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Abstract
BackgroundThe study aimed to investigate the association between content-based problematic smartphone use and obesity in school-age children and adolescents, including variations in the association by educational stage and sex.MethodsTwo-stage non-probability sampling was used to recruit 8419 participants from nineteen primary schools, five middle schools, and thirteen high schools in Shanghai in December 2017. Obesity was identified by body mass index (BMI), which was obtained from the school physical examination record, while problematic smartphone use was measured by the Revised Problematic Smartphone Use Classification Scale as the independent variable.ResultsThe rates of obesity varied with educational stages, while problematic smartphone use increased with educational stages. Male students reported higher obesity rates (37.1%vs19.4%, P < 0.001) and greater problematic smartphone use scores (25.65 ± 10.37 vs 22.88 ± 8.94, P < 0.001) than female students. Problematic smartphone use for entertainment (smartphone users addicted to entertainment games, music, videos, novels and other applications) was positively associated to obesity status for primary school [odds ratio (OR), 1.030; 95% confidence interval (95% CI), 1.005–1.057] and high school students (OR, 1.031; 95% CI, 1.004–1.059). For female students, problematic smartphone use for entertainment was positively associated with obesity status (OR, 1.046; 95% CI, 1.018–1.075).ConclusionsProblematic smartphone use may be associated with obesity in children and adolescents. The association differed based on the educational stage and sex, and the difference possessed dimensional specificity.
Highlights
The study aimed to investigate the association between content-based problematic smartphone use and obesity in school-age children and adolescents, including variations in the association by educational stage and sex
Except for the middle school group, the proportion of overweightness/obesity was higher in male students than in female students in the primary and high schools
Our study showed that problematic smartphone use for entertainment was significantly associated with obesity status for female students, and the association was positive
Summary
Sample and procedure This research was conducted in nineteen primary schools, five middle schools, and thirteen high schools in Shanghai between December 14, 2017, and December 27, 2017. Indoor and outdoor physical activity times were measured by asking how long the participant performed indoor and outdoor (including walking and cycling) physical activity per day in the recent school term, with the following five possible options provided as answers: < 10, 10–30, 30–60, 60–90, and > 90 min per day. Since this study needs to include all variables (including research variables and other possible influencing factors) into the model at one time and make corrections, the multivariate logistic regression model using the “Enter” method was adopted to investigate the relationship between problematic smartphone use and BMI, adjusted for sex, age, educational stage, mental health, physical activity, academic stress, and non-smartphone screen time. Analyses were performed using the Statistical Package for Social Sciences version 25 (IBM Corp., Armonk, NY, USA)
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