Comparisons in Screen-Time Behaviours among Adolescents with and without Long-Term Illnesses or Disabilities: Results from 2013/14 HBSC Study

Physical activity of children and adolescents with disabilities in Poland - First Para Report Card

Background

This study provides a comprehensive evaluation of the Polish Para Report Card, which assesses various aspects of physical activity (PA) and related indicators among Polish children and adolescents with disabilities. This area has been under-researched, especially in the Polish context.

Methods

The research methodology included systematic literature searches from 2014 to 2022, utilizing databases such as PubMed, EBSCO, and Google Scholar. This was complemented by outreach to governmental institutions for additional reports and data. The search strategy was aligned with the Global Matrix methodology and aimed at evaluating ten distinct indicators: Overall PA, Organized Sport and PA, Active Play, Active Transportation, Sedentary Behavior, Family and Peers, School, Community and Environment, Government.

Results

Grades were assigned to three of ten indicators. The Overall PA, Sedentary Behavior, and Government indicators each received a D-grade.

Conclusions

The study reveals the need for an extensive system to monitor PA among Polish children and adolescents with disabilities, and the development of effective strategies to enhance PA in this group. Children with disabilities in Poland are under-researched in the area of PA compared to their their counterparts without disabilities.

Association of Friendly School and Family Contexts and Reducing Health Risk Behaviors Among Adolescents: A Cross-National Study in Europe, North America, and China

BACKGROUND

Social factors play an important role in adolescents' behaviors. This study aims to understand percentages of health risk behaviors across country in Europe, North America, and China; explore the associations between friendly school and family contexts and involvement for several health risk behaviors among adolescents.

METHODS

Data derived from health behavior in school-aged children cross-sectional surveys and China Education Panel Survey in 2014-2015. Hierarchical generalized linear modeling was used to analyze data.

RESULTS

The highest percentages of health risk behaviors including unhealthy diet, smoking or alcohol, screen-based sedentary behaviors, and violent behaviors across country ranged from 28.62% to 65.24%. National classmate friendliness was negatively associated with 5 out of 9 health risk behaviors prevalence rates in 41 countries (p < 0.05). Adolescents' perceived peer friendly and helpful were common protective factor for engaging in several health risk behaviors (p < 0.01). Individual family contexts were associated with 3 types of health risk behaviors involvement (p < 0.001).

SCHOOL HEALTH POLICY IMPLICATIONS

Health risk behaviors among adolescents reducing was associated with the implementation of friendly school and family contexts, emphasizing the significance of the goals of embedding friendly adolescents, along with the home-school collaboration.

CONCLUSIONS

Public health strategies should promote national climate of friendship and individual perceived friendly school contexts to reduce health risk behaviors.

Chronic health conditions and school experience in school-aged children in 19 European countries

This study investigates chronic conditions (CC) prevalence among children in mainstream schools, their school experience and life satisfaction in Europe. Data were collected from the 2017/2018 HBSC survey, a cross-national study using self-reported questionnaires administered in classrooms. Nationally representative samples of children aged 11, 13, and 15 years in mainstream schools from 19 European countries (n = 104,812) were used. School experience was assessed using four variables: low school satisfaction, schoolwork pressure, low teacher support, and peer-victimization, which were related to life satisfaction. Latent class analysis (LCA) was conducted to identify patterns of school experience among students with CC. The prevalence of CC varied from 8.4 (Armenia) to 28.2% (Finland). Children with CC (n = 17,514) rated their school experience and life satisfaction lower than children without CC. LCA identified three school experience patterns: "negative on all items" (37%), "negative on all items, except school pressure" (40%) and "overall positive" (23%). The distribution of subgroups varied across countries-in countries with a higher proportion of children with CC in mainstream schools, children reported more negative school experiences. Compared to the "overall positive" group, low life satisfaction was highest for students classified as "negative on all items" (relative risk (RR) = 2.9; 95% CI 2.2-3.8) with a lesser effect for "negative on all items, except school pressure" (RR) = 1.8; 95% CI 1.4-2.4). These findings provide cross-national data documenting the diversity in inclusive educational practices regarding school placement and school experiences, and suggest that efforts are still needed to allow a fully inclusive environment.

Evaluation of Physical Activity Indicators for French Children and Adolescents With Disabilities: National Para Report Card and SWOT Analysis

The objectives of this work were (a) to adopt the Active Healthy Kids Global Alliance Report Card methodology to evaluate the state of physical activity (PA) for French children and adolescents with disabilities (CAWD) and (b) to identify the strengths, weaknesses, opportunities, and threats (SWOT) perceived by French PA experts for promoting PA among CAWD. The harmonized Active Healthy Kids Global Alliance Report Card development process was used to assign a grade to the 10 common PA indicators. SWOT templates were completed by PA experts and then collapsed in a summary figure. Despite increasing efforts to provide active opportunities to CAWD, concerning low grades were assigned to behavioral indicators. SWOT analysis provided important insights for the promotion of PA in CAWD. This work highlighted the need for the inclusion of CAWD in a comprehensive national PA surveillance system and for more efficient strategies promoting PA specifically targeting CAWD in France.

Screen time among school-aged children of aged 6-14: a systematic review

BACKGROUND

Screen time refers to the time an individual spends using electronic or digital media devices such as televisions, smart phones, tablets or computers. The purpose of this study was to conduct systematic review to analyze the relevant studies on the length and use of screen time of school-aged children, in order to provide scientific basis for designing screen time interventions and perfecting the screen use guidelines for school-aged children.

METHODS

Screen time related studies were searched on PubMed, EMBASE, Clinical Trials, Controlled Trials, The WHO International Clinical Trials Registry Platform, the Cochrane Central Register of Controlled Trials, CNKI, and Whipple Journal databases from January 1, 2016 to October 31, 2021. Two researchers independently screened the literature and extracted the data, and adopted a qualitative analysis method to evaluate the research status of the length and usage of screen time of school-aged students.

RESULTS

Fifty-three articles were included. Sixteen articles studied screen time length in the form of continuous variables. Thirty-seven articles studied screen time in the form of grouped variables. The average screen time of schoolchildren aged 6 to 14 was 2.77 h per day, and 46.4% of them had an average screen time ≥ 2 h per day. A growth trend could be roughly seen by comparing studies in the same countries and regions before and after the COVID-19 outbreak. The average rates of school-aged children who had screen time within the range of ≥ 2 h per day, were 41.3% and 59.4% respectively before and after January 2020. The main types of screen time before January 2020 were watching TV (20 literatures), using computers (16 literature), using mobile phones/tablets (4 literatures). The mainly uses of screens before January 2020 were entertainment (15 literatures), learning (5 literatures) and socializing (3 literatures). The types and mainly uses of screen time after January 2020 remained the same as the results before January 2020.

CONCLUSIONS

Excessive screen time has become a common behavior among children and adolescents around the world. Intervention measures to control children's screen use should be explored in combination with different uses to reduce the proportion of non-essential uses.

Is the Health Behavior in School-Aged Survey Questionnaire Reliable and Valid in Assessing Physical Activity and Sedentary Behavior in Young Populations? A Systematic Review

Backgrounds

Using the self-reported questionnaire to assess the levels of physical activity (PA) and sedentary behavior (SB) has been a widely recognized method in public health and epidemiology research fields. The selected items of the Health Behavior in School-aged (HBSC) Survey Questionnaire have been used globally for measurements and assessments in PA and SB of children and adolescents. However, there are no comprehensive and critical reviews to assess the quality of studies on reliability and validity of selected items for PA and SB measurement and assessment derived from the HBSC. Thus, this review aimed to critically assess the quality of those studies and summary evidence for future recommendations.

Methods

A systematic review protocol was used to search potentially eligible studies on assessing reliability and validity of PA and SB measures of the HBSC questionnaire. electronically academic databases were used. The information on the reliability and validity of the PA and SB measures were extracted and evaluated with well-recognized criteria or assessment tools.

Results

After a literature search, six studies were included in this review. The reliability of PA measures of the HBSC questionnaire showed a moderate agreement while the reliability of SB measures showed a great variation across the different items in the different subgroups. The validity of the PA measures had acceptable performance, whereas no studies assess the validity of the SB measures. The included studies all had quality weaknesses on reliability or validity analysis.

Conclusions

The PA and SB measures of the HBSC questionnaires were reliable in assessing PA and SB among adolescents. However, a little evidence showed that PA measures are partially valid in assessing PA, but no evidence confirmed the validity of SB measures. The included studies all had methodological weaknesses in examining the reliability and validity of the PA and SB measures, which should be addressed in the future. Further studies are encouraged to use a more standardized study design to examine the reliability and validity of the PA and SB measures in more young populations.

Relation of Anxiety, Depression, and Behavioral Problems With Time Allocated to Television, Computer, and Smartphone in Children Receiving Renal Replacement Therapy

OBJECTIVES

Children and adolescents with chronic diseases have more screen exposure time compared with their healthy peers. In this study, we investigated screen exposure time of children who received renal replacement therapy, which included kidney transplant and dialysis treatment, versus a healthy control group.

MATERIALS AND METHODS

Our study included 55 children and adolescents between the ages of 8 and 18 years. Although 28 participants did not have any chronic disease, 27 had chronic diseases and received renal replacement therapy. Among these patients, 17 had kidney transplant and 10 were receiving dialysis. A sociodemographic information form and the Conners Short-Form Parent Rating Scale were given to parents. Pediatric and adolescent patients completed the Children's Depression Inventory and Spielberger State-Trait Anxiety Scale-2. We analyzed differences between the groups with and without renal replacement therapy and examined relations between continuous variables.

RESULTS

Duration of television screen time was significantly higher in children and adolescents receiving renal replacement therapy. Patients in the renal replacement therapy group showed a positive correlation between the Conners Short-Form Parent Rating Scale anxiety subscores and duration of smartphone use. In the kidney transplant recipient group, smartphone and computer durations were positively correlated and television duration was negatively correlated with the Conners Short-Form Parent Rating Scale behavioral problems subscores.

CONCLUSIONS

Children on renal replacement therapy may be at risk in terms of excessive television exposure. Children who are on dialysis and have had a kidney transplant may be more prone to the negative effects of screen exposure than healthy peers who do not have chronic illnesses. These children and adolescents should be closely monitored to avoid the negative effects of excessive screen exposure.

Social Adventure

Social environments can be challenging for people with intellectual disability. These challenges impact a person’s social inclusion and participation in their communities. Social skills development requires training and practice, but training is often time-limited, costly, and hard to access. However, games on smart speakers provide interesting opportunities to improve training access, motivate self-directed learning, and focus on speech. The authors developed an interactive narrative-based social skills training game for smart-speakers. The game facilitates exploration of the social consequences of making various choices in different social situations and uses natural language inputs. Having tested the game with ten adults with intellectual disability, the authors offer designers insights into participant engagement and the game’s audio-only, natural language interface usability. The authors also propose four design considerations to help designers design applications that help people with intellectual disability participate in social activities.

Meeting physical activity and screen time among Colombian adolescents with or without sensory-related problems

The aim of this study was to assess the extent to which adolescents with and without visual and hearing-related problems meet physical activity (PA) and recreational screen time (ST) recommendations in a representative Colombian sample. A total of 35,404 adolescents aged 13-17 years were included from the Encuesta Nacional de Salud Escolar (ENSE) (Colombia). Sociodemographic-related information, anthropometric variables, PA, ST, and both visual- and hearing-related problems were collected by self-administered questionnaires. The prevalence of adolescents meeting with PA, ST, and both recommendations was 14.8%, 53.4%, and 7.8%, respectively. Both sexes with visual- (males: OR=0.70, 95%CI 0.59-0.83; females: OR=0.73, 95%CI 0.61-0.88) and hearing-related problems (males, OR=0.75, 95%CI 0.61-0.93; females, OR=0.76, 95%CI 0.61-0.94) are less likely to meet combined recommendations. Sensory problems such as vision- and hearing-related problems could be considered key barriers to engagement in PA and facilitators of recreational ST in Colombian adolescents.

Czech adolescents' remote school and health experiences during the spring 2020 COVID-19 lockdown

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One in five adolescents reported economic disruptions during spring 2020 lockdown.

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Girls and older adolescents reported the worst social and mental well-being.

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Perceived change in sleep and physical activity varied by gender and behavior.

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Adolescents reported consuming more fruits and vegetables and less energy drinks.

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Findings can be used for time trends that include the lockdown period.

Schools around the world were closed during the spring 2020 lockdown to reduce the spread of COVID-19. As such, these rapid changes to adolescent daily routines may have had immediate as well as long-term effects on their physical, social, and mental health. Therefore, the aim of this study was to examine the experiences, health behaviors and perceived change in health behaviors among adolescents in Czechia during the spring 2020 lockdown. Adolescents (n = 3,440, 54% girls; M_age = 13.5 years, SD = 1.6) from all regions of Czechia were recruited to complete a self-report survey based on the Health Behaviour in School-aged Children study, with additional items on household disruptions and socialization during lockdown, as well as items on perceived changes in health behaviors during lockdown. First, we described the self-reported impacts of the spring lockdown by gender and grade. Second, log-linear analyses were used to examine the perceived behavioral changes based on standardized cut-off values reporting for health behaviors and gender. Less than a third, 19% and 32% of the respondents reported economic and psychosocial disruptions to their family life, 79% indicated they had positive opportunities for family interactions or learning new things. Girls and older adolescents reported the worst levels of social and mental well-being. Changes in respondents’ perceived health behaviors varied by reported behavior frequencies and gender. These results may be useful to compare with future secular trends, and may serve as input in developing strategies to counter the impact of the spring 2020 or future similar lockdowns on the adolescents' well-being..

Risk and Protective Factors for Frequent Electronic Device Use of Online Technologies

A sample of 10,460 U.S. elementary schoolchildren was analyzed to identify early predictors of frequent use of online technologies (i.e., messaging, online gaming, and social networking). Children (Mage  = 67.44 months) at greater risk displayed more externalizing problem behaviors in kindergarten (messaging OR = 1.11; online gaming OR = 1.21; social networking OR = 1.12) or were Black (messaging OR = 1.65; online gaming OR = 1.64; social networking OR = 1.68). Children from higher-income families were at lower risk (online gaming OR = 0.89; social networking OR = 0.89). Boys were more frequent users of online gaming (OR = 3.35) but less frequent users of messaging (OR = 0.62) and social networking (OR = 0.80). Protective factors included specific parenting behaviors.

Mobile media exposure and use in children aged zero to five years with diagnosed neurodevelopmental disability

OBJECTIVE

The present study was conducted to determine the extent of exposure to and use of mobile devices by children (aged 0-60 months) with a diagnosed neurodevelopmental disability.

DESIGN

A self-report survey-based design was employed.

SETTING

Questionnaires were administered at a tertiary care hospital in Mumbai, India.

PARTICIPANTS

The study included a convenience sample of 423 children with a neurodevelopmental disability (aged 0-60 months). The self-report survey was administered to the parents of the children.

RESULTS

Analyses showed that 92.7% (n = 392) of all respondents have smartphones. 61% (n = 258) of the respondents stated that their children used mobile devices before 2 years of age. 58% (n = 246) of the parents gave children devices while feeding. A statistically significant difference was found in the mobile media usage between groups of children with different diagnoses (p < 0.001). Children diagnosed with ASD appeared to spend the largest amount of time on mobile media (m = 180.44 mins), as compared to children included with other diagnoses. Of the diagnosed children, only 13.4% (n = 57) of parents were informed about the possible negative effects of media use by their paediatricians.

CONCLUSION

The results suggest premature mobile media habits, frequent use and lack of awareness about the effects of mobile media usage among children diagnosed with a neurodevelopmental disability. We suggest there is a need to update recommendations for caregivers on the use of mobile media by young children with disability.Implications for rehabilitationThe usage and consequences of mobile media use differ based on the type of neurodevelopmental disorder diagnosis. Parents of children with neurodevelopmental disorders often use mobile media as a distraction while engaging in various activities themselves, this information helps identify times at which mobile media might be purposefully used by parents as distractorsThere is an urgent need for clinical guidelines regarding mobile media usage among young children with neurodevelopmental disorders.

Outdoor physical activity, compliance with the physical activity, screen time, and sleep duration recommendations, and excess weight among adolescents

BACKGROUND

Spending time outdoor has been identified as an important way to achieve the physical activity required for maintaining and improving health and to lower sedentary time among young children. However, evidence of such relationships in adolescents is particularly limited. This study investigated the relationships between frequency of outdoor physical activity after school, compliance with the physical activity, screen time, and sleep duration recommendations, and overweight/obesity among adolescents.

METHODS

A total of 10 028 middle and high school students (mean age of 15.2 y) self-reported the number of weekdays they spent physically active outdoors after school. Physical activity, screen time, sleep duration, height, and weight were self-reported. Logistic regression models for the total sample and stratified by sex were adjusted for important covariates.

RESULTS

Overall, there was a positive gradient between the number of weekdays spent physically active outdoor after school and compliance with the physical activity (more than or equal to 60 min/day at moderate-to-vigorous intensity) and screen time (less than or equal to 2 h/day) recommendations while a negative gradient with overweight/obesity was observed. Significant sex differences were observed in the associations of outdoor physical activity after school with adherence to the sleep duration and physical activity recommendations. For example, outdoor physical activity after school on all 5 days was associated with greater odds of compliance with the sleep duration recommendation among males (OR = 1.53; 95% CI, 1.01-2.31), but not females (OR = 0.92; 95% CI, 0.65-1.30).

CONCLUSIONS

Results suggest that outdoor physical activity after school could be a behavioural target to increase compliance with the physical activity and screen time recommendations and to possibly tackle excess weight among adolescents.

Twenty-Four-Hour Movement Guidelines and Body Weight in Youth

OBJECTIVE

To examine the prevalence of youth meeting the 24-hour healthy movement guidelines (ie, ≥60 minutes of moderate-to-vigorous physical activity, ≤2 hours of screen time, age-appropriate sleep duration), and which combination of meeting these guidelines was most associated with bodyweight status, in a nationally representative US sample.

STUDY DESIGN

Cross-sectional data from the 2016-2017 National Survey of Children's Health were used. A multinomial regression model of body weight status was generated (underweight, overweight, obese vs healthy weight) and then stratified by sex. Analyses were adjusted for potential confounders.

RESULTS

The sample (n = 30 478) was 50.4% female, 52.4% white, and the mean age was 13.85 ± 2.28 years; 15% percent were obese and 15.2% were overweight. Overall, 9.4% met all 3 of the 24-hour healthy movement guidelines, 43.6% met 2, 37.9% met 1, and 9.1% met none. Meeting zero guidelines (vs 3) was associated with the greatest likelihood of overweight (aOR, 1.85; 95% CI, 1.31-2.61), and obesity (aOR, 4.25; 95% CI, 2.87-6.31). Females (aOR, 4.97; 95% CI, 2.59-9.53) had higher odds of obesity than males (aOR, 3.99; 95% CI, 2.49-6.40) when zero (vs 3) guidelines were met. Meeting the moderate-to-vigorous physical activity guideline, either alone or in combination with screen time or sleep duration (vs all 3), was associated with the lowest odds for overweight and obesity in the full sample.

CONCLUSION

Meeting all movement guidelines was associated with the lowest risk for obesity, particularly in females. Meeting the moderate-to-vigorous physical activity guideline may be a priority to prevent overweight and obesity in youth.

Are adolescent sports fans more physically active than the sports indifferent? A self-reported questionnaire study

AIMS

Physical inactivity in adolescents is a global health problem. Eighty percent of adolescents worldwide do not meet the minimum recommended physical activity. Although many adolescents define themselves as a 'sports fan', the relationships between sports spectatorship and sport participation in adolescents have not yet been investigated. Here, we determine whether there is a relationship between the levels of sports spectatorship and physical activity among adolescents.

METHODS

The Physical Activity Questionnaire for Adolescents (PAQ-A), Sport Spectator Identification Scale (SSIS) and three questions regarding total screen time spent watching a sports game and other sports-related screen time on weekdays and weekends were given to high school students in two cities in Turkey (Konya and Ankara).

RESULTS

After excluding 21 invalid questionnaires, a total of 1100 full and valid questionnaires were returned from the participants (578 females, 522 males). Participants were aged between 13 and 19 (median = 15) years. Female students had lower PAQ-A (median = 2.38, interquartile range (IQR) = 0.99) and SSIS scores (median = 19, IQR = 24) and less total screen time on weekends compared to male students (median PAQ-A = 2.64, IQR = 1.05; median SSIS = 29, IQR = 30) (p < .05). The physical activity level of the students was significantly lower among those at higher grades. A weak positive correlation was found between SSIS scores and PAQ-A scores (r = .28, p < .01). Multiple linear regression analysis revealed that sex, age and SSIS scores were all significant predictors of PAQ-A scores (p < .001).

CONCLUSIONS

When comparing female and male adolescents, we found that females scored significantly less in mean physical activity levels, screen time on weekends and sports spectator identification. A positive correlation was observed between sports spectator identification and physical activity levels, both in males and in females. Higher sports spectator identification, being younger and being male were all significant predictors of higher levels of physical activity.

Screen time among Spanish university students with disabilities: a self-organizing maps analysis

BACKGROUND

Screen time can play a significant role in the health and quality of life of people with disabilities. However, there is a lack of studies on this issue among people with disabilities, and even fewer in the university setting. Thus, the aim of our study was to explore the relationships between screen time, disability grade, body mass index (BMI), physical activity and sociodemographic variables (gender and socioeconomic status) in university students with different disabilities.

METHODS

A cross-sectional study was conducted on a sample of 1091 students with disabilities from 55 Spanish universities. Instruments used for data gathering were the Adolescent Sedentary Activity Questionnaire (ASAQ) and the International Physical Activity Questionnaire-Short Form (IPAQ-SF). A Self-Organizing Maps (SOM) analysis was carried out to explore the relationships between the variables under study.

RESULTS

Participants reported high values in overall screen time (5.45 h per day/week), with computers being the media most used (2.45 h per day/week). The SOM analysis showed slightly higher screen time values in women than men. People with a high disability grade spent less screen time than those with lower disability grade. Contradictory results exist when a group of men with the highest BMI had the highest screen time and the lowest physical activity (PA) while women with low BMI show the highest screen time and PA.

CONCLUSIONS

Gender and disability grade played a moderating role in screen time among people with disabilities while BMI and PA do not play such a role.