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Glassman J, Humphreys KL, Jauregui A, Milstein A, Sanders L. Evidence for Changes in Screen Use in the United States During Early Childhood Related to COVID-19 Pandemic Parent Stressors: Repeated Cross-Sectional Study. JMIR Pediatr Parent 2024; 7:e43315. [PMID: 38446995 PMCID: PMC11153974 DOI: 10.2196/43315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/01/2023] [Accepted: 02/12/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic transformed the home lives of many families in the United States, especially those with young children. Understanding the relationship between child and parent screen time and family stressors exacerbated by the pandemic may help inform interventions that aim to support early child development. OBJECTIVE We aim to assess the changing relationship between family screen time and factors related to pandemic-induced remote work and childcare or school closures. METHODS In the spring of 2021 we administered a survey, similar to one administered in the spring of 2019, to a national sample of parents of young children (aged 6 to 60 months). Using iterative sampling with propensity scores, we recruited participants whose sociodemographic characteristics matched the 2019 survey. Participants were aged >18 years, proficient in English or Spanish, and residing in the United States. The main outcomes were changes in child screen time (eg, mobile phone, tablet, computer, and television) and parenting technoference, defined as perceived screen-related interference with parent-child interactions. Additional survey items reported pandemic-related job loss, and changes to work hours, work location, caregiving responsibilities, day care or school access, and family health and socioeconomic status. RESULTS We enrolled 280 parents, from diverse backgrounds. Parents reported pandemic-related changes in child screen time (mean increase of 1.1, SD 0.9 hours), and greater parenting technoference (3.0 to 3.4 devices interfering per day; P=.01). Increased child screen time and parenting technoference were highest for parents experiencing job loss (mean change in child screen time 1.46, SD 1.03; mean parenting technoference score 3.89, SD 2.05), second highest for working parents who did not lose their job (mean change in child screen time 1.02, SD 0.83; mean parenting technoference score 3.37, SD 1.94), and lowest for nonworking parents (mean change in child screen time 0.68, SD 0.66; mean parenting technoference score 2.66, SD 1.70), with differences significant at P<.01. School closure and job loss were most associated with increased child screen time during the pandemic after controlling for other stressors and sociodemographic characteristics (d=0.52, P<.001; d=0.31, P=.01). Increased child screen time and school closure were most associated with increased parenting technoference (d=0.78, P<.001; d=0.30, P=.01). CONCLUSIONS Work and school changes due to the COVID-19 pandemic were associated with increased technology interference in the lives of young children. This study adds to our understanding of the interaction between technology use at home and social factors that are necessary to support early childhood health and development. It also supports possible enhanced recommendations for primary care providers and childcare educators to guide parents in establishing home-based "screen time rules" not only for their children but also for themselves.
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Affiliation(s)
- Jill Glassman
- Clinical Excellence Research Center (CERC), Stanford University School of Medicine, Stanford, CA, United States
| | - Kathryn L Humphreys
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, United States
| | | | - Arnold Milstein
- Clinical Excellence Research Center (CERC), Stanford University School of Medicine, Stanford, CA, United States
| | - Lee Sanders
- Departments of Pediatrics, Stanford University, Stanford, CA, United States
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Algethami RG, Tamur SA, Alsofyani RM, Alfaifi HH, Qattan FM, Alharthi MS, Aljaid MS, Almalki SA, Khayat AM, Alzahrani AS, Khalifa EA, Shams AM. Parents' Knowledge, Attitudes, and Practices Regarding Baby Walkers, Baby Car Seats, Oral Health, and Child Screen Time in Saudi Arabia: A Cross-Sectional Study. Cureus 2024; 16:e52464. [PMID: 38371110 PMCID: PMC10873485 DOI: 10.7759/cureus.52464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 02/20/2024] Open
Abstract
Background Awareness of age-appropriate milestones and developmental stages is crucial for parents to identify any potential delays or concerns early on and seek appropriate interventions. This study aimed to assess the knowledge, attitudes, and practices of caregivers in Saudi Arabia regarding baby walkers, baby car seats, early dental visits, and screen time for young children. Methods A cross-sectional survey was conducted among parents in Saudi Arabia using a structured questionnaire. A convenience and snowball sampling method was employed to recruit participants from various regions of the country. The questionnaire aimed to assess parents' knowledge regarding the recommended use of baby walkers and baby car seats, their awareness of the importance of early dental visits, and their understanding of appropriate screen time guidelines. Additionally, the survey explored parents' practices toward these recommendations. Descriptive statistics were used to analyze the data, and associations between variables were examined using the chi-squared test. Results A total of 1318 participants were included. The analysis revealed that the majority of the participants (n=1066,81.3%) use a baby walker, while only (n=292,22.3%) consider that they should never be used. Overall, (n=388,29.6%) of the participants never used a car seat for their infants or children. In terms of early childhood dental visits, approximately (n=518,39.5%) of the participants reported actually taking their child to the dentist within the recommended timeframe. Regarding screen time for children, (n=148,11.3%) of the participants reported that their children spend >5 hours daily in front of the screen. Conclusions Raising parents' awareness about recent childcare recommendations and safe practices is crucial for promoting optimal child development, preventing health problems, facilitating evidence-based decision-making, reducing risks, enhancing parental confidence and empowerment, and nurturing positive parent-child relationships.
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Affiliation(s)
- Rawan G Algethami
- Medicine and Surgery, College of Medicine, Taif University, Taif, SAU
| | - Shadi A Tamur
- Pediatrics, College of Medicine, Taif University, Taif, SAU
| | - Rawan M Alsofyani
- Medicine and Surgery, College of Medicine, Taif University, Taif, SAU
| | | | - Faris M Qattan
- Medicine, College of Medicine, Taif University, Taif, SAU
| | | | | | | | | | | | - Eman A Khalifa
- Microbiology and Parasitology, College of Medicine, Taif University, Taif, SAU
| | - Anawr M Shams
- Pharmacology, College of Medicine, Taif University, Taif, SAU
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Feng J, Khan A, Lau PWC, Huang WY. Parental role-modeling on 24-hour movement behaviors among preschoolers during the COVID-19 pandemic. Scand J Med Sci Sports 2024; 34:e14563. [PMID: 38268068 DOI: 10.1111/sms.14563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 12/12/2023] [Accepted: 01/02/2024] [Indexed: 01/26/2024]
Abstract
INTRODUCTION Little is known about the association between parents' and children's 24-h movement behaviors during the pandemic. This cross-sectional study examined the association between the 24-h movement behaviors of parents and their preschoolers and investigated sex differences in this association. METHODS A total of 1740 preschoolers (4.5 ± 0.8 years old, 50.3% boys) and their parents (35.4 ± 4.9 years old, 24.3% males) in China participated in this study and provided valid and complete data. Parents completed an online survey or a written questionnaire in the period between October and December 2020. Preschoolers' and parents' movement behaviors (physical activity [PA], sedentary behavior [SB], screen time, and sleep) and demographic information were reported by the parents. Generalized linear models and logistic regression models were performed. RESULTS Positive associations were found between parents' and preschoolers' moderate-to-vigorous intensity PA (β = 0.28; 95% confidence interval [CI]: 0.20, 0.36), total PA (β = 0.21; 95% CI: 0.17, 0.24), and sleep (β = 0.05; 95% CI: 0.03, 0.06) with no apparent sex difference. No significant association was found between parents' and preschoolers' SB or screen time. Girls were more likely to meet all three 24-h movement guidelines when their parents met them (odds ratio = 2.38; 95% CI: 1.42, 4.01), but the relationship was not significant for boys. CONCLUSIONS Parental role-modeling was positively associated with children's PA and sleep. This finding suggests that supporting parents' movement behaviors has the potential to promote a healthy lifestyle among preschoolers.
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Affiliation(s)
- Jie Feng
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Patrick Wing Chung Lau
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
- Laboratory of Exercise Science and Health, BNU-HKBU United International College, Zhuhai, China
| | - Wendy Yajun Huang
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
- Dr Stephen Hui Research Centre for Physical Recreation and Wellness, Hong Kong Baptist University, Hong Kong, China
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Alkalash SH, Alshamrani FA, Alharthi SA, Alzubaidi MA, Alqarehi RM, Bazaid AA, Asiri B. Parents' Knowledge On, Attitude Toward, and Practice of Screen Time Exposure Regulation of Their Children Under Six Years of Age in Western Region, Saudi Arabia. Cureus 2023; 15:e49464. [PMID: 38152829 PMCID: PMC10751468 DOI: 10.7759/cureus.49464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Children and teenagers spend a significant amount of time watching screens, which include cellphones, tablets, gaming consoles, televisions, and computers. Regulation of screen time exposure is a crucial matter to avoid the health drawbacks of prolonged screen exposure. OBJECTIVES Assessment of parents' knowledge, attitude, and practice of regulation screen exposure among their children under six years old in the western region of Saudi Arabia. METHODS A cross-sectional study was conducted on a convenience sample of 451 parents of under-six-year-old children in the western region of Saudi Arabia. Data were collected by using an online questionnaire, and a link to the survey was distributed to respondents via electronic platforms as well as to primary healthcare visitors. The data were analyzed using SPSS software. RESULTS This study included 451 parents from the Saudi western region. Most of the participating parents were female (64.3%), aged 25-34 years (34.8%), married (86.0%), and had completed their university education (56.1%). This study found that 76.4% of parents had adequate knowledge, 73.1% had a positive attitude, and 69.8% had adequate practice of screen time regulation for their children under six years of age. Factors associated with their good knowledge include being married (p = 0.002), having government work (p = 0.020), having children who use mobile phones, and having children attend kindergarten (p <0.001) for each. Furthermore, highly educated parents showed more positive attitudes than others (p-value = 0.004). Finally, better practice of screen time regulation was noted among highly educated parents (p = 0.011), who had government jobs (p = 0.031), and children who went to kindergarten (p = 0.031) for their children. CONCLUSION In this study, parents of under-six-year-old children possessed overall good knowledge and a positive attitude, but their actual practice of screen time regulation for their children was low, specifically in terms of parental supervision of the content that children watch, their care of children's regular exercise, and using devices as a method for motivating or punishing their children. Additionally, sociodemographic characteristics like education, occupation, and marital status played a role in this issue. Healthcare professionals such as pediatricians, family doctors, general practitioners, and others can caution parents of young children under six years old about the harmful consequences of excessive screen use. Further longitudinal research is needed to understand the long-term effects of screen time exposure among young children. From this study, further qualitative research would aid in a greater understanding of the impact of parental knowledge, attitude, and practice on their children's use of screen time.
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Affiliation(s)
- Safa H Alkalash
- Community Medicine and Health Care, Umm Al-Qura University, Al-Qunfudah, SAU
- Family Medicine, Menoufia University, Shebin Elkom, EGY
| | - Faisal A Alshamrani
- Medicine, Al-Qunfudah College of Medicine, Umm Al-Qura University, Al-Qunfudah, SAU
| | - Saleh A Alharthi
- Medicine, Al-Qunfudah College of Medicine, Umm Al-Qura University, Al-Qunfudah, SAU
| | - Muslih A Alzubaidi
- Medicine, Al-Qunfudah College of Medicine, Umm Al-Qura University, Al-Qunfudah, SAU
| | | | - Abdurahman A Bazaid
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Bushra Asiri
- College of Medicine, Ibn Sina National for Medical Sciences, Jeddah, Saudi Arabia, Jeddah, SAU
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Wu HY, Lin WY, Huang JP, Lin CL, Au HK, Lo YC, Chien LC, Chao HJ, Chen YH. Effects of mobile device use on emotional and behavioral problems in the CBCL among preschoolers: Do shared reading and maternal depression matter? PLoS One 2023; 18:e0280319. [PMID: 37450499 PMCID: PMC10348560 DOI: 10.1371/journal.pone.0280319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/27/2022] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Although mobile devices are used ubiquitously, studies on their detrimental effects on preschoolers are limited. Furthermore, no study has considered shared reading and mobile device usage simultaneously. Therefore, this study examined the effects of mobile devices and shared reading on preschoolers' development along with the effects of maternal depression on this association. MATERIALS AND METHODS Mothers of 202 children aged 2-5 years were recruited in Taiwan. Maternal self-reported questionnaires on mobile device usage, shared reading, and child's emotional and behavioral development were collected. Multiple linear regression models were used for analyses. RESULTS Mothers' higher usage time on mobile devices and an education level of college or less were significantly associated with the child's exceeding recommended use of mobile devices. Particularly among depressed mothers, preschoolers' exceeding recommended use of mobile devices was associated with more sleep (β = 9.87, 95% confidence interval [CI] = 1.34, 18.40) and attention (β = 7.20, 95% CI = 1.50, 12.91) problems, whereas shared reading was associated with less somatic complaints (β = -16.19, 95% CI = -32.22, -0.15) and withdrawn (β = -21.50, 95% CI = -40.52, -2.47), compared with their respective counterparts. CONCLUSION Our study suggested the beneficial effects of shared reading. Moreover, we highlighted the adverse effects of preschoolers' exceeding recommended use of mobile device on sleep and attention problems, especially for children of mothers with depression.
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Affiliation(s)
- Hsin-Yi Wu
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Wen-Yi Lin
- Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Jian-Pei Huang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chen-Li Lin
- Department of Obstetrics and Gynecology, Taipei City Hospital, Taipei, Taiwan
| | - Heng-Kien Au
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yu-Chun Lo
- Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Ling-Chu Chien
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Hsing Jasmine Chao
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hua Chen
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
- Ph. D. program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan
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Nicholson E, Kelly B. Establishing the Minimum Media Time Sample Required to Obtain Reliable Estimates of Children's Digital Media Food Marketing Exposures. Curr Dev Nutr 2023; 7:100092. [PMID: 37213717 PMCID: PMC10196768 DOI: 10.1016/j.cdnut.2023.100092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/27/2023] [Accepted: 04/21/2023] [Indexed: 05/23/2023] Open
Abstract
Background The ubiquitous nature of food marketing on digital media likely has a profound effect on children's food preferences and intake. Monitoring children's exposure to digital marketing is necessary to raise awareness of the issue, inform policy development, and evaluate policy implementation and effect. Objectives This study aimed to establish whether smaller time samples (less time and/or fewer days captured) would provide robust estimates of children's usual exposures to food marketing. Methods Using an existing data set of children's digital marketing exposures, which captured children's total screen use over 3 d, a reliability assessment was performed. Results A subsample of 30% of children's usual screen time was found to provide reliable estimates of digital food marketing exposure compared with the full sample (intraclass correlation coefficient: 0.885; Cronbach α: 0.884). There was no difference in the rates of marketing (exposures/h) between weekdays and weekend days. Conclusions These findings enable researchers to reduce the time and resource constraints that have previously restricted this type of monitoring research. The reduced media time sample will further lessen participant burden.
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7
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Goncalves WSF, Byrne R, de Lira PIC, Viana MT, Trost SG. Parental Influences on Physical Activity and Screen Time among Preschool Children from Low-Income Families in Brazil. Child Obes 2023; 19:112-120. [PMID: 35653741 DOI: 10.1089/chi.2021.0305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Children from low-middle income countries (LMIC) are disproportionately affected by obesity, and low physical activity (PA) and high screen time (ST) are major contributors. Parents are key influencers on children's PA and ST, yet, no study has investigated relationships between parenting practices and children's PA and ST in LMIC families. This study examined parental influences on PA and ST among preschool-aged children from low-income families in Brazil. Methods: Parents completed a validated, culturally adapted interviewer-administered survey assessing child ST and parenting practices. Child sedentary time, total movement, and energetic play were measured by accelerometery. Results: Data were available on 77 parent-child dyads [mean age 4.6 years (standard deviation = 0.8), 53% male, and 41% mixed-race]. Parenting practices associated with greater PA were use of PA to reward/control behavior (rho = 0.34-0.49), limiting or monitoring ST (rho = 0.30), explicit modeling/enjoyment of PA (rho = 0.24), verbal encouragement for PA (rho = 0.30), and importance and value of PA (rho = 0.24-0.38; p < 0.05). Parenting practices associated with higher ST were rules around active play indoor (rho = 0.23), use of ST to reward/control behavior (rho = 0.30), exposure to screens (rho = 0.40), and explicit modeling/enjoyment of ST (rho = 0.50; p < 0.05). Conclusion: Recognized parenting practices such as explicit modeling of PA and ST, monitoring and limiting ST, and rules and restrictions about PA and ST are associated with young children's PA and ST in low-income Brazilian families. The findings identify potential targets for family-based interventions to promote healthy lifestyle behaviors and prevent childhood obesity.
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Affiliation(s)
| | - Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
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Dennis CL, Birken CS, Brennenstuhl S, Wrottesley S, Marini F, Bell RC, Tremblay MS, Prioreschi A. Describing 24-hour movement behaviours among preconception and recently pregnant Canadian parents: who do we need to target? Behav Med 2023; 49:83-95. [PMID: 34809524 DOI: 10.1080/08964289.2021.1987854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This study aimed to describe adherence to 24-hour movement guidelines and determine factors associated with meeting guidelines in pregnancy planning and recently postpartum parents. A survey of preconception care attitudes and beliefs was conducted in Canadian adults who were pregnancy planning or ≤5 years postpartum. The Global Physical Activity Questionnaire was used to evaluate physical activity and sedentary time. Respondents reported the number of hours spent sleeping and using a screen per day. Multiple logistic regressions were run to determine factors (sociodemographic and health related) associated with meeting each individual movement guideline and number of guidelines met. 1080 females and 224 males provided survey data. 54.0% (n = 654) of the sample met the physical activity guideline, with no difference between females and males. More than 78.4% (n = 909) met the sedentary behavior guideline, 56.4% (n = 679) met the sleep guideline, and 15.4% (n = 187) met the screen time guideline. Only 5.0% (n = 60) of the sample met all four guidelines. Higher odds of meeting more guidelines were associated with parity and perceived health. Lower odds of meeting more guidelines were associated with obesity and overweight; and with depression. Most parents and parents-to-be are not meeting 24-hour movement guidelines. Interventions should focus on optimizing movement behaviors in the peri-partum period, while focusing on mental health, obesity, and general wellbeing.
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Affiliation(s)
- Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Catherine S Birken
- Faculty of Medicine, University of Toronto, Toronto, Canada.,Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Sarah Brennenstuhl
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Stephanie Wrottesley
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Flavia Marini
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Rhonda C Bell
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.,Department of Pediatrics, University of Ottawa, Ottawa, Canada
| | - Alessandra Prioreschi
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
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Vidmar AP, Cáceres NA, Schneider-Worthington CR, Shirazipour C, Buman MP, de la Haye K, Salvy SJ. Integration of Time-Based Recommendations with Current Pediatric Health Behavior Guidelines: Implications for Obesity Prevention and Treatment in Youth. Curr Obes Rep 2022; 11:236-253. [PMID: 36348216 PMCID: PMC9742346 DOI: 10.1007/s13679-022-00491-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE OF REVIEW Youth-onset obesity is associated with negative health outcomes across the lifespan including cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, dyslipidemias, asthma, and several cancers. Pediatric health guidelines have traditionally focused on the quality and quantity of dietary intake, physical activity, and sleep. RECENT FINDINGS Emerging evidence suggests that the timing (time of day when behavior occurs) and composition (proportion of time spent allocated to behavior) of food intake, movement (i.e., physical activity, sedentary time), and sleep may independently predict health trajectories and disease risks. Several theoretically driven interventions and conceptual frameworks feature behavior timing and composition (e.g., 24 h movement continuum, circadian science and chronobiology, intermittent fasting regimens, structured day hypothesis). These literatures are, however, disparate, with little crosstalk across disciplines. In this review, we examine dietary, sleep, and movement guidelines and recommendations for youths ages 0-18 in the context of theoretical models and empirical findings in support of time-based approaches. The review aims to inform a unifying framework of health behaviors and guide future research on the integration of time-based recommendations into current quantity and quality-based health guidelines for children and adolescents.
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Affiliation(s)
- Alaina P Vidmar
- Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, 4650 Sunset Boulevard, Mailstop #61, Los Angeles, CA, 90027, USA.
| | - Nenette A Cáceres
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | | | - Celina Shirazipour
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, Tempe, USA
| | - Kayla de la Haye
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Sarah-Jeanne Salvy
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
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Ishii K, Shibata A, Koohsari MJ, Oka K. The relationships between parents' and children's screen times on body mass index: a cross-sectional path analysis. BMC Public Health 2022; 22:2190. [PMID: 36437475 PMCID: PMC9703793 DOI: 10.1186/s12889-022-14664-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 11/17/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Understanding factors contributing to an individual reducing screen time is essential for promoting a healthy weight. Parents' behavior affects children by influencing their daily decision-making through modeling, rules or restrictions, social support, and co-participation. We examined how the direct and indirect effects of parents' and children's behaviors regarding screen time influenced body mass index (BMI) among Japanese elementary school children. METHODS We included 283 Japanese children, one child per household, aged 6-12 years, who were randomly selected from resident registries of two cities. The questionnaires were completed by children and their mothers and fathers. Screen time and sociodemographic attributes, including sex, age, employment status, height, and weight, were assessed using a mail-based survey. Path analyses were conducted to determine associations among children's, fathers', and mothers' variables. It was hypothesized that after controlling for household income and children's sex and age, mothers' and fathers' screen time on weekdays and weekends would be related to children's weekdays and weekend screen time, respectively. In addition, we hypothesized that children's weekday and weekend screen time was related to children's BMI. RESULTS Both fathers' and mothers' weekday screen times were associated with children's weekday and weekend screen times. BMI was affected by children's weekday screen time (0.117). The path coefficients for the indirect effects of mothers' and fathers' screen time on children's BMI through children's weekday screen time were 0.016 from the fathers' weekday screen time and 0.024 from the mothers' weekday screen time (GFI = .980, AGFI = .953, RMSEA = .030, AIC = 93.030). CONCLUSIONS Both fathers' and mothers' weekday screen times indirectly affected children's BMI through children's weekday screen time among Japanese elementary school children. The strongest indirect effects could be seen by examining the paths of a mother's weekday screen time through children's screen time to BMI. Mothers who spend much time with their children are role models, and their behavior could affect the child's behavior. The findings imply that intervention strategies to reduce screen time in children should also focus on modeling the mothers' behavior.
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Affiliation(s)
- Kaori Ishii
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, 359-1192, Japan.
| | - Ai Shibata
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Mohammad Javad Koohsari
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, 359-1192, Japan.,School of Knowledge Science, Japan Advanced Institute of Science and Technology, Nomi, Japan
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, 359-1192, Japan
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de Brito JN, Matsumoto M, Bonilla Z, Loth KA, Geppert J, McCoy MB, Stang JS. Identification of positive parenting practices among parents of young children living in low-income and racially, ethnically, and culturally diverse households. Appetite 2022; 178:106281. [PMID: 35988800 PMCID: PMC9578111 DOI: 10.1016/j.appet.2022.106281] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 08/09/2022] [Accepted: 08/16/2022] [Indexed: 11/19/2022]
Abstract
Using the positive deviance approach, the purpose of this study was to identify parent feeding practices that might be protective against early childhood obesity among children with lower weight status (BMI percentile ≥5th-<85th) relative to higher weight status (BMI percentile ≥85th). Qualitative interviews were conducted with 71 parents of children aged 2-5 years old (48% girls) enrolled in the Minnesota Special Supplemental Nutrition Program for Women Infants and Children (WIC). Children were identified as having lower weight status (defined as 'positive deviants') (n = 36) or 'higher weight status' (n = 35), and were African American [n = 22], Hispanic [n = 23], or Hmong [n = 26]). Parents were asked about approaches to child feeding and health- and weight-related practices. Findings indicated that relative to caregivers of children with higher weight status, parents of children identified as positive deviant were more likely to report having a consistent routine for providing meals, using a guided choices approach, serving small portions of food during mealtimes, and trusting their child hunger and satiety cues. Moreover, parents of children identified as positive deviant were more likely to promote healthful eating and physical activity engagement and implement clear rules and limits for screen time than parents of children with higher weight status. Results suggest specific parent feeding behaviors and health-related practices that may influence child weight status among children living in low-income and racialized households. The findings of this study also provide research evidence and support the tenets of the Satter Division of Responsibility in Feeding framework. Parenting practices and strategies among parents of children identified as positive deviant are expected to be feasible and should be explored and communicated in future interventions to support age- and sex-recommended weight and health-related outcomes among young children to promote health equity.
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Affiliation(s)
- Junia N de Brito
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Suite 300, Minneapolis, MN, 55455, United States.
| | - Moko Matsumoto
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Suite 300, Minneapolis, MN, 55455, United States
| | - Zobeida Bonilla
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Suite 300, Minneapolis, MN, 55455, United States
| | - Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware St SE, Suite 400, Minneapolis, MN, 55414, United States
| | - Joni Geppert
- Special Supplemental Nutrition Program for Women, Infants, and Children, Division of Child and Family Health, Minnesota Department of Health, PO Box 64882, St Paul, MN, 55164, USA
| | - Marcia B McCoy
- Special Supplemental Nutrition Program for Women, Infants, and Children, Division of Child and Family Health, Minnesota Department of Health, PO Box 64882, St Paul, MN, 55164, USA
| | - Jamie S Stang
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Suite 300, Minneapolis, MN, 55455, United States
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Raj D, Ahmad N, Mohd Zulkefli NA, Lim PY. ‘Stop & Play’ digital health education intervention in reducing excessive screen time among preschoolers from low socioeconomic families in Malaysia: A Cluster Randomized Control Trial (Preprint). J Med Internet Res 2022; 25:e40955. [PMID: 37140970 DOI: 10.2196/40955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 01/09/2023] [Accepted: 03/15/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND High prevalence of excessive screen time among preschool children is attributable to certain parental factors such as lack of knowledge, false perception about screen time, and inadequate skills. Lack of strategies to implement screen time guidelines, in addition to multiple commitments that may hinder parents from face-to-face interventions, demands the need to develop a technology-based parent-friendly screen time reduction intervention. OBJECTIVE This study aims to develop, implement, and evaluate the effectiveness of Stop and Play, a digital parental health education intervention to reduce excessive screen time among preschoolers from low socioeconomic families in Malaysia. METHODS A single-blind, 2-arm cluster randomized controlled trial was conducted among 360 mother-child dyads attending government preschools in the Petaling district, who were randomly allocated into the intervention and waitlist control groups between March 2021 and December 2021. This 4-week intervention, developed using whiteboard animation videos, infographics, and a problem-solving session, was delivered via WhatsApp (WhatsApp Inc). Primary outcome was the child's screen time, whereas secondary outcomes included mother's screen time knowledge, perception about the influence of screen time on the child's well-being, self-efficacy to reduce the child's screen time and increase physical activity, mother's screen time, and presence of screen device in the child's bedroom. Validated self-administered questionnaires were administered at baseline, immediately after the intervention, and 3 months after the intervention. The intervention's effectiveness was evaluated using generalized linear mixed models. RESULTS A total of 352 dyads completed the study, giving an attrition rate of 2.2% (8/360). At 3 months after the intervention, the intervention group showed significantly reduced child's screen time compared with the control group (β=-202.29, 95% CI -224.48 to -180.10; P<.001). Parental outcome scores also improved in the intervention group as compared with that in the control group. Mother's knowledge significantly increased (β=6.88, 95% CI 6.11-7.65; P<.001), whereas perception about the influence of screen time on the child's well-being reduced (β=-.86, 95% CI -0.98 to -0.73; P<.001). There was also an increase in the mother's self-efficacy to reduce screen time (β=1.59, 95% CI 1.48-1.70; P<.001) and increase physical activity (β=.07, 95% CI 0.06-0.09; P<.001), along with reduction in mother's screen time (β=-70.43, 95% CI -91.51 to -49.35; P<.001). CONCLUSIONS The Stop and Play intervention was effective in reducing screen time among preschool children from low socioeconomic families, while improving the associated parental factors. Therefore, integration into primary health care and preschool education programs is recommended. Mediation analysis is suggested to investigate the extent to which secondary outcomes are attributable to the child's screen time, and long follow-up could evaluate the sustainability of this digital intervention. TRIAL REGISTRATION Thai Clinical Trial Registry (TCTR) TCTR20201010002; https://tinyurl.com/5frpma4b.
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Affiliation(s)
- Diana Raj
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Norliza Ahmad
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Nor Afiah Mohd Zulkefli
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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Wanderley Júnior RDS, Queiroz DDR, Guerra PH, Martins CL, Hardman CM, Umpierre D, da Silva LR, Souza Filho AND, Azevedo Cavalcante FVS, Sandreschi PF, Barros MVGD. Correlatos de atividade física e comportamento sedentário em crianças pré-escolares sul-americanas: revisão de escopo. Rev Panam Salud Publica 2022. [PMID: 34131427 PMCID: PMC9168416 DOI: 10.26633/rpsp.2022.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objetivo.
Sintetizar os achados sobre correlatos da atividade física (AF) e do comportamento sedentário (CS) em crianças sul-americanas.
Método.
Realizou-se uma busca dos artigos no período de 24 de junho até 27 de outubro de 2020, nas bases de dados LILACS, PubMed, SciELO, Scopus e Web of Science. Para ampliar a busca, foram examinadas as referências dos artigos de revisão identificados e realizada uma consulta a um painel de especialistas. Foram incluídos estudos com delineamentos observacional e de intervenção com foco em crianças sul-americanas de zero a 5 anos de idade.
Resultados.
Dos 3 111 artigos inicialmente identificados, 18 foram elegíveis: 14 com delineamento observacional, 12 realizados no Brasil e 17 conduzidos com pré-escolares (3 a 5 anos de idade). Além do Brasil, os únicos países representados foram o Chile e o Equador. A AF e o CS foram medidos por acelerômetros em sete estudos, porém houve alta variabilidade nos instrumentos e pontos de corte usados. Embora as crianças tenham sido consideradas fisicamente ativas em 12 estudos, seis estudos mostraram que elas despendiam muito tempo em CS. Os domínios de influência mais avaliados foram o individual (14 estudos) e o interpessoal (11 estudos), seguidos pelo ambiental (oito estudos) e o político (um estudo). As intervenções no contexto escolar (quatro estudos) aumentaram os níveis de AF e diminuíram o tempo em CS. Entretanto, as evidências dos estudos transversais e de intervenção apresentaram alto risco de viés.
Conclusão.
Diante das lacunas identificadas, recomendam-se estudos com delineamentos robustos que incluam mais países sul-americanos, com foco em bebês e crianças com menos de 3 anos de idade e que investiguem correlatos dos domínios ambiental e político.
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Affiliation(s)
| | - Daniel da Rocha Queiroz
- Universidade Federal de Pernambuco (UFPE), Departamento de Educação Física, Recife (PE), Brasil
| | | | - Clarice Lucena Martins
- Universidade Federal da Paraíba (UFPB), Departamento de Educação Física, João Pessoa (PB), Brasil
| | - Carla Menêses Hardman
- Universidade Federal de Pernambuco (UFPE), Departamento de Educação Física, Recife (PE), Brasil
| | - Daniel Umpierre
- Universidade Federal do Rio Grande do Sul (UFRGS), Departamento de Saúde Coletiva, Porto Alegre (RS), Brasil
| | - Larissa Rosa da Silva
- Universidade Estadual do Oeste do Paraná (Unioeste), Departamento de Educação Física, Marechal Candido Rondon (PR), Brasil
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Nobre JNP, Morais RLDS, Ramos-Jorge ML, Fernandes AC, Viegas ÂA, Figueiredo PHS, Costa HS, Esteves EA, da Silva Júnior FA, Camargos ACR, Peixoto MFD, Mendonça VA, Lacerda ACR. Determinants of High Fat Mass Index in Preschoolers Living in Brazilian Urban Areas. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:532-539. [PMID: 35618405 DOI: 10.1016/j.jneb.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 12/17/2021] [Accepted: 01/24/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Determine the social, environmental, and personal factors associated with high fat mass index in preschoolers. DESIGN A quantitative, exploratory, and cross-sectional study. SETTING AND PARTICIPANTS Fifty-one Brazilian preschoolers from public schools living in urban areas. MAIN OUTCOME MEASURE(S) The preschoolers' fat mass index was determined using dual-energy radiological absorptiometry. The quality of home and school environments were accessed using the Early Childhood Home Observation for Measurement of the Environment and Early Childhood Environment Rating Scales. The physical activity levels were recorded by accelerometers. The daily energy intake was recorded and sociodemographic data using the Brazilian Economic Classification criterion. Data on exposure time to screens and parental obesity were collected according to the parents' reports. ANALYSIS Data analyses were performed using simple and multiple regressions models. RESULTS Parental obesity (β, 0.516; 95% confidence interval [CI], 2.078-5.133), high quality of environmental stimulation of home (β, 0.429; 95% CI, 1.294-4.023), and high exposure time to screens (β, 0.256; 95% CI, 0.215-2.554) explained 43% of preschoolers' high fat mass index. CONCLUSIONS AND IMPLICATIONS Identification of parental obesity, high quality of environmental stimulation of home, and high exposure time to screens as the most important determinants of the high fat mass index in preschoolers from Brazilian urban areas.
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Affiliation(s)
- Juliana Nogueira Pontes Nobre
- Integrated Center for Postgraduation and Health Research, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil.
| | - Rosane Luzia De Souza Morais
- Faculty of Physiotherapy, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Maria Letícia Ramos-Jorge
- Faculty of Dentistry-Pediatric Dentistry, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Amanda Cristina Fernandes
- Integrated Center for Postgraduation and Health Research, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Ângela Alves Viegas
- Integrated Center for Postgraduation and Health Research, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | | | - Henrique Silveira Costa
- Faculty of Physiotherapy, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Elizabethe Adriana Esteves
- Integrated Center for Postgraduation and Health Research, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Fidelis Antônio da Silva Júnior
- Integrated Center for Postgraduation and Health Research, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | | | - Marco Fabrício Dias Peixoto
- Integrated Center for Postgraduation and Health Research, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Vanessa Amaral Mendonça
- Faculty of Physiotherapy, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
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15
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Effect of screen time intervention on obesity among children and adolescent: A meta-analysis of randomized controlled studies. Prev Med 2022; 157:107014. [PMID: 35248682 DOI: 10.1016/j.ypmed.2022.107014] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 01/04/2022] [Accepted: 02/28/2022] [Indexed: 11/23/2022]
Abstract
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.
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Jensen ML, Dillman Carpentier FR, Corvalán C, Popkin BM, Evenson KR, Adair L, Taillie LS. Television viewing and using screens while eating: Associations with dietary intake in children and adolescents. Appetite 2022; 168:105670. [PMID: 34478756 PMCID: PMC8671257 DOI: 10.1016/j.appet.2021.105670] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 07/15/2021] [Accepted: 08/29/2021] [Indexed: 01/03/2023]
Abstract
Screen time has been associated with overweight and obesity, as well as with poorer dietary quality. However, the reasons explaining these associations are not well understood. The objectives of this cross-sectional study were [1] to determine the extent of overall TV viewing as well as using screens while eating (e.g., watching TV or using a tablet), [2] to compare food and nutrient consumption of on-versus off-screen eating occasions, and [3] to determine whether TV viewing and using screens while eating is associated with overall dietary intake. Participants were from the Food Environment Chilean Cohort (n = 938, 4-6 y) and the Growth and Obesity Cohort Study (n = 752, 12-14 y). Dietary data was collected via one 24-h food recall. For each eating occasion, activity performed during consumption (e.g., watching TV, playing sports) was reported. Weekly TV viewing time was collected via an additional survey instrument. Analyses included multivariable linear and logistic regression. Post-hoc pairwise comparisons examined differences in outcomes by tertiles. Our sample reported a median of 9-13.5 weekly hours of TV viewing and 87.5% reported consuming at least one meal or snack per day while using screens. The median kilocalories contributed by eating during screen use was 387 kcal/d in children and 848 kcal/day in adolescents, which represents 34.7% and 42.3% of daily energy intake, respectively. There were no consistent differences when comparing eating occasions consumed on-screen versus off-screen. Higher weekly TV viewing was associated with elements of a less healthy diet including more sweets and desserts in children, and more sugar sweetened beverages in adolescents. A large percentage of Chilean children and adolescents' daily energy is consumed while using screens. In depth, longitudinal work is needed to understand how screen time eating affects diet quality and nutritional status.
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Affiliation(s)
- Melissa L Jensen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Global Food Research Program, Carolina Population Center, Chapel Hill, NC, USA; School of Nutrition, University of Costa Rica, San José, Costa Rica
| | | | - Camila Corvalán
- Instituto de Nutrición y Tecnología de Alimentos, Universidad de Chile, Macul, Chile
| | - Barry M Popkin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Global Food Research Program, Carolina Population Center, Chapel Hill, NC, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Linda Adair
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Global Food Research Program, Carolina Population Center, Chapel Hill, NC, USA.
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Chong WW, Abd Rahman FN, Harun NA. Screen time of children with speech delay: a cross-sectional study in a tertiary center in Kuantan, Malaysia. Pediatr Int 2022; 64:e15105. [PMID: 35411977 DOI: 10.1111/ped.15105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 11/11/2021] [Accepted: 12/22/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Studies suggest excessive screen time (use of smartphones, televisions, computers and/or video games) is linked to speech and language delay. This study explored the sociodemographic characteristics of children with speech delay in Kuantan, Malaysia, and the association of screen time with speech and other developmental delays. METHODS This cross-sectional study was conducted between July and November 2019 at the child psychiatry and speech therapy clinics, at Kuantan Hospital, Pahang, Malaysia. Parents of children with speech delay aged <72 months provided information on their children's and their own screen times. Speech and other developmental skills were assessed using the Schedule of Growing Skills II with scores reported as developmental quotient (DQ) level. RESULTS The study included 91 children (67 boys, 24 girls) of whom 54.9% had primary speech delay and 45.1% had neurodevelopmental disorders; their mean age was 39.9 ± 11.52 months. The children's mean screen time was 2.26 ± 1.98 h daily, with 36.3% exceeding 2 h. Higher children's screen time was moderately correlated with higher parental screen time (rs = 0.479, P < 0.01). Household income was positively correlated with screen times of the children and the parents (rs = 0.243, P = 0.02 and rs = 0.390, p < 0.01, respectively). Parents who intended to reduce their children's screen time reported higher screen time in their children (t(89) = 2.322, P = 0.023). Children's age was positively correlated with the number of types of screen media (rs = 0.225, P = 0.032). The mean speech DQ was 54.76 ± 24.06%. Lower speech DQ was associated with lower DQs in other skills (P < 0.01). No significant correlation was shown between children's and parents' screen time with DQs of speech and other skills (P > 0.05). CONCLUSION The correlation between parent and child screen time provides an opportunity for possible intervention, where necessary. Larger studies are required to examine this correlation further.
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Affiliation(s)
- Wei Wei Chong
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.,Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
| | - Fairuz Nazri Abd Rahman
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Noorul Amilin Harun
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
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Assessment of the influence of physical activity and screen time on somatic features and physical fitness in 6 to 7-year-old girls. ANTHROPOLOGICAL REVIEW 2022. [DOI: 10.2478/anre-2021-0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Aim of the study is to assess the relationship between screen time, physical activity and physical fitness among girls 6–7 years-old.
21,528 girls aged 6 and 7 from Poland were assessed in terms of physical fitness. Arm strength, abdominal strength and explosive strength of the lower limbs were measured using the EUROFIT test. Basic somatic features were measured and BMI and WHtR indices were calculated. Spontaneous and organized physical activities as well screen time were assessed by the parents utilizing a questionnaire. The multiple logistic regression method was used to evaluate the influence of screen time and spontaneous physical activity on various components of physical fitness.
Physically active (PA) girls (≥1h/day) and those who participated in additional physical activities (APA) during the week had significantly higher height, weight, and BMI (p<0.001), but not WHtR. They had a higher level of flexibility, explosive strength of the lower limbs and arm strength (p<0.001). With an increase in screen time, the BMI, WHtR increased significantly and explosive strength of the lower limbs, abdominal strength and arm strength were lower. Regression analysis showed that more frequent participation in extracurricular activities increased the values of BMI and WHtR in quartile 4 (Q4), and strength components: Q2–Q4 (p<0.05). Spontaneous physical activity was positively related to the values of BMI, WHtR (both: Q4; p<0.05), explosive force of lower limbs (Q3–Q4; p=0.001), and negatively related to arm strength (Q2; p=0.001). Screen time (≥2hrs/day) increased odds for higher BMI values (p<0.05). Each screen time category decreased the odds of achieving abdominal muscle strength related to the quartiles: Q2–Q4 (p<0.05), arm strength (Q4: p<0.05). ST (1 <2hrs/day) decreased arm strength (Q3; p= 0.045). Our research has shown that screen time-related sedentary behavior and physical activity affect overweight and obesity indices (especially BMI) and strength abilities. The observed associations more often affected girls with a higher level of fitness The results observed in girls aged 6-7 indicate a need for early intervention aimed at limiting time spent watching TV and computer use, as well as to encourage both spontaneous and organized physical activities.
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Alqarni TA, Alshamrani MA, Alzahrani AS, AlRefaie AM, Balkhair OH, Alsaegh SZ. Prevalence of screen time use and its relationship with obesity, sleep quality, and parental knowledge of related guidelines: A study on children and adolescents attending Primary Healthcare Centers in the Makkah Region. J Family Community Med 2022; 29:24-33. [PMID: 35197725 PMCID: PMC8802733 DOI: 10.4103/jfcm.jfcm_335_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/22/2021] [Accepted: 11/13/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Since the use of handheld electronic devises is prevalent among people of all ages, health organizations have specified appropriate screen times for the different age groups. The aim of this study was to investigate the prevalence of screen use and its association with sleep quality and obesity. MATERIALS AND METHODS: This cross-sectional study was conducted on people attending three Primary Healthcare Centers in the Makkah region between January and October 2019. The three-part questionnaire filled by parents collected data on sociodemographics, parental knowledge of guidelines, and asleep quality. Data were analyzed using STATA 14.2. For continuous variables, groups were compared using t-test; Pearson Chi-squared test or Fisher's exact test, as appropriate, was employed for categorical variables. RESULTS: A total of 450 individuals completed the questionnaire. Children 2–12 years old spent more time and used phones, tablets, and television (TV) more frequently, while those younger than 2 or older than 12 used phones and TVs more than other devices. High body mass index was associated with the daily usage of electronic devices. Fewer hours of sleep, longer time to fall sleep, and longer hours in bed were associated with the usage of all electronic devices. Furthermore, a good knowledge of the maximum time allowed for children and teenagers and content scoring system was associated with hours slept per night, and low knowledge was associated with higher frequency of using electronic devices. CONCLUSION: Children spent long periods using electronic devices, and despite knowing the guidelines, parents still allowed their children to exceed the time acceptable for the use of electronic devices, which could lead to future social problems.
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Affiliation(s)
- Turki A. Alqarni
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia,King Abdullah International Medical Research Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia,Address for correspondence: Dr. Turki A. Alqarni, P.O. Box 9515, Jeddah, 21423, Makkah Region, Saudi Arabia. E-mail:
| | - Mohammed A. Alshamrani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia,King Abdullah International Medical Research Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Alhussain S. Alzahrani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia,King Abdullah International Medical Research Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia,Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Asmaa M. AlRefaie
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia,King Abdullah International Medical Research Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia,Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Ohoud H. Balkhair
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia,King Abdullah International Medical Research Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia,Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Samar Z. Alsaegh
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia,King Abdullah International Medical Research Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia,Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, Jeddah, Saudi Arabia
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Byrne R, Terranova CO, Trost SG. Measurement of screen time among young children aged 0-6 years: A systematic review. Obes Rev 2021; 22:e13260. [PMID: 33960616 PMCID: PMC8365769 DOI: 10.1111/obr.13260] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 12/16/2022]
Abstract
The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.
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Affiliation(s)
- Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Caroline O. Terranova
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Stewart G. Trost
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
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Arumugam CT, Said MA, Nik Farid ND. Screen-based media and young children: Review and recommendations. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2021; 16:7-13. [PMID: 34386158 PMCID: PMC8346754 DOI: 10.51866/rv1143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Early childhood development is influenced by a child's environmental experiences. The qualities of surrounding in which a child lives, grows up and learns are key for attaining their milestones. Increased availability of screen-based media in families leads to excessive screen time among young children, resulting in high chances of displacing parent-child interaction which is fundamental in a thriving child's process of learning and development. Numerous publications have investigated the potential health impacts of early exposure and excessive usage of screen-based media among children, with literature suggesting links between excessive screen time and behavioural difficulties, developmental delay and increased risk of obesity, among other issues. Existing guidelines from international bodies call for limiting screen time to an hour per day for children aged two to five years old and urge that children below the age of two should not be exposed to any screen time. To spark awareness among parents and caregivers concerning the potential health impacts of screen-based media usage among young children, child media habits are recommended to be incorporated as part of toddlers' developmental assessment in health clinics. A guideline for mindful usage of screen-based media focusing on children below the age of five tailored to a Malaysian context ought to be developed based on current evidence from research, theory and practice. A collaborative effort between concerned agencies is essential to ensuring a developmentally stimulating environment in which young children may grow up.
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Affiliation(s)
- Catherine Thamarai Arumugam
- Medical Degree (MD), Master of Public Health (MPH), Doctor in Public Health (DrPH) Candidate, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia,
| | - Mas Ayu Said
- MBBS, MPH (Epidemiology), PhD, Centre for Epidemiology and Evidence-Based Practice (CEEBP), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nik Daliana Nik Farid
- MBBS (Adelaide), MPH (Malaya), DrPH (Malaya), Medical Lecturer and Public Health Specialist, Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Nassar MF, Allam MF, Shata MO. Effect of COVID-19 Lockdown on Young Egyptian Soccer Players. Glob Pediatr Health 2021; 8:2333794X211012980. [PMID: 34017905 PMCID: PMC8114258 DOI: 10.1177/2333794x211012980] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/01/2021] [Indexed: 12/23/2022] Open
Abstract
The present study was designed to highlight the physical and psychological health hazards that a young Egyptian soccer team faced during the first COVID-19 wave lockdown. The study included 37 young Egyptian male soccer players. History taking and anthropometric measurements were taken. Two questionnaires were filled covering the athletes’` sleep habits and quality of life (QoL). Finally, the mothers were asked to fill in a questionnaire concerned with depression, anxiety, and stress. More than 50% of the enrolled athletes gained weight during the lockdown especially those without compliance to home exercises. The mothers’ anxiety score correlated positively with the increased body mass index (BMI) of the athletes. The athletes mean QoL Score worsened significantly and significant negative correlation was found between the increased BMI and the change of QoL. The increased BMI was significantly reported among the athletes who didn’t do home exercises and had a negative correlation with their QoL change throughout the lockdown. The mothers’ anxiety had a possible reflection on their youngsters’ weight gain. These findings highlight the need for weight control when outdoors physical activity is restricted during pandemics with better compliance to home exercising schedules and less screen time.
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Lee EY, Song YK, Hunter S, Jeon J, Kuzik N, Predy M, Carson V. Levels and correlates of physical activity and screen time among early years children (2-5 years): Cross-cultural comparisons between Canadian and South Korean data. Child Care Health Dev 2021; 47:377-386. [PMID: 33463740 DOI: 10.1111/cch.12850] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 12/22/2020] [Accepted: 01/14/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cross-cultural research can provide insight into whether levels and correlates of movement behaviours among early years children vary across different cultural contexts. This study (1) compared children's physical activity (PA) and screen time (ST) and parental and environmental correlates of PA and ST between samples of Canadian and South Korean (Korean thereafter) early years children (2-5 years) and (2) investigated parental and environmental correlates of PA and ST and whether country moderates the relationships. METHODS Cross-sectional data from 121 Canadian children (3.4 years; 49.6% girls) and 101 Korean children (3.4 years; 54.9% girls) who participated in the Parents' Role in Establishing healthy Physical activity and Sedentary behaviour habits (PREPS) study were used. Demographic information, children's PA, ST, PA- or ST-specific parental cognitions and behaviours, and home and neighbourhood environments were measured using a proxy-reported questionnaire. Two-tailed independent samples T test or Mann Whitney U test, chi-square tests, linear regression and moderation analyses were performed. RESULTS Canadian children spent more time in non-organized PA compared to Korean children (111 vs. 63 min/day), whereas time spent in organized PA was higher in Korean children than Canadian children (25 vs. 9 min/day). Canadian children had more ST than Korean children (159 vs. 110 min/day). Similarly, Canadian parents reported higher screen (142 vs. 116 min/day) and sitting time (317 vs. 286 min/day) than Korean parents. Though children's behaviours, as well as parental cognitions and behaviours, varied between the two samples, similar correlates of children's PA and ST were observed. The relationship between presence of electronics in children's bedrooms and children's ST was moderated by country, with Canadian children showing a stronger relationship than Korean children. CONCLUSIONS Supporting parents to adopt cognitions and behaviours that are conducive to healthy PA and ST patterns of their own and their early years children may be important for both Canada and Korea.
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Affiliation(s)
- Eun-Young Lee
- School of Kinesiology and Health Studies, Queens University, Kingston, Ontario, Canada
| | - Yoon-Kyung Song
- Department of Sport Industry, Yonsei University, Seoul, South Korea
| | - Stephen Hunter
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Justin Jeon
- Department of Sport Industry, Yonsei University, Seoul, South Korea
| | - Nicholas Kuzik
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Madison Predy
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
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Miller MA, Bates S, Ji C, Cappuccio FP. Systematic review and meta-analyses of the relationship between short sleep and incidence of obesity and effectiveness of sleep interventions on weight gain in preschool children. Obes Rev 2021; 22:e13113. [PMID: 33237635 DOI: 10.1111/obr.13113] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 12/23/2022]
Abstract
The aim of this study is to determine (a) whether short sleep is associated with the incidence of obesity and (b) whether interventions beneficial for sleep reduce weight gain in preschool children. We systematically searched PubMed, Embase, Web of Science and Cochrane up to 12/09/2019. (a) Studies that were included were prospective, had follow-up ≥1 year, with sleep duration at baseline and required outcome measures. (b) Intervention trials with sleep intervention and measures of overweight or obesity were included. Data were extracted according to PRISMA guidelines. (a) The risk of developing overweight/obesity was greater in short sleeping children (13 studies, 42 878 participants, RR: 1.54; 95% CI, 1.33 to 1.77; p < 0.001). Sleep duration was associated with a significant change in BMI z-score (10 studies, 11 cohorts and 29 553 participants) (mean difference: -0.02 unit per hour sleep; -0.03 to -0.01; p < 0.001). (b) Four of the five intervention studies reported improved outcomes: for BMI (-0.27 kg/m2 ; -0.50 to -0.03; p = 0.03); for BMI z-score (-0.07 unit; -0.12 to -0.02; p = 0.006). Short sleep duration is a risk factor or marker of the development of obesity in preschool children. Intervention studies suggest that improved sleep may be beneficially associated with a reduced weight gain in these children.
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Affiliation(s)
- Michelle A Miller
- Division of Health Sciences (Mental Health and Wellbeing), Warwick Medical School, University of Warwick, Coventry, UK
| | - Sarah Bates
- Birmingham Community Healthcare NHS Foundation Trust (Birmingham Community Nutrition), Birmingham, UK
| | - Chen Ji
- Division of Health Sciences (Mental Health and Wellbeing), Warwick Medical School, University of Warwick, Coventry, UK
| | - Francesco P Cappuccio
- Division of Health Sciences (Mental Health and Wellbeing), Warwick Medical School, University of Warwick, Coventry, UK.,University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
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Liberali R, Del Castanhel F, Kupek E, Assis MAAD. Latent Class Analysis of Lifestyle Risk Factors and Association with Overweight and/or Obesity in Children and Adolescents: Systematic Review. Child Obes 2021; 17:2-15. [PMID: 33306451 DOI: 10.1089/chi.2020.0115] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background: Multiple modifiable lifestyle factors are well-known contributors to many health problems. Objectives: This study aims to determine the association between latent class analysis (LCA) of modifiable lifestyle risk factors with being overweight and/or obese for children and/or adolescents. Methods: Articles were selected from six databases, without limitation regarding language or date. The review included studies that identify latent classes of modifiable lifestyle risk factors [e.g., physical activity (PA), diet, sedentary behavior (SB), and/or unhealthy behavior] by LCA to determine the association between latent classes with being overweight and/or obese. The methodology of the selected studies was evaluated using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Owing to the heterogeneity between latent classes of modifiable lifestyle risk factors with obesity and/or being overweight, the results are described narratively. Results: Using a selection process in two phases, nine articles were included. All of the included studies were of high methodological quality. The studies were conducted in six different countries: the USA, Brazil, Canada, Portugal, Italy, and Australia. Sample sizes ranged from 166 to 18.587 children and adolescents, and in terms of age (range 5-19 years). Across study clusters characterized by low consumption of fruit and vegetables, and high consumption of fatty foods, sugar snack foods, sweets, chips and fries, low PA (<1 hour each day), and high SB (screen time and TV >2 hours/day), sleep time (<10 hours/day) were positively associated with being overweight and/or obese. Conclusion: Overall there is good evidence to support that the modifiable lifestyle risk factors clustered together by LCA should be novel targets for the treatment of obesity and its associated comorbidities.
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Affiliation(s)
- Rafaela Liberali
- Post-graduation Program in Medical Sciences, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Flavia Del Castanhel
- Post-graduation Program in Medical Sciences, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Emil Kupek
- Department of Public Health, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
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Cross-Cultural Adaptation of Instruments Measuring Children's Movement Behaviors and Parenting Practices in Brazilian Families. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010239. [PMID: 33396197 PMCID: PMC7794996 DOI: 10.3390/ijerph18010239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/18/2020] [Accepted: 12/29/2020] [Indexed: 12/31/2022]
Abstract
Childhood obesity is a global problem, disproportionately affecting children in low-to-middle income countries (LMIC). Despite this evidence, no previous study has adapted instruments measuring children’s movement behaviors and associated parenting practices for use in LMIC families. This study reports the results of a cross-cultural adaptation of previously validated measures of children’s movement behaviors and parenting practices in economically disadvantaged Brazilian families. Study 1 involved translation of the instruments from English to Portuguese. A team of translators (fluent in both English and Portuguese) and researchers followed established procedures for translating measurement scales, identifying problematic items, and reaching consensus on discrepancies. Study 2 involved cognitive interviews with 24 parents from urban and rural North-eastern Brazil addressing the format, content, and clarity of the items. Half the parents provided feedback on the first 33 items of the questionnaire, with the remaining parents providing feedback on the final 29 items. Notes were recorded during the interview and parents’ feedback summarized in a report. In the translation and back-translation, 15 discrepancies were identified. These were mostly due to multiple Portuguese words having the same meaning in English. The research team discussed these discrepancies and consensus was reached to ensure that the concepts depicted in the Portuguese version were consistent with the English version. In the cognitive interviews, parents identified minor problems with item comprehension resulting in minor adaptations to response options, recall period, and format of the questionnaire. The process of translation and cognitive interviews conducted in Brazilian families resulted in an appropriate cultural adaptation of scales measuring children’s movement behaviors and parenting practices. Future studies should evaluate the validity and reliability of the measures in LMIC families.
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Guerrero MD, Vanderloo LM, Rhodes RE, Faulkner G, Moore SA, Tremblay MS. Canadian children's and youth's adherence to the 24-h movement guidelines during the COVID-19 pandemic: A decision tree analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2020; 9:313-321. [PMID: 32525098 PMCID: PMC7276134 DOI: 10.1016/j.jshs.2020.06.005] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 05/20/2020] [Accepted: 05/25/2020] [Indexed: 05/27/2023]
Abstract
PURPOSE The purpose of this study was to use decision tree modeling to generate profiles of children and youth who were more or less likely to meet the Canadian 24-h movement guidelines during the coronavirus disease-19 (COVID-19) outbreak. METHODS Data for this study were from a nationally representative sample of 1472 Canadian parents (Meanage = 45.12, SD = 7.55) of children (5-11 years old) or youth (12-17 years old). Data were collected in April 2020 via an online survey. Survey items assessed demographic, behavioral, social, micro-environmental, and macro-environmental characteristics. Four decision trees of adherence and non-adherence to all movement recommendations combined and each individual movement recommendation (physical activity [PA], screen time, and sleep) were generated. RESULTS Results revealed specific combinations of adherence and non-adherence characteristics. Characteristics associated with adherence to the recommendation(s) included high parental perceived capability to restrict screen time, annual household income of ≥ $100,000, increases in children's and youth's outdoor PA/sport since the COVID-19 outbreak began, being a boy, having parents younger than 43 years old, and small increases in children's and youth's sleep duration since the COVID-19 outbreak began. Characteristics associated with non-adherence to the recommendation(s) included low parental perceived capability to restrict screen time, youth aged 12-17 years, decreases in children's and youth's outdoor PA/sport since the COVID-19 outbreak began, primary residences located in all provinces except Quebec, low parental perceived capability to support children's and youth's sleep and PA, and annual household income of ≤ $99,999. CONCLUSION Our results show that specific characteristics interact to contribute to (non)adherence to the movement behavior recommendations. Results highlight the importance of targeting parents' perceived capability for the promotion of children's and youth's movement behaviors during challenging times of the COVID-19 pandemic, paying particular attention to enhancing parental perceived capability to restrict screen time.
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Affiliation(s)
- Michelle D Guerrero
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada.
| | - Leigh M Vanderloo
- ParticipACTION, Toronto, ON M5S 1M2, Canada; Child Health and Evaluative Sciences, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Ryan E Rhodes
- Behavioral Medicine Laboratory, School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC V8W 2Y2, Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
| | - Sarah A Moore
- Department of Therapeutic Recreation, Faculty of Child, Family, and Community Studies, Douglas College, Coquitlam, BC V3B 7X3, Canada; School of Health and Human Performance, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; Department of Pediatrics, University of Ottawa, Ottawa, ON K1H 8L1, Canada
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Martin KB, Bednarz JM, Aromataris EC. Interventions to control children's screen use and their effect on sleep: A systematic review and meta-analysis. J Sleep Res 2020; 30:e13130. [PMID: 32567219 DOI: 10.1111/jsr.13130] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 01/09/2023]
Abstract
Prolonged viewing of screen-based media is associated with poor sleep in children. Previous systematic reviews have analysed the effectiveness of interventions that aim to limit children's screen use; however, none have evaluated its effect on sleep. The aim of this systematic review was to evaluate the effect of interventions that incorporate strategies to control children's screen use on screen use and sleep. The databases Pubmed, Embase, Eric, Scopus and PsycInfo were searched during October 2017 and updated in February 2019 for experimental studies with a control that assessed interventions to control screen use in children aged 2-14 years and reported both screen use and sleep outcomes. From 3,872 initial records, 11 studies (six randomized control [RCT], four cluster RCT and one cluster, quasi-experimental) were eligible for inclusion. A total of 4,656 children aged 2-13 years were included in the studies. The mean reduction in screen time was 0.56 hr (33 min)/day (95% confidence interval [CI], 0.92, 0.20) and the mean sleep duration increased by 0.19 hr (11 min)/day (95% CI, 0.05, 0.33). Bedtime was advanced by 0.16 hr (10 min) on weekdays and by 1.0 hr at the weekend. Subgroup analyses indicated stronger intervention effects for interventions of shorter duration (<3 months), which specifically targeted screen use or sleep, and those with direct participant contact. In conclusion, small improvements in screen time and sleep duration can be achieved in children. It is not possible to determine if a reduction in screen time directly improves sleep, due to the limited number of studies, the presence of co-interventions, issues with studies' methodological quality and heterogeneity.
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Affiliation(s)
- Katie B Martin
- Joanna Briggs Institute, University of Adelaide, Adelaide, SA, Australia
| | - Jana M Bednarz
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
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Rhodes RE, Guerrero MD, Vanderloo LM, Barbeau K, Birken CS, Chaput JP, Faulkner G, Janssen I, Madigan S, Mâsse LC, McHugh TL, Perdew M, Stone K, Shelley J, Spinks N, Tamminen KA, Tomasone JR, Ward H, Welsh F, Tremblay MS. Development of a consensus statement on the role of the family in the physical activity, sedentary, and sleep behaviours of children and youth. Int J Behav Nutr Phys Act 2020; 17:74. [PMID: 32539730 PMCID: PMC7296673 DOI: 10.1186/s12966-020-00973-0] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/18/2020] [Indexed: 02/07/2023] Open
Abstract
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.
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Affiliation(s)
- Ryan E. Rhodes
- Behavioural Medicine Laboratory, Faculty of Education, University of Victoria, PO Box 3010 STN CSC, Victoria, BC V8W 3N4 Canada
| | - Michelle D. Guerrero
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1 Canada
| | | | - Kheana Barbeau
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1 Canada
- School of Psychology, University of Ottawa, Ottawa, ON K1N 9A8 Canada
| | - Catherine S. Birken
- SickKids Research Institute and the Department of Pediatrics, University of Toronto, Toronto, ON M5G 1X8 Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1 Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, BC V6T 1Z4 Canada
| | - Ian Janssen
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - Sheri Madigan
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB T2N 1N4 Canada
| | - Louise C. Mâsse
- BC Children’s Hospital Research Institute / School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC V6H 3N1 Canada
| | - Tara-Leigh McHugh
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta T6G 2H9 Canada
| | - Megan Perdew
- Behavioural Medicine Laboratory, Faculty of Education, University of Victoria, PO Box 3010 STN CSC, Victoria, BC V8W 3N4 Canada
| | | | - Jacob Shelley
- Faculty of Law & School of Health Studies, Faculty of Health Sciences, Western University, London, ON N6A 3K7 UK
| | - Nora Spinks
- The Vanier Institute of the Family, Ottawa, ON K2G 6B1 Canada
| | - Katherine A. Tamminen
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2W6 Canada
| | - Jennifer R. Tomasone
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - Helen Ward
- Kids First Parents Association of Canada, Burnaby, BC V5C 2H2 Canada
| | - Frank Welsh
- Canadian Public Health Association, Ottawa, ON K1G 3Y6 Canada
| | - Mark S. Tremblay
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1 Canada
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Influence of Parental Physical Activity and Screen Time on the BMI of Adult Offspring in a Saudi Population. Healthcare (Basel) 2020; 8:healthcare8020110. [PMID: 32344646 PMCID: PMC7348799 DOI: 10.3390/healthcare8020110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/17/2020] [Accepted: 04/22/2020] [Indexed: 01/02/2023] Open
Abstract
Saudi Arabia is witnessing a drastic rise in adult obesity. Geographic limitations hamper somatic activities to counter this rise. Parental physical inactivity in the region has never been addressed. This study’s purpose is to determine the differences between parent and adult child (the subjects here) levels of physical activity (PA) and screen time (ST) between normal weight and obese adults in the Saudi Arabian population. Two hundred and forty adult subjects (18 to 35 years) were screened for their body mass index (BMI) values (18.5 ≤ 25 as normal and 25 ≤ 30) or above as overweight/obese), followed by their congregation into normal weight (N) (n = 150) and overweight/obese (Ov/Ob) (n = 90) groups. A self-reported questionnaire assessed parenting practices, while a physical activity record diary calculated existing levels of PA and ST. Statistical significance was determined by a chi-squared test (p < 0.01) and BMI correlation was found by Pearson’s correlation coefficient. Maternal age (87.8% ≤ 20 years in the Ov/Ob group (Gp) and consanguineous marriage (88.9% in the Ov/Ob Gp) showed significant differences. A high prevalence of inactivity was observed among families (father 53.3%, mother 53.3%, subject 80.0%) in the Ov/Ob Gp. Higher amounts of ST (76.7% ≥ 9 h/day) were found in the Ov/Ob Gp, which significantly differed. Differences in the parent and child levels of PA and ST exist between normal weight and obese Saudi Arabian adults. Physically active parents having adult children inspire them to develop healthy physical behaviors which counter the development of obesity. Consanguineous marriage and early maternal age may be associated with progressive adult obesity.
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Thompson DA, Tschann JM. Update on Screen-Related Parenting Practices in Early Childhood. Acad Pediatr 2020; 20:1066-1068. [PMID: 32653689 PMCID: PMC7655564 DOI: 10.1016/j.acap.2020.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/20/2020] [Accepted: 07/05/2020] [Indexed: 11/16/2022]
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