Screen Time Recommendations Research Articles

Parental Voices on Screen Time Guidelines in Early Childhood

This article critically engages with the concept of screen time. We explore the screen time recommendations from the World Health Organization (WHO) and their application in the Swedish context. We also investigate the experiences and opinions on the recommendations and advice on screen time and screen media use in early childhood among parents of young children (0–3 yrs.) in Sweden. The study draws from qualitative semi-structured interviews during multiple home visits from a diverse sample of 16 families. Findings are discussed through the prism of the ‘moral economy’ of the household and the ‘social imaginaries’ underpinning this. We have identified two types of approaches to guidelines on screen time among parents, and based on our findings we recommend organizations in Sweden and beyond, to rethink and revise the current guidelines, including the WHO recommendations.

Multiple recommended health behaviors among medical students in Western Canada: a descriptive study of self-reported knowledge, adherence, barriers, and time use

BackgroundGeneral medical practitioners are responsible for promoting and prescribing lifestyle modification and serve as role models for healthy behaviors. We aimed to assess self-reported knowledge, adherence, barriers and time spent on all recommended health behaviors among medical students.MethodsA cross-sectional online survey of eight behavioral domains among undergraduate medical students in The University of British Columbia, Canada, was analysed using descriptive statistics and visual display.ResultsBetween March and April 2023, 137 medical students participated in the survey (74% female). Over 80% had knowledge of five health behavior recommendations, but lacked knowledge of specific dietary recommendations in particular. Over 60% reported meeting guideline-recommended levels for tobacco, weekly alcohol, daily alcohol (females only), and physical activity (males only). Large gaps existed between knowledge and adherence for physical activity, sleep, sedentariness, screen time, and dietary recommendations. Sex differences in knowledge and adherence to recommended health behaviors were identified. Time spent on wellness focused on sleep (47–49 h/week), diet (9.6 h/week), exercise (5.8 h/week), and hobbies (6.1 h/week). Forgetting recommendations (69% of females, 71% of males), and lack of time (72% of females, 52% of males) were principal barriers to knowledge and adherence.ConclusionMost medical students in Western Canada reported not meeting multiple recommended health behaviors. Time was the largest barrier to adherence and free time was spent on sleep. Medical education may require protected time and dedicated content for health behaviors to ensure future physicians can be role models of health promotion for patients.

Assessment of screen time and its correlates among adolescents in selected rural areas of Puducherry.

To assess screen time and its correlates among adolescents in selected rural areas of Puducherry. This cross-sectional analytical study was conducted among adolescents aged 10-19 years visiting the Pediatrics and other departments at Sri Lakshmi Narayana Institute of Medical Sciences (SLIMS), Puducherry. The sample size of 164 was determined based on previous studies, with a systematic random sampling technique used for participant selection. Data collection involved a semi-structured questionnaire covering sociodemographic factors, screen time, sleep, dietary, and physical activity patterns. Increased screen time was defined as more than 2 h per day, and adequate physical activity was considered as at least 60 min of moderate-to-vigorous intensity exercises. Statistical analysis was performed using Stata version 17, with associations tested using Chi-square analysis and a significance level set at p<0.05. The mean age of the participants was 18.2 (0.9) years, with 86 % in the 16-19 years age group. Males comprised 53.7 %, and 66.5 % were from rural areas. The mean screen time was 4.4 (1.5) hours per day, with 79.1 % exceeding the recommended limit. Mobile phones were the most frequently used devices (92.7 %), primarily for watching movies (51.8 %) and videos (23.8 %). Increased screen time was significantly associated with younger age (10-15 years), urban residence, and school-going status. Adolescents with increased screen time exhibited lower physical activity and inadequate sleep. Additionally, increased consumption of packaged foods was observed among those with higher screen time. More than three-fourths of the adolescents exceeded the recommended screen time, negatively impacting their physical activity and sleep. These findings underscore the need for targeted interventions to promote healthier lifestyle choices among adolescents in rural Puducherry.

Improving physical activity and screen time in Australian Outside School Hours Care: Study protocol.

Children's physical activity and screen time behaviours impact their physical health and well-being. In Australia, less than half of children meet daily physical activity recommendations and only one-third meet daily screen time recommendations. Nearly half a million Australian school children aged 5-12 attend Outside School Hours Care (OSHC) weekly, activities undertaken at OSHC play a key role in meeting these recommendations. Currently, physical activity and screen time practices in OSHC vary and lack policy guidance. The Activated OSHC program is a policy-based intervention that supports OSHC services to implement the physical activity and screen time guidelines. 192 OSHC services across Australia will be recruited. 96 services will be randomly allocated to receive the Activated OSHC program. OSHC coordinators will complete online surveys examining physical activity and screen time scheduling, cost, acceptability, and feasibility. Primary outcome; changes in the proportion of intervention and control services meeting OSHC sector physical activity and screen time guidelines, and secondary outcomes; changes in children's physical activity and screen time behaviours; changes in staff behaviour will be assessed using mixed-effects regression models. The aim of this study is to examine the impact of the Activated OSHC program on children's physical activity and screen time. Recent Australian research in Outside School Hours Care (OSHC) has identified significant inconsistency in practices related to physical activity and screen time, compounded by an absence of explicit policy guidance. The Activated OSHC program is a policy-based intervention that supports OSHC services to implement the Australian OSHC physical activity and screen time guidelines. This study will assess the implementation and effectiveness of the Activated OSHC program in an effectiveness-implementation hybrid type 2 trial design. Implementation of outside school hours care sector physical activity and screen time guidelines may improve children's physical activity and screen time behaviours.

Gender differences in the proportion of Japanese parents meeting 24-h movement guidelines and associations with weight status.

Parents' healthy behaviors are important for both their health and role models for their children. The purpose of this study was to evaluate adherence to the three recommendations associated with health in the Canadian 24-h movement or Japanese physical activity (PA) guidelines and their relationship with weight status (underweight or obesity) in Japanese parents. This cross-sectional study included 425 mothers and 237 fathers. Meeting the 24-h movement guidelines was defined as: ≥150 min/week of moderate-to-vigorous PA (MVPA) (Canada) or at least 60 min/day of MVPA (Japan), ≤8 h/day of sedentary time which includes ≤3 h of recreational screen time, and 7 to 9 h/night of sleep. MVPA and sedentary time were accelerometer-determined while screen time and sleep duration were self-reported. The prevalence of mothers meeting all three recommendations was 30.6% using Canadian PA guidelines and 20.7% using Japanese PA guidelines, while that of fathers was 10.6% and 8.0%, respectively. Mothers not meeting the sedentary behavior recommendation had a lower odds ratio and those not meeting Japanese PA recommendations had a higher odds ratio for underweight compared to mothers meeting the recommendations, adjusted for age and area socioeconomic status. The screen time recommendation and Japanese PA recommendation were associated with underweight in mothers. None of the recommendations was associated with weight status in fathers. Further research is needed to understand the relationships among movement behaviors and weight status, particularly among Japanese women, whose routine behaviors, such as household activities, may be misclassified by a questionnaire.

Adherence to physical activity and screen time recommendations of youth: Demographic differences from National Health and Nutrition Examination Survey 2017-2018.

Engaging in physical activity (PA) and reducing sedentary behaviors among youth are linked to improved mental and physical health. This study aimed to examine demographic differences among youth adhering to PA and Screen Time (ST) recommendations. The present study utilized data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES). The NHANES survey employed a cross-sectional design and gathered information on the daily duration of moderate-to-vigorous PA lasting 60min or more, as well as the maximum daily ST not exceeding 2h. The analysis encompassed a total of 1697 youth aged between 6 and 17years. Overall, 36.3% of participants adhered to PA recommendations, 20.9% adhered to ST recommendations and 10.8% of youth met both recommendations. The odds of meeting PA, ST and both recommendations were inversely associated with obesity (obese vs. normal: aOR, 0.56 [95% CI, 0.42-0.75]), (aOR, 0.67 [95% CI, 0.48-0.94]) and (aOR, 0.51 [95% CI, 0.32-0.82]) respectively, and age (14-17years vs. 6-9years: aOR, 0.2 [95% CI, 0.15-0.27]), (aOR, 0.33 [95% CI, 0.23-0.47]) and (aOR, 0.16 [95% CI, 0.09-0.3]) respectively. A small portion of the youth met PA and ST recommendations. Older youth, youth with obesity, and youth with a parent or guardian who had not completed a high school education were particularly at risk.

Impact of Elevated Screen Time on School-Age Adolescents During the COVID-19 Pandemic: An Analytical Study.

The rise in digital technology use, especially during the COVID-19 pandemic, has heightened concerns about extended "screen time" (ST) among adolescents. Excessive screen use is linked to negative physical and cognitive effects, yet digital media also offers educational and social advantages. Cultivating healthy digital habits is crucial as technology continues to evolve. Thiscross-sectional studywas conducted betweenJuly and August 2022 amongschool-going adolescents and a total of 221 participants were assessed through questionnaires, employing statistical analysis. In the current study, all participants fell within the 16-18 year age group, with 114 (51.6%) being male and 107 (48.4%) female. The majority 209 (94.5%) identified as Hindu, while the rest were from Muslim and Christian communities. Most participants, both male and female, resided in urban areas, 140 (63.3%) were pursuing Class 12, and73 (33.1%) were pursuing Class 11. Mobile phones were the most commonly owned devices, followed by desktops or laptops and tablets. Males generally spend more time on these devices than females. Notably, 168 (76.01%) adolescents exceeded the recommended 2-hour daily screen time limit set by the American Academy of Pediatrics (AAP), with92 (80.7%) males more likely to do so than 76 (71%) females. The study found a significant link between increased screen time, reduced physical activity, and academic performance, while no association was observed for behavioral risk factors. There is increased digital device use among youth, with many exceeding recommended screen time limits, particularly males. This was significantly linked to reduced physical activity and academic decline, highlighting the need for further research and balanced digital use.

Associations of 24-hour movement behaviors with emotional and behavioral problems among Chinese adolescents.

The role of adherence to the recommendations for 24-hour movement behaviors (24-HMB), including physical activity (PA), screen time (ST), and sleep duration (SLP), in relation to emotional and behavioral problems in Chinese adolescents remains uncertain. This study aimed to investigate these associations and explore potential sex differences. This school-based cross-sectional study included 15,071 Chinese adolescents with a mean age of 14.53 (SD: 1.65) years. Data on emotional and behavioral problems and 24-HMB (including PA, ST, and SLP) were collected. Analysis was performed using general linear mixed models, with additional sex-stratified analyses conducted. The number of 24-HMB recommendations met was negatively associated with total difficulties (β estimate=-0.96, 95% CI: -1.07 to -0.85) and positively related to prosocial behavior (β estimate = 0.41, 95% CI: 0.37 to 0.46) among adolescents. Compared with none of the recommendations met, meeting all recommendations (total difficulties: β estimate=-2.98, 95% CI: -3.41 to -2.55; prosocial behaviors: β estimate = 1.05, 95%CI: 0.87 to 1.24) demonstrated the strongest association with both difficulties and prosocial behaviors, followed by meeting recommendations for PA + ST (total difficulties: β estimate=-2.15, 95% CI: -2.41 to -1.90; prosocial behaviors: β estimate = 0.98, 95% CI: 0.87 to 1.09). These associations were consistently significant in both boys and girls. Adherence to more 24-HMB recommendations, particularly meeting all recommendations or combined PA + ST recommendations, could improve emotional and behavioral well-being among adolescent girls and boys. The significance of balanced movement behaviors for promoting adolescent mental health merits increased attention.

Compliance with the 24-h Movement Guidelines for Portuguese children: differences between boys and girls

The 24-h Movement Guidelines for children recommend at least 60 min per day of moderate-to-vigorous intensity physical activity (PA), ≤ 2 h/day of screen time, and 9–11 h/day of sleep for children. Since little information is available on the 24-h Movement Guidelines in Portuguese children, this research attempts to know the proportion of Portuguese children meeting individual and combinations of these 24-h Movement Guidelines. Another aim of this study is to test sex differences in compliance with 24-h Movement Guidelines. A final sample of 1351 Portuguese children (51.4% girls, aged 7.65 ± 1.21) participated in this cross-sectional study. PA, screen time and sleep duration were parent-reported through a questionnaire. Only 3.7% of children met all three 24-h Movement Guidelines, whereas 11.9% met none. Although boys showed greater compliance with PA recommendations and girls with screen time recommendations, no significant sex differences were found in the compliance of all three 24-h Movement Guidelines. Given that 96.3% of Portuguese children did not meet 24-h Movement Guidelines, promoting these three movement behaviours in both boys and girls is crucial to encouraging positive consequences early.

Sociodemographic differences in recreational screen time before and during the COVID-19 pandemic in Canada.

Over the last several years, recreational screen time has been increasing. During the COVID-19 pandemic, recreational screen time rose among Canadian youth and adults, and those who increased screen time had poorer self-reported mental health compared with those who decreased or maintained their recreational screen time levels. Using data from the 2017, 2018, and 2021 Canadian Community Health Survey, the prevalence of meeting the recreational screen time recommendation from the Canadian 24-Hour Movement Guidelines was compared before and during the pandemic across sociodemographic groups. Logistic regression was used to identify sociodemographic groups that were more likely to meet the recreational screen time recommendation before and during the pandemic. The amount of time Canadians spent engaging in daily recreational screen time increased from 2018 to 2021, leading to fewer youth and adults meeting the recreational screen time recommendation during the pandemic compared with before. The prevalence of meeting the recommendation was lower during the pandemic compared with before the pandemic among almost all sociodemographic groups. Among youth, living in a rural area was associated with a greater likelihood of meeting the recommendation before and during the pandemic. Among adults, the following characteristics were all associated with a greater likelihood of meeting the recommendation during the pandemic: being female; living in a rural area or a small population centre; identifying as South Asian; being an immigrant to Canada; living in a two-parent household; being married or in a common-law relationship or widowed, separated, or divorced; working full time; and being a health care worker. The prevalence of meeting the recreational screen time recommendation during the pandemic was lower overall compared with before the pandemic. Several sociodemographic groups were more likely to meet the recommendation during the pandemic. Continued surveillance of recreational screen time is necessary to monitor the indirect effects of the pandemic and to identify population subgroups that would benefit from tailored interventions in the pandemic recovery period.

The impact of the world’s first regulatory, multi-setting intervention on sedentary behaviour among children and adolescents (ENERGISE): a natural experiment evaluation

BackgroundRegulatory actions are increasingly used to tackle issues such as excessive alcohol or sugar intake, but such actions to reduce sedentary behaviour remain scarce. World Health Organization (WHO) guidelines on sedentary behaviour call for system-wide policies. The Chinese government introduced the world’s first nation-wide multi-setting regulation on multiple types of sedentary behaviour in children and adolescents in July 2021. This regulation restricts when (and for how long) online gaming businesses can provide access to pupils; the amount of homework teachers can assign to pupils according to their year groups; and when tutoring businesses can provide lessons to pupils. We evaluated the effect of this regulation on sedentary behaviour safeguarding pupils.MethodsWith a natural experiment evaluation design, we used representative surveillance data from 9- to 18-year-old pupils before and after the introduction of the regulation, for longitudinal (n = 7,054, matched individuals, primary analysis) and repeated cross-sectional (n = 99,947, exploratory analysis) analyses. We analysed pre-post differences for self-reported sedentary behaviour outcomes (total sedentary behaviour time, screen viewing time, electronic device use time, homework time, and out-of-campus learning time) using multilevel models, and explored differences by sex, education stage, residency, and baseline weight status.ResultsLongitudinal analyses indicated that pupils had reduced their mean total daily sedentary behaviour time by 13.8% (95% confidence interval [CI]: -15.9 to -11.7%, approximately 46 min) and were 1.20 times as likely to meet international daily screen time recommendations (95% CI: 1.01 to 1.32) one month after the introduction of the regulation compared to the reference group (before its introduction). They were on average 2.79 times as likely to meet the regulatory requirement on homework time (95% CI: 2.47 to 3.14) than the reference group and reduced their daily total screen-viewing time by 6.4% (95% CI: -9.6 to -3.3%, approximately 10 min). The positive effects were more pronounced among high-risk groups (secondary school and urban pupils who generally spend more time in sedentary behaviour) than in low-risk groups (primary school and rural pupils who generally spend less time in sedentary behaviour). The exploratory analyses showed comparable findings.ConclusionsThis regulatory intervention has been effective in reducing total and specific types of sedentary behaviour among Chinese children and adolescents, with the potential to reduce health inequalities. International researchers and policy makers may explore the feasibility and acceptability of implementing regulatory interventions on sedentary behaviour elsewhere.

Effects of Modifiable Activity-Related Health Behaviors on the Sleep-Pain Relationship in Adolescents

Poor sleep and chronic pain are commonly related in adolescents. Only 5% of adolescents meet recommendations for physical activity and screen time, both of which impact the experience of sleep and pain disturbances. Research is needed to better understand the sleep-pain relationship in adolescents and to identify potential protective factors, such as activity-related health behaviors. This study examined sleep, behaviors that influence activity (i.e., physical activity, screen time), and their interaction as predictors of pain in a sleep-disordered sample of 105 adolescents aged 12–18 presenting for polysomnography. A hierarchical multiple linear regression was conducted to examine these relationships. Consistent with hypotheses, worse insomnia predicted worse pain. However, other activity-related health behaviors did not influence this relationship, ps > .05. Findings suggest that sleep should be the focus of treatment for adolescents with primary sleep disorders to prevent the onset or exacerbation of pain.

School-aged children’s movement behaviours and subjective health complaints in Japan: a cross-sectional study during COVID-19 pandemic-related school closures and after school reopenings

BackgroundSocial restrictions associated with the COVID-19 pandemic have altered children’s movement behaviours and impacted their mental health. However, the influence of social restrictions on subjective health complaints remains inadequately understood. This study compared adherence to 24-hour movement behaviour guidelines and the prevalence of subjective health complaints during school closure and one year after reopening. We also examined how combinations of adherence to movement behaviour recommendations relate to subjective health complaints.MethodsA repeated cross-sectional survey was conducted at two points. The first survey in May 2020 included 1535 (766 boys and 769 girls) participants during school closures, while the second survey from May to July 2021 involved 1125 (583 boys and 542 girls) participants one year after school reopening. The questionnaire covered socio-demographics, physical activity, screen time, sleep, and subjective health complaints. Differences between periods were analysed using chi-square tests. Logistic regression models assessed the association between adherence to guidelines and subjective health complaints.ResultsDuring school closure, children were more likely to meet ‘only sleep’ recommendations and have irritability and lethargy symptoms. Irrespective of sex, those adhering to two or all three recommendations (excluding physical activity and screen time) had a lower risk of symptoms related to physical and mental pain, fatigue, irritability, and lethargy as compared to those who met none of the recommendations.ConclusionsChildren should meet at least one physical activity or screen time recommendation in addition to sleep recommendations for subjective health. Strategies considering the priority of each movement behaviour are crucial, even during abnormal situations, such as pandemic-related social restrictions. This study offers insightful findings concerning children’s mental health issues during unprecedented and massive disasters or crises.

Behavioral and Functional Changes Due to Smartphone Overusage among Under-five Children in Rural Puducherry: A Community-based Cross-sectional Study

Abstract Context: Smartphones have revolutionized, and become an integral part of a child’s life. The child’s interaction with these modern devices needs to be assessed because it could have an enormous effect on their behavior, sleep habits, and psychological addiction. Aims: The aim of this study is to determine the pattern of exposure to smartphone, and the association between the exposure and behavioral, functional changes among under-five children in rural Puducherry. Settings and Design: This community-based cross-sectional study was done in the field practice area of a private medical college in Puducherry. A multistage sampling technique was used to select 340 eligible participants. Subjects and Methods: A semi-structured questionnaire was used to assess the pattern of exposure and physical, social, and behavioral changes among study participants. Statistical Analysis Used: The data were analyzed using SPSS software, and P &lt; 0.05 was considered statistically significant. Results: Among 340 children, more than half of participants 180 (52.9%) were female. Interestingly, around half of the study participants’ parents 181 (53.2%) accepted that their children were exposed to smartphone for entertainment purposes, and around one-tenth 35 (10.3%) of the participants viewed screen for more than the recommended screen time for age. Increased smartphone exposure was statistically associated with behavioral and functional changes. Conclusions: Measures must be undertaken to prevent deleterious behavioral and functional changes in under-five children due to excessive smartphone usage. Health education sessions and social behavioral change communication should be planned for the parents to protect the budding generation from the negative effects of smartphone usage.

IJCM_82A: Behavioral and Functional Changes Due to Smartphone Over-usage among Under-five Children in Rural Puducherry- A Community-Based Cross-Sectional Study

Background: Smartphone have revolutionized, and become an integral part of a child’s life. The child’s interaction with these modern devices needs to be assessed because it could have an enormous effect on their behavior, sleep habits, and psychological addiction. Objective: The objective of this study is to determine the pattern of exposure to smartphone, and the association between the exposure and behavioral, functional changes among under-five children in rural Puducherry Methodology: This community based cross-sectional study was done in the field practice area of a private medical college in Puducherry. A multistage sampling technique was used to select 340 eligible participants. A semi- structured questionnaire was used to assess the pattern of exposure, physical, social, and behavioral changes among study participants. The data were analyzed using SPSS software, and p-value of Results: Among 340 children, more than half of participants 180(52.9%) were female. Interestingly, around half of the study participants parents 181(53.2%) accepted that, their children were exposed to smartphone for entertainment purposes, and around one-tenth 35 (10.3%) of the participants viewed screen for more than the recommended screen time for age. Increased smartphone exposure was statistically associated with behavioral, and functional changes. Conclusion: Measures must be undertaken to prevent the deleterious behavioral and functional changes in under-five children due to excessive smartphone usage. Health education sessions and social behavioral change communication should be planned for the parents to protect the budding generation from the negative effects of smartphone usage.

Exploring urban-rural differences in 24-h movement behaviours among tunisian preschoolers: Insights from the SUNRISE study

Little is known about differences in physical activity among children from urban and rural areas in low-to middle-income countries and some previous investigations revealed disparities in physical activity levels among children and adolescents residing in urban and rural environments. We aimed to: (i) assess the proportion of preschool-aged children (3.0–4.9 years) meeting the global movement guidelines, (ii) evaluate the feasibility of the methods for the SUNRISE study, (iii) examine gender- and urban-rural differences in health and behavior outcomes. Urban and rural location was based on national classifications. Physical activity (waist-worn ActiGraph); sleep duration, screen time and movement behaviors; Gross and fine motor skills (Lower body strength and mobility, Supine-Timed up and go [S-TUG], One-leg standing balance test, hand grip dynamometer, 9-hole peg-board test); and executive functions (visual-spatial working memory and inhibition) were assessed in 112 preschoolers (n ​= ​50 boys, 33 urban), (n ​= ​62 girls, 41 urban). The results showed that only 18% of children met all movement guidelines, with 53% and 41% meeting the recommendations for sedentary screen time and total physical activity, respectively. A large proportion of children (81%) met the recommended sleep duration of 10–13 ​hours (h) per day. There is a clear need to promote healthy movement behaviours among preschool-aged children through targeted interventions that address their unique challenges related to gender and urban/rural residence.

Changes in Healthy Behaviors among Arab Israeli Children Diagnosed with ASD amid the Coronavirus Outbreak: Mothers’ Perceptions

The constraints imposed by the COVID-19 pandemic may have adverse effects on the health behaviors of children and adolescents, particularly those with neurodevelopmental conditions such as autism spectrum disorder (ASD). This study aimed to examine changes in health-related behaviors, including physical activity, screen time, and sleep duration, among children with ASD and their adherence to the 24-h movement guidelines during the pandemic. An online cross-sectional survey was conducted with 46 Arab Israeli mothers of children diagnosed with ASD. According to the responses provided by the mothers, the findings indicate a noteworthy reduction in physical activity, a marked rise in screen time, and a considerable increase in sleep duration amid the COVID-19 pandemic. Additionally, there was a decline in the portion of the sample complying with physical activity and screen time recommendations, coupled with an increase in the percentage of children meeting sleep duration guidelines. The prevalence of ASD children adhering to the overall 24-h movement guidelines was notably low during the COVID-19 outbreak. These findings contribute to the growing body of literature indicating adverse effects of the coronavirus pandemic on individuals with neurodevelopmental disorders, emphasizing the urgent necessity for healthcare, interventions, and programs tailored to ASD children.

Family Meal Environment Differentially Conditions the Prospective Association between Early Childhood Screen Time and Key Social Relationships in Adolescent Girls.

Background: Despite screen time recommendations, children are increasingly spending time on electronic devices, rendering it an important risk factor for subsequent social and developmental outcomes. Sharing meals could offer a way to promote psychosocial development. This study examines the interaction between family meal environment and early childhood screen time on key adolescent social relationships. Methods: Participants are 1455 millennial children (49% boys) from the Quebec Longitudinal Study of Child Development birth cohort. Parents reported on child screen use at ages 2 and 6 years and family meal environment quality at age 6 years. Parents and children reported on parent-child relationships and peer victimization experiences, respectively, at age 13 years. Sex-stratified multiple regression estimated the direct association between screen time trends, family meal environment quality, and their interaction on later social relationship outcomes. Results: For girls, when preschool screen time increased, sharing family meals in high-quality environments was associated with more positive and less conflictual relationships with their mothers, whereas meals shared in low- and moderate-quality environments were associated with fewer instances of victimization by their peers. Non-linear associations were not significant for boys. Conclusion: Capitalizing on family meal environment represents a simple/cost-efficient activity that can compensate for some long-term risks associated with increased screen use, above and beyond pre-existing and concurrent individual and family characteristics. Public health initiatives may benefit from considering family meals as a complementary intervention strategy to screen use guidelines.

Association between screen time and physical activity on mental health among preschoolers: a cross-sectional study from Southwest China.

Screen time and physical activity behaviors undergo development during early childhood and impact mental health. However, there is limited knowledge regarding the associations between physical activity, screen time, and mental health problems (MHP) in preschoolers. This study examines these associations using a large sample size and brief measures. A multistage cluster stratified sampling method was used to conduct an observational cross-sectional study of 19,015 Chinese preschoolers in 2020. Information on physical activity, and screen time was collected by a self-administered questionnaire; MHP was assessed by the parent-reported Strengths and Difficulties Questionnaire (SDQ). Logistic regression models were used to obtain the odds ratios (ORs) and 95% confidence intervals (95% CIs) of preschoolers' MHP associated with screen time, total physical activities, moderate to vigorous physical activity (MVPA), and outdoor physical activities. A total of 19,015 participants from the 19,548 recruited population were included in the analyses (missing rate: 2.73%), 52.60% were boys. 64.01%, 57.96%, 35.98%, and 82.64% of preschoolers were reported to meet total physical activities, MVPA, and outdoor activities with screen time recommendations level. The results of multivariable-adjusted ORs (95% CIs) of preschoolers' MHP for comparisons of different levels of screen time (< 2h/day, 2-4h/day,≥4h/day) show that screen time positively associated with MHP after adjusting for confounders (P < 0.05), but the association was not significant among girls with screen time ≥ 4h/day. In addition, increased engagement in physical activity was reversely linked to MHP (P < 0.05). A stronger association between MHP and MVPA was observed in boys, however, this association was weakened when the total time spent engaging in MVPA exceeded two hours per day (P < 0.05). Less physical activity and more screen time positively relate to MHP, but the relationship differs by type of physical activity, total time, and gender. These findings provide novel insights and evidence supporting for guidelines on physical activity, screen time, and improvement of mental health for preschoolers.

Night Screen Time is Associated with Cognitive Function in Healthy Young Adults: A Cross-Sectional Study.

In recent years, a significant shift toward remote work, virtual education, and social distancing measures was witnessed, thereby leading people to increasingly depend on digital devices for communication, work, and entertainment. This increased exposure to screens has raised concerns regarding its potential impact on cognitive function. This study investigated the relationship between screen time and cognitive function among healthy young adults. One hundred forty-five healthy individuals (mean age 21.55 ± 2.84 years) participated in this cross-sectional study. Sociodemographic information including age, sex, height, weight, and level of education were obtained. Participants reported screen time using a screen time questionnaire. Cognitive function tests including, Paced Auditory Serial Addition Task (PASAT), Montreal Cognitive Assessment (MoCA) and Symbol Digit Modalities Test (SDMT) were conducted. Multilinear regression analyses were used to examine the associations between age, sex, level of education, screen time, and cognitive function. One hundred thirty-nine participants (76 women) completed the study. Increased night screen time, bachelor's educational level, and women were associated with lower PASAT scores (R2=0.258; p≤0.047). Moreover, increased night screen time was associated with lower MoCA scores (R2=0.029; p=0.035). However, no associations were found between night screen time and SDMT scores. Participants who had higher night screen exposure had lower cognitive scores in the information speed processing, working memory, calculation, and attention domains. Considering these findings, this study emphasizes on the importance of setting a future recommended screen time guidelines for young adults as well as to promote healthy cognitive habits in order to preserve cognitive function and reduce the risk of developing neurodegenerative disease in the future. Future prospective cohort studies involving a more diverse age range is needed.