Children's Screen Time Research Articles

Pilot Study of a Screen-Free Week: Exploration of Changes in Parent and Child Screen Time, Parent Well-Being and Attitudes, and Parent-Child Relationship Quality

Screen use is associated with a variety of potential impacts on child development, which has led to recommendations to regulate screen use. The current pilot study was conducted to explore the potential effects of implementing screen-free times (Screen-Free Week) on parent and child screen use, parent feelings and well-being, and parent-child interactions and relationships. Specifically, we evaluated the outcomes utilizing pre and postintervention self-report surveys with 24 parents (of a child age 5 years or younger). Overall, the screen-free week program decreased parent depressive symptoms, increased the parenting of child screen time and establishments of screen time limits, and decreased both parent and child screen time. Though the decrease in overall parent and child screen time was not maintained by 4 weeks after, effects on parent depression, child TV watching, and parent phone use specifically during child time were maintained. These findings support previous research emphasizing screen-free times as a viable method to increase intentionality around screen use. Interestingly, the program appears to have had the strongest effects on parent phone use around their child, suggesting the program may build awareness in parents and may cause them to change or desire to change their screen habits during family time. Although we saw initial shifts in parent-child play, effects were not maintained by week 4. Yet, the small changes parents made across one week were not sufficient to shift the overall parent-child relationship. While effects cannot be viewed as definitive, it is promising that shifts were seen in parent well-being and screen use for a relatively small amount of effort across one week.

Childhood and Adolescent Television Viewing and Metabolic Syndrome in Mid-Adulthood.

Excessive sedentary behaviors, such as television viewing or other screen time, may have adverse metabolic effects. We hypothesized that television viewing time in childhood would be associated with the risk of metabolic syndrome at 45 years of age. We studied a population-based birth cohort born in Dunedin, New Zealand in 1972 and 1973. Parent- and self-reported weekday television viewing times were recorded at ages 5, 7, 9, 11, 13, 15, and 32 years. The primary outcome was metabolic syndrome at age 45 years, defined as 3 or more of: high glycated hemoglobin; high waist circumference; high blood triglyceride; low high-density lipoprotein cholesterol; and high blood pressure. Reported television viewing time and metabolic syndrome data were available for 870 (87%) of 997 surviving participants. Mean television viewing time between ages 5 and 15 years was associated with metabolic syndrome at 45 years of age. This association persisted after adjusting for sex, socioeconomic status, and BMI at age 5 (odds ratio: 1.30; 95% confidence interval: 1.08 to 1.58; P = .006) and after further adjustment for adult television viewing (odds ratio: 1.26; 95% confidence interval: 1.03 to 1.54; P = .026). Childhood television viewing was also associated with lower cardiorespiratory fitness and higher BMI at 45 years of age. Time spent watching television during childhood and adolescence is associated with the risk of metabolic syndrome in mid-adulthood. Interventions to reduce screen time for children and young people may have long-lasting benefits for health.

The relationship between screen time and attention deficit/hyperactivity disorder in Chinese preschool children under the multichild policy: a cross-sectional survey

BackgroundLong screen time has become a public health problem that cannot be ignored. The association between screen time and attention-deficit/hyperactivity disorder (ADHD) in preschool children has received widespread attention.MethodsA questionnaire was used to survey 2452 people. ADHD symptoms were assessed by the Conners Child Behavior Scale. Considering that the ADHD symptoms of boys and girls might be different, we stratified the data by gender. Logistic regression model was used for regression analysis. To exclude the influence of multichild family and obesity level, we also conducted a sensitivity analysis. P values were two-tailed with a significance level at 0.05.ResultsThe results showed that the association between screen time and ADHD symptoms in preschool children was significant (OR = 1.826, 95%CI: 1.032, 3.232). After grouping the genders, the correlation was not significant. There was an association between screen time and ADHD symptoms in children from families with multiple children. However, after excluding overweight and obese children from the overall population, the association between screen time and ADHD symptoms did not have statistical significance.ConclusionsThe issue of screen time for preschoolers needs to be taken seriously. Although the results indicate a significant correlation between screen time and ADHD symptoms, clearer evidence is needed to provide recommendations to policy makers.

Passive and social screen time in children with autism and in association with obesity.

Screen time has been identified as a risk factor for childhood obesity, but the media landscape has evolved rapidly. Children with autism tend to be heavy users of screens and have an elevated prevalence of obesity. We know little about screen use patterns among children with autism vs. typically developing (TD) peers and in association with obesity. Baseline data from 10,842 participants in the Adolescent Brain Cognition Development Study was used to characterize time spent with child-reported passive screen use (television/movies/watching videos), playing video games, and using social media. Duration of screen time by autism status and gender was summarized as mean time per day; obesity was defined using CDC/WHO criteria. A propensity score analysis was used to create a matched dataset for analysis. Overall, 1.7% of children were was identified as having autism. Significant mean differences were observed by autism status and gender for both passive viewing and playing video games. Compared to TD children, boys with autism spent more time (2.9 vs. 2.3 h, p < 0.001) watching TV, movies or videos, as did girls (3.0 vs. 2.0 h, p = 0.002). Compared to TD peers, boys with autism reported more video game time (102.7 vs. 77.5 min, p = 0.001), as did girls with autism (64.4 vs. 37.9 min, p = 0.03); girls with autism also spent more time on social media sites or video chat (45.5 vs. 21.9 min, p = 0.04). Overall, obesity prevalence increased with increasing screen time duration, significantly for passive screen time (p-value = 0.002) and texting (p-value = 0.02). Associations between obesity and screen time duration did not differ by autism status. Children with autism spend more time playing video games and on passive and social screen activities than their TD peers, with some variations by gender. High rates of social media use among girls with autism and multiplayer video game use among both boys and girls with autism may challenge the notion that the high levels of screen time reflect social isolation in the group. Given potential positive aspects of screen time in children with autism movement to focus on content and context is appropriate.

Association of health predictors with quality of life in children and adolescents.

To evaluate the association of health-related quality of life (HRQOL) with physical activity, food consumption, sleep duration and screen time in children and adolescents. Cross-sectional study with 268 students aged 10-17 years from a public school in Brazil. The outcome variable was HRQOL score, evaluated by the Pediatric Quality of Life Inventory™ (PedsQL™). Exposure variables were habitual physical activity, food consumption, sleep duration, and screen time. A general linear model was used to estimate age-adjusted means and 95 % confidence interval (95 % CI) of HRQOL scores, and a multivariable analysis of variance to identify factors associated with lower/higher HRQOL scores. The study was approved by the Human Research Ethics Committee of the Pontifical Catholic University of Campinas. Overall HRQOL score was 70.3 (95 % CI: 68.0-72.6). Multivariable analyses showed lower HRQOL scores for those adolescents who: 1-were physically inactive (67.3; p=0.014); 2-sleep less than 6 h per night (66.8; p=0.003); 3-eat fruits and vegetables less than five days/week (68.9; p=0.027); and 4-eat fast food twice/week or more (68.6; p=0.036) when compared to their opposite groups. Screen time was not statistically significantly associated with total HRQOL. The joint association found in our study suggests that at least three habits must change to improve the HRQOL of children and adolescents (physical activity, food consumption, and sleep duration). Therefore, interventions in schools to promote a healthy lifestyle to achieve a better HRQOL should include a multidisciplinary team to properly guide children and adolescents about these habits simultaneously.

High screen time and internalizing and externalizing behaviours among children aged 3 to 14years during the COVID-19 pandemic in France.

Children's screen time increased as a result of the COVID-19 pandemic. In the summer of 2021, we explored the association between high screen time over a period of one year since May 2020 and behavioural problems among children and adolescents. The data were derived from the French EpiCov cohort study, collected in spring 2020, autumn 2020, and spring 2021. Participants (N = 1089) responded to online or telephone interviews about one of their children aged 3 to 14years. Screen time was categorized as high if the daily mean screen time exceeded recommendations at each collection time. The Strengths and Difficulties Questionnaire (SDQ) was completed by parents to identify internalizing (emotional or peer problems) and externalizing (conduct problems or hyperactivity/inattention) behaviours in their children. Among the 1,089 children, 561 (51.5%) were girls, the average age was 8.6years (SD 3.7). Internalizing behaviours: High screen time was not associated with internalizing behaviours (OR [95% CI] 1.20 [0.90-1.59]) or emotional symptoms (1.00 [0.71-1.41]) while it was associated with peer problems (1.42 [1.04-1.95]). Externalizing behaviours: High screen time was associated with externalizing problems (1.63 [1.01-2.63]) and conduct problems (1.91 [1.15-3.22]) only among older children aged 11 to 14years. No association with hyperactivity/inattention was found. In a French cohort, exploration of persistent high screen time in the first year of the pandemic and behaviour difficulties in Summer 2021 resulted in mixed findings according to behaviour's type and children's age. These mixed findings warrant further investigation into screen type and leisure/school screen use to enhance future pandemic responses appropriate for children.

LITERATUR REVIEW: PENGARUH SCREEN TIME TERHADAP MASALAH PERILAKU ANAK

Introduction: Technological developments and easy access to digital devices cause excessive screen time in children. Excessive screen time in children can cause various problems in children. This review aimed to examine the association between screen time and behavioral problems of children. Methods: Three databases were searched, including ScienceDirect, Medline/Pubmed, and Google Scholar databases. Articles were selected using inclusion criteria, namely articles that have been limited since the last five years (2019-2023), are pure research articles, full text, and in English. Results: Eight articles were included in this review. The research was conducted in 8 countries namely Spain, Korea, China, Saudi Arabia, Turkey, the United States, Canada, and Israel with an age range from 1-18 years. Research instruments used to measure behavioral problems in children vary. Conclusion: This review identified that there is a relationship between increased screen time and increased behavior problems in children. Keywords: behavior problem; children; screen time

Preschool children's screen time during the COVID-19 pandemic: associations with family characteristics and children's anxiety/withdrawal and approaches to learning.

With schools closed due to the COVID-19, many children have been exposed to media devices for learning and entertainment, raising concerns over excessive screen time for young children. The current study examined how preschoolers' screen time was associated with their family characteristics and anxiety/withdrawal and approaches to learning during the COVID-19 pandemic. Participants were 764 caregivers of 3- to 6-year-old children (mean age = 59.07 months, SD = 12.28 months; 403 boys and 361 girls) from nine preschools in Wuhan, China, where the pandemic started. The effects of family characteristics on children's screen time during the pandemic outbreak and the associations between screen time and children's anxiety/withdrawal and approaches to learning were examined using path analysis. The results showed that children who spent more time on interactive screen use (e.g., playing with tablets) showed higher levels of anxiety/withdrawal and fewer positive learning behaviors. Unexpectedly, children who spent more time on noninteractive screen use (e.g., watching TV) showed lower levels of anxiety/withdrawal. Additionally, children's screen time was related to family characteristics: children living in more chaotic families with fewer screen time restrictions spent more time on screen use after the pandemic outbreak. The findings suggest that young children's frequent use of interactive screens, such as tablets and smartphones, might be harmful to their learning and wellbeing during the pandemic. To mitigate the potential negative effects, it is essential to manage the screen time of preschoolers by establishing rules for their interactive screen use and improving the household routines related to the overall screen use.

The challenges of screen time in children with typical development and children with developmental disorders during COVID-19 pandemic.

The significant lifestyle changes that occurred during the lockdown period associated with the COVID-19 pandemic may have had many potential adverse effects on children, in particular, sedentary screen exposure among children, including those with developmental disorders. We conducted a cross-sectional study to investigate and compare the screen time and outdoor activity time of children with typically development (TD) and those with developmental disorders during and before the emergence of COVID-19, and identified the risk factors related to screen time during the COVID-19 pandemic. A total of 496 children were surveyed via online questionnaires. Parents or/and children filled in the online questionnaire, including basic characteristics, screen time, outdoor activity time, and other related factors. The Statistical Product and Service Solutions software was used to analyze all data. Children spent less time outdoors (t=14.774, P<0.001) and more time on electronic screens (t=-14.069, P<0.001) during the lockdown period of COVID-19, compared to the periods before COVID-19. Age (P=0.037), pre-COVID-19 screen time (P=0.005), screen time used for learning/education (P<0.001), screen time of siblings (P=0.007), and use of screen devices as electronic babysitters (P=0.005) were risk factors for screen time during the COVID-19 pandemic, while restrictive use of electronic devices by parents (P<0.05) was a protective factor. The screen time of children with autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD) was significantly longer than children with TD before COVID-19 pandemic, but there is no statistical difference during the COVID-19 pandemic. During the COVID-19 pandemic, children's screen exposure time increased, and outdoor activities decreased significantly. This represents a significant challenge, and we should focus our efforts on managing children's screen time and promoting healthier lifestyles, including children with typical development, as well as those with developmental disorders.

The Effects of TV Viewing, Computer and Gaming Console Use on Academic Achievement: A Longitudinal Study

Background: Early learning experiences are crucial for children’s optimal development. The rising prevalence of screen time (ST) in children’s lives have raised concerns regarding their effect on academic outcomes (Gingold et al., 2013). Aim: This study used a longitudinal design to examine the effects of the amount of ST on academic achievement. Method and Sample: The “Growing Up in Australia: A Longitudinal Study in Australia (LSAC)” (Soloff et al., 2005) was the primary data source for this research and focused on children from this cohort who were 4-5 years of age on enrolment (N=2954). The National Assessment Program for Literacy and Numeracy (NAPLAN) was used to measure five academic domains: reading, writing, numeracy, spelling and grammar/punctuation at two time points. Results: Increased ST at Time 1 (T1) demonstrated a negative association with Year 3 NAPLAN scores in reading (B= -5.94), writing (B= -3.08), numeracy (B= -4.85), spelling (B= -4.03), and grammar/punctuation (B= -5.74). Increased ST at Time 2 (T2) demonstrated a significant negative association with only Year 5 NAPLAN scores in grammar/punctuation (B= -2.72). ST at T1 predicted lower scores on the Year 5 NAPLAN in reading (B= -1.67), writing (B= -2.36), and grammar/punctuation (B= -1.96). This effect was not observed for numeracy and spelling. Conclusions: Overall, these findings illustrate that more ST leads to a decreased performance in academic achievement over time, although this was not present across all domains. These findings may have implications for educational settings, as technology is increasingly utilised for educational purposes.

Prospective associations between child screen time and parenting stress and later inattention symptoms in preschoolers during the COVID-19 pandemic.

Child attention skills are critical for supporting self-regulation abilities, especially during the first years of life. On the other hand, inattention symptoms in preschoolers have been associated with poor school readiness, literacy skills and academic achievement. Previous research has linked excessive screen time with increased inattention symptoms in early childhood. However, most research has only focused on TV exposure and did not investigate this association during the COVID-19 pandemic. This atypical context has increased screen time in children worldwide, including preschoolers. We hypothesize that higher levels of child screen media and parenting stress at age 3.5 will be associated with higher child inattention symptoms at age 4.5. This study draws on participants followed longitudinally over the span of 2-years for an investigation of Canadian preschoolers' screen media use during the pandemic (N = 315, 2020). A follow-up with this sample was completed in 2021 (N = 264). Analyses using multiple linear regression, revealed a positive association between child screen time at age 3.5 and inattention symptoms at 4.5 years. Parental stress was also positively associated with child inattention symptoms. Associations were observed above individual (child age, inhibitory control, and sex) and family (parent education and family income) characteristics. These results confirmed our hypothesis and highlight that preschooler screen use and parenting stress may undermine attentional skills. Since attention is a crucial component for children development, behavior and academic outcomes, our study reinforces the importance for parents of adopting healthy media habits.

The Relationship Between Screen Time and Symptom Severity in Children with ADHD during COVID-19 Lockdown

Objectives: To investigate the relationship between screen time and symptom severity in children with ADHD during the COVID-19 lockdown. Methods: Caregivers of children with ADHD aged 7 to 16 years completed the screen time questionnaire and ADHD rating scales of the SNAP-IV-Thai version during and after the COVID-19 lockdown. The correlation between screen time and ADHD scores was assessed. Results: Of the 90 children, aged 11.31 ± 2.29 years, enrolled, 74.4% were male, 64.4% were in primary school, and 73% had electronic screens in their bedrooms. After adjusting with other factors, recreational screen time, both on weekdays and on weekend days, were positively correlated with ADHD scores (both inattention and hyperactive/impulsive scores). Studying screen time, on the other hand, was not associated with ADHD symptom severity. Compared to during the lockdown, studying screen time decreased after the lockdown, but recreational screen time and ADHD scores were not changed. Conclusion: Increasing recreational screen time was associated with worsening ADHD symptoms.

Potential impact of extra education on the development of executive functions within a year in preschool children: an exploratory research.

Executive functions have been shown to develop through various extra classes in preschool age. But the optimal for executive functions development system of such classes has not yet been explored. The present exploratory study aimed to examine the difference in the executive functions development within a year between children attending the system of extra classes (music, choreography, art, foreign language, literacy, math, computer science, and science) twice a week for 4 h in a preschool education center and children who did not take no extra classes. There were 60 children who attended extra classes and 64 children who did not take extra classes. In each group, approximately 17% were boys. The first assessment of executive functions was performed in the penultimate year of kindergarten, when the children were 5-6 years old. The second was performed 1 year later. The executive function level was assessed using NEPSY-II subtests "Inhibition," "Statue," "Memory for Designs," "Sentences Repetition," and "Dimensional Change Card Sort." Mothers also reported about their children's attendance in extra classes, their children's screen time, the level of maternal education, and the level of family income. The study revealed that children attending the system of the extra classes showed a higher verbal working memory development within a year than the children taking no extra classes. The obtained data plays an important role for the design of further research of the topic and for the practical recommendations for parents and teachers.

Impact of Screen Time on Children’s Development: Cognitive, Language, Physical, and Social and Emotional Domains

Technology has become integral to children’s lives, impacting many aspects, from academic to socialization. Children of today’s generation are growing up with digital devices, such as mobile phones, iPads, computers, video games, and smart gadgets; therefore, screen time has become ubiquitous in children’s daily routines. This paper provides a review of screen time usage and its impact in children across multiple developmental domains: cognitive, language, physical, and socio-emotional domain of children under eight years of age. The cognitive domain considers factors such as attention span and memory; language domain examines vocabulary, speech, and language development; physical domain focuses on motor development, exercise, sleep, and diet; and social-emotional domain considers relationships, self-identity, and emotional behaviors/regulation. Our findings are mixed, as there are both benefits and drawbacks in technology use, but screen time in children requires controlled observation and monitoring for sustainable improved progress across developmental domains. Specific recommendations advise that children’s screen time per day should be limited to zero minutes (min) (0–2 years), &lt;60 min (3–5-years), and 60 min (6–8 years).

Screen time in children and adolescents during the COVID-19 pandemic

&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Introduction.&amp;lt;/strong&amp;gt; With the beginning of the pandemic caused by the COVID-19 virus, restrictions on movement, the so-called &amp;amp;ldquo;lockdown&amp;amp;rdquo; were applied by many governments. As a result of these actions taken against the transmission of the COVID-19 virus, the use of digital devices has increased, i.e. the time spent in front of screens has increased. &amp;lt;strong&amp;gt;Methods.&amp;lt;/strong&amp;gt; This paper dealt with a bibliometric analysis of scientific publications on the topic of screen time in children and adolescents during the COVID-19 pandemic. The Dimensions database was chosen as the data source. No time frame is given, but given the topic, publications from 2020-2023 are included in the analysis. The data were analyzed in the VOSviewer program, specified for bibliometric and visual data analysis. &amp;lt;strong&amp;gt;Results.&amp;lt;/strong&amp;gt; Map of word co-occurrence show that there are three different clusters. In the red cluster, consisting of 53 terms, the most frequent terms are sleep (124), lifestyle (103) and restriction (83), while in the green cluster, consisting of 41 terms, family (126), education (88), relationship (86) are the most represented. The blue cluster consists of significantly fewer terms, 12 of them, of which anxiety (91), symptom (81), depression (58) are the most represented. &amp;lt;strong&amp;gt;Conclusion.&amp;lt;/strong&amp;gt; Based on the bibliometric analysis, we can conclude that the scientists were mostly concerned with the impact of the screen time phenomenon on the physical health of children and adolescents. In addition, screen time has been linked to mental health, education and socio-emotional relationships.&amp;lt;/p&amp;gt;

Parental influences on children’s dietary intake, screen time and its relationship to their weight status

It is important to know more about the influence of parent’s actions and behaviours on children’s dietary intake, screen time and weight of children in developing countries. This study aimed to understand parental influences on children’s dietary intake, screen time and its relationship to children’s weight in Bangalore urban district. Data was collected from parents of children aged 6 to 12 through a self administered questionnaire. Sample comprised of 140 children selected among a purposive method from a tertiary hospital and three private schools. BMI Percentile of children was calculated using the IAP application. Data were analysed using SPSS version 25. Pearson’s correlation and Spearman’s correlation was used to analyze correlation of various parameters. The frequency of consumption of fried foods, processed foods, fast foods and bakery foods was significantly associated with children’s BMI (p&amp;#60;0.05). Parental screen time was positively associated with child screen time, (r=0.368, p=0.001). A significant positive relationship was found between screen time and child’s BMI, (r=0.559, p= 0.001). Over one quarter of children aged 6 to 12 who took part in the study were overweight and obese. Healthy diet and lifestyle guidelines were provided to parents to understand the importance of it in preventing chronic diseases in their children. More such intervention programmes must be implemented to encourage parents to take appropriate measures concerning children’s unhealthy eating habits, long term screen exposure and reduced outdoor activities.

Interaction Time, Play Time and Screen Time of Typically Developing Children

Exposure to language rich and stimulating environments plays a very crucial role in developing normal speech and language skills in children. The aim of the current research is to investigate the duration of parent child interaction, duration of playtime with the child and screen time in TD children. A total of 60 parents of TD children participated in the study. The TD children were in the age range of 1 to 5 years. A survey study was conducted, in which an online questionnaire was prepared using google form. The questionnaire consisted of 13 closed ended questions. Data collection was carried out by sending the questionnaire to the participants through WhatsApp- a mobile phone application. Participants consent was received prior to filling up the questionnaire. Their responses were compiled and mean percent responses were calculated, tabulated and described. The results of the study indicated that more than 50% of mothers and fathers spend about 3 hours interacting with child and compared to father, mother spend more time playing with the child and increased screen time found in TD children. Findings of the study would help Speech language pathologists and Rehabilitation professionals to counsel parents of children with communication disorders on language stimulation. Keywords: Language stimulation, typically developing, parent’s role, screentime.

Behavioral and Environmental Risk Factors Associated with Primary School Children's Overweight and Obesity in Urban Indonesia.

To aid the design of nutrition interventions in low- and middle-income countries undergoing a nutrition transition, this study examined behavioral and environmental risk factors associated with childhood overweight and obesity in urban Indonesia. Body height and weight of children were measured to determine BMI-for-age Z-scores and childhood overweight and obesity status. A self-administered parental survey measured socioeconomic background, children's diet, physical activity, screen time, and parental practices. Logistic and quantile regression models were used to assess the association between risk factors and the BMI-for-age Z-score distribution. Public primary schools in Central Jakarta, sampled at random. Children (n=1,674) aged 6-13 years from 18 public primary schools. Among the children, 31.0% were overweight or obese. The prevalence of obesity was higher in boys (21.0%) than in girls (12.0%). Male gender and height (aOR=1.67; 95% CI 1.30, 2.14 and aOR=1.16; 95% CI 1.14, 1.18, respectively) increased the odds of being overweight or obese, while the odds reduced with every year of age (aOR=0.43; 95% CI 0.37, 0.50). Maternal education was positively associated with children's BMI at the median of the Z-score distribution (P=0.026). Dietary and physical activity risk scores were not associated with children's BMI at any quantile. The obesogenic home food environment score was significantly and positively associated with the BMI-for-age Z-score at the 75th and 90th percentiles (P=0.022 and 0.023, respectively). This study illustrated the demographic, behavioral, and environmental risk factors for overweight and obesity among primary school children in a middle-income country. To foster healthy behaviors in primary school children, parents need to ensure a positive home food environment. Future gender-responsive interventions should involve both parents and children, promote healthy diets and physical activity and improve food environments in homes and schools.

Prevalence and socio-demographic distributions of meeting RMI Guidelines for Healthy Living among elementary school children in Majuro, Republic of Marshall Islands: a cross-sectional population-based survey

Childhood obesity is high in Republic of Marshall Islands (RMI). We report the prevalence and socio-demographic distribution of selected obesity-related risk factors among children in Majuro, RMI. Sixteen elementary schools were approached and students and parents in Grades 1, 3, and 5 invited to participate in this cross-sectional population-based survey. Accelerometry and a questionnaire were used to collect data on children's physical activity (PA), sleep, screen time and dietary behaviours. Descriptive statistics and mixed-effects logistic regression were used to examine differences in the proportions of children meeting selected RMI Healthy Living Guidelines by sex, school grade and school sector. Thirteen schools and 958 children were recruited, of which 892 (52.2% girls; mean age 9.3±1.8 years) provided useable data. Around 90% met the PA, 29% screen time, 13% sleep, 69% sugar-sweetened beverage and 56% highly processed food guidelines. The proportion meeting individual guidelines was higher among children in Grade 1 compared with Grade 5. Being a girl (0.27; 95% CI 0.16, 0.46) was associated with lower odds of meeting the PA recommendation. Compared with children from Grade 1, those in Grade 5 had lower odds of meeting the PA (0.28; 95% CI 0.15, 0.55), screen time (0.60; 95% CI 0.40, 0.89), sleep duration (0.33; 95% CI 0.18, 0.59), sugar-sweetened beverage (0.35; 95% CI 0.23, 0.53), and consumption of highly processed foods recommendations (0.49; 95% CI 0.33, 0.72). While most children in RMI are adequately active, resources are needed to promote healthier levels of screen time, sleep, sugar-sweetened beverage and highly processed food consumption, especially among older children. This study was funded by World Diabetes Foundation; Canvasback Missions, RMI; NHMRC Australia (APP1176858); Pacific Community.

Determinants of pupils' energy drink consumption – Findings from a Hungarian primary school

Consumption of energy drinks is harmful in childhood and adolescence, and its increasing popularity makes it a public health threat in this age group. Our study aimed to assess energy drink (ED) consumption and identify the context and determinants of its consumption at a Hungarian primary school. A mixed-method approach was used for the research, including a survey filled in by 157 10-15-year-old pupils and World Café workshops (WCWs) involving pupils, home-room teachers, and Parental Council representatives (N = 39). The Jamovi 2.2.5. The software was used to perform descriptive statistics and logistic regression, and a causal loop diagram was created based on the results of the WCWs. The survey results revealed that almost one-third of the pupils consumed EDs regularly, and most daily consumers drank high amounts (500ml). Most students considered ED consumption unhealthy, yet every fifth drank them. Buying breakfast on the way to school increased the odds of ED consumption almost threefold. According to the WCWs' findings, the determinants of ED consumption were embedded in two critical contextual sets; one was the need for energy and concentration boost and the Perception of high social acceptance of ED consumption. Our results suggest that interventions to reduce students' ED consumption need to include increased parents' involvement in controlling their children's screen time and encouraging them to provide breakfast at home for their children. There is also an urgent need to restrict the marketing of EDs and strictly regulate access to EDs for under-18s.