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

Are child and parent health behaviors associated with childhood obesity? A descriptive and methodological study

PURPOSE

This study was conducted to determine the relationship between child and parents' health behaviors and childhood obesity. In addition, an adaptation of the Turkish version of the Family Health Behavior Scale (FHBS) was performed in this study.

DESIGN AND METHODS

This is a descriptive and methodological study. The research sample consisted of 358 parents who have a child between the ages of 5 and 12 studying in one of the seven state schools at the kindergarten, primary, and secondary school levels in Istanbul. Data were collected between February 2022 to May 2022 using the Parent and Child Descriptive Information Form, the Family Nutrition and Physical Activity (FNPA) Screening Tool, and the FHBS. IBM SPSS 25.0 (IBM, Armonk, NY, USA) and SPSS AMOS 21.0 software were used to analyze the data.

RESULTS

It was found that the confirmatory factor analysis result of FHBS confirmed the original structure of the scale, and Cronbach's Alpha coefficient was calculated as 0.80. A positive correlation was found between the parents' total scores of FNPA and FHBS (r:0.511, p < 0.001).

CONCLUSIONS

It is recommended to evaluate the child and their parents holistically in preventing and managing childhood obesity. School health nurses should plan family-centered interventions to improve health behaviors and carry out these interventions with a multidisciplinary team. Moreover, it has been determined that FHBS is a valid and reliable measurement tool for the Turkish population.

Why Do Iranian Preschool-Aged Children Spend too Much Time in Front of Screens? A Preliminary Qualitative Study

There is evidence that Iranian preschool children are increasingly spending their time in front of screens (screen time: ST; time spent with any screen such as TVs, computers, tablets, smartphones, game consoles, or video games), but few studies have explored the possible causes of such an increase. Given this, the present study aimed to qualitatively explore determinants of excessive ST in Iranian children. To this end, parents of preschool children were interviewed, and their answers were qualitatively clustered to identify additional important factors. Key informant interviews were conducted with parents of preschool children in Tehran (Iran). A semi-structured interview was developed to assess child and family life, daily routine, family rules, family interactions, and home climate as possible contributing factors to ST. Parents' audiotaped statements were transcripted verbatim, coded, and clustered into main themes using thematic analysis with the MaxQda^® software. A total of 20 parents of children aged 2 to 7 were interviewed, and a total of 6 key themes and 28 subthemes were extracted from their interviews. The results of the analysis identified a broad range of both independent and interrelated factors leading to the development and maintenance of ST behaviors among preschool children. Our findings indicate that the central concept is the family. Considering screen-related behaviors, family life encompasses parental health literacy (e.g., parenting pattern, monitoring standards, thoughtful parenting), family psychological atmosphere (e.g., presence of parents, family norms, parent-parent and parent-child interaction, congruency/incongruency of parents with each other) and the digital structure of the home. The child's and parents' actions and characteristics can influence family interactions. A child's and parent's behavior is also influenced by social/cultural factors. Parents' behaviors and attitudes, family communications, and interactions contribute to healthy ST habits in children. It is not possible to examine the child's behavior without considering the family and the dominant environment, since the behavior of family members as a whole affects each family member. Given this, interventions should make parents aware of their role and responsibilities in reducing children's ST and consider the family system as a whole, and interventions also can benefit from considering the parental perceptions of children's behaviors.

Media screen time use and mental health in school aged children during the pandemic

BACKGROUND

Children's screen time activity has increased significantly during the pandemic. Extended school closures and heightened parent stress are associated with children's behavioural difficulties and time spent watching screens. The primary aim of this study was to determine which school and household factors were associated with challenging behaviours in Canadian schoolchildren during the COVID-19 pandemic.

METHODS

This longitudinal survey study examined the association amongst screen time, internalizing and externalizing behaviours in school-aged children at two time points over the 2020-2021 academic school year. Parents completed survey measures on their parental involvement, stress levels, and their child's screen time use as well as their emotional and behavioural difficulties.

RESULTS

Children's average daily screen time was 4.40 h (SE = 18.45) at baseline and 3.89 h (SE = 16.70) at 1-year follow up, with no significant change across the school year (p = .316). Increased screen time use was associated with a greater incidence of internalizing behaviours in children (p = .03). Children who spent more time on screens and who were in households with parents reporting higher stress levels had increased internalizing behaviours (p < .001). No association between screen time use and externalizing behaviours was evident; however, parent stress was positively associated with children's externalizing behaviours (p < .001).

CONCLUSIONS

Children's screen time use has remained high during the pandemic and is associated with anxious and depressive symptoms. Children who spent more time on screens and who were in households with parents reporting higher stress levels had increased internalizing behaviours. Parent stress was positively associated with children's externalizing behaviours. Targeted family intervention plans focused on reducing parent stress and screen time use may aid in improving children's mental health during the ongoing pandemic.

Effectiveness of multilevel interventions based on socio-ecological model to decrease sedentary time in children: a systematic review of controlled studies

Objectives

Preventive actions of sedentary behavior (SB) based on the socio-ecological model are needed among children and young adolescents. The aim of this systematic review is to ascertain the effectiveness of multilevel interventions (i.e., involving consideration of at least two interventional levels) in reducing sedentary time (ST) in children aged 5-12 years.

Methods

Adhering to PRISMA guidelines, a systematic literature search was conducted in three databases (PsyInfo, PubMed and ERIC) until July 2021.

Results

30 trials met the eligibility criteria and were included. They showed acceptable (< 8, n = 18) and high (≥ 8, n = 12) methodological quality. Among studies targeting 2 (n = 2), 3 (n = 19) and 4 levels (n = 9), 1 (50%), 9 (47%) and 7 (78%) were effective and reported significant reduction of ST, respectively.

Conclusion

Interventions tend to be more effective when they involve 4 levels, using both agentic and structural strategies (targeting intrinsic determinants, in the organizational environment of the child). Findings underline the relevance of multilevel strategies to reduce ST in children, but also raise issues about operationalization of the socio-ecological perspective.

Systematic review registration

PROSPERO, identifier: CRD42020209653.

Early language outcomes in Argentinean toddlers: Associations with home literacy, screen exposure and joint media engagement

This study aimed to analyse the contribution of mothers' home literacy beliefs and practices and the quantity and quality of screen media exposure on Argentinean toddler's language. In addition, we considered parent-child joint engagement, as well as adult scaffolding behaviours during the use of electronic devices. A total of 465 mothers of 18-36 months old children completed an online survey including: the MacArthur Bates CDI, home literacy, screen exposure, joint engagement and scaffolding questionnaires. We observed positive effects of literacy beliefs, PC times and verbal scaffolding on language outcomes. TV exposure contributed negatively to vocabulary and, along with educational content, to sentence use. Shared reading and screen media experiences can be an opportunity for language stimulation, provided there is dialogue and joint engagement. Passive screen exposure and inadequate content may be detrimental for toddlers' language outcomes, probably by displacement of socially significant interactions.

Patterns of parent screen use, child screen time, and child socio-emotional problems at 5 years

Digital media screens have become an essential part of our family life. However, we have insufficient knowledge about parental screen use patterns and how these affect children's socio-emotional development. In total, 867 Canadian parents of 5-year-old children from the TARGet Kids! Cohort (73.1% mothers, mean ± SD age = 38.88 ± 4.45 years) participated in this study from 2014 to the end of 2019. Parents reported parental and child time on television (TV) and handheld devices and completed the Strengths and Difficulties Questionnaire (SDQ). Latent profile analysis identified six latent profiles of parent screen use: low handheld users (P1, reference; n = 323), more TV than handheld (P2; n = 261), equal TV and handheld (P3; n = 177), more handheld than TV (P4; n = 57), high TV and handheld (P5; n = 38), and extremely high TV and handheld (P6; n = 11). Parents that were more likely to belong to P6 were also more likely to be living in single-parent households compared to P1 (estimate = -1.49 ± 0.70), p = .03). High membership probability for P2 (estimate = -0.67 ± 0.32, p = .04) and P4 (estimate = -1.42 ± 0.40, p < 0.001) was associated with lower household income compared to P1. Children of parents with higher P4 (χ²  = 12.32, p < 0.001) or P5 (χ²  = 9.54, p = .002) membership probability had higher total screen time compared to P1. Finally, a higher likelihood to belong to P6 (χ²  = 6.82, p = .009) was associated with a higher SDQ Total Difficulties Score compared to P1. Thus, patterns of parent screen use were associated with child screen use and child socio-emotional problems. The emerging link between parental screen use profiles and child behaviors suggests the need for more research on parent screen time.

Quality of life by dysmenorrhea severity in young and adult Japanese females: A web-based cross-sectional study

Dysmenorrhea is a monthly menstrual pain that can limit a woman's quality of life (QOL). The relationship between dysmenorrhea severity and QOL has been reported in several countries; however, the results cannot be generalized because lifestyle and cultural background affect menstrual pain. This study sought to uncover whether 1) different factors, such as emotions and ways of coping with symptoms, vary with the severity of dysmenorrhea and 2) the severity of dysmenorrhea ultimately affects QOL in Japan. A web-based cross-sectional survey was sent to 1000 Japanese females aged 16-30 years. The respondents were divided into two groups: those without dysmenorrhea (n = 24) and those with dysmenorrhea (n = 471). The severity of dysmenorrhea was classified using the Numerical Rating Scale as either mild (1-3), moderate (4-7), or severe (8-10). In total, 156 respondents reported mild dysmenorrhea, 249 reported moderate dysmenorrhea, and 66 reported severe dysmenorrhea. QOL was measured using the 26-item World Health Organization Quality of Life scale. One-way ANOVA and Kruskal-Wallis tests were used to compare QOL across different levels of dysmenorrhea severity, depending on normality. Ultimately, significant differences in QOL scores (p<0.001) were observed based on dysmenorrhea severity, with respondents with severe dysmenorrhea reporting the lowest QOL scores. Meanwhile, significant differences were observed in the physical, psychological, and environmental subscales (p<0.001, p<0.001, p = 0.019) across respondents with different levels of dysmenorrhea severity; notably, respondents with severe dysmenorrhea demonstrated a negative spiral of chronic pain, which may significantly impact QOL, and, relatedly, a relatively low psychological QOL. This study is the first to show the relationship between dysmenorrhea severity and QOL in Japanese females, who are more likely to experience negative feelings during menstruation.

The relationship between the severity of perimenstrual symptoms and a regular exercise habit in Japanese young women: a cross-sectional online survey

Background

Experiencing perimenstrual symptoms is a major health concern for young women. Women in the reproductive age experience menstruation about once a month, and many experience perimenstrual symptoms. Drug therapies such as painkillers (commonly used) and hormonal medications help to achieve symptomatic relief from perimenstrual symptoms. However, many women are concerned about tolerance and compliance of the drugs used to treat perimenstrual symptoms and lack awareness on how to cope with perimenstrual symptoms. If the association between exercise habits and the severity of symptoms is emphasized in young women, methods for coping with perimenstrual symptoms can be established, not relying only on pharmaceuticals. The objective of this study was to determine the differences in the severity of perimenstrual symptoms in young Japanese women with and without a regular exercise habit.

Methods

A cross-sectional study using an online survey was sent among 500 Japanese women aged 18–25 years. The severity of perimenstrual symptoms was assessed using the Menstrual Distress Questionnaire (MDQ). The differences in MDQ scores between those with and without exercise habits (exercise for more than 30 min for 2 days a week) were compared using the chi-square test and Mann–Whitney U test. The logistic regression analysis detected subscales of the premenstrual and menstrual symptoms affected by an exercise habit.

Results

282 (56.4%) young Japanese women were answered this survey. Respondents were divided into the exercise group (n = 157) and the non-exercise group (n = 125). The exercise group had significantly low premenstrual and menstrual MDQ scores. The results of the logistic regression analysis stated that the subscale related to negative emotion before menstruation was associated with an exercise habit. In the analysis performed during menstruation, a statistically significant association was detected between an exercise habit and a behavioral change such as avoiding interaction with others.

Conclusions

This study suggested that exercise habits may reduce the severity of perimenstrual symptoms and could help to develop a non-pharmacological coping strategy. In addition, this study provides useful information for young women who want to prevent perimenstrual symptoms but do not have an exercise habit. Further, it may encourage young women to start exercising.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-022-01720-2.

Association between sedentary behavior and depression among Japanese medical students during the COVID-19 pandemic: a cross-sectional online survey

BACKGROUND

Sedentary behavior, particularly prevalent during the 2019 coronavirus disease (COVID-19), has been shown to lead to depression. In medical students, this could negatively affect the provision of healthcare. Thus, this study aimed to investigate the association between sedentary behavior and depression in Japanese medical students during the COVID-19 pandemic.

METHODS

An online cross-sectional survey was conducted from July 30 to August 30, 2021, using anonymous questionnaire system to assess respondents' sociodemographic characteristics, physical activity, sedentary behavior among 1000 Japanese university students. Depression was assessed using the Patient Health Questionnaire-2 (PHQ-2). The data of 484 respondents (48.4%) were included in a stepwise analysis, where we set the difference between medical and non-medical students as Model 1 and that between medical students with and without depression as Model 2. For group comparisons of both models, the chi-square test was used for sociodemographic characteristics, and the Mann-Whitney U-test was used for physical activity and sedentary behavior. In Model 2, factors associated with depression among medical students were analyzed by logistic regression analysis.

RESULTS

In Model 1, medical students were less physically active (p < 0.001), had longer sedentary time (p < 0.001), and had higher PHQ-2 scores (p = 0.048) than non-medical students. In Model 2, medical students with depression had longer sedentary time (p = 0.004) and longer leisure screen time than those without depression (p = 0.007). Moreover, logistic regression analysis adjusted for potential confounders showed that sedentary time (OR = 1.001, p = 0.048) and leisure screen time (OR = 1.003, p = 0.003) were significantly associated with depression among medical students.

CONCLUSIONS

Based on these results, it is evident that reducing Japanese medical students' sedentary time and leisure screen time can help combat depression during the COVID-19 pandemic; thus, these results can guide the development of appropriate interventions to prevent and treat depression.

Effect of screen time intervention on obesity among children and adolescent: A meta-analysis of randomized controlled studies

Several studies have investigated the effect of screen time interventions on obesity in children and adolescents, but the existing results were controversial. This study aimed to analyze the effect of screen time intervention on obesity in children and adolescents. PubMed, Cochrane, Web of Science, Embase databases were searched through December 2020 to identify publications meeting a priori inclusion criteria and references in the published articles were also reviewed. Finally, 14 randomized controlled trials and 1894 subjects were included in this meta-analysis. The results showed that interventions targeting screen time are effective in reducing total screen time (MD: -6.90 h/week, 95% CI: [-9.19 to -4.60], p < 0.001) and television time (MD: -6.17 h/week, 95% CI: [-10.70 to -1.65], p < 0.001) in children and adolescents. However, there was no significant difference between the intervention and control groups in body mass index and body mass index-z score. In conclusion, there is no evidence that screen time interventions alone can decrease obesity risk in children and adolescents, though they can effectively reduce screen time.

Association of Night-Time Screen-Viewing with Adolescents' Diet, Sleep, Weight Status, and Adiposity

Night-time screen-viewing (SV) contributes to inadequate sleep and poor diet, and subsequently excess weight. Adolescents may use many devices at night, which can provide additional night-time SV. Purpose: To identify night-time SV patterns, and describe differences in diet, sleep, weight status, and adiposity between patterns in a cross-sectional and longitudinal manner. Methods: Adolescents (10–16 y) reported devices they viewed at night and completed food recalls. Accelerometry, anthropometrics, and imaging were conducted to measure sleep, weight status, and adiposity, respectively. Latent class analysis was performed to identify night-time SV clusters. Linear regression analysis was used to examine associations between clusters with diet, sleep, weight status, and adiposity. Results: Amongst 273 adolescents (12.5 ± 1.9 y, 54% female, 59% White), four clusters were identified: no SV (36%), primarily cellphone (32%), TV and portable devices (TV+PDs, 17%), and multiple PDs (17%). Most differences in sleep and adiposity were attenuated after adjustment for covariates. The TV+PDs cluster had a higher waist circumference than the no SV cluster in cross-sectional analysis. In longitudinal analysis, the primarily cellphone cluster had less change in waist circumference compared to the no SV cluster. Conclusions: Directing efforts towards reducing night-time SV, especially TV and PDs, may promote healthy development.

Changes in Families' Leisure, Educational/Work and Social Screen Time Behaviours before and during COVID-19 in Australia: Findings from the Our Life at Home Study

This study aimed to understand differences in leisure, educational/work and social screen time behaviours experienced by parents and children due to COVID-19 lockdown restrictions, which may inform behaviour change strategies and policy in the transition to a COVID-normal life. Participants in the "Our Life at Home" study (n = 218 parents from Australia, 43.4 ± 6.8 years, 88% female) completed a cross-sectional online survey in April/May 2020. Parents recalled their own and their child (8.7 ± 2.0 years, 42% female) or adolescents (15.0 ± 1.5 years, 50% female) participation in nine screen time behaviours in the past month (during lockdown) and retrospectively for February 2020 (pre-lockdown), providing data on 436 individuals. Screen time behaviours included leisure (computer/laptop and tablet/smartphone for leisure, TV/videos/DVDs and game consoles); education/work (computer/laptop and tablet/smartphone for work/education); and social screen time (computer/tablet/smartphone for social communication with friends, family and work (parents only)). Wilcoxon signed-rank tests and effect sizes (r) compared the time spent in each behaviour pre-lockdown and during lockdown. Large differences were observed in social (parents: r = 0.41-0.57; children: r = 0.55-0.65; adolescents: r = 0.28-0.43) and education (children: r = 0.50-0.65 and adolescents: r = 0.25-0.37) behaviours. There were small or no differences in leisure time screen use. COVID-19 lockdown restrictions have impacted parent's and children's screen time, and future research and policy should consider strategies to support families to manage screen time.