Screen-based Behaviors Research Articles

Design and Feasibility Analysis of a Smartphone-Based Digital Cognitive Assessment Study in the Framingham Heart Study.

Smartphone-based digital technology is increasingly being recognized as a cost-effective, scalable, and noninvasive method of collecting longitudinal cognitive and behavioral data. Accordingly, a state-of-the-art 3-year longitudinal project focused on collecting multimodal digital data for early detection of cognitive impairment was developed. A smartphone application collected 2 modalities of cognitive data, digital voice and screen-based behaviors, from the FHS (Framingham Heart Study) multigenerational Generation 2 (Gen 2) and Generation 3 (Gen 3) cohorts. To understand the feasibility of conducting a smartphone-based study, participants completed a series of questions about their smartphone and app use, as well as sensory and environmental factors that they encountered while completing the tasks on the app. Baseline data collected to date were from 537 participants (mean age=66.6 years, SD=7.0; 58.47% female). Across the younger participants from the Gen 3 cohort (n=455; mean age=60.8 years, SD=8.2; 59.12% female) and older participants from the Gen 2 cohort (n=82; mean age=74.2 years, SD=5.8; 54.88% female), an average of 76% participants agreed or strongly agreed that they felt confident about using the app, 77% on average agreed or strongly agreed that they were able to use the app on their own, and 81% on average rated the app as easy to use. Based on participant ratings, the study findings are promising. At baseline, the majority of participants are able to complete the app-related tasks, follow the instructions, and encounter minimal barriers to completing the tasks independently. These data provide evidence that designing and collecting smartphone application data in an unsupervised, remote, and naturalistic setting in a large, community-based population is feasible.

Can mindfulness play a role in building social-emotional capacities among youth exposed to screens?

Increased screen time coupled with public safety restrictions may pose a serious challenge to adequate social-emotional development in youth during the pandemic. Social-emotional competence (resilience, self-esteem, and self-compassion) are essential for youth to adapt to the "new normal" in the prolonged pandemic timeline. The current study investigated the efficacy of a mindfulness-based intervention on youth social-emotional capacity while accounting for screen time. One hundred and seventeen youth participated in a 12-week, online mindfulness-based program and completed pre-, post- and follow-up surveys across five cohorts during the COVID-19 pandemic (spring 2021 to spring 2022). Changes in youths' resilience (RS), self-esteem (SE), and self-compassion (SC) between the three-time points were examined using linear regression analyses (unadjusted, partially adjusted for screen time, and fully adjusted for demographic and screen time variables). The regression models accounted for demographic (age, sex), baseline mental health status, and screen time (passive, social media, video games, and educational types of screen-based behaviours) factors. In an unadjusted regression model, resilience [β = 3.68, 95%CI = 1.78-5.50, p < 0.001], self-compassion [β = 0.50, 95%CI = 0.34-0.66, p < 0.001], and self-esteem [β = 2.16, 95%CI = 0.98-3.34, p < 0.001] significantly increased after the mindfulness program, and the effects were maintained in the follow-up. The efficacy of the mindfulness program persisted after controlling for five types of screen time [RS: β = 2.73, 95%CI = 0.89-4.57, p < 0.01; SC: β = 0.50, 95%CI = 0.32-0.67, p < 0.001; SE: β = 1.46, 95%CI = 0.34-2.59, p < 0.01] and in a fully adjusted model which additionally accounted for the baseline mental health status and demographic factors [RS: β = 3.01, 95%CI = 1.20, p < 0.01; SC: β = 0.51, 95%CI = 0.33-0.68, p < 0.001; SE: β = 1.64, 95%CI = 0.51-2.77, p < 0.01] and maintained its impact in the follow-up. Our findings reinforce the evidence base on the efficacy of mindfulness and support the use of online mindfulness programs in building social-emotional competencies (i.e., self-compassion, self-esteem, and resilience) among youth exposed to screens during the pandemic.

Screen-based and non-screen-based sedentary behaviors are differentially associated with affective states in older adults

Excessive sedentary behavior (SB) contributes to poor affective and physical feeling states, which is particularly concerning for older adults who are the most sedentary sector of the population. Specific types of SB have been shown to differentially impact health in cross-sectional and longitudinal studies, with screen-based SB more negatively impacting aspects of mental health. This study used Ecological Momentary Assessment (EMA), a real-time, intensive longitudinal data capture methodology, to examine the differential impact of screen-based behaviors on momentary affective responses during SB in naturalistic settings. A diverse sample of older adults (pooled across 2 studies) completed an EMA protocol for 8–10 days with six randomly delivered, smartphone assessments per day. At each EMA prompt, participants reported their current activity, whether they were sitting while doing that activity, and affective states. Multilevel models assessed whether screen-based (vs. non-screen-based) behavior moderated affective response during SB.At the within-person level, older adults experienced less positive affect during SB when engaged in a screen-based behavior compared to a non-screen-based SB (B = −0.10, p < 0.01). At the between-person level, positive associations between SB and negative affect (B = 0.79, p = 0.03) were stronger if participants reported engaging in screen-based behaviors for a greater proportion of prompts. Among older adults, screen-based SB may lead to poorer affective states compared to non-screen-based SB. Interventions aiming to reduce SB in this population should consider targeting reductions in screen-based SB as means to improve affective states.

Factors of heavy social media use among 13-year-old adolescents on weekdays and weekends

BackgroundFew studies have investigated which factors were related to adolescents’ social media use. This study aimed to evaluate which factors were associated with heavy social media use on weekdays and weekends among 13-year-old adolescents.MethodsWe analyzed data from 3727 children from the Generation R Study, a population-based cohort study in the Netherlands. Associations of demographic factors (child age, sex, ethnic background, and family situation), socioeconomic position (parental educational level, parental employment status, and net household income), screen-based behaviors (computer playing and TV viewing), and the home environment (communication, supervision, and restriction) with adolescents’ heavy social media use (≥ 2 hours/day) were assessed separately on weekdays and weekends. Multivariate logistic regression analysis was applied.ResultsThe prevalence of heavy social media use was 37.7% on a weekday and 59.6% on a weekend day. Being a girl, living in a one-parent family, and more time spent playing on the computer were associated with heavy social media use on weekdays and weekends (all P < 0.05). Low socioeconomic position adolescents (low parental educational level and low household income) were more likely to show heavy social media use only on weekends (all P < 0.05). Children whose social media use was restricted by parents on weekdays or children whose social media use was supervised by parents on weekends had lower odds of heavy social media use (all P < 0.05).ConclusionsBeing a girl, living in a one-parent family, or having a longer computer playing time were associated with heavy social media use on weekdays and weekends. More studies are needed to understand the factors associated with heavy social media use and the impact of heavy social media use on child health.

Multimorbidity is associated with TV-viewing, but not with other types of screen-based behaviors in Brazilian adults

BackgroundThe presence of multimorbidity increases the risk of mortality, and identifying correlates of multimorbidity can direct interventions by targeting specific modifiable correlates. Here we aimed to investigate the association between two types of screen-based behaviors and multimorbidity.MethodsWe used data from 87,678 Brazilian adults from the National Health Survey (2019). Multimorbidity (presence of two or more chronic conditions among 12 possibilities), TV-viewing, and time on other types of screens (computer, tablet, or cell phone), were self-reported. Crude and adjusted binary and multinominal logistic regression models were performed stratified by sex, age group, and the number of chronic conditions.ResultsConsidering adjusted values, 2 h/day as a reference, and reporting values in odds ratio (OR) and prevalence ratio (PR) with 95% confidence intervals (95%CI), multimorbidity presented associations with TV-viewing in general [from OR (95%CI) 1.10 (1.03–1.18) in 2 to < 3 h/d, to OR (95%CI) 1.57 (1.40–1.76) in ≥ 6 h/d], except in 2 to < 3 h/d time category for male and 35 to 49 years, and all time categories for 18 to 34 years. In addition, TV-viewing was associated with an increasing number of chronic conditions, all greater in ≥ 6 h/d [2 conditions - PR (95%CI) 1.24 (1.08–1.43); 3 conditions - PR (95%CI) 1.74 (1.45–2.08); 4 or more conditions - PR (95%CI) 2.29 (1.93–2.73)], except in 2 conditions on 2 to < 3 h/d. Other types of screen-based behaviors were only associated with multimorbidity among males [≥ 6 h/d: OR (95%CI) 1.22 (1.01–1.48)] and older individuals (65 years) in some time categories [3 to < 6 h/d: OR (95%CI) 1.98 (1.42–2.77) and ≥ 6 h/d: OR (95%CI) 1.73 (1.06–2.84)].ConclusionIntervention strategies for reducing screen time in Brazilian adults should focus mainly on TV-viewing, which seems to be associated with more harmful conditions than time on other types of screen-based behaviors.

The moderating effect of physical activity on the association between screen-based behaviors and chronic diseases

We analyzed the associations of screen-based behaviors with obesity, hypertension, and diabetes, and the moderation of different physical activity (PA) domains in these associations. We used data from the 2019 Brazilian National Health Survey, including data from 80,940 adults (mean age of 32.6 years). TV viewing, other screens (PC, tablet, and cell phone), PA domains (leisure-time, occupational, and transport) were collected via interview. Logistic regression models were used. There was a dose–response association of higher TV viewing with diabetes. Within the groups with medium and higher time spent on other screens, those with < 150 min/week in leisure-time PA increased the odds for obesity [1–2.9 h/day: OR = 1.18 (1.01, 1.39)] and hypertension [1–2.9 h/day: OR = 1.29 (1.08, 1.53); ≥ 6 h/day: OR = 1.47 (1.03, 2.09)]. Likewise, among the participants who spent ≥ 6 h/day of TV viewing, those with < 150 min/week of occupational PA presented higher odds for hypertension [OR = 1.61 (1.03, 2.53)]. In the group with higher use of other screens, < 150 min per week of occupational PA was associated with lower odds for obesity [1–2.9 h/day: OR = 0.81 (0.68, 0.97)] and hypertension [≥ 6 h/day: OR = 0.65 (0.44, 0.98)]. In conclusion, the associations of other screens with obesity and hypertension were strongest among those without leisure-time PA, while the moderator role of occupational PA was not clear.

Clusters of obesogenic behaviors and metabolic risk according to somatic maturity status among adolescents.

This study aimed to identify the clusters of obesogenic behaviors, and verify the association with metabolic risk according to the categories of somatic maturity status of adolescents. This is a cross-sectional study conducted with 1159 (55.1% girls) Brazilian adolescents aged between 10 and 16 years (mean age: 12.9 years). Measurements of waist circumference, blood pressure, blood glucose, HDL-C, and triglycerides were combined to calculate a metabolic risk score. Somatic maturity was assessed by estimating the peak of height velocity. The obesogenic behaviors analyzed were physical activity (Baecke questionnaire), sedentary behavior (screen-based behaviors) and dietary habits (consumption of healthy and unhealthy food). The Two Step clustering algorithm using the log-likelihood measure was employed to cluster formation and regression models were adopted to the main analysis. We observed a complex co-existence of obesogenic behaviors. Differences regarding the metabolic risk between clusters was only observed among the early-maturing adolescents, where the cluster with higher number of healthy behaviors but lower physical activity presented higher metabolic risk score. We conclude that physical activity has an important role on the association of clusters of obesogenic behaviors and metabolic risk in early-maturing adolescents.

The diurnal pattern and social context of screen behaviours in adolescents: a cross-sectional analysis of the Millennium Cohort Study

BackgroundScreen behaviours are highly prevalent in young people and excessive screen use may pose a risk to physical and mental health. Understanding the timing and social settings in which young people accumulate screen time may help to inform the design of interventions to limit screen use. This study aimed to describe diurnal patterns in adolescents’ screen-based behaviours and examine the association of social context with these behaviours on weekdays and weekend days.MethodsTime use diary data are from the sixth wave (2015/2016) of the Millennium Cohort Study, conducted when participants were aged 14 years. Outcome variables were electronic games/Apps, TV-viewing, phone calls and emails/texts, visiting social networking sites and internet browsing. Social context was categorised as alone only, parents only, friends only, siblings only, parents and siblings only. Multilevel multivariable logistic regression was used to examine the association between social contexts and screen activities.ResultsTime spent in TV-viewing was greatest in the evening with a peak of 20 min in every hour between 20:00 and 22:00 in both sexes on weekdays/weekend days. Time spent using electronic games/Apps for boys and social network sites for girls was greatest in the afternoon/evening on weekdays and early afternoon/late evening on weekend days. Screen activities were mainly undertaken alone, except for TV-viewing. Compared to being alone, being with family members was associated with (Odds Ratio (95% Confidence Interval)) more time in TV-viewing in both boys and girls throughout the week (Weekdays: Boys, 2.84 (2.59, 3.11); Girls, 2.25 (2.09, 2.43); Weekend days: Boys, 4.40 (4.16, 4.67); Girls, 5.02 (4.77, 5.27)). Being with friends was associated with more time using electronic games on weekend days in both sexes (Boys, 3.31 (3.12, 3.51); Girls, 3.13 (2.67, 3.67)).ConclusionsReductions in screen behaviours may be targeted throughout the day but should be sensitive to differing context. Family members, friends, and adolescent themselves may be important target groups in behaviour change interventions. Future research to address the complex interplay between social context, content and quality of screen behaviours will aid the design of behaviour change interventions.

Using Wearable Cameras to Categorize the Type and Context of Screen-Based Behaviors Among Adolescents: Observational Study.

BackgroundAutomated wearable cameras present a new opportunity to accurately assess human behavior. However, this technology is seldom used in the study of adolescent’s screen exposure, and the field is reliant on poor-quality self-report data.ObjectiveThis study aimed to examine adolescents’ screen exposure by categorizing the type and context of behaviors using automated wearable cameras.MethodsAdolescents (mean age 15.4 years, SD 1.6 years; n=10) wore a camera for 3 school evenings and 1 weekend day. The camera captured an image every 10 seconds. Fieldwork was completed between February and March 2020, and data were analyzed in August 2020. Images were date and time stamped, and coded for screen type, content, and context.ResultsData representing 71,396 images were analyzed. Overall, 74.0% (52,842/71,396) of images contained screens and 16.8% (11,976/71,396) of images contained multiple screens. Most screen exposures involved television sets (25,950/71,396, 36.3%), smartphones (20,851/71,396, 29.2%), and laptop computers (15,309/71,396, 21.4%). The context of screen use differed by device type, although most screen exposures occurred at home (62,455/64,856, 96.3%) and with solitary engagement (54,430/64,856, 83.9%). The immediate after-school period saw high laptop computer use (4785/15,950, 30.0%), while smartphone use (2059/5320, 38.7%) peaked during prebedtime hours. Weekend screen exposure was high, with smartphone use (1070/1927, 55.5%) peaking in the early morning period and fluctuating throughout the day.ConclusionsThere was evidence for high screen use during the after-school and weekend period, mostly through solitary engagement, and within the home environment. The findings may inform the basis of larger studies aimed at examining screen exposure in free-living conditions.

Screen-based behaviour in children is more than meets the eye.

Increased screen time (ST) in children is quickly becoming a public health concern as children are now reliant on technology for social interaction and educational development. The eye-health community has paid considerable attention to this in the recent literature, documenting it as digital eye strain. Continual close eye work and a lack of outdoor play contribute to digital eye strain and today’s myopia epidemic. This is a cause for concern for public health stakeholders insofar as it leads to sedentary, screen-based behaviour (SSB) in children. This results in a lack of physical activity and impacts both their bodies and their mental health. The potentially harmful effects of prolonged screen exposure on developing brains and bodies are likely to be unique and significant as physiological growth changes intersect with exponentially expanding e-platforms. While embracing the benefits of a highly digitalised world, we need to simultaneously mitigate the potential risks they pose to the health of growing children.

Different Types of Screen Behavior and Depression in Children and Adolescents.

The purpose of this study was to examine the associations between different types of screen behavior and depression, taking into account exercise and sleep among children and adolescents. A total of 23,573 Japanese children and adolescents (aged 8–15 years) participated in this cross-sectional study. Different types of screen behavior, weekly exercise time, sleep duration, and prevalence of depression were assessed using a questionnaire. Independent associations between various types of screen behavior and prevalence of depression were examined using logistic regression analyses after adjusting for age, school, sleep duration, exercise time, and other screen behavior types. A two-way analysis of covariance was conducted to examine whether exercise and sleep can attenuate the negative effects of screen behavior. The associations between screen behavior and depression varied by screen behavior types and participant characteristics. More time spent engaging in newer types of screen behavior, including social media, online games, and online videos, was associated with a higher prevalence of depression. In contrast, more time spent on TV was associated with a lower prevalence of depression. Sufficient exercise can lower the prevalence of depression, regardless of the length of time and content of the screen, and its associations were particularly significant for junior high school girls. Sleep was not associated with the prevalence of depression among any participant group except elementary school boys. Our findings suggest that age- and sex-specific intervention strategies that also consider screen-based behavior can effectively lower the risk of depression in children and adolescents.

Sedentary Lifestyle with Social Interaction In Adolescent

Background: Sedentary lifestyle is problematic among millennial generation teenagers. One of the factors is that technological advances in the 4.0 era are very rapid, especially the use of technology such as television, computers, gadgets, and the internet. The purpose of this study was to determine the relationship between Sedentary Lifestyle and Social Interaction in Adolescents at SMP 1 Sudimoro. Methods: The design of this research is the correlation with approach cross-sectional, the sample is 30 respondents, the sampling technique is total sampling. The independent variable in this study is a sedentary lifestyle, while the dependent variable in this study is social interaction. The measuring instrument used is a questionnaire. This study was analyzed using the Spearman Rank Test. Results: The results showed that most (76.7%) experienced a Sedentary Lifestyle in the moderate category, and most (83.3%) social interactions in the maladaptive category. Based on the spearman's rho test, a p-value of 0.033 (α&lt;0.05) was found, meaning that there was a relationship between a sedentary lifestyle and social interaction among adolescents at SMPN 1 Sudimoro. Interaction mediated by screen-based behavior does not teach healthy social skills to adolescents. Conclusion: They are more comfortable and willing to spend more time interacting with their friends in cyberspace. It is recommended for parents to always provide direction and monitoring on the use of media screens in adolescents, as well as reducing a sedentary lifestyle.

International trends in screen-based behaviours from 2012 to 2019

Many adults accumulate considerable time in screen-based behaviours, some of which have been associated with negative physical and psychological health outcomes. The aims of this study were to characterise contemporary patterns of screen-based behaviours and describe their temporal trends by global region, age, sex and education. Data covering the period 2012–2019 were obtained in aggregated form from GWI (previously known as Global Web Index), a global market research company. Temporal trends in the duration of adults' (16–64 years) self-reported personal computer, laptop and tablet use, mobile phone use, broadcast television viewing, online television viewing and games console use were described using data from over 2 million participants from 46 countries. For each activity, participants selected from response options ranging from less than 30 min to more than 10 h. Internationally, daily screen time increased from approximately 9 h in 2012 to 11 h in 2019, with notable increases in mobile phone use (approx. 2 h), online television viewing (approx. 37 min) and games console use (approx. 26 min). Differences were seen in the duration of time spent engaging in screen-based behaviours across regions and between socio-demographic groups, with Latin America, the Middle East and Africa and younger age groups seeing greater increases in overall screen time. The findings have important implications for health behaviour surveillance and for research exploring the links between screen-based behaviours and health.

The Home Environment Interview and associations with energy balance behaviours and body weight in school-aged children \u2013 a feasibility, reliability, and validity study

BackgroundThe home environment is thought to influence children’s weight trajectories. However, few studies utilise composite measures of the home environment to examine associations with energy balance behaviours and weight. The present study aimed to adapt and update a comprehensive measure of the obesogenic home environment previously developed for pre-schoolers, and explore associations with school-aged children’s energy balance behaviours and weight.MethodsFamilies from the Gemini cohort (n = 149) completed the Home Environment Interview (HEI) via telephone when their children were 12 years old. The HEI comprises four composite scores: one for each domain (food, activity and media) of the environment, as well as a score for the overall obesogenic home environment. The primary caregiver also reported each child’s height and weight (using standard scales and height charts), diet, physical activity and sedentary screen-based behaviours. A test-retest sample (n = 20) of caregivers completed the HEI a second time, 7–14 days after the initial interview, to establish test-retest reliability.ResultsChildren (n = 298) living in ‘higher-risk’ home environments (a 1 unit increase in the HEI obesogenic risk score) were less likely to consume fruits (OR; 95% CI = 0.40; 0.26–0.61, p < 0.001), and vegetables (0.30; 0.18–0.52, p < 0.001), and more likely to consume energy-dense snack foods (1.71; 1.08–2.69, p = 0.022), convenience foods (2.58; 1.64–4.05, p < 0.001), and fast foods (3.09; 1.90–5.04, p < 0.001). Children living in more obesogenic home environments also engaged in more screen-time (β (SE) = 4.55 (0.78), p < 0.001), spent more time playing video games (β (SE) = 1.56 (0.43), p < 0.001), and were less physically active (OR; 95% CI = 0.57; 0.40–0.80, p < 0.01). Additionally, there was a positive association between higher-risk overall home environment composite score and higher BMI-SDS (β (SE) = 0.23 (0.09), p < 0.01). This finding was mirrored for the home media composite (β (SE) = 0.12 (0.03), p < 0.001). The individual home food and activity composite scores were not associated with BMI-SDS.ConclusionFindings reveal associations between the overall obesogenic home environment and dietary intake, activity levels and screen-based sedentary behaviours, as well as BMI in 12 year olds. These findings suggest that the home environment, and in particular the home media environment, may be an important target for obesity prevention strategies.

Correlates of screen-based behaviors among adults from the 2019 Brazilian National Health Survey

We aimed to investigate correlates of TV viewing and other types of screen-based behaviors in a nationally representative sample of Brazilian adults. In the 2019 Brazilian National Health Survey (including 88,509 adults), TV viewing time and other types of screen behaviors (computer, tablet, and cellphone use) were self-reported and different geographical, sociodemographic, behavioral, and health status factors were investigated as potential correlates. Multinomial logistic regression models were used for the main analyses. Living in capital cities, urban areas, being unemployed, high consumption of soft drinks, obesity, and elevated depressive symptoms were each associated with more TV viewing and more time using other types of screens. There were differential associations between TV viewing and the use of other types of screen across age and socioeconomic variables. For instance, younger adults have a more diverse portfolio of screen time than older adults. To conclude, levels of screen-based behaviors vary by geographical, sociodemographic, behavioral, and health status characteristics. Interventions should focus on high-risk population groups and may benefit from targeting specific sedentary behaviors of interest.

Efectos de una intervención escolar en la actividad física, el tiempo de sueño, el tiempo de pantalla y la dieta en niños

Multiple health-risk behaviors such as physical inactivity, sedentary behaviors or unhealthy diet represent a public health problem among adolescents. The aim of this study is to examine the effects of a school-based intervention on 24-hour movement behaviors (i.e., physical activity, screen-based behaviors, and sleep), Mediterranean diet, and self-rated health status. A quasi-experimental design has been carried out for two months and a half in a sample of 121 children, aged 8-9 years (M=9.01± .09 years old; 47.11% girls), from two elementary schools. Sixty-six students from one of the schools has been assigned to the control group and 55 students from the other school has been included in the experimental group. In the experimental group, ten one-hour weekly sessions about knowledge, awareness, and practices of health-related behaviors have been implemented by a research group member through the tutorial action plan. 24-hour movement behaviors, Mediterranean diet, and self-rated health status has been measured before and after the school-based intervention using self-reported questionnaires. Experimental group children show a significant increase in adherence to the Mediterranean diet and being physically active during the weekdays compared to their baseline values. Moreover, the greater baseline values in the adherence to the Mediterranean diet, as well as being physically active during weekend days in the control group, disappear between both groups after the intervention. Ten one-hour sessions of a school-based intervention conducted through the tutorial action plan seem effective in improving children's adherence to the Mediterranean diet and the proportion of active children, but not other health-related behaviors.

Effects of a school-based intervention on physical activity, sleep duration, screen time, and diet in children

Multiple health-risk behaviors such as physical inactivity, sedentary behaviors or unhealthy diet represent a public health problem among adolescents. The aim of this study is to examine the effects of a school-based intervention on 24-hour movement behaviors (i.e., physical activity, screen-based behaviors, and sleep), Mediterranean diet, and self-rated health status. A quasi-experimental design has been carried out for two months and a half in a sample of 121 children, aged 8-9 years (M = 9.01 ± .09 years old; 47.11% girls), from two elementary schools. Sixty-six students from one of the schools has been assigned to the control group and 55 students from the other school has been included in the experimental group. In the experimental group, ten one-hour weekly sessions about knowledge, awareness, and practices of health-related behaviors have been implemented by a research group member through the tutorial action plan. 24-hour movement behaviors, Mediterranean diet, and self-rated health status has been measured before and after the school-based intervention using self-reported questionnaires. Experimental group children show a significant increase in adherence to the Mediterranean diet and being physically active during the weekdays compared to their baseline values. Moreover, the greater baseline values in the adherence to the Mediterranean diet, as well as being physically active during weekend days in the control group, disappear between both groups after the intervention. Ten one-hour sessions of a school-based intervention conducted through the tutorial action plan seem effective in improving children’s adherence to the Mediterranean diet and the proportion of active children, but not other health-related behaviors.

Sedentary Behaviour Among Male Adolescents in Sagamu, Southwest Nigeria.

Sedentary behaviour (SB) is a leading risk factor for development of non-communicable diseases (NCDs) and associated morbidity worldwide. Several studies have reported a high prevalence of sedentary behaviour among adolescents in developing countries with a male preponderance. The Nigerian male adolescent is similarly faced with lifestyle challenges as his counterparts in other countries. This study determined the pattern, knowledge and factors associated with sedentary behaviour among male adolescents in Sagamu, Nigeria. A cross-sectional study was carried out among 330 in-school male adolescents in Sagamu, selected via multi-stage sampling technique. Data were collected using a semi-structured, self-administered questionnaire and analyzed using IBM SPSS version 20. Relevant descriptive and inferential statistics were calculated, with p < .05. Participation was fully voluntary and strict confidentiality was ensured. The mean age of respondents was 15.9 ± 1.4 years; 86.9% of respondents were aged 15-19years. About 94.8% of sedentary respondents had poor knowledge. Over 90% of respondents were sedentary. Screen-based behaviour (79%) contributed more to respondents' pattern of SB while using a tablet or a smart phone (23.6%) singularly contributed the largest to sedentariness. SB was associated with motorized transport (p = .038), smoking (p ≤ .001) and central obesity status (p = .040) but not with socio-demographic characteristics and alcohol intake. Knowledge of SB was poor among respondents. The prevalence of sedentary behaviour was high and associated with central obesity, smoking and motorized transport. School-based interventions including health education, should be initiated to reduce the risk of developing NCDs.

Trends of Healthy Lifestyles Among Adolescents: An Analysis of More Than Half a Million Participants From 32 Countries Between 2006 and 2014.

The purpose of this study was to provide data regarding the prevalence and trends of adolescents' healthy lifestyles from 32 countries between 2006 and 2014 by sex and age interval. The data used in the present study were derived from the Health Behavior in School-aged Children (HBSC) 2006, 2010, and 2014 international database. Healthy lifestyle was assessed using the combination of daily physical activity, daily fruit and vegetable consumption, <2 h daily on screen-based behaviors, abstinence from alcohol, and abstinence from tobacco products. Healthy lifestyle measures were based on self-report. The final sample comprised 519,371 adolescents (aged between 10 and 16 years old). The prevalence of healthy lifestyle behaviors increased between 2006 and 2014. The healthy lifestyle score worsened with advancing age for boys and girls. Comparing countries, for boys, the highest values were observed in adolescents from Ireland (5.2%, 95% CI: 3.9, 6.4), and for girls, the highest values were observed in adolescents from Iceland (4.2%, 95% CI: 3.6, 4.7). The present study showed a slight trend to an improved healthy lifestyle among adolescents, although much more has to be done. A joint effort from multiple areas of knowledge must be made to improve adolescent health policies, since lifestyles in adolescence play an important role for the development of vulnerability and health in later life.

Screen-based behaviors in Australian adolescents: Longitudinal trends from a 4-year follow-up study

The longitudinal trends of screen time, a highly prevalent behavior in adolescents, are relatively unknown. This study examined longitudinal trends in screen time among a large sample of Australian primary school-aged children transitioning into secondary school-aged adolescence. Data were derived from the Longitudinal Study of Australian Children (LSAC). In 2010, 2179 children (49.7% boys; 10.3 ± 1.1 years) completed a time-use diary, recording their main activities during waking hours. This was repeated with the same sample in 2012 (12.4 ± 0.5 years) and 2014 (14.4 ± 0.5 years). Data were analyzed for time spent in TV viewing, computer use, electronic gaming, and social networking and online communication. Repeated-measures MANCOVA tests were performed to analyze trends in screen time. Trends were also analyzed by sex. Total screen time significantly increased (+85.9 min/day) over four years (ηp2 = 0.010, P < .001), but differed by sex, with a larger increase in boys (boys: +41.6, girls: +22.7 min/day). Electronic gaming increased in boys (+43.2 min/day) and decreased in girls (−16.8 min/day). In contrast, girls reported larger increases in TV viewing (boys: +0.4, girls: +29.1 min/day), computer use (boys: +24.8, girls: +34.3 min/day) and time communicating online and social networking (boys: +4.3, girls: +15.2 min/day). To conclude, screen time among adolescents increases between the ages of 10 and 14 years, but differs by sex and screen time domain. Future screen time reduction interventions may choose to focus on recreational computer use and electronic gaming in boys and TV viewing and time spent communicating online and social networking for girls.