Screen Time Behaviors Research Articles

Stay-at-Home Orders during COVID-19: The Influence on Physical Activity and Recreational Screen Time Change among Diverse Emerging Adults and Future Implications for Health Promotion and the Prevention of Widening Health Disparities.

Background: The purpose of this study was to examine changes in physical activity (PA) and recreational screen time (RST) behaviors from pre-COVID-19 in 2018 to Spring 2020 during the mandatory stay-at-home order in an ethnically/racially, socioeconomically diverse sample of emerging adults. Methods: Longitudinal data were analyzed from 218 participants (Mage = 24.6 ± 2.0 years) who completed two surveys: EAT 2018 (Eating and Activity over Time) and C-EAT in 2020 (during COVID-19). Repeated ANCOVAs and multiple linear regression models were conducted. Results: Moderate-to-vigorous and total PA decreased (4.7 ± 0.3 to 3.5 ± 0.3 h/week [p < 0.001] and 7.9 ± 0.4 to 5.8 ± 0.4 h/week [p < 0.001], respectively), and RST increased from 26.5 ± 0.9 to 29.4 ± 0.8 h/week (p = 0.003). Perceived lack of neighborhood safety, ethnic/racial minoritized identities, and low socioeconomic status were significant predictors of lower PA and higher RST during COVID-19. For example, low SES was associated with 4.04 fewer hours of total PA compared to high SES (p < 0.001). Conclusions: Stay-at-home policies may have significantly influenced PA and RST levels in emerging adults with pre-existing disparities exacerbated during this mandatory period of sheltering-in-place. This suggests that the pandemic may have played a role in introducing or magnifying these disparities. Post-pandemic interventions will be needed to reverse trends in PA and RST, with a focus on improving neighborhood safety and meeting the needs of low socioeconomic and ethnic/racial minoritized groups.

Enabling Better Physical Activity and Screen Time Behaviours for Adolescents from Middle Eastern Backgrounds: Semi-Structured Interviews with Parents.

The unrelenting obesity pandemic in Middle Eastern (ME) adolescents living in Australia warrants culturally responsive and locally engineered interventions. Given the influence of parents on the lifestyle behaviours of adolescents, this qualitative study aimed to capture the opinions of ME parents on the barriers and enablers to sufficient physical activity and limiting screen time behaviours in adolescents. Semi-structured interviews were conducted with 26 ME parents (female) aged 35–59 years old, most of whom resided in lower socioeconomic areas (n = 19). A reflexive thematic analysis using the Theoretical Domains Framework and the Capability, Opportunity, Motivation-Behaviour model was performed for coding. Parents voiced confidence in their knowledge of the importance of physical activity and limiting screen time but were less optimistic in their ability to enable change in behaviours, especially for older adolescents without outside support. Despite adolescents having the necessary skills to engage in a wide array of sports, the parents admitted deep fears regarding the safety of the social environment and restricted their children’s independent mobility. Gender differences were noted, with parents reporting older girls expressing disinterest in sports and having limited physical opportunities to participate in sports at school. It may be that a community-based participatory framework is needed to improve physical activity opportunities and to address specific physical, social, and cultural barriers.

Physical Activity and Screen Time Practices of Family Child Care Providers: Do They Meet Best Practice Guidelines?

Background: Child care settings significantly influence children's physical activity (PA) and screen time (ST) behaviors, yet less research has been conducted in family child care homes (FCCHs) than in child care centers. While a few studies have measured family child care providers' (FCCPs') PA practices, none have used observation to assess which specific evidence-based, best practice guidelines FCCPs met or did not meet, and no previous studies have included Latinx providers. This article examines FCCPs' adherence to PA and ST best practice guidelines using primarily observational methods with diverse FCCPs (including Latinx). Methods: We examined baseline data from a cluster randomized trial including surveys and observational data collected at the FCCH to assess whether providers met specific PA and ST best practices from the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) and the American Academy of Pediatrics. Results: Providers completed a telephone survey and participated in two full-day observations (n = 127; 72% Hispanic). Overall, only 4 of 14 PA and ST best practices were met by >50% of providers including: leading a planned PA class more than once a week; no ST during meal or snack; not modeling sedentary behavior; and providing families with information about children's ST. Best practices least likely to be met (<20% of providers) include: providing children with >60 minutes of outdoor play daily; providing children with >45 minutes of adult-led PA each day; participating in outdoor PA with children; participating in indoor PA with children; prompting and praising children for being active; and talking with children informally about the importance of PA. Conclusions: While FCCPs engage in some positive PA and ST practices, many providers do not meet best practice guidelines. There is a need for more research about how to overcome providers' personal and environmental barriers for meeting these guidelines as well as interventions and supports to overcome these barriers. Clinical Trial Registration Number NCT0245645.

Recreational Screen Time Use among a Small Sample of Canadians during the First Six Months of the COVID-19 Pandemic.

(1) Background: The coronavirus (COVID-19) pandemic has caused disruptions in the daily lives of individuals in Canada. Purpose: Examine how total and specific (i.e., watching television, using social media, going on the Internet, playing video games, and engaging in virtual social connection) recreational screen time behaviours changed throughout the first six months of the COVID-19 pandemic, in comparison to pre-pandemic levels; (2) Methods: Sixty four Canadians (mostly Caucasian, female, age range = 21–77 years) completed monthly surveys from April to September of 2020; (3) Results: A one-way repeated measures analysis of variance (RM-ANOVA) and subsequent post hoc analysis revealed that total recreational screen time was statistically higher in late March/April (292.5 min/day ± 143.0) and into May, compared to pre-COVID-19 (187.8 min/day ± 118.3), before declining in subsequent months; (4) Conclusions: Generally, specific recreational screen time behaviours, such as time spent watching television, followed the same trend. Future studies with larger sample sizes and from other countries examining recreational screen time behaviours longitudinally over the pandemic are still needed to allow for greater generalizability.

Effects of telephone support or short message service on body mass index, eating and screen time behaviours of children age 2 years: A 3-arm randomized controlled trial.

SummaryBackgroundFew randomized controlled trial (RCT) interventions targeted children's early risk behaviours using telephone or short message service (SMS) support.ObjectiveTo evaluate the effectiveness of telephone or SMS early intervention focusing on mothers' behaviours starting from late pregnancy to improve BMI, and eating and screen time behaviours of children aged 2 years in comparison with the control group.MethodsA 3‐arm RCT was conducted in Australia, 2017–2019. Two arms involved the interventions using nurse‐led telephone or SMS support, delivered in nine stages from late pregnancy to age 2 years. The third arm was control. The primary outcome was children's objectively measured BMI and BMI z‐score at 2 years. Secondary outcomes included child eating and screen time behaviours as reported by parents at 2 years.ResultsAt 2 years, 797 mother–child dyads (69%) completed the telephone survey with 666 (58%) completing weight and height measurements. The study found no statistically significant difference in BMI between the groups. The mean BMI for telephone support was 16.93 (95% CI: 16.73 to 17.13), for SMS 16.92 (95% CI: 16.73 to 17.11) or for control 16.95 (95% CI: 16.73 to 17.16) with a difference of −0.02 (95% CI: −0.31 to 0.27, p = 0.907) in telephone versus control, and a difference of −0.03 (95% CI: −0.30 to 0.24, p = 0.816) in SMS versus control. Telephone support was associated with higher odds of no bottle at bedtime (adjusted odds ratio [AOR]: 2.99; 95% CI: 2.01 to 4.47), family meals (AOR: 2.05; 95% CI: 1.26 to 3.33), drinking from a cup (AOR: 1.89; 95% CI: 1.24 to 2.88), less screen time (<1 h/day) (AOR: 1.56; 95% CI: 1.10 to 2.23) and not eating dinner in front of the TV (AOR: 1.50; 95% CI: 1.09 to 2.06). SMS support was also associated with higher odds of no bottle at bedtime (AOR 2.30, 95% CI: 1.58 to 3.33) than the control.ConclusionThe telephone or SMS support intervention had no significant effects on BMI, but was effective in increasing no bottle use at bedtime. Telephone support showed more effects than SMS on reducing screen time and eating behaviours.

Parents' Report of Canadian Elementary School Children's Physical Activity and Screen Time during the COVID-19 Pandemic: A Longitudinal Study.

COVID-19 public health protocols have altered children’s daily routines, limiting their physical activity opportunities. The purpose of this study was to examine how the COVID-19 pandemic affected children’s (ages 10–12 years) physical activity and screen time, and to explore the impact of gender, socioeconomic status (SES), and public health constraints (i.e., facility use and social interaction) on the changes in children’s health behaviors. Online surveys were disseminated to parents at two time points: before COVID-19 (May 2019 to February 2020) and during COVID-19 (November to December 2020). Wilcoxon signed-rank tests were used to assess changes in physical activity and screen time, and for subgroup analyses. Parents (n = 95) reported declines in children’s physical activity (Z = −2.53, p = 0.01, d = 0.18), and increases in weekday (Z = −4.61, p < 0.01, d = 0.33) and weekend screen time (Z = −3.79, p < 0.01, d = 0.27). Significant changes in physical activity and screen time behaviors were identified between gender, SES, and facility use groups. All social interaction groups underwent significant changes in screen time. Overall, COVID-19 protocols have negatively influenced children’s physical activity and screen time. Due to the negative consequences of inactivity and excessive screen time, resources must be made available to support families during the pandemic.

Changes in Families' Leisure, Educational/Work and Social Screen Time Behaviours before and during COVID-19 in Australia: Findings from the Our Life at Home Study.

This study aimed to understand differences in leisure, educational/work and social screen time behaviours experienced by parents and children due to COVID-19 lockdown restrictions, which may inform behaviour change strategies and policy in the transition to a COVID-normal life. Participants in the “Our Life at Home” study (n = 218 parents from Australia, 43.4 ± 6.8 years, 88% female) completed a cross-sectional online survey in April/May 2020. Parents recalled their own and their child (8.7 ± 2.0 years, 42% female) or adolescents (15.0 ± 1.5 years, 50% female) participation in nine screen time behaviours in the past month (during lockdown) and retrospectively for February 2020 (pre-lockdown), providing data on 436 individuals. Screen time behaviours included leisure (computer/laptop and tablet/smartphone for leisure, TV/videos/DVDs and game consoles); education/work (computer/laptop and tablet/smartphone for work/education); and social screen time (computer/tablet/smartphone for social communication with friends, family and work (parents only)). Wilcoxon signed-rank tests and effect sizes (r) compared the time spent in each behaviour pre-lockdown and during lockdown. Large differences were observed in social (parents: r = 0.41–0.57; children: r = 0.55–0.65; adolescents: r = 0.28–0.43) and education (children: r = 0.50–0.65 and adolescents: r = 0.25–0.37) behaviours. There were small or no differences in leisure time screen use. COVID-19 lockdown restrictions have impacted parent’s and children’s screen time, and future research and policy should consider strategies to support families to manage screen time.

Mothers’ Strategies for Promoting Children’s Healthy Eating, Physical Activity, and Screen-Related Behaviors

Parents model and teach early health practices that persist into adulthood by establishing a family culture through which children learn related family beliefs, values, and expectations. This phenomenological study examined the ways in which a purposefully selected group of mothers (selected due to their high scores on the Family Nutrition and Physical Activity screening tool) shaped family culture related to physical activity, addressed screen-time behaviors, and established positive eating related routines. Findings related to mothers’ knowledge and belief systems about parenting within this domain pointed to the impact of family health history and mothers’ own upbringing; a finding that reinforced the powerful nature of early habit formation. Mothers prioritized this parenting domain and were intentional in their efforts as they maneuvered threats from the obesigenic environment and worked to support their children’s developing autonomy over related behaviors. This study presents a strengths perspective and imparts a new narrative which serves to complement existing obesity research in representative and at-risk populations.

Intrafamilial Characteristics Are Important Predictors of Children's Diets in New Mexico's Border Colonias.

We assessed selected nutritional indicators in Mexican-origin children in two low-income, rural colonias in New Mexico on the U.S.-Mexico border. These children are at higher risk for obesity and other chronic diseases linked to poor nutrition in childhood, but little is known about their diets. We surveyed mothers of 202 children 6 to 10 years old about sociodemographic characteristics, family and child attitudes and behaviors, and the child's diet. We compared diet with dietary recommendations and used regression trees to identify significant predictors of recommended intake. Among families, 89.1% participated in Medicaid, and 52.5% participated in a Supplemental Nutrition Program. More children met recommendations for fruit (36.1%) than vegetables (1.5%). Greater vegetable intake was associated with a child's not thinking healthy food tasted bad, greater family activity, and younger maternal age. Only 5.0% of children met the recommendation for <10% of energy from added sugar, with the average child consuming 2.4 times that from sugar-sweetened beverages and snacks. Lower sugar intake was associated with less screen time, not having TV on during meals, and playing team sports. Family access to healthy food and child use of mobile food vendors, vending and convenience stores were not predictive of diet. Hispanic children in border colonias have poor diets that put them at risk for obesity and numerous chronic diseases. Addressing this problem will require changing family norms and attitudes toward healthy food, screen time behavior, and physical activity levels within families.

Ethnic Differences in Family Childcare Providers' Nutrition- and Activity-Related Attitudes and Barriers.

Objective The aim of the study is to examine family childcare providers' (FCCPs) attitudes and perceived barriers related to nutrition, physical activity (PA), and screen time (ST) behaviors of preschool children, exploring differences by provider ethnicity. Design Baseline survey data from a cluster-randomized trial. Participants. Around 168 FCCPs completed a telephone survey, and 126 completed both telephone and in-person surveys. Main Outcome Measures. Phone and in-person surveys include 44 questions to assess FCCPs attitudes and perceived barriers regarding nutrition, PA, and ST in the family childcare home. Analysis. Associations by ethnicity (Latinx vs. non-Latinx) were assessed by ANOVA, adjusting for provider education and Bonferroni correction. Results Some FCCP attitudes were consistent with national obesity prevention guidelines; for example, most FCCPs agreed that they have an important role in shaping children's eating and PA habits. However, many FCCPs agreed with allowing children to watch educational TV and did not agree that children should serve themselves at meals. Adjusting for education, there were statistically significant differences in attitude and perceived barrier scores by provider ethnicity. For example, Latinx FCCPs were more likely to agree that they should eat the same foods as children(p < .001) but less likely to agree that serving the food at meal and snack time is the adult's responsibility (p < .001). Latinx FCCPs were more like to perceive barriers related to children's safety playing outside (p < .001). Conclusions and Implications. While FCCPs hold some nutrition-, PA-, and ST-related attitudes consistent with national guidelines, training opportunities are needed for FCCPs to improve knowledge and skills and overcome perceived barriers related to nutrition and PA. Latinx FCCPs, in particular, may need culturally tailored training and support to overcome misperceptions and barriers.

A dual process model to predict adolescents’ screen time and physical activity

Objective Many adolescents report a lack of physical activity (PA) and excess screen time (ST). Psychological theories aiming to understand these behaviours typically focus on predictors of only one behaviour. Yet, behaviour enactment is often a choice between options. This study sought to examine predictors of PA and ST in a single model. Variables were drawn from dual process models, which portray behaviour as the outcome of deliberative and automatic processes. Design 411 Finnish vocational school students (age 17–19) completed a survey, comprising variables from the Reasoned Action Approach (RAA) and automaticity pertaining to PA and ST, and self-reported PA and ST four weeks later. Main outcome measures Self-reported time spent on PA and ST and their predictors. Results PA and ST correlated negatively (r = −.17, p = .03). Structural equation modelling revealed that intentions and habit for PA predicted PA while ST was predicted by intentions and habit for ST and negatively by PA intentions. RAA-cognitions predicted intentions. Conclusion PA and ST and their psychological predictors seem to be weakly interlinked. Future studies should assess more behaviours and related psychological influences to get a better picture of connections between different behaviours. Highlights Physical activity and screen time are largely mutually exclusive classes of behaviours and might therefore be related in terms of their psychological predictors. 411 adolescent vocational school students self-reported variables from the Reasoned Action Approach and behavioural automaticity related to physical activity and leisure time screen time behaviours as well as those behaviours. Structural equation modelling revealed expected within-behaviour predictions but, against expectations, no strong connections between the two behaviour classes in terms of their predictors. Only intentions to engage in physical activity negatively predicted screen time. Future research should aim to measure a wider range of mutually exclusive classes of behaviours that cover a large share of the day to uncover relations between behaviours and their respective predictors.

Study protocol for Healthy Conversations @ Playgroup: a multi-site cluster randomized controlled trial of an\xa0intervention to promote healthy lifestyle behaviours in young children attending community playgroups

BackgroundEarly childhood is a critical window for preventing obesity and chronic disease. Yet, 1 in 4 Australian children aged 5 years and under are affected by overweight or obesity; and significant proportions of children under 5 years fail to meet guidelines for diet quality, physical activity (PA), screen time, and sleep. Consequently, effective interventions to promote healthy lifestyle behaviors and prevent obesity during early childhood are needed. Community playgroups provide an opportunity for parents, carers, and children to meet in a safe and relaxed environment to play and share information. The structure, low cost and reach of playgroups provide a unique platform to engage parents in a scalable program to promote healthful lifestyle behaviors and prevent childhood obesity. However, the evidence base for the effectiveness of health promotion programs delivered in community playgroup settings is limited and lacking credible evidence from rigorously conducted randomized controlled trials.MethodsThe Healthy Conversations @ Playgroup randomized controlled trial (RCT) aims to address the underlying behavioral risk factors for obesity by helping parents take effective steps to improve their child’s dietary, PA, screen time, and sleep behaviors. The intervention program comprises 10 “healthy conversations” led by a trained peer facilitator, designed to increase parents’ behavioral capability and self-efficacy to implement autonomy-supportive parenting practices. The program will be delivered biweekly during regularly scheduled playgroup sessions over 10-weeks. Effectiveness will be tested in a 2-arm cluster RCT involving 60 community playgroups in three states across Australia. After baseline assessments, participating playgroups will be randomly allocated to either intervention or wait-list control conditions. Primary outcomes (vegetable intake, discretionary foods, daily PA, screen time, sleep duration, and body mass index [BMI] z-score) will be assessed at baseline, immediately post-intervention (10-weeks; T2) and 6-months post-intervention (T3). Outcomes will be assessed for differential change at T2 and T3.DiscussionThe Healthy Conversations @ Playgroup trial will rigorously evaluate a novel peer-led intervention program to promote healthful lifestyle behaviors and prevent obesity in children and families attending community playgroups. If effective, the program could be immediately scaled-up and delivered in community playgroups across Australia.Trial registrationTrial registered 22nd January 2021 with the Australian and New Zealand Clinical Trials Registry (ACTRN12621000055808).

Screen time and child behaviour and health-related quality of life: Effect of family context

This study investigated family contextual effects on the association between screen time, behaviour and health-related quality of life (HRQOL) in child siblings. Data were from 1772 participants in the Australian Longitudinal Study of Women's Health 1973–78 cohort and their three youngest children (N = 4010 siblings) aged two to 12, collected in Mothers and their Children's Health cross-sectional sub-study (2016/17). The exposure was average daily recreational screen time (televisions, computers, tablets, mobile phones, electronic games). Outcomes were child overall behaviour and prosocial behaviour, and psychosocial and physical HRQOL. Multilevel models were used to test 1) the absolute effect of screen time, and 2) change in the child's outcomes when their own screen time changes relative to their siblings (within-family contextual effects) and change in the child's outcomes when the sibling average screen time changes (between-family contextual effects). The children were average 7.37 years (SD 2.76). There was an absolute effect of screen time on behaviour and HRQOL. Between-family effects were found for child total behaviour (0·22 (95%CI, 0.06, 0.37)) and prosocial behaviour (−0.10 (−0.17, −0.04)), but there were no within-family effects. For HRQOL, within-family effects were found for psychosocial (−0.97 (−1.91, −0.02)) and physical (−1.32 (−2.25, −0.39)) HRQOL, but no between-family effects were found. In conclusion, the higher the average screen time by all children in the family, the worse the child's behaviour, while the greater the deviation of the child's screen time from their siblings, the poorer their HRQOL. Family contextual factors should be considered in screen time research and screen time recommendations.

Packaging and Scaling the Stanford Pediatric Weight Control Program: A Family-Based, Group, Behavioral Weight Management Program for Children with Obesity and Their Families: Background, Rationale, and Design of the Stanford CORD 3.0 Project.

Efficacious treatments for children with obesity have not been broadly disseminated. The Stanford Pediatric Weight Control Program (SPWCP) is grounded in behavioral theory and prior observations, follows a proven treatment model, and is consistent with the US Preventive Services Task Force (USPSTF) recommendations. It has shown high levels of participation and retention and reductions in BMI and percent of median BMI for age and sex comparable to many studied programs, as well as improvements in physiological risk factors, psychological measures, and diet, activity, and screen time behaviors in children with obesity when delivered as a real-world clinical program with sociodemographically diverse families in multiple clinic and community settings. The Stanford CORD 3.0 Project proposes to use technology, design, behavioral theory, and biomedical business innovation strategies to package and scale the SPWCP to reach low-income children throughout the United States. Efficacy and success of implementation of the new packaged program will be tested in a one-arm pilot implementation study when delivered by community partners.

1500Determinants of dietary behaviour and physical activity in Australian adolescents

Abstract Background The increased prevalence of obesity, unhealthy diet and sedentary lifestyles among Australian adolescents has become a public health concern. This study investigated the associations between socio-economic status, screen-time, social networks, sleep, and wellbeing and subsequent health behaviours. Methods A cohort of 582 adolescents aged 13-19 years from Sydney were prospectively followed for 22-weeks (8 November 2019 – 19 April 2020). Study factors were collected via mobile phone app using weekly ecological momentary assessments (EMAs). Multi-level mixed effects logistic regression model assessed associations between baseline characteristics of participants, socio-economic status, screen-time, sleep, and wellbeing and subsequent dietary behaviour and physical activity. Results TV watching (odds ratio [OR]=1.22, 95% CI: 0.98-1.5), social media and internet use (OR = 1.22, 95% CI: 0.97-1.53) were associated with fast food consumption. Participants who spent more than four hours a day on social media were also less likely to be physically active for ³60 minutes (OR = 0.75, 95% CI: 0.6-0.94). Fast food consumption was associated with lower vegetable (OR = 0.61, 95% CI: 0.43-0.85) and fruit intake (OR = 0.78, 95% CI: 0.61-1.01), and was also more prevalent in participants with a job (OR = 1.42, 95% CI: 1.09-1.86). There was no substantial effect of psychological distress, positive emotions, social relationships and sleep on any health behaviour. Conclusions The present study has shown that lifestyle behaviours had a stronger effect on dietary behaviour and physical activity than some of the socio-demographic factors. Key messages Future studies with a balanced sample in terms of sex, age and cultural background are needed.

The Differential Impact of Screen Time on Children's Wellbeing.

Increased screen time has been found to be associated with a number of negative health and wellbeing indicators in youth populations. An increasing number of studies have investigated the association between screen time and wellbeing in adolescents, but evidence in younger children is still emerging. This 2017 study explored the effect of leisure screen time and gender on dimensions of wellbeing (measured using KIDSCREEN-27) in a national sample of 897 Irish primary school children aged 8–12 years. Participants had a mean age of 10.9 ± 1.16 years and were 47.7% female. Just over 30% of the sample accumulated 2 h or more of leisure screen time daily. Results show that there was no significant interaction between screen time category (<2 h/2 h + daily) and gender on overall wellbeing, while controlling for BMI. Children who self-reported <2 h of leisure screen time scored significantly higher on four dimensions of wellbeing: physical, parental, peers, and school, but not psychological. This study supports the growing evidence of the impact that leisure screen time has on health. Further longitudinal research investigating the impact of sub-categories of leisure screen time behaviour on wellbeing is warranted.

Organized Physical Activity Program Participation, Physical Activity, and Related Psychosocial Factors Among Urban Adolescents.

The study purpose was to examine whether adolescents who participated in organized physical activity (PA) programs differed from nonparticipants in motivation, social support, and self-efficacy related to PA; PA (min/hr); and sedentary screen time behavior. Thirty-nine 5th-7th grade adolescents participated in organized PA programs; 41 did not. Approximately 56.3% were Black, and 52.5% had annual family incomes <$20,000. Compared to nonparticipants, those who participated reported significantly higher social support (M = 2.32 vs. 3.13, p < .001) and fewer hours watching television or movies on a usual weekend day (M = 2.49 vs. 1.59, p = .016); and had higher accelerometer-measured vigorous PA (M = 0.58 vs. 1.04, p = .009) and moderate-to-vigorous PA (M = 2.48 vs. 3.45, p = .035). Involving adolescents in organized PA programs may be important for improving their moderate-to-vigorous PA, vigorous PA, and related psychosocial factors, as well as reducing sedentary screen time behavior.

Anxiety And Depressive Symptoms Differ Between Levels Of Physical Activity And Screen Time Among Adolescents

The influence of physical activity (PA) and sedentary behaviours, especially screen time, on anxiety and depressive symptoms is comparatively less studied among adolescents. PURPOSE: Thus, this study quantified differences in anxiety and depressive symptoms between levels of PA and screen time among 1756 adolescents (14.8 ± 1.7y; 995 female) in secondary school in the Republic of Ireland. METHODS: Participants self-reported depressive (QIDS) and anxiety (STAI-Y2) symptoms, PA (PACE+), and average daily weekday/weekend hours of television (TV), computer and smartphone use. ANOVA with Bonferroni-corrected pairwise comparisons examined anxiety and depressive symptom differences between levels of PA and screen-time. Cohen’s d quantified the magnitude of differences. RESULTS: Anxiety and depressive symptoms significantly differed between PA levels (p ≤ 0.001), and weekday and weekend TV (p ≤ 0.001), computer use (p < 0.001), and smartphone use (p < 0.001). Results were materially the same when adjusted for age, gender, school type and residence (all p ≤ 0.001). Anxiety symptoms were greater for low compared to moderate (p < 0.001, d = 0.58) and high (p < 0.001, d = 0.87) PA, and for moderate compared to high PA (p < 0.001, d = 0.33). Depressive symptoms were greater for low compared to moderate (p < 0.001, d = 0.47) and high (p < 0.001, d = 0.67) PA, and for moderate compared to high PA (p < 0.001, d = 0.21). Compared to no TV, symptoms were lower for ≤2 h of weekday TV (anxiety: all p ≤ 0.004, d: 0.27-0.34; depressive: all p ≤ 0.01, d: 0.26-0.37) and ≤ 30 min/d of weekend TV (anxiety: p ≤ 0.007, d = 0.35; depressive: p ≤ 0.005, d = 0.36). For computer use, compared to lower use categories, symptoms were greater for ≥5 h/d of weekday (anxiety: all p ≤ 0.003, d: 0.53-0.79; depressive: all p < 0.001, d: 0.63-0.66) and weekend (anxiety: all p ≤ 0.02, d: 0.34-0.59; depressive: all p < 0.001, d: 0.43-0.72) use. For smartphone use, compared to lower use categories, symptoms were greater for ≥5 h/d of weekday (anxiety: all p ≤ 0.03, d: 0.31-0.70; depressive: all p ≤ 0.002, d: 0.34-0.74) and weekend (anxiety: all p ≤ 0.001, d: 0.34-0.76; depressive: all p < 0.001, d: 0.30-0.80) use. CONCLUSION: Anxiety and depressive symptoms differed based on PA and screen time behaviours. Dose-response and threshold effects were suggested for PA and screen time, respectively.

Improving Physical Activity Levels in Prevocational Students by Student Participation: Protocol for a Cluster Randomized Controlled Trial.

BackgroundA consistent finding in the literature is the decline in physical activity during adolescence, resulting in activity levels below the recommended guidelines. Therefore, promotion of physical activity is recommended specifically for prevocational students.ObjectiveThis protocol paper describes the background and design of a physical activity promotion intervention study in which prevocational students are invited to participate in the design and implementation of an intervention mix. The intervention is expected to prevent a decline in physical activity in the target group.MethodsThe effectiveness of the intervention was evaluated in a two-group cluster randomized controlled trial with assessments at baseline and 2-year follow-up. A simple randomization was applied, allocating 11 schools to the intervention group and 11 schools to the control group, which followed the regular school curriculum. The research population consisted of 3003 prevocational students, aged 13-15 years. The primary outcome measures were self-reported physical activity levels (screen time, active commuting, and physical activity). As a secondary outcome, direct assessment of physical fitness (leg strength, arm strength, hip flexibility, hand speed, abdominal muscle strength, BMI, and body composition) was included. An intervention-control group comparison was presented for the baseline results. The 2-year interventions began by mapping the assets of the prevocational adolescents of each intervention school using motivational interviewing in the structured interview matrix and the photovoice method. In addition, during focus group sessions, students, school employees, and researchers cocreated and implemented an intervention plan that optimally met the students’ assets and opportunities in the school context. The degree of student participation was evaluated through interviews and questionnaires.ResultsData collection of the SALVO (stimulating an active lifestyle in prevocational students) study began in October 2015 and was completed in December 2017. Data analyses will be completed in 2021. Baseline comparisons between the intervention and control groups were not significant for age (P=.12), screen time behavior (P=.53), nonschool active commuting (P=.26), total time spent on sports activities (P=.32), total physical activities (P=.11), hip flexibility (P=.22), maximum handgrip (P=.47), BMI (P=.44), and sum of skinfolds (P=.29). Significant differences between the intervention and control groups were found in ethnicity, gender, active commuting to school (P=.03), standing broad jump (P=.02), bent arm hang (P=.01), 10× 5-m sprint (P=.01), plate tapping (P=.01), sit-ups (P=.01), and 20-m shuttle run (P=.01).ConclusionsThe SALVO study assesses the effects of a participatory intervention on physical activity and fitness levels in prevocational students. The results of this study may lead to a new understanding of the effectiveness of school-based physical activity interventions when students are invited to participate and cocreate an intervention. This process would provide structured health promotion for future public health.Trial RegistrationISRCTN Registry ISRCTN35992636; http://www.isrctn.com/ISRCTN35992636International Registered Report Identifier (IRRID)DERR1-10.2196/28273

The role of motivation on physical activity and screen time behaviors among parent-adolescent dyads: The FLASHE study

Behavioral theories inform the development of lifestyle interventions to address low participation in physical activity (PA); however, relatively little is known about the value of self-determination theory (SDT) for explaining screen time (ST) behaviors or in extending SDT into a dyadic context. Actor-partner (i.e., parent-adolescent) interdependence models (APIMs) allow for examination of these interpersonal relationships. The purpose of this study was to examine PA and ST among parent-adolescent dyads using the cross-sectional Family Life, Activity, Sun, Health, and Eating (FLASHE) Study. Parent-adolescent dyads provided responses to online surveys addressing PA (n = 1177 dyads) and ST (n = 1489 dyads) behaviors. We examined the influence of SDT-based constructs (perceived competence and motivation) on PA and ST behaviors. Structural equations were used to estimate APIMs in STATA 15.1. Full models provided a good fit to the data. For both PA and ST, perceived competence was more strongly associated with motivation among adolescents compared with parents (PA: β = 0.72 vs. 0.58, ST: β = 0.34 vs. 0.22, p's < 0.001). Parental motivation was associated with parental PA and both adolescent motivation for PA and ST (p's < 0.001). Parental motivation was not associated with adolescent ST-behavior. Adolescent motivation was only associated with parent motivation for PA. In the FLASHE study, SDT constructs extend acceptably to the dyadic setting, with PA models providing a slightly better fit to the data than ST models. Longitudinal studies that target perceived competence and the self-regulation of motivation in parents and their adolescents are a next logical step to understanding both PA and ST behaviors.