Digital Screen Time and Associated Health Factors: A Bibliometric Study on Global Research Trends Between 2012-2023

SummaryBackgroundScreen time has increased as a result of the COVID-19 pandemic, and several correlates have been associated with these increases. These changes, however, have not been aggregated. It was the aim of this review to (a) aggregate changes in screen time in adults and children, and (b) report on variables in relation to screen time during the COVID-19 pandemic.MethodsA systematic review of major databases was undertaken for studies published from inception to 06/12/2021, using a pre-published protocol (PROSPERO ID: CRD42021261422). Studies reporting (a) screen time pre-versus-during the pandemic, (b) screen time percentage change, or (c) correlates of screen time during the pandemic were included. A random effects meta-analysis was undertaken with subgroup analysis by age group and type of screen time.FindingsAfter review, 89 studies (n = 204,734; median age=20·6; median female=53·3%) were included. The majority of studies were cross-sectional. With regards to total screen time, primary aged children (6–10 years) reported largest increases (1·4 hrs/day; 95%CI 1·1–1·7), followed by adults (>18 years; 1·0 hrs/day; 95%CI 0·7–1·2), adolescents (11–17 years; 0·9 hrs/day; 95%CI 0·3–1·5), and young children (0–5 years; 0·6 hrs/day 95%CI 0·3–0·9 hrs/day). For leisure screen time (non-work/non-academic), primary aged children reported largest increases (1·0 hrs/day 95%CI 0·8–1·3), followed by adults (0·7hr/day 95%CI 0·3–1·2), young children (0·6 hrs/day; 95%CI 0·4–0·8), with adolescents reporting the lowest increase (0·5 hrs/day 95%CI 0·3–0·7). Several correlates were associated with reported increases in screen time, including adverse dietary behaviours, sleep, mental health, parental health, and eye health.InterpretationPooled evidence suggest that primary aged children reported the highest increase in both total and leisure screen time during COVID-19. It is recommended that screen time should be reduced in favour of non-sedentary activities. This study has the potential to inform public health policy and future guidance regarding screen time, and to inform future research in this area.FundingNo funding was received for this study.

The good, the bad and the ugly of children´s screen time during the COVID-19 pandemic.

Although understanding long-term trends in adolescent screen time and the influence of family structure is essential, there is a lack of research addressing these issues comprehensively. This study aimed to conduct comprehensive investigations into adolescent screen time before and during the COVID-19 pandemic, with a particular focus on family structures. This study used nationwide, large-scale data from the Korea Youth Risk Behavior Web-Based Survey from South Korea. We aimed to indicate the changes in adolescent screen time over 15 years from 2008 to 2022. Weighted linear regression was used to analyze annual trends in screen time before and during the pandemic, and stratified analyses were conducted to examine associated risk factors across different family structures. This study used data from a total of 836,972 individuals (n=403,456, 48.2% women), with an age range of 12-18 years. The analysis revealed an overall increase in screen time prepandemic (β=8.06, 95% CI 7.74-8.39), with a notable increase observed at the onset of the pandemic (β=162.06, 95% CI 159.49-164.64). Among diverse family structures, the orphanage group showed the most substantial increase in screen time during the pandemic (βdiff=221.90, 95% CI 159.62-284.17). Risk factors associated with screen time during the pandemic varied by family structure. Notably, the nuclear family group presented distinct screen time-related risk factors, including grade, region of residence, physical activity frequency, sadness and despair, and the highest education level of parents. There has been a notable increase in average screen time among adolescents since the onset of the pandemic, with the orphanage group exhibiting a pronounced trend. The risk factors associated with screen time during the pandemic varied for each family structure. Findings from this study suggest that the implementation of individualized measures tailored to each family structure should be adopted to effectively address the increased issue of adolescent screen time since the pandemic.

The COVID-19 pandemic has led to an increase in screen time for children and families. Traditionally, screen time has been associated with negative physical and mental health outcomes, and children with autism spectrum disorder (ASD) are at increased risk of these outcomes. The primary objectives of this study were to (1) characterize the change in screen time during COVID-19 school closures for children with ASD, and (2) examine the parent perceived impact of screen time on mental health and quality of life of children and their families. Canadian parents and caregivers of children 19 years of age and younger were eligible to participate in an anonymous, online survey study. This survey was available in English, consisted of 28 questions, took ~10-min to complete, and was available for 6 weeks (May 22 through July 6, 2020). The total sample consisted of 414 responses (ASD: n = 127, mean age = 11.7 ± 4.06 years; community sample: n = 287, mean age = 9.4 ± 4.26 years). Seventy-one respondents were missing responses to our primary question and removed from the analyses (final sample n = 344). Compared to the community sample, the ASD group had a significantly higher screen time use before and during the COVID-19 pandemic school closures [weekdays: difference = 1.14 (SE = 0.18), t = 6.56, p < 0.0001; weekends: difference = 1.41 (SE = 0.20), t = 6.93, p < 0.0001]. Mean total screen time during the pandemic was 6.9 h (95% CI 6.49, 7.21) on weekdays and 6.3 h (95% CI 5.91, 6.63) on weekends for the ASD group, and 5.6 h (95% CI 5.28, 5.92) on weekdays and 5.0 h (95% CI 4.70, 5.34) on weekends for the community sample. There was a significant increase in screen time during the COVID-19 pandemic as compared to before the pandemic period in the ASD group [weekdays: mean difference = 3.8 h (95% CI 3.35–4.25), p < 0.0001; weekends: mean difference = 1.5 h (95% CI 1.17–1.92), p < 0.0001]. Gender was a significant predictor of parent perceived mental health and quality of life, with male gender associated with a higher likelihood of negative impact [quality of life (child/family) OR = 1.8 (95% CI 1.1–2.9), corrected p = 0.040; mental health OR = 1.9 (95% CI 1.1–3.1), corrected p = 0.0028]. Parents' most frequently endorsed emotions toward screen time were guilt, frustration, and worry. Results of this survey study revealed that children with ASD were less likely to benefit from screen time to cope with social isolation, and screen time resulted in significantly more lost time on social interactions than the community sample, which may exacerbate difficulties in social domains. Given the unprecedented circumstances of the COVID-19 pandemic and the novel context of technology use, the findings of this study highlight the need for revision of screen time recommendations to reflect the current needs of children and families.

Screen time refers to the duration spent on digital devices, including televisions, computers, and mobile devices. Increased screen exposure among children raises concerns about its psychological, physical, and social health effects. Excessive screen time has been linked to poor dietary habits, reduced physical activity, and oral health issues such as dental caries. However, the association between screen time, dietary patterns, and oral health remains inadequately explored. This study aimed to assess the association between screen time and children's dietary patterns, oral hygiene practices, and oral health status. A cross-sectional observational study was conducted in a hospital-based setting in the Departments of Pediatric & Preventive Dentistry and Pediatrics over two months (December 2023-January 2024). A total of 353 children aged 6-13 years were recruited using convenience sampling. Screen time data were collected through parental interviews, while oral health status was assessed using the International Caries Detection and Assessment System II (ICDAS II)index. Dietary patterns were evaluated using a seven-day dietary recall. Data were analyzed using SPSS v23.0 (IBM Corp., Armonk, NY), with statistical significance set at p ≤ 0.05. Among the 353 participants, 187 (53.0%) were female. Nearly 66 (18.7%) children exceeded two hours of screen time per day on weekdays, while 276 (78.2%) exceeded this threshold on weekends. Only 60 (17.0%) reported brushing twice daily. The mean number of non-cavitated carious lesions was 0.7, while cavitated carious lesions averaged 3.8. Children who frequently watched screens while eating consumed approximately 22% of their meals in front of a screen. A statistically significant correlation was found between cavitated carious lesions and screen-related eating habits (p < 0.05), though the correlation coefficients were low. The study identified a significant increase in screen time during weekends compared to weekdays. Higher screen use was associated with a greater number of cavitated carious lesions and total caries. Additionally, frequent screen use during meals was linked to unhealthy dietary patterns. Our findings highlight the importance of parental monitoring and structured screen time limits to encourage healthier dietary habits and improved oral hygiene among children.

Longitudinal relations of television, electronic games, and digital versatile discs with changes in diet in adolescents

Background: With the ongoing growth and expansion of digital media and COVID-19 pandemic, children are inclining more and more toward spending time on digital media as compared to outdoor sports, leading to poor physical and mental growth. Developed nations have already set up a screen time guideline which is yet to be established in developing nations. This study was conducted with the objectives of identifying the needs of screen time guidelines and to study the impact of screen time on mental and physical health in children. Aims and Objectives: This study aims to check the screen time in children aged 2–18 and find the health consequences both physical and psychological in those children. Materials and Methods: A cross-sectional study on children aged 2–18 years was conducted between 2019 and 2020. Parents were asked to fill a pre-structured questionnaire. Impact on health physical and mental were assessed by pediatrician and psychologist. Results: A total of 155 children were enrolled in the study. Mean child hours in children aged 2–5 years, 5–10 years, and 10–18 years were 4 h, 5.83 h, and 6.29 h on week days and 5.64 h, 5.76 h, and 7.69 h on weekends, respectively. More than one-third of children had age of onset of screen time below 2 years of age. About 70% of children had malnutrition. Only 18% of parents were aware of concept of screen free days. Screen time had negative impact on health (P=0.0001) and on behavior of child (P=0.001). Average increase in screen time during COVID-19 was nearly 3 times the pre-COVID era. Conclusion: This study has paved the way for the need of larger study and development of guidelines on impact of screen time on children in developing nations where screen time guidelines is yet to be set more so in era of COVID 19 pandemic.

The factors associated with toddlers’ screen time change in the STEPS Study: A two-year follow-up

Background: The COVID-19 pandemic presented a unique opportunity to study the effects of increased screen time on student mental health, as colleges and universities in the United States transitioned to virtual learning. Current literature suggests that college/university students, particularly those enrolled in Honors programs, are at an increased risk for symptoms of anxiety. Emerging research suggests that increased screen time increases anxiety but never had there been such a marked increase in screen time. Purpose: The aim of this pilot study was to observe the relationships between anxiety, screen time, and physical activity in Honors students during the COVID-19 pandemic. Methods: A REDCap survey, consisting of the GAD-7 measure of anxiety, screen time questionnaire, physical activity questionnaire, and self-reported impact of the pandemic, was distributed to Honors students. Results: Anxiety and screen time increased during the pandemic, while physical activity did not significantly change. Eighty-point-nine percent of respondents met GAD-7 scoring guidelines for mild to severe anxiety and 71.56% self-reported experiencing more anxiety than before the pandemic. Increased screen time was associated with increased GAD-7 score, independent of physical activity or COVID-19 impact. Increased physical activity was associated with decreased GAD-7 score. Conclusion: Anxiety and screen time increased in Honors students during COVID-19. Increases in screen time were associated with increased anxiety in Honors students, while physical activity was associated with decreased anxiety. Universities should consider strategies to mitigate negative effects of increased screen time, including the use of physical activity. KEYWORDS: COVID-19; Pandemic; Screen Time; Physical Activity; Anxiety; College Students; GAD-7; Technology; Media Effects; Children and Media

Purpose:The objective of the study was to assess the effect of increased screen time on ocular health during the coronavirus disease (COVID-19) crisis.Materials and Method:An online pretested, self-reported questionnaire with relevant details was generated through Google form and sent to participants. Chi-square or Fisher’s exact test was used to investigate the associations between the qualitative variables. The associated risk factors of number and frequency of ocular health problems were analysed by univariate and multivariate logistic regression.Result:A total of 435 responses were considered where 48.5% (N = 211) were female participants and 51.5% (N = 224) were male. Average age of the participants was 35 years. 89% of the participants reported an increase in the screen time during the during the lockdown period. Younger age group reported to have greater screen time than the older participants (p = 0.001) and hence experienced more symptoms of digital eye strain (DES) (p = 0.003). The most common symptoms associated with digital eye strain in our study were eyestrain 52.8% (N = 230) and headache 31.3% (N = 136). In total, 81.37% (354/435) of participants had experienced at least one symptom related to digital screen usage.Conclusion:DES is non-vision-threatening but discomfort caused due to it can have implications on overall physical, mental, and social well-being. The study highlights the increase in digital screen time during the pandemic and the resultant eye strain. There is need of spreading awareness regarding the adverse effects of digital device use and the preventive measures to safeguard our ocular health.

Aims: To examine prospective and cross-sectional associations between screen time and blood pressure (BP) in preschool children. Methods: The Odense Child Cohort study started in January 2010. Children who were born in the municipality of Odense underwent a clinical examination at 3 and 5 years of age and their parents were asked to complete a questionnaire. A total of 628 children were included in the prospective analysis and 964 children were included in two cross-sectional analyses at 5 years of age. Multivariable adjusted linear and logistic regression models were computed to examine prospective and cross-sectional associations between screen time and BP with adjustment for putative confounding factors. Results: No significant prospective association was found between a 2-year change in screen time and systolic BP (0.55 BP percentile change per 1 h increase in screen time, 95% confidence interval (CI) -1.51 to 2.60) and diastolic BP (0.74 BP percentile change per 1 h increase in screen time, 95% CI -1.09 to 2.57). No significant cross-sectional association was observed between screen time (⩽1 h/day, >1-2 h/day, >2 h/day) and the prevalence of high BP at 5 years of age. Exposure to screen time before bedtime 2-5 days/week and ⩾6 days/week was significantly associated with a greater prevalence of high BP compared with screen time before bedtime 0-1 day/week (odds ratios 1.57 (95% CI 1.02-2.42) and 1.82 (95% CI 1.18-2.89), respectively. Conclusions: No prospective association was found between screen time and BP. However, a significant cross-sectional association was found between screen time before bedtime and high BP in preschool children.

Background: Lockdown measures during the COVID-19 pandemic led to an increased reliance on screens. This study aimed to assess screen usage before and after the pandemic and to determine the association of this increased screen time with the frequency of headaches, digital eye strain (DES), and sleep disturbances among undergraduate students. Methodology: An analytical cross-sectional study using a convenience non-probability sampling technique was conducted over five months among 413 university students in the twin cities attending online classes. Individuals with preexisting visual problems, headaches, or sleep disorders were excluded. The study tool was a pretested, self-developed semi-structured questionnaire shared online via Google Forms. Descriptive analysis using SPSS 23.0 included percentages, frequencies, means, and standard deviations. Results: An increase in post-pandemic screen time of 4.34 hours was observed. There was a 56% increase in the number of students reporting eye complaints compared to before the pandemic, with 15.7% reporting symptoms immediately following online classes. Additionally, 72% of students reported headaches, with 8.7% experiencing them immediately after online classes. Over 69.5% of students agreed that increased screen time affected their sleep quality. The association between increased screen time and DES, headaches, and sleep disturbances was significant, with p-values of 0.045, 0.003, and &lt;0.001, respectively. Conclusion: This study concludes that there was a significant increase in screen time due to the implementation of online classes during the pandemic. A significant association exists between increased screen time and the frequency of headaches, DES, and sleep disturbances.

Background: The rapid increase in screen time among adolescents has raised concerns about its potential impact on mental health. This study aims to examine the relationship between screen time, sleep duration, and anxiety levels among school-going adolescents in Dhaka, Bangladesh. Methods: A cross-sectional observational study was conducted with 568 students from multiple schools in Dhaka, Bangladesh, specifically targeting Grades 9 and 10. Statistical analyses were performed using SPSS version 25, with Chi-square tests and ANOVA used to determine significance, set at p&lt;0.05. Results: The study included 568 participants, with 60.2% female and 82.0% in Grade 10. The majority (54.9%) had a normal BMI, while 32.2% were underweight. Most participants (62.9%) reported getting 7-8 hours of sleep per day, with a mean sleep duration of 7.13 hours (SD=1.25). The mean screen time was 4.02 hours (SD=1.63), with 68.0% reporting 2-4 hours of screen use per day. Anxiety levels varied, with 54.2% reporting no anxiety symptoms, 35.9% mild anxiety, 7.0% moderate anxiety, and 2.8% severe anxiety. ANOVA results showed a significant association between screen time and anxiety levels (p=0.043), with severe anxiety corresponding to the highest mean screen time (5.01 hours). Conclusions: The study found significant associations between screen time, sleep duration, and anxiety levels among adolescents. These findings underscore the need for interventions promoting balanced screen use and adequate sleep to improve adolescent mental health. Further research is recommended to explore long-term effects and develop targeted interventions.

BackgroundMany authors have described a significant mental health burden on children and adolescents during the COVID-19 pandemic, possibly moderated by social disparities. This analysis explores whether pre-pandemic family circumstances might be related to different aspects of child health during the pandemic.MethodsWe analyzed trajectories of health-related outcomes in children aged 5 to 9 years (T7 to T11) using the Ulm SPATZ Health study, a population based birth cohort study (baseline 04/2012–05/2013) conducted in the South of Germany. Outcomes were children’s mental health, quality of life, and lifestyle, such as screen time and physical activity. We conducted descriptive statistics of maternal and child characteristics before and throughout the pandemic. We defined three different groups of pre-pandemic family situations and used adjusted mixed models to estimate differences in means associated with the time during the pandemic vs. before the pandemic in (a) all children and in (b) children belonging to specific pre-pandemic family situations.ResultsWe analyzed data from n = 588 children from whom at least one questionnaire was completed between T7 and T11. When not considering the pre-pandemic family situation, adjusted mixed models showed statistically significant lower mean scores of health-related quality of life among girls during vs. before the COVID-19 pandemic (difference in means (b): − 3.9 (95% confidence interval (CI): − 6.4, − 1.4). There were no substantial differences in mental health, screen time, or physical activity in boys or girls. When considering pre-pandemic family situations, boys with mothers having symptoms of depression or anxiety showed a substantial loss of health-related quality of life on the subscale of friends (b: − 10.5 (95% CI: − 19.7, − 1.4)). Among girls in this group, 60% of the 15 assessed outcomes were negatively associated with a remarkable loss in health-related quality of life (e.g., KINDL-physical well-being difference in means: − 12.2 (95% CI: − 18.9, − 5.4)). Furthermore, a substantial increase in screen time was found (+ 2.9 h (95% CI: 0.3, 5.6)).ConclusionOur results suggest that the health (and behavior) of primary school-aged children is possibly impacted by the COVID-19 pandemic, with adverse consequences differing by gender and very likely by the pre-pandemic family situation. Especially in girls having a mother with depression or anxiety symptoms, the adverse consequences of the pandemic on mental health seem to be aggregated. Boys showed fewer adverse trajectories, and it needs to be further assessed which factors exactly are behind the (socio-economic) factors, such as maternal working habits and limited living space, when analyzing the effect of the pandemic on children’s health.

The widespread adoption of smartphones and social media has led to a significant increase in screen time among adolescents. This study investigated the relationship between screen time and mental health in adolescents, with a focus on the impact of screen time on mental health symptoms, social relationships, and productivity. A mixed-methods approach was employed, combining both quantitative and qualitative data collection and analysis methods. The study found that excessive screen time was associated with negative mental health outcomes, including anxiety, depression, and lower self-esteem. Focus group discussions revealed that adolescents experience social pressure to be constantly connected to their screens, contributing to feelings of anxiety and stress. The findings of this study have implications for promoting healthy screen use habits among adolescents, including the need for parents, educators, and healthcare professionals to be aware of the potential negative effects of excessive screen time on adolescents’ mental health.