Abstract
BackgroundHigher screen viewing time (SVT) in childhood has been associated with adverse health outcomes, but the predictors of SVT in early childhood are poorly understood. We examined the sociodemographic and behavioral predictors of total and device-specific SVT in a Singaporean cohort.MethodsAt ages 2 and 3 years, SVT of 910 children was reported by their parents. Interviewer-administered questionnaires assessed SVT on weekdays and weekends for television, computer, and hand-held devices. Multivariable linear mixed-effect models were used to examine the associations of total and device-specific SVT at ages 2 and 3 with predictors, including children’s sex, ethnicity, birth order, family income, and parental age, education, BMI, and television viewing time.ResultsAt age 2, children’s total SVT averaged 2.4 ± 2.2 (mean ± SD) hours/day, including 1.6 ± 1.6 and 0.7 ± 1.0 h/day for television and hand-held devices, respectively. At age 3, hand-held device SVT was 0.3 (95% CI: 0.2, 0.4) hours/day higher, while no increases were observed for other devices. SVT tracked moderately from 2 to 3 years (r = 0.49, p < 0.0001). Compared to Chinese children, Malay and Indian children spent 1.04 (0.66, 1.41) and 0.54 (0.15, 0.94) more hours/day watching screens, respectively. Other predictors of longer SVT were younger maternal age, lower maternal education, and longer parental television time.ConclusionsIn our cohort, the main predictors of longer children’s SVT were Malay and Indian ethnicity, younger maternal age, lower education and longer parental television viewing time. Our study may help target populations for future interventions in Asia, but also in other technology-centered societies.Trial registrationThis ongoing study was first registered on July 1, 2010 on NCT01174875 as. Retrospectively registered.
Highlights
Higher screen viewing time (SVT) in childhood has been associated with adverse health outcomes, but the predictors of SVT in early childhood are poorly understood
At age 2 years, the children spent an average of 2.4 ± 2.2 h of total SVT, mainly contributed by 1.6 ± 1.7 h of television and 0.7 ± 1.0 of hand-held devices (Table 1)
In our tri-ethnic Singaporean mother-offspring cohort, we found a substantial amount of reported total SVT in early childhood, mainly attributable to television and hand-held devices, whereas computers were used by few children
Summary
Higher screen viewing time (SVT) in childhood has been associated with adverse health outcomes, but the predictors of SVT in early childhood are poorly understood. Sedentary lifestyle has been independently associated with obesity, higher blood pressure and poorer mental health [9] This level of evidence remains fragile, owing to cross-sectional designs, the complexity of accurately measuring sedentary behavior in young children, and the potential for residual confounding. As early as age 2, SVT has been associated with childhood obesity [14] Based on this evidence, the American Academy of Pediatrics (AAP) recommends that children below 18 months avoid any digital media use but suggests the gradual introduction of family-shared, high-quality content between 18 months and 2 years, while limiting screen time to a maximum of 1 h/day between 2 and 5 years of age [15]
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