive parent-child relationships, home participation, and occupational performance. Therapists should account for screen time in their interventions associated with parent-child relationships, home participation, and occupational performance.

Parent-based interventions to improve multiple lifestyle risk behaviors among adolescents: A systematic review and meta-analysis

Lifestyle risk behaviors often co-occur and are prevalent among adolescents. Parent-based interventions addressing risk behaviors concurrently have the potential to improve youth and parent outcomes. This systematic review evaluated the efficacy of parent-based interventions targeting multiple lifestyle risk behaviors among adolescents and parents. MEDLINE (Ovid), Embase (Ovid), PsycInfo (Ovid), Scopus, CINAHL, the Cochrane Database of Systematic Reviews (CDSR) and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from 2010-May 2021. Eligible studies were randomised controlled trials (RCTs) of parent-based interventions addressing 2+ risk behaviors: alcohol use, smoking, poor diet, physical inactivity, sedentary behaviors, and poor sleep. Studies directly targeting parents, and that assessed adolescent outcomes (11-18 years) were eligible. Where possible, random-effects meta-analysis was conducted. From 11,975 identified records, 46 publications of 36 RCTs (n = 28,322 youth, n = 7385 parents) were eligible. Parent-based interventions were associated with improved adolescent moderate-to-vigorous physical activity (MVPA) [Odds Ratio (OR) = 1.82, 95% CI = 1.18, 2.81; p = 0.007], and reduced screen time (SMD = -0.39, 95% CI = -0.62, -0.16, p = 0.0009) and discretionary food intake (SMD = -0.18; 95% CI = -0.30, -0.06; p = 0.002) compared to controls. However, there was some evidence that interventions increased the odds of ever using tobacco in the medium-term (OR = 1.47, 95% CI = 0.99, 2.18, p = 0.06) and of past month tobacco use in the long-term (OR = 1.46, 95% CI = 1.12, 1.90; p = 0.005). Overall, the quality of evidence was moderate. Parent-based interventions targeting multiple risk behaviors improved adolescent MVPA, and reduced screen time discretionary food intake. Further research is needed to address sleep problems and increase intervention efficacy, particularly for alcohol and tobacco use.

Problematic Child Media Use During the COVID-19 Pandemic

OBJECTIVES

Assess how family stressors (including structural stressors, social determinants of health inequities, and parent psychological distress) relate to media rule implementation and problematic child media use during the coronavirus disease 2019 pandemic.

METHODS

Nationally representative survey of 1000 United States parents with at least one 6 to 17 year old child was conducted in October through November 2020.

RESULTS

Problematic use was greater in families where parents were employed full time, present in the home (eg, working from home), had low levels or formal educational attainment, and were experiencing more psychological distress. Although there was a small decline in the number of media-related rules implemented during the pandemic (fewer parents enforced screen limits on weekdays or weekends or limited screen use at mealtimes), there was no association between rule implementation and problematic media use.

CONCLUSIONS

Family stressors were associated with problematic child media use during the coronavirus disease 2019 pandemic. As we emerge from the pandemic, it will be important to help parents adjust their family's media practices cognizant of the fact that additional children may have developed problematic screen use behaviors. Such efforts should center the role of structural and social determinants of health inequities on the stressors that families experience and that impact media use.

Mothers' Perceptions of Children's Screen Use During the COVID-19 Lockdown in Israel

The contemporary parenting challenge of regulating children's screen time became even more difficult during the coronavirus pandemic (COVID-19). The current research addresses the characteristics of this challenge and explores mothers' perceptions regarding their children's screen use, through two consecutive studies. Study 1 included 299 mothers of elementary school children, who were asked to complete questionnaires regarding their children's screen habits. Mothers were also asked about their own attitudes towards screens, as parents, and about their personal feelings of frustration and guilt. Study 2 replicated this procedure among a new sample of 283 mothers who also completed validated scales assessing their sense of parental competence and authority style. Retrospective reports of mothers indicated that, during the lockdown, entertainment use of screens increased by 73% among 4^th-6^th graders and by 108% among 1^st-3^rd graders. Educational use increased by 86% in both age groups. Mothers' guilt increased as well and was predicted by children's entertainment use (but not educational use), after accounting for demographic variables and mothers' attitudes. Other factors, such as parenting style and having at-least one child with a diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD), were associated with entertainment use (regardless of the COVID-19 lockdown). Factors that were found to moderate the lockdown effect were mothers' attitudes towards screens and parental confidence. The findings are discussed in the context of parents' efforts to regulate their children's screen use.

Risk and protective factors related to children's symptoms of emotional difficulties and hyperactivity/inattention during the COVID-19-related lockdown in France: results from a community sample

OBJECTIVE

The COVID-19 epidemic has spread worldwide since December 2019. To contain it, preventive measures including social distancing, economic shutdown, and school closures were introduced, carrying the risk of mental health burden in adults and children. Although the knowledge base regarding children's response to trauma and adverse events in general has broadened, descriptions of their mental health during epidemics remain scarce. In particular, the role of family socioeconomic characteristics and parental mental health are poorly understood.

METHODS

We assessed the correlates of children's emotional difficulties and symptoms of hyperactivity/inattention during the COVID-19 lockdown in a French community-based sample. Data came from 432 community-based parents (27-46 years, TEMPO cohort) and their children (mean age 6.8 ± 4.1) interviewed online. Children's symptoms of emotional difficulties and hyperactivity/inattention were assessed using the parent-reported Strengths and Difficulties Questionnaire during the 5th week of home confinement. Family socioeconomic characteristics and parental mental health and substance use were assessed weekly during the first 5 weeks of home confinement. Data were analyzed using logistic regression models.

RESULTS

7.1% of children presented symptoms of emotional difficulties and 24.7% symptoms of hyperactivity/inattention. Family financial difficulties and parental symptoms of anxiety and depression, as well as children's sleeping difficulties and screen time, were associated with the presence of psychological difficulties.

CONCLUSION

Children's emotional and behavioural difficulties are associated with parental mental health and socioeconomic difficulties. In the unprecedented situation of the COVID-19 epidemic, parents and professionals involved in caring for children should pay special attention to their mental health needs.

Recreational screen media use in Danish school-aged children and the role of parental education, family structures, and household screen media rules

Screen media use is part of most children's everyday lives, but organisations have advised that use should be limited. The aims of this study were to describe 6-11-year-old Danish children's screen device ownership and screen media use (weekdays and weekends), including the role of parental education, family structure and household screen media rules. We conducted a cross-sectional study including 5274 Danish children aged 6-11-years sampled from ten Danish municipalities from May 2019 to November 2020. Characteristics of the sample and source population were obtained from the Danish Health Data Authority. Parent's completed the SCREENS questionnaire, which was developed to assess children's screen media habits. We used inverse probability weighted logistic and linear regression models. Smartphone and laptop ownership was higher with increasing age, and use of screen media varied across day type, age and gender. The proportion of children using screen media more than 4 h/day was 13% (95% CI 12%;14%) for weekdays and 28% (95% CI 27%;29%) for weekend days. Children of parents with medium-length or long educations had statistically significant lower odds of using screen media more than 4 h/day. We found a statistically significant graded relationship between household screen media rules and children's screen media use; the less parents reported presence of rules, the more time their children spent on screen media engagements. Our results suggest that parental educational level and family structure are related to unfavourable screen media habits, and household screen media rules may play an important role for parents to limit children's screen use.

The Home Environment Interview and associations with energy balance behaviours and body weight in school-aged children - a feasibility, reliability, and validity study

BACKGROUND

The home environment is thought to influence children's weight trajectories. However, few studies utilise composite measures of the home environment to examine associations with energy balance behaviours and weight. The present study aimed to adapt and update a comprehensive measure of the obesogenic home environment previously developed for pre-schoolers, and explore associations with school-aged children's energy balance behaviours and weight.

METHODS

Families from the Gemini cohort (n = 149) completed the Home Environment Interview (HEI) via telephone when their children were 12 years old. The HEI comprises four composite scores: one for each domain (food, activity and media) of the environment, as well as a score for the overall obesogenic home environment. The primary caregiver also reported each child's height and weight (using standard scales and height charts), diet, physical activity and sedentary screen-based behaviours. A test-retest sample (n = 20) of caregivers completed the HEI a second time, 7-14 days after the initial interview, to establish test-retest reliability.

RESULTS

Children (n = 298) living in 'higher-risk' home environments (a 1 unit increase in the HEI obesogenic risk score) were less likely to consume fruits (OR; 95% CI = 0.40; 0.26-0.61, p < 0.001), and vegetables (0.30; 0.18-0.52, p < 0.001), and more likely to consume energy-dense snack foods (1.71; 1.08-2.69, p = 0.022), convenience foods (2.58; 1.64-4.05, p < 0.001), and fast foods (3.09; 1.90-5.04, p < 0.001). Children living in more obesogenic home environments also engaged in more screen-time (β (SE) = 4.55 (0.78), p < 0.001), spent more time playing video games (β (SE) = 1.56 (0.43), p < 0.001), and were less physically active (OR; 95% CI = 0.57; 0.40-0.80, p < 0.01). Additionally, there was a positive association between higher-risk overall home environment composite score and higher BMI-SDS (β (SE) = 0.23 (0.09), p < 0.01). This finding was mirrored for the home media composite (β (SE) = 0.12 (0.03), p < 0.001). The individual home food and activity composite scores were not associated with BMI-SDS.

CONCLUSION

Findings reveal associations between the overall obesogenic home environment and dietary intake, activity levels and screen-based sedentary behaviours, as well as BMI in 12 year olds. These findings suggest that the home environment, and in particular the home media environment, may be an important target for obesity prevention strategies.

The Association of Maternal Emotional Status With Child Over-Use of Electronic Devices During the COVID-19 Pandemic

The quarantine during the COVID-19 pandemic may generate high levels of maternal depression/anxiety, and maternal emotional status may affect child behavioral development. Online education during the pandemic may induce child over-use of electronic-devices. However, child electronic-device over-use (especially among children under 12 who are immature in physical and mental development) during the pandemic has not attracted sufficient attention, and the association of child over-use with maternal emotional status remains unknown. Therefore, this study aims to assess the characteristics of child electronic-device over-use and the association between maternal emotional status and child over-use among 1,300 children from nurseries (<3 years), kindergartens (3-6 years), and primary schools (6-12 years) in Shanghai and Wuhan during COVID-19. Mothers completed an online questionnaire (including the Self-Rating-Depression/Anxiety-Scales and Family-Environment-Scale). The use of electronic devices (mobile-phones, iPads, computers, and televisions) and online courses taken by the children were investigated. Associations of maternal emotional status with electronic-device-use by child age were analyzed. The proportions of children in nurseries, kindergartens and primary schools were 8.5, 44.5, and 47.0%, their percentages following online-courses were 24.5, 48.4, and 99.0%, and their rates of electronic-device over-use were 34.2, 62.2, and 93.4%, respectively. Significant associations were observed between higher maternal anxiety/depression levels and higher risks of mobile-phone/iPad over-use among preschoolers and primary-school students. Lower family intimacy and higher conflict levels were associated with higher maternal depression/anxiety levels and higher risks of electronic-device over-use. Our findings suggested that over-use of electronic-devices among children under 12 was common during COVID-19, especially among children ≥6 years, and online-teaching may exacerbate over-use. Maternal anxiety/depression levels were associated with over-use of portable internet-devices (mobile-phone/iPad), especially among preschoolers and school-aged students, and family environment may mediate the association. These findings may contribute to a better understanding of factors leading to over-use of electronic-device and developing strategies to decrease over-use during COVID-19.

Parental perceptions, attitudes and knowledge on European preschool children's total screen time: the ToyBox-study

BACKGROUND

Preschool children spend a significant proportion of their waking hours being sedentary. Parents play a critical role in developing and shaping their children's lifestyle behaviours, particularly in the early years of life. This study aims to assess parental perceptions, attitudes and knowledge of their preschool children's sedentary behaviours and the association with children's television (TV)/video/DVDs viewing and total screen time.

METHODS

Data were obtained from a sample of 4836 children (3.5-5.5 years), participating in the multi-centre ToyBox-study at baseline (T0) and at 1-year follow-up (T1) periods. Data on children's sedentary behaviours were collected via a standardized proxy-administered primary caregiver's questionnaire.

RESULTS

Regarding total screen time, 66.6% of the children at T0 and 71.8% at T1 in the control group exceeded the recommendations, whereas the proportion in the intervention group varied from 69.7% at T0 to 72.5% at T1. The odds of exceeding total screen time recommendations were significantly higher when parental perceptions towards limiting the total screen time were negative [(both T0 and T1 and in the intervention and control groups (P < 0.05)]. Similarly, the odds of exceeding TV/video/DVDs viewing recommendations were significantly higher (both T0 and T1 is observed in both groups) when parental knowledge of recommendation were absent.

CONCLUSIONS

Preschool children whose caregivers stated rules limiting their sedentary screen time were less likely to spend a high amount of time watching TV/video/DVDs. Interventions to increase parental practices may be a promising approach to decrease total screen time of preschool children but studies are needed to confirm this.

Predictors of Changes in Sleep Duration in Dutch Primary Schoolchildren: the ChecKid Study

BACKGROUND

Healthy sleep duration is essential to health and well-being in childhood and later life. Unfortunately, recent evidence shows a decline in sleep duration among children. Although effective interventions promoting healthy sleep duration require insight into its predictors, data on these factors are scarce. This study therefore investigated (i) which individual (lifestyle), social and cultural factors, and living conditions and (ii) which changes in these factors might be associated with the changes in sleep duration of Dutch primary schoolchildren observed over time.

METHOD

Data from the ChecKid study was used, a dynamic cohort study among 4-13-year-old children living in the city of Zwolle, the Netherlands. Associations between changes in sleep duration and individual (lifestyle) factors (i.e., age, sex, physical activity behavior, sugar-sweetened beverage consumption, screen behavior), social and cultural factors (i.e., parental rules, ethnicity), and living conditions (i.e., parental education, presence of screens in the bedroom, household size) were analyzed using multivariable linear regression.

RESULTS

A total of 1180 children participated, aged 6.6 ± 1.4 years in 2009. Mean sleep duration decreased from 11.4 ± 0.5 h/night in 2009 to 11.0 ± 0.5 h/night in 2012. Older children, boys, children who used screens after dinner, children with greater computer/game console use, and children whose parents had low levels of education had a greater decrease in sleep duration.

CONCLUSIONS

This article reports on one of the first large, longitudinal cohort studies on predictors of child sleep duration. The results of the study can inform future interventions aimed at promoting healthy sleep in primary schoolchildren.

Influence of technology usage on family communication patterns and functioning: A systematic review

The upsurge of technological advancement and the introduction of the internet has impacted face to face communication.

BACKGROUND

The advances in this field have gained much interest in implying increased technology usage on various psychosocial factors, mainly mental health and changing communication patterns in the family system.

METHODOLOGY

This paper provides a systematic review of the literature published between 1990-2020, examining the relationship between technology usage and its impact on family factors like communication and family relationships.

RESULTS

A database search was conducted using certain keywords, and in total, 20 papers were selected according to inclusion criteria. The results are categorized into domains of 1) technology use of the family, 2) family communication 3) family bonding 4) rules for technology use 5) boundaries maintained by the family members related to technology use.

CONCLUSION

The results indicate that technology usage in families is very high, and maximum daily communication happens through technology. Family leisure time, offline family bonding and communication is negatively affected due to technology use. A model was developed which has implications in the family psychiatry field and specifically in working with families having difficulties managing healthy use of technology.

Associations between Home Environment, Children's and Parents' Characteristics and Children's TV Screen Time Behavior

In Ireland, television (TV) screen time is a highly prevalent sedentary behavior among children aged less than five years. Little is known about the influence of parental rules and policies or screen time availability and accessibility within the home on children’s TV screen time behaviors. This cross-sectional study aimed to examine the extent to which parents’ sociodemographic and sedentary behaviors are associated with children’s TV screen time; and to determine the associations between parents’ rules and practices, home physical environment and children’s daily TV viewing. Three hundred and thirty-two children aged 3–5 years and their parents participated in the study. Children’s TV screen time and home environmental characteristics (parents’ rules and practices and the physical environment) were assessed using questions from standardized and validated questionnaires. The data were analyzed using binary logistic regression. Within the different sedentary behaviors evaluated, parents’ TV viewing was positively associated with children’s TV screen time (OR 1.65, 95%CI 1.09–2.50, p = 0.018). Leaving the TV on, whether or not it was being watched, was associated with a 38% increased probability of children watching ≥ 1 h TV daily. Children whose parents restricted their outdoor activity were more likely to watch ≥ 1 h TV daily (OR 2.01, 95%CI 1.04–3.88, p = 0.036). Findings from the study demonstrated that parents’ own screen time behaviors, leaving the TV on whether it was being watched or not and restricting outdoor play were associated with higher children’s TV viewing in the home environment. This knowledge is essential to inform future interventions aimed to address the increase in screen time among young children.

Home-based screen time behaviors amongst youth and their parents: familial typologies and their modifiable correlates

Background

Excessive screen time behaviors performed by children and parents at home is a major public health concern. Identifying whether child and parent screen time behaviors cluster and understanding correlates of these familial clusters can help inform interventions for the whole family. This study characterized familial typologies of screen time behaviors and identified key modifiable correlates of these typologies.

Methods

Parents participating in the cross-sectional Sitting in the Home (SIT) study reported the duration (mins/day) they and their child (aged 11.2 ± 2.62 years) spent in six screen time behaviors at home (computer/laptop for home/work, computer/laptop for leisure, TV/videos/DVDs, tablet/smart phone for home/work, tablet/smart phone for leisure, and electronic games) and completed items related to 21 potential correlates framed by an adapted Social Cognitive Theory, Family Perspective. Latent Class Analysis was used to identify typologies based on parent and child data for the six behaviors. Multinomial logistic regression analysis assessed the relative risk of typology membership for each potential correlate, adjusting for child and parent age and sex.

Results

The sample comprised 542 parent-child dyads (parents: 40.7 ± 6.3 yrs., 94% female; children: 11.2 ± 2.6 yrs., 46% female). Three typologies were identified: 1) high computer/moderate TV (n = 197); 2) high TV/tablet/smartphone, low computer (n = 135); and 3) low-screen users (n = 210). ‘Low-screen users’ spent the least amount of time in all screen time behaviors (assigned as reference category). Greater child preference for screen time behaviors, parental support for screen time behaviors and frequency of homework requiring a tablet/laptop were associated with higher odds of being in the ‘high computer/moderate TV’ typology. The odds of being in the ‘high TV/tablet/smartphone, low computer’ typology were greater amongst children with a higher preference for screen time behaviors, and lower among more active parents.

Conclusions

Three familial typologies of screen time behaviors were identified. The findings highlight that screen time in the home can be influenced by the home environment, parental behaviours and role modelling, child preferences as well as school policies. Findings can inform the development of family screen time interventions, however more research exploring the influence of factors outside of the home is warranted.

Sedentary Behaviors of a School Population in Brazil and Related Factors

Background. Overweight and obesity arise from a complex range of genetic, environmental, behavioral, educational, and socioeconomic factors. The present study explored the sedentary practices and some life habits related to health among children from the school population of Uruguaiana (Rio Grande do Sul, Brazil). Methods: A cross-sectional descriptive study was conducted to characterize the life habits of the school boys and girls from fourth grade (9-10 years old). Results: A total of 470 fourth-grade boys and girls (9-10 years old) participated in the study. As regards the variables linked to habits, 24% of the boys and girls answered they had not had breakfast the day they completed the questionnaire and 51.8% stated they did not have breakfast any given day of the week. Regarding sedentary habits, 25.3% of children watched TV or played video games five or more hours a day and 9% rarely played sports with their parents or caregivers. Statistical significance was recorded between "number of hours watching TV and playing video games" and "playing sports with parents or caregivers" (p < 0.05). Conclusions: Association between the times spent watching TV or playing video games and the practice of physical exercise in the family proves once again the importance of the family in education for the health of children. The school provides direct access to schoolchildren and their parents to launch numerous health education programs.

Positive mother-child interactions and parenting styles were associated with lower screen time in early childhood

AIM

This study examined long-term associations between mother-child interactions and parenting styles and electronic screen time.

METHODS

We studied 280 healthy children (53.2% girls) enrolled at a mean age of 36 ± 0.4 months from February 2015 to September 2016. The study included retrospective data on 267 children who had been recruited from medical facilities in Thailand at 6 months of age. Mother-child interaction, parenting styles and screen time were assessed at various ages and path analyses were performed to elucidate the directionality and relationships between the variables.

RESULTS

Increased mother-child interaction at 18 months of age was positively associated with less screen time at 2 and 3 years of age. Likewise, nurturing authoritative parenting at 3 years of age was directly related to lower media exposure at 4 years. The total screen time at younger ages had positive direct relationships with relaxed permissive and strict authoritarian parenting styles, but negative direct relationships with nurturing authoritative parenting in subsequent years.

CONCLUSION

Early mother-child interaction and nurturing authoritative parenting were associated with subsequent decreased screen time, while media exposure at the age of two was related to relaxed permissive and strict authoritarian parenting at 3 years of age.

Unrestricted prevalence of sedentary behaviors from early childhood

Background

Light and sedentary behaviors impose heavy challenges on societies. The objectives of this study are to identify child sedentary behaviors, and to examine the relationship between parent knowledge and behavioral style on children’s sedentary time in Iran.

Methods

This cross-sectional study was done among children and their parents selected randomly using multi-stage method, from 12 urban districts in Tabriz, Iran;2017. Data were collected through designing a multi-sectional questionnaire adopted from the Bjelland and previous studies to assess the time spent on sedentary behaviors among children/adolescents along with parent knowledge and behavioral style.

Results

From 480 children/adolescents and their parents 54.6% came from middle class families, and 55.62% were boys aged 2 to18. The percentage of time spent more than 120 min per day (min/d) on weekdays was for watching television (TV): (girls 24.4%, boys 21.0%), for playing computer and video games: (girls 38.7%, boys 54.7%), for electronic media communication (EMC): (girls 52.8%, boys 60.2%). The associated factors for watching TV: child age [12 years and above OR = 1.37; 95% CI = 0.53–3.54], parent knowledge [OR = 0.59, 95% CI = 0.35–0.99], and communicative styles [OR = 1.43, 95%CI = 1.11–1.86], and for playing computer and EMC: child age [5 years old and above OR = 4.83,95% CI =1.52–15.38, 12 years old and above OR = 13.76, 95% CI= 4.22–24.91], family socio-economic status [middle class OR = 2.52, 95% CI = 1.54–4.11, high class OR = 5.53, 95%CI = 1.80–15.89].

Conclusion

There is an urgent need to combat the unrestricted prevalence of sedentary behaviors among Iranian children/ adolescents who use computers and other electronic devices more than the recommended time every day from early childhood.

Parents should be provided with appropriate information about adverse effects of using electronic devices longer than recommended time by children. It is also essential to teach them beneficial communicative styles to monitor their children’s sedentary behaviors.

Screen time behaviour in a sample of 11- to 12-year-old Greek-Cypriot children: A cross-sectional study of parental and child reports

Objective:

This cross-sectional study examined the association between parental and child-reported correlates and children’s screen time.

Methods:

Children (N = 154) and their parents completed questionnaires examining correlates of screen time. Children recorded the time they devoted to screen-based and study-related sedentary activities and wore a pedometer for 6 days (four weekdays and two weekend days). Parents also provided information relating to the time their children devoted to screen time.

Results:

Children reported significantly higher time watching television and playing electronic games as well as higher total screen time during the weekend compared to weekdays. On the contrary, they reported significantly lower time doing homework and recorded significantly lower steps during the weekend compared to weekdays. The scale ‘Parent-child Television Viewing’ yielded significant associations with both parent and child-reported total screen time and television watching. Associations ranged from r = 0.193, p < 0.05 to r = 0.599, p < 0.001. The scales ‘Child Screen Time with Friends’ and ‘Friends’ Norms for Screen Time’ demonstrated significant associations with child-reported electronic games and total screen time, and with parent-reported electronic games and computer use. Associations ranged from r = 0.180, p < 0.05 to r = 0.478, p < 0.001. Variance explained for total screen time at the multivariate level ranged from 8% to 37% with the scale ‘Parent-child Television Viewing’ having significant associations with both parent and child-reported weekday total screen time.

Conclusions:

Obtaining data from both parents and children may provide further understanding of screen time behaviour. While parental factors appear to be consistently associated with children’s total screen time, studies may consider focusing more on parents to reduce time spent watching television, and more on friends to limit time spent in electronic games.

Informing Behaviour Change: What Sedentary Behaviours Do Families Perform at Home and How Can They Be Targeted?

Home-based interventions targeting children's sedentary behaviours have had limited and inconsistent effectiveness, possibly due to a mismatch between the behaviours targeted, the behaviours actually performed, and health-risk messages parents need to initiate change. Between October 2017-February 2018, 540 parents completed an online survey indicating their own and their child's participation in 15 home-based sedentary behaviours (child mean age 11.1 ± 2.61 years, 52% male; parent mean age 40.7 ± 6.14, 93% female). Parents also indicated which home-based sedentary behaviours they and their child could reduce, and what health-risk messages would make them change their child's behaviours. The most prevalent sedentary behaviours among children (particularly older children) and parents were screen-based leisure-time activities, specifically TV/video/DVD use (67.5 and 62.5 min/day, respectively) and using a tablet/smart phone for leisure (53.6 and 80.8 min/day, respectively). Importantly, these were also perceived as the most feasible behaviours parents and children could reduce. Parents reported that the following messages would help them reduce their child's sedentary behaviour: sitting may increase the risk of poor mental health (85.2% of parents) and adversely impact future health as an adult (85.1%). These findings highlight feasible behavioural targets and intervention content for programs aiming to reduce sedentary behaviours in the home environment. Further research is needed to test these strategies.

Sedentary Behaviors in Today's Youth: Approaches to the Prevention and Management of Childhood Obesity: A Scientific Statement From the American Heart Association

This scientific statement is about sedentary behavior and its relationship to obesity and other cardiometabolic outcomes in youth. A deleterious effect of sedentary behavior on cardiometabolic health is most notable for screen-based behaviors and adiposity; however, this relation is less apparent for other cardiometabolic outcomes or when sedentary time is measured with objective movement counters or position monitors. Increasing trends of screen time are concerning; the portability of screen-based devices and abundant access to unlimited programming and online content may be leading to new patterns of consumption that are exposing youth to multiple pathways harmful to cardiometabolic health. This American Heart Association scientific statement provides an updated perspective on sedentary behaviors specific to modern youth and their impact on cardiometabolic health and obesity. As we reflect on implications for practice, research, and policy, what emerges is the importance of understanding the context in which sedentary behaviors occur. There is also a need to capture the nature of sedentary behavior more accurately, both quantitatively and qualitatively, especially with respect to recreational screen-based devices. Further evidence is required to better inform public health interventions and to establish detailed quantitative guidelines on specific sedentary behaviors in youth. In the meantime, we suggest that televisions and other recreational screen-based devices be removed from bedrooms and absent during meal times. Daily device-free social interactions and outdoor play should be encouraged. In addition, parents/guardians should be supported to devise and enforce appropriate screen time regulations and to model healthy screen-based behaviors.

Parenting practices that may encourage and discourage physical activity in preschool-age children of Brazilian immigrant families: A qualitative study

Brazilians are a rapidly increasing Latino immigrant group in the United States (US), yet little research has examined factors influencing physical activity (PA) levels and behaviors of children growing up in Brazilian immigrant families. This information is needed to develop culturally sensitive interventions tailored to this population. Therefore, this qualitative study explored PA parenting practices used by Brazilian immigrant mothers living in the US. Thirty-seven Brazilian immigrant mothers with at least one child between the ages of 2 and 5 years participated in 1of 7 focus group discussions. Thematic analysis identified seven parenting practices that mothers employ that may encourage or facilitate physical activity their preschool-aged children's PA including: 1) modeling PA; 2) engaging and being physically active with child; 3) providing logistic support; 4) encouraging, praising, and offering motivational support; 5) watching, supervising, and teaching children how to engage in PA; 6) monitoring and setting limits to child's screen time; and 7) prompting child to be physically active. In addition, analysis identified four parenting practices that may discourage or inhibit children's PA including: 1) modeling of sedentary behaviors; 2) having rules and restrictions due to safety- and weather-related concerns; 3) limiting child's outdoor time due to parental time constraints; and 4) restricting child's outdoor and play time as punishment. Furthermore, analyses demonstrated that social contextual factors (e.g., income, housing, neighborhood safety, etc.) influence mothers' PA parenting practices and consequently, their children's PA. This is the first qualitative study, to our knowledge, to explore PA parenting practices of Brazilian-born immigrant mothers living in the US. Future research should further explore PA parenting practices of Brazilian immigrant parents including quantifying PA parenting practices that encourage and discourage PA, as well as examining the influence of fathers' PA parenting practices on young children's PA.

"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

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.

Associations between perceived social and physical environmental variables and physical activity and screen time among adolescents in four European countries

OBJECTIVES

Associations between the perceived social and physical environment and self-reported moderate-to-vigorous physical activity (MVPA) and screen time (ST) were examined among adolescents in four European countries.

METHODS

Representative samples were surveyed with standardised methodologies. Associations between environmental variables and meeting MVPA recommendations and tertiles of ST were tested in gender-specific logistic regression models. Moderation by country and country-specific relationships were also examined.

RESULTS

The most consistent findings across countries were found for the significant associations between neighbourhood social environment and MVPA in both boys and girls. Significant associations with the physical environment varied more between countries and by gender. The most consistent negative associations with ST were found for the social environmental variable of having parental rules for spending time outside the home.

CONCLUSIONS

The present findings provided evidence for the generalisability of the associations between environmental correlates and MVPA across four European countries. The findings show clear differences in correlates for MVPA and ST. Further research is needed to better understand the unique aspects of the social and physical environment which explain each of the two behaviours.

Examining Influences of Parenting Styles and Practices on Physical Activity and Sedentary Behaviors in Latino Children in the United States: Integrative Review

BACKGROUND

Research indicates that parents influence their children's physical activity (PA) and sedentary behaviors (SB) through their parenting styles and practices.

OBJECTIVE

The objectives of this paper were to evaluate existing research examining the associations between parenting styles, parenting practices, and PA and SB among Latino children aged between 2 and 12 years, highlight limitations of the existing research, and generate suggestions for future research.

METHODS

The method of this integrative review was informed by methods developed by Whittemore and Knafl, which allow for the inclusion of qualitative, quantitative, and mixed-methods studies. Using the Preferred Reporting Items for Systematic Reviews Meta-Analyses guidelines, five electronic academic databases (PubMed, SPORTDiscus, PsycINFO, PsycARTICLES, and CINAHL) were searched for peer-reviewed, full-text papers published in English. Of the 641 unique citations identified, 67 full-text papers were retrieved, and 16 were selected for review.

RESULTS

The majority of the 16 reviewed studies were conducted with predominantly Mexican American or Mexican immigrant samples, and only 1 study examined the association between parenting styles and Latino children's PA and SB. Most (n=15) reviewed studies assessed the influence of parenting practices on children's PA and SB, and they provide good evidence that parenting practices such as offering verbal encouragement, prompting the child to be physically active, providing logistic support, engaging and being involved in PA, monitoring, and offering reinforcement and rewards encourage, facilitate, or increase children's PA. The examined studies also provide evidence that parenting practices, such as setting rules and implementing PA restrictions due to safety concerns, weather, and using psychological control discourage, hinder, or decrease children's PA.

CONCLUSIONS

Because this review found a very small number of studies examining the relationship between parenting styles and Latino children's PA and SB, additional research is needed. Given that the majority of reviewed studies were conducted with predominantly Mexican American or Mexican immigrant samples, additional research examining parenting styles, parenting practices, and PA and SB among multiethnic Latino groups is needed to design interventions tailored to the needs of this ethnically diverse population group.

Computer/Mobile Device Screen Time of Children and Their Eye Care Behavior: The Roles of Risk Perception and Parenting

This study assessed the computer/mobile device screen time and eye care behavior of children and examined the roles of risk perception and parental practices. Data were obtained from a sample of 2,454 child-parent dyads recruited from 30 primary schools in Taipei city and New Taipei city, Taiwan, in 2016. Self-administered questionnaires were collected from students and parents. Fifth-grade students spend more time on new media (computer/smartphone/tablet: 16 hours a week) than on traditional media (television: 10 hours a week). The average daily screen time (3.5 hours) for these children exceeded the American Academy of Pediatrics recommendations (≤2 hours). Multivariate analysis results showed that after controlling for demographic factors, the parents with higher levels of risk perception and parental efficacy were more likely to mediate their child's eye care behavior. Children who reported lower academic performance, who were from non-intact families, reported lower levels of risk perception of mobile device use, had parents who spent more time using computers and mobile devices, and had lower levels of parental mediation were more likely to spend more time using computers and mobile devices; whereas children who reported higher academic performance, higher levels of risk perception, and higher levels of parental mediation were more likely to engage in higher levels of eye care behavior. Risk perception by children and parental practices are associated with the amount of screen time that children regularly engage in and their level of eye care behavior.