Screen-based Sedentary Behavior Research Articles

Prevalence of Internet Addiction and Its Relationship With Combinations of Physical Activity and Screen-Based Sedentary Behavior Among Adolescents in China.

Given the widespread prevalence and serious nature of Internet addiction (IA), this study aimed to estimate the prevalence of IA and assess the relationships between IA and combinations of physical activity (PA) and screen-based sedentary behavior (SB) among adolescents in China. This cross-sectional study surveyed 31,954 adolescents in grades 7 to 12 in Beijing. IA, PA, screen-based SB, and other information were obtained from a self-administrated questionnaire. The chi-square test and mixed-effects logistic regression model were applied to estimate the relationship between IA and combinations of PA and screen-based SB. 6.2% of the surveyed adolescents reported IA and the prevalence of low PA/high screen-based SB, high PA/high screen-based SB, low PA/low screen-based SB, and high PA/low screen-based SB were 53.7%, 19.5%, 18.8%, and 8.0%, respectively. Mixed-effects logistic regression analysis showed that adolescents with low PA/high screen-based SB were 1.99 (95% confidence interval, 1.62-2.44, P < .001) times more likely to prefer IA than those with high PA/low screen-based SB. The prevalence of IA among Chinese adolescents is still high. Intervention programs like maintaining sufficient PA and reducing screen-based SB might contribute to reducing their IA.

Physical Activity Levels of 1053 Omani 4th Grade Children: The Importance of Gender and Sport Team Participation in Achieving 60 Minutes of Daily Moderate-to-Vigorous Physical Activity

Sufficient daily physical activity is associated with many positive mental, physical, and societal benefits in children. Unfortunately, most children worldwide do not achieve recommended levels of daily physical activity (PA), and a majority of evidence is from Western countries and based on subjective measures. This study examined the prevalence and correlates of objectively measured PA levels among Omani children in 2017 (pre-pandemic). A two-stage cluster sampling was used to recruit the 4th grade children across five regions of Oman. A final analytic sample included 1053 children (504 boys, 549 girls) with a mean age of 9.21 years old. PA was objectively measured using a wrist-worn Polar Active Watch during three consecutive school days. Screen-based sedentary behaviors and other PA-related behaviors were subjectively measured. On average, boys were less sedentary and more active, with a greater likelihood of meeting current recommendations when compared with girls. The self-reported time spent in screen-based sedentary behaviors was relatively low for both boys and girls and was not associated with PA; however, sports team participation was associated with a greater likelihood of meeting the current recommendation. The present study provides empirical data on objectively measured PA in Omani children. The gender disparities concerning daily PA, including sports team participation, should receive further attention.

Prospective relationships of adolescents' screen-based sedentary behaviour with depressive symptoms: the Millennium Cohort Study.

Frequent use of screen-based devices could be a modifiable risk factor for adolescent depression, but findings have been inconsistent and mostly from cross-sectional studies. We examined prospective associations of video gaming, social media, and internet use with depressive symptoms in adolescents. A total of 11 341 adolescents from the Millennium Cohort Study, a representative, UK population-based. The main outcome was depressive symptoms from a Moods and Feelings Questionnaire (age 14). Exposures were frequency of video game, social media, and internet use (age 11). Physical activity (effect modifier) was measured by self-report. The fully adjusted models indicated that boys playing video games most days, at least once a week, and at least once a month at age 11 had lower depression scores at age 14 by 24.2% (IRR = 0.77, 95% CI 0.66-0.91), 25.1% (IRR = 0.75, 95% CI 0.62-0.90), and 31.2% (IRR = 0.69, 95% CI 0.57-0.83), compared with playing less than once a month/never. In girls, compared with less than once a month/never, using social media most days at age 11 was associated with 13% higher depression scores at age 14 (IRR = 1.13, 95% CI 1.05-1.22). We found some evidence of associations between using the internet most days and depressive symptoms compared with less than once a month/never in boys (IRR = 0.86, 95% CI 0.75-1.00). More frequent video game use was consistently associated with fewer depressive symptoms in boys with low physical activity, but not in those with high physical activity. Different types of screen-time may have contrasting associations with depressive symptoms during adolescence. Initiatives to address adolescents' screen-time may require targeted approaches.

Trends in sociodemographic and lifestyle factors associated with sedentary behavior among Brazilian adults.

To analyze sociodemographic and lifestyle factors associated with screen-based sedentary behavior (watching television ≥ 3 hours/day) among adult individuals in Brazil. Quantitative analysis of ten editions of the cross-sectional health survey VIGITEL, representative at the population level. Individuals from states' capitals living in households with land-line telephone were randomly selected and interviewed with a structured questionnaire, through the telephone. A multivariate logistic regression model was estimated for identification of factors associated with screen-based sedentary behavior. There was stability in trends referring to prevalence of sedentary behavior from 2008 to 2017. Prevalence of sedentary behavior was higher between individuals with unhealthier lifestyles: consumption of < two in natura food items (vegetables, fruits, and beans) per day (26.73% [95%CI 25.2 - 28.31]) in comparison with ≥ two items per day (23.79% [95%CI 21.92 - 25.77]); consumption of soft drinks ≥ five days per week (31.24% [95%CI 29.58 - 32.95]) than < five days per week (23.82% [95%CI 22.2 - 25.52]); and practice of < 150 minutes of physical activity per week (28.2% [95%CI 26.17 - 30.33]) than ≥ 150 minutes per week (22.54% [95%CI 21.27 - 23.86]). Regular consumption of in natura food items (OR = 0.984), practice of physical activity (OR = 0.798), and living in richer municipality (OR = 0.826) represented protective factors in relation to screen-based sedentary behavior, whilst regular consumption of soft drinks (OR = 1.440), smoking (OR = 1.375) and alcohol abuse (OR = 1.334) represented risk factors. The adoption of screen-based sedentary behavior among adult individuals in Brazil presented significant association with modifiable behavioral factors in the period 2008-2017.

Sedentary Behavior in Children by Wearable Cameras: Development of an Annotation Protocol

There is increasing evidence that not all types of sedentary behavior have the same harmful effects on children's health. Hence, there has been a growing interest in the use of wearable cameras. The aim of this study is to develop a protocol to categorize children's wearable camera data into sedentary behavior components. Wearable camera data were collected in 3 different samples of children in 2014. A development sample (3 children aged 4-8 years) was used to design the annotation protocol. A training sample (4 children aged 10 years) was used to train 3 different coders. The independent reliability sample (14 children aged 9-11 years) was used for independent coding of wearable camera images and to estimate inter-rater agreement. Data were analyzed in 2018. Cohen's κ was calculated for every rater pair on a per-participant basis. Means and SDs were then calculated across per-participant κ scores. A total of 41,651 images from 14 participants were considered for analysis. Inter-rater agreement over all raters over all the sedentary behavior components was almost perfect (mean κ=0.85, 95% CI=0.83, 0.87). Inter-rater reliability for screen-based sedentary behavior (mean κ=0.72, 95% CI=0.62, 0.82) and nonscreen sedentary behavior (κ=0.69, 95% CI=0.65, 0.72) showed substantial agreement. Inter-rater reliability for location (κ=0.91, 95% CI=0.88, 0.93) showed almost perfect agreement. A reliable annotation protocol to categorize wearable camera data of children into sedentary behavior components was developed. Once applied to larger samples in children, this protocol can ultimately help to better understand the potential harms of screen time and sedentary behavior in children.

Validation Of Previous-day Recalls Of Screen-based Sedentary Behavior In Young Male Adults

PURPOSE: Previous-day recall (PDR) has been suggested as a valid measurement of type, purpose and amount of sedentary behaviors in youth and adults. However, no studies have explored the feasibility and validity of using PDR to estimate sedentary behaviors in various bouts. This study examined the validity of a self-administered PDR in evaluating the total screen-based sedentary behaviors (SSB) and SSB by types and bouts using the activPAL as a criterion measure. METHODS: One hundred young male adults aged 18-35 years volunteered to participate in the validation study. They completed a web-based PDR over 7 consecutive days, in which three categories of SSB (computer work & surf internet, watching TV/video, and play computer games) were recorded to the nearest 15 minutes. Participants wore an activPAL over the 7 days to determine the daily sedentary time and the sedentary time during each 15-min segment. The activPAL-based SSB were calculated based on the start point and endpoint of sedentary behavior from PDR. Total SSB, SSB by type of activities and by duration of bouts were drawn from PDR. Bivariate correlations between PDR- and activPAL-assessed outcomes were conducted. Bland-Altman Plots were performed to determine the agreement between two methods by type of activities and by the duration of bouts. RESULTS: Total SSB assessed by PDR was associated with activPAL-determined sedentary time (r = 0.37). The absolute mean difference between PDR and activPAL was -1.38 h/day (95% confidence interval [CI]: -3.64, 0.88) for total SSB, -1.07 h/day (95% CI: -3.11, 0.96) for computer work & surf internet, -0.20 h/day (95% CI: -1.17, 0.76) for watching TV/video, and -0.15 h/day (95% CI: -0.95, 0.65) for playing computer games. The mean difference between two methods was smaller for sedentary bouts of ≥ 4 h (-0.20 h/day, 95% CI: -0.69, 0.29) than for the sedentary bout shorter than 1 h (-0.42 h/day, 95% CI: -1.42, 0.57). CONCLUSIONS: The online PDR could be used as an easy and valid tool to identify SSB, in particular the type and bouts of SSB in young male adults.

Sedentary Behavior And Associations To Portable Screen-Based Device Use And Parental Influence In Rural Children

Previous studies from our research group have examined the potential link between portable screen-based devices (i.e., smartphones and tablet computers) and sedentary behavior/physical activity in a primarily suburban population of young children and their parents. It was determined child sedentary behavior was related to portable screen-based device use while physical activity was not. While such relationships were found in a suburban population, rural demographic groups have been shown to differ in both their screen-based device use and physical activity variables suggesting the corresponding associations may also differ. PURPOSE: To examine screen-based media device (smartphone, tablet, television, video games, computer) use in children and parents from a rural population in relation to sedentary behavior and physical activity. METHODS: Parents (N = 7, 33.57 ± 3.95 years old) completed validated questionnaires assessing average daily total screen use (smartphone, tablet, television, video games, computer), portable screen-based device use (smartphone, tablet), sedentary behavior, and physical activity for both themselves and their children (N = 7, 7.00 ± 1.15 years old). Four standard regression models were used to assess the relationship between criterion variables and the following predictor variables: child age, child sex, child average daily sedentary time, and child physical activity. Criterion variables included (a) child portable screen-based device use (Model 1), (b) child total screen use (Model 2), (c) parent portable screen-based device use (Model 3), and (d) parent total screen use (Model 4). RESULTS: Child sedentary time was significantly (β = 0.92, t = 4.65, p = 0.04) and positively associated with parent screen-based device use. Child age, sex, and physical activity were not significantly (p > 0.05) related to either parent or child portable or total device use. CONCLUSION: Contrary to findings in young children from suburban populations, the current results from this limited sample suggest child sedentary behavior was not found to be related to portable screen-based device use in rural children. Furthermore, the data confirms previous findings that parental screen-based device use was predictive of sitting in their children.

Associations Between Leisure-Time Sedentary Behaviors with Unhealthy Dietary Behaviors and Leisure-Time Physical Activity Among Chinese Adults: A Cross-Sectional Study

Abstract Objectives Evidence that sedentary behaviors were correlated with unhealthy diet and physical activity were mostly among children and adolescents, but still limited for adults. The aim of this study was to examine the associations between screen-based leisure-time sedentary behaviors (LTSB) including television time and computer time with unhealthy dietary behaviors, and leisure-time physical activity (LTPA) among Chinese adults. Methods Participants (n = 10,108, aged 18–59 years) from a recent cross-sectional study of CHNS (China Health and Nutrition Survey) conducted in 2015 were analyzed. Time spent in LTSB and LTPA were collected from questionnaire. Unhealthy dietary behaviors were collected from three consecutive 24-hour food recalls and the food frequency method. Multivariable logistic regression models were produced to study the odds ratios for unhealthy dietary behaviors and LTPA as the function of the quintile of LTSB. Results Versus the lowest quartile, the OR(95%CI) of the highest quintile of computer time for insufficient vegetable intake (&amp;lt; 300 g/d) was 1.4(1.0,2.0) for male and 1.5(1.1,2.2) for female; the OR(95%CI) for excessive snack intake (≥1 time/day) was 1.6(1.0,2.3) for male and 1.7(1.3,2.4) for female; the OR(95%CI) for excessive western fast food intake (≥1 time/week) was 2.4(1.2,4.4) for male and 2.7(1.4,4.9) for female. The OR(95%CI) of the highest quintile of television time for no LTPA group (0 Mets.h/w) was 1.8(1.3,2.6) for male and 1.5(1.1,2.0) for female; the OR(95%CI) for sufficient LTPA group (≥8 Mets.h/w) was 0.5(0.4,0.8) for male and 0.7(0.5,0.9) for female. The OR(95%CI) of the highest quintile of computer time for no LTPA group (0 Mets.h/w) was 0.4(0.3,0.6) for male and 0.5(0.4,0.7) for female; the OR(95%CI) for sufficient LTPA (≥8 Mets.h/w) group was 2.4(1.7,3.3) for male and was 2.1(1.5,2.9) for female. Conclusions LTSB were associated with unhealthy dietary behaviors and mixed LTPA among Chinese adults. The patterns of “Television time-less LTPA” and “Computer time-unhealthy diet-more LTPA” for Chinese adults were principal associations. Our findings suggest the need for different behavior preventive intervention on different types of screen-based LTSB among Chinese adults. Funding Sources The survey received funding from NIH and from Ministry of Finance of the People's Republic of China.

Cross-sectional and longitudinal associations between physical activity, sedentary behaviour and bone stiffness index across weight status in European children and adolescents

BackgroundThe associations between physical activity (PA), sedentary behaviour (SB) and bone health may be differentially affected by weight status during growth. This study aims to assess the cross-sectional and longitudinal associations between PA, SB and bone stiffness index (SI) in European children and adolescents, taking the weight status into consideration.MethodsCalcaneus SI was first measured by quantitative ultrasound among children aged 2–9 years old in 2007/08. It was measured again after 2 years in the IDEFICS study and after 6 years in the I. Family study. A sample of 2008 participants with time spent at sports clubs, watching TV and playing computer/games self-reported by questionnaire, and a subsample of 1037 participants with SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) objectively measured using Actigraph accelerometers were included in the analyses. Weight status was defined as thin/normal and overweight/obese according to the extended International Obesity Task Force criteria. Linear mixed-effects models were used to estimate the cross-sectional and longitudinal associations between PA, SB and SI percentiles, stratified by weight status.ResultsThe cross-sectional association between weekly duration of watching TV and SI percentiles was negative in thin/normal weight group (β = − 0.35, p = 0.008). However, baseline weekly duration of watching TV (β = − 0.63, p = 0.021) and change after 2 years (β = − 0.63, p = 0.022) as well as the change in weekly duration of playing computer/games after 6 years (β = − 0.75, p = 0.019) were inversely associated with corresponding changes in SI percentiles in overweight/obese group. Change in time spent at sports clubs was positively associated with change in SI percentiles after 2 years (β = 1.28, p = 0.001), with comparable effect sizes across weight status. In the subsample with accelerometer data, we found a positive cross-sectional association between MVPA and SI percentiles in thin/normal weight group. Baseline MVPA predicted changes in SI percentiles after 2 and 6 years in all groups.ConclusionsOur results suggested the beneficial effect of PA on SI. However, the increasing durations of screen-based SB might be risk factors for SI development, especially in overweight/obese children and adolescents.

The relationship between screen-based sedentary behaviors and symptoms of depression and anxiety in youth: a systematic review of moderating variables

BackgroundTo elucidate the populations and conditions where screen-based sedentary behaviors (SB) and internalizing symptoms are coupled, this review synthesized the evidence for factors that may moderate the associations between screen-based SB, depressive symptoms, and anxiety symptoms among youth.MethodsTwo independent researchers conducted a systematic literature search of the Medline, psycINFO, and Scopus electronic databases in late 2018 for observational studies assessing moderators of the association between screen-based SB and depressive and anxiety symptoms. Studies among children and adolescents were eligible if moderation was assessed by statistical test (interaction) or stratification; and a narrative synthesis of eligible studies was conducted in accordance with PRISMA guidelines.ResultsSeventy empirical studies (46 cross-sectional, 19 longitudinal, and 5 both) of 13 different moderating variables of screen-based SB-internalizing symptom associations met the eligibility criteria. Of these, 40 studies were of depressive symptoms, 2 were of anxiety symptoms, and 28 studies assessed symptoms of both. The most consistent evidence of moderation was for screen-type, such that TV viewing was not as strongly associated with internalizing symptoms compared to other forms of screen-based SB. There was also inconsistent evidence for physical activity buffering screen-based SB-internalizing symptom associations and for female sex amplifying screen-based SB-internalizing symptom associations. In general, the body of evidence for anxiety symptoms was more limited than that for depressive symptoms, and were therefore more inconsistent.ConclusionsScreen-type, physical activity, and sex may influence the magnitude of screen-based SB-internalizing symptom coupling; highlighting potential sources of heterogeneity of screen-based SB-internalizing symptom associations. Additional studies aimed at understanding potential mechanistic explanations for the above moderators are needed prior to the development of tailored intervention strategies designed to decouple screen-based SB and internalizing symptoms among youth.

Five-year Evolution Patterns of Physical Activity and Sedentary Behavior in Patients with Lower-limb Osteoarthritis and Their Sociodemographic and Clinical Correlates.

The present study aimed to identify trajectories of physical activity (PA) components (frequency, duration, intensity, and type) and screen-based sedentary behavior (SB) as well as baseline predictors of each trajectory in patients with hip and/or knee osteoarthritis (OA). We included 878 patients with a 5-year follow-up from the KHOALA cohort. PA and SB were measured by the Modifiable Activity Questionnaire. We used group-based trajectory analysis to identify the trajectories of PA components and screen-based SB, and multivariable logistic regression to determine predictors of the identified trajectories. Two groups of trajectories were identified for each PA component and 3 for SB. High and decreasing PA duration was associated with female sex (OR 0.3, 95% CI 0.1-0.5) as was low and stable, more so than high and decreasing prevalence of weight-bearing activities (OR 0.6, 95% CI 0.4-0.9). Patients with impaired patient-reported outcome measures and obese patients often featured low versus high and decreasing prevalence of weight-bearing activities. Predictors of moderate and high versus low and slightly increasing screen-based SB trajectories were male sex, age < 60 years, single status (OR 1.5, 95% CI 1.1-2.1), obesity (OR 2.1, 95% CI 1.4-3.1), smoking (OR 2.0, 95% CI 1.1-3.7), and less physical jobs. Predictors of moderate and high versus low screen-based SB trajectories were all sociodemographic: male sex, age < 60 years, single status, obesity, smoking, and less physical jobs. Sociodemographic and clinical predictors of trajectories vary between PA components; they are associated mainly with PA frequency and type. No clinical characteristics were associated with screen-based SB.

Is there an association between children's screen use and cariogenic diet?

Data sources Databases searched included the International Database for Medical Research MEDLINE/Pubmed, ISI Web of Science, Scopus, Scientific Electronic Library Online (SciELO), and Latin American and Caribbean Health Sciences (LILACS).Study selection Studies of observational design that examined the association between any screen-time behaviour and dietary intake in preschool and school-aged children (younger than 12 years) were selected by two independent reviewers. If a consensus could not be reached, a third reviewer was consulted.Data extraction and synthesis Data were extracted independently by two reviewers using a pre-tested data extraction form. Risk of bias was assessed using an adapted version of the Newcastle-Ottawa Quality Assessment Scale for cross-sectional studies. A PRISMA flow chart was used to present the study selection results. The GRADE system was used to evaluate the strength of evidence. A qualitative synthesis was used to report the results. A meta-analysis was not conducted.Results Nineteen studies were included in the review, all of which were of cross sectional design or conducted cross-sectional analysis. Fourteen studies were assessed as high quality, three as moderate quality and two as low quality. All studies found a significant positive association between television and/or total screen-time viewing and poor quality diet including lower intake of fruit and vegetables and higher intake of unhealthy foods. Screen-based sedentary behaviour was positively associated with cariogenic foods consumption in 15 studies. Based on the GRADE rating, there was moderate evidence of an association between TV viewing and intake of potentially cariogenic diet.Conclusions Although there could be an association between TV viewing and poor quality cariogenic diet in preschool and school-aged children, the authors conclude that the strength of evidence is limited.

Automaticity facets applied to screen-time sedentary behaviours and active commuting measured by accelerometers

ABSTRACT Background: The time adults spend sitting in front of screens is a health risk factor. In contrast, walking and cycling to and from work, also known as active commuting, could promote physical activity and improve population health. Objective: This study investigated automatic properties role in explaining active commuting and screen-based sedentary behaviours. The stable, daily conditions for carrying out active commuting and screen-based sedentary behaviour are most likely to develop automatic properties. These characteristics mean performing behaviours via external cues (i.e. lack of intentionality), with an unpleasant emotional experience of not carrying out a set routine (i.e. lack of controllability), and without paying much attention (i.e. efficiency). Method: This article describes findings of a prospective and correlational study in which 128 people participated. First, participants responded to questions assessed using the Generic Multifaceted Automaticity Scale (GMAS), which measured the automatic properties of screen-based sedentary behaviour and active commuting. The following week, both behaviours were assessed by daily logs to document active commuting and screen-based sedentary behaviour events, and by an accelerometer, worn for seven days, as an objective criterion. Confirmatory factor analyses, bivariate correlations, and multiple linear regressions were computed for the associations between the GMAS scores and objective criterion measures of screen-based sedentary behaviours and active commuting. Results: Automaticity facets displayed different relationships with screen-based sedentary behaviours and active commuting – people with higher lack of intentionality and lack of controllability for active commuting present higher levels of moderate physical activity. In contrast, the lack of controllability of screen-based sedentary behaviours was a significant predictor of sedentary screen time. Conclusions: The multidimensional approach to automaticity could be useful in determining more precisely the features that need to be addressed to promote the adoption of active commuting and limit the time spent sitting in front of screens.

More Than Just Screen Time: Children's Sedentary Behaviors at Home and the Interplay of Home Environment Factors

Children's sedentary behavior (SB) is associated with various negative health outcomes. Because the home is an important site of children's SB, it is essential to study the correlations between different kinds of SBs in which children engage and home environment factors. This paper studies 7-12-year-old children's home-based SB in a Swedish municipality to understand the amount and correlates of different kinds of SBs, using logistic regression. Results show that children engage in both non-screen and screen-based SBs, all with multiple yet different correlates. The amount of non-screen and screen-based SBs differed by age and gender.

Is there an association between children's screen use and cariogenic diet?

Data sources Databases searched included the International Database for Medical Research MEDLINE/Pubmed, ISI Web of Science, Scopus, Scientific Electronic Library Online (SciELO), and Latin American and Caribbean Health Sciences (LILACS).Study selection Studies of observational design that examined the association between any screen-time behaviour and dietary intake in preschool and school-aged children (younger than 12 years) were selected by two independent reviewers. If a consensus could not be reached, a third reviewer was consulted.Data extraction and synthesis Data were extracted independently by two reviewers using a pre-tested data extraction form. Risk of bias was assessed using an adapted version of the Newcastle-Ottawa Quality Assessment Scale for cross-sectional studies. A PRISMA flow chart was used to present the study selection results. The GRADE system was used to evaluate the strength of evidence. A qualitative synthesis was used to report the results. A meta-analysis was not conducted.Results Nineteen studies were included in the review, all of which were of cross sectional design or conducted cross-sectional analysis. Fourteen studies were assessed as high quality, three as moderate quality and two as low quality. All studies found a significant positive association between television and/or total screen-time viewing and poor quality diet including lower intake of fruit and vegetables and higher intake of unhealthy foods. Screen-based sedentary behaviour was positively associated with cariogenic foods consumption in 15 studies. Based on the GRADE rating, there was moderate evidence of an association between TV viewing and intake of potentially cariogenic diet.Conclusions Although there could be an association between TV viewing and poor quality cariogenic diet in preschool and school-aged children, the authors conclude that the strength of evidence is limited.Commentary.

Reciprocal associations between depression and screen-based sedentary behaviors in adolescents differ by depressive symptom dimension and screen-type

BackgroundThe heterogeneity of depression and sedentary behavior complicates understanding of mechanisms underlying and interventions addressing comorbid depression and sedentary behavior in adolescents. This study investigated reciprocal associations between four depressive symptom dimensions and two types of screen-based sedentary behaviors in adolescents, and tested whether these associations differed by sex. MethodsA school-based longitudinal cohort (N = =2,717, baseline Mage=14.57 years) completed questionnaires during two assessments one year apart. Participants reported on levels of four depressive symptom dimensions (continuous) and television viewing and computer/videogame use (≥2 h/day; yes vs. no). ResultsReciprocal associations between computer/videogame use and higher negative affect symptoms were observed (computer/video games predicting negative affect, β=0.06, 95%CI 0.01–0.11, p = =0.01; negative affect predicting computer/video games, OR 1.29, 95%CI 1.06–1.58, p = =0.01). The relationship between baseline computer/videogame use and subsequent negative affect differed by sex (p = =0.02), and was significant in girls (β=0.11, 95%CI 0.04–0.18, p = =0.002), but not boys (β=0.004, 95%CI -0.06–0.07, p = =0.90). Baseline computer/videogame use predicted somatic symptoms at follow-up (β=0.06, 95%CI 0.01–0.10, p = =0.02), but the reverse association was non-significant. Higher baseline positive affect predicted computer/videogame use at follow-up (OR 1.16, 95%CI 1.02–1.31, p = =0.02), but the reverse association was non-significant. Television viewing was unrelated to each depressive symptom dimension in either direction. LimitationsSelf-reports may be subject to recall errors and biases, and do not provide clinical diagnoses. ConclusionsAssociations are not uniform across screen-based sedentary behavior type, depressive symptom dimension, and sex. The association between computer/videogame use and negative affect symptoms may be reciprocal across time and particularly robust among girls.

How socio-demographic and familiar circumstances are associated with total and domain-specific sedentary behaviour in youth? The UP&DOWN study

Objective: The aims of the present study were to analyze the associations between the socio-demographic and familiar circumstances with: (i) the total leisure-time sedentary behavior (SB) assessed by accelerometry, and (ii) the domain-specific leisure-time SB (i.e., screen-based, educational-based, social-based, and other-based SB), in a sample of Spanish youth. Method: The sample consisted of 1,543 youth (12.02 ± 2.51 years) included in the UP&DOWN study. SB was evaluated by accelerometry and questionnaire. Nationality, location of school, type of school, socio-economic status, parental educational level, parental occupation status, family structure, number of siblings and position among siblings were self-reported by participants or their parents. Linear mixed models, including school and city as random effects, were performed. Results: Several associations were found; however, socio-demographic and family circumstances differently associated with SB according to the domain-specific SB, the sex and the type of day. For example, participants with a father holding a high-skilled occupation spent lower time in screen-based SB during weekdays; and mother occupation status of high qualification was related to higher educational-based SB in boys. Having three or more sibling was associated with lower total SB in boys, while having an obese mother was related to higher screen-based SB on weekends both in boys and girls. Conclusions: Socio-demographic and familiar circumstances are associated with SB in young people, so future interventions should consider multiple and sex-specific factors for reduce SB of young people, focusing especially on youth with a low number of siblings and with parents holding low-skilled employments.

The CHIRPY DRAGON intervention in preventing obesity in Chinese primary-school--aged children: Acluster-randomised controlled trial.

BackgroundIn countries undergoing rapid economic transition such as China, rates of increase in childhood obesity exceed that in the West. However, prevention trials in these countries are inadequate in both quantity and methodological quality. In high-income countries, recent reviews have demonstrated that school-based prevention interventions are moderately effective but have some methodological limitations. To address these issues, this study evaluated clinical- and cost- effectiveness of the Chinese Primary School Children Physical Activity and Dietary Behaviour Changes Intervention (CHIRPY DRAGON) developed using the United Kingdom Medical Research Council complex intervention framework to prevent obesity in Chinese primary-school–aged children.Methods and findingsIn this cluster-randomised controlled trial, we recruited 40 state-funded primary schools from urban districts of Guangzhou, China. A total of 1,641 year-one children with parent/guardian consent took part in baseline assessments prior to stratified randomisation of schools (intervention arm, 20 schools, n = 832, mean age = 6.15 years, 55.6% boys; control arm n = 809, mean age = 6.14 years, 53.3% boys). The 12-month intervention programme included 4 school- and family-based components delivered by 5 dedicated project staff. We promoted physical activity and healthy eating behaviours through educational and practical workshops, family activities, and supporting the school to improve physical activity and food provision. The primary outcome, assessed blind to allocation, was between-arm difference in body mass index (BMI) z score at completion of the intervention. A range of prespecified, secondary anthropometric, behavioural, and psychosocial outcomes were also measured. We estimated cost effectiveness based on quality-adjusted life years (QALYs), taking a public sector perspective. Attrition was low with 55 children lost to follow up (3.4%) and no school dropout. Implementation adherence was high. Using intention to treat analysis, the mean difference (MD) in BMI z scores (intervention − control) was −0.13 (−0.26 to 0.00, p = 0.048), with the effect being greater in girls (MD = −0.18, −0.32 to −0.05, p = 0.007, p for interaction = 0.015) and in children with overweight or obesity at baseline (MD = −0.49, −0.73 to −0.25, p < 0.001, p for interaction < 0.001). Significant beneficial intervention effects were also observed on consumption of fruit and vegetables, sugar-sweetened beverages and unhealthy snacks, screen-based sedentary behaviour, and physical activity in the intervention group. Cost effectiveness was estimated at £1,760 per QALY, with the probability of the intervention being cost effective compared with usual care being at least 95% at a willingness to pay threshold of £20,000 to 30,000 per QALY. There was no evidence of adverse effects or harms. The main limitations of this study were the use of dietary assessment tools not yet validated for Chinese children and the use of the UK value set to estimate QALYS.ConclusionsThis school- and family-based obesity prevention programme was effective and highly cost effective in reducing BMI z scores in primary-school–aged children in China. Future research should identify strategies to enhance beneficial effects among boys and investigate the transferability of the intervention to other provinces in China and countries that share the same language and cultures.Trial registrationISRCTN Identifier ISRCTN11867516.

Investigating the prevalence of and factors associated with depressive symptoms among urban and semi-urban school adolescents in Bangladesh: a pilot study.

Adolescent depression is an alarming issue for Bangladesh since a large number of Bangladeshi adolescents suffer from depression but cannot get proper treatment. This study aimed to investigate the prevalence of depression and factors associated with this psychological health hazard among urban and semi-urban adolescents of the Dhaka region in Bangladesh. A cross-sectional pilot study was performed among 311 adolescents, grades 8-10, in Dhaka city and Savar Upazila, adjacent to the city, in 2018. Data were collected using a questionnaire consisting of items on sociodemographics, lifestyle information, screen-based sedentary behaviour (SBSB) and mental health. A total of 36.6% of the adolescents reported depressive symptoms, with a greater prevalence among females (42.9%) than males (25.7%). Sociodemographic factors including being female, residence and grade in school were significantly associated with depression. Logistic regression analysis showed that SBSBs, such as the use of social media (odds ratio [OR] 2.06 [95% confidence interval {CI} 1.27-3.35]), high screen time (>120min/day; OR 2.35 [95% CI 1.30-4.25]) and sleep disturbance (OR 3.93 [95% CI 2.37-6.50]) were significantly linked with depressive symptoms. Depressive symptoms are prevalent among urban and semi-urban adolescents of Dhaka, Bangladesh. Therefore, urgent initiatives should be taken to curb the spread of depression among Bangladeshi adolescents.

&lt;p&gt;Combined Patterns Of Physical Activity And Screen-Related Sedentary Behavior Among Chinese Adolescents And Their Correlations With Depression, Anxiety And Self-Injurious Behaviors&lt;/p&gt;

Background and purposeThere are increasing concern about independent associations between physical activity, screen-based sedentary behavior (SSB), and psychological problems, but only a few studies have attempted to explore combined patterns of physical activity and SSB in adolescents and their correlations with psychological problems. This study was aimed at identifying combined patterns of moderate-to-vigorous physical activity (MVPA) and SSB and examining the prevalence of different combined patterns and their correlations with depression, anxiety, and self-injurious behavior among Chinese adolescents.MethodsJunior and senior high school students (N = 13,659; mean age 15.18±1.89) were recruited. Latent class analysis was conducted to identify combined patterns of MVPA and SSB. Associations between subgroups of MVPA and SSB and socio-demographic characteristics were assessed by logistic regression. Their correlation with depression, anxiety, and self-injurious behaviors was assessed by analysis of variance with analysis stratified by gender.ResultsFour latent classes were identified: high MVPA/low SSB group (64.7%), low MVPA/low SSB (26.7%), low MVPA/high SSB (4.8%), and low MVPA/moderate SSB (3.9%). Generally, the high MVPA/low SSB class was a relatively healthy group. The low MVPA/high SSB class was at risk of enduring depression, anxiety, and self-injurious behavior, with boys being more at risk than girls.ConclusionFour latent subgroups of MVPA and SSB were identified in Chinese adolescents. The findings highlight the potential role of concurrent MVPA and SSB, with gender-specific characteristics in the primary prevention of adolescent depression, anxiety, and self-injurious behaviors.