Screen Time Research Articles

Limited Recommendations and Evidence for Timing and Frequency of Anti-Mullerian Hormone Screening in Female Pediatric Cancer Survivors: A Systematic Review from the Pediatric and Adolescent Committee of the Oncofertility Consortium

Limited Recommendations and Evidence for Timing and Frequency of Anti-Mullerian Hormone Screening in Female Pediatric Cancer Survivors: A Systematic Review from the Pediatric and Adolescent Committee of the Oncofertility Consortium

Effects of multidisciplinary therapy on energy balance, inflammation, and metabolic diseases in adolescents with obesity: A narrative review.

Obesity is a consequence of multiple factors, including genetics, lifestyle and nutritional choices, physical activity, sleep duration, screen time, and mood disorders. These behavioral elements can impair the regulation of energy balance and obesity management that link obesity to a constellation of chronic conditions that lead to a high prevalence of cardiometabolic risk factors, metabolic syndrome, and nonalcoholic fatty liver disease. Multidisciplinary therapy is defined as an approach delivered by a multidisciplinary-trained health team covering at least two components of behavior, physical activity/exercise, dietary habits, and/or psychological counseling associated with clinical interventions. This narrative review summarizes the effects of multidisciplinary therapy on neuroendocrine regulation of energy balance, inflammatory biomarkers, cardiometabolic risk factors, metabolic syndrome, nonalcoholic fatty liver diseases, behavior, and quality of life. We found that multidisciplinary therapy, including medical, nutritional, exercise, and behavioral counseling, and/or education, was useful for addressing outcomes such as visceral adiposity, neuroendocrine regulation of energy balance, inflammatory biomarkers, cardiometabolic risk factors, nonalcoholic fatty liver disease, and metabolic syndrome. The effects were mediated by improvements in neuroendocrine regulation of energy balance, downregulation of the pro-inflammatory states, and a reduction in comorbidities. Multidisciplinary therapy also improved mood disorders and quality of life.

External Occipital Protuberance Enlargement in Children: A Benign Anatomic Variant with Rare Associations

Objective − The aim of this study is to raise awareness about External Occipital Protuberance (EOP) enlargement in children, its typically benign anatomical variant, and the importance of considering associated conditions in diagnosis and management.Case Report − We reviewed the cases of four male patients, presenting with EOP enlargement. Among the cases, one involved a newborn diagnosed with Menkes disease, a rare genetic disorder affecting copper transport, which was associated with occipital exostosis. The other three cases involved adolescents with varying degrees of EOP enlargement, linked to factors such as prior trauma and excessive screen time. Conclusion − While EOP enlargement is generally a benign anatomical variant, this study underscores the importance of differential diagnosis, particularly in the pediatric population. Clinicians should be aware of the potential, albeit rare, associations with serious conditions such as Menkes disease. A comprehensive approach to diagnosis and management is recommended, especially in symptomatic cases.

Irregular meal pattern and later sleep midpoint are associated with increased BMI z-score and waist–height ratio during early adolescence

BackgroundRapid gains in adiposity may have more adverse health implications in later life compared with having stable adiposity throughout childhood and adolescence. A knowledge gap concerns concomitant health behaviors contributing to adiposity gain among adolescents.ObjectivesWe investigated the associations of health behaviors relating to dietary habits, sleep, physical activity (PA), and screen time with an increase in body mass index z-score (BMIz) and waist–height ratio (WHtR) during adolescence.MethodsWe included 4,785 adolescents (53% of girls) aged 11.1 (SD 0.8) years at baseline and followed them for 3 years. We clustered them into decreased, stable, and increased BMIz and WHtR categories using the K-means clustering method. Using Cox regression, we computed hazard ratios (HR) with 95% CI for the associations of self-reported health behaviors (dietary habits, physical activity, sleep midpoint, and sedentary digital media use) with belonging to an increased BMIz or WHtR group. In a subsample (n = 3,840), we ran a sensitivity analysis considering puberty status as an additional covariate.ResultsLater sleep midpoint (having later midpoint of sleep between bedtime and waking time) and irregular meal pattern (not eating lunch and dinner every school day) predicted increased BMIz (HR 1.26 [95% CI 1.13–1.41] and 1.23 [1.08–1.39], respectively) and WHtR (1.23 [1.09–1.39] and 1.18 [1.02–1.36], respectively) over the follow-up period, after adjusting for other health behaviors. Associations remained after considering puberty status as a covariate.ConclusionsEarly bedtime with adequate sleep duration and regular meal pattern should be encouraged to prevent adiposity gain during early adolescence.

Risk factors and discrimination model for screen exposure among children under 3 years: findings from Fujian province in China.

Compliance with screen time guidelines among children worldwide remains low, and there is insufficient evidence on the current prevalence in China. This study aimed to investigate the prevalence of compliance with screen time guidelines among children under 3 years old in Fujian Province, East China, identify risk factors and their independent effects, and develop a risk discrimination model for targeted interventions. A cross-sectional survey was conducted among low-income families recruited from welfare programs at 96 sites in both urban and rural areas of Fujian Province, China. Face-to-face interviews gathered sociodemographic data, lifestyle information, attitudes towards screen exposure, and details on screen media device ownership. A multivariable logistic regression model was employed to identify independent risk factors for compliance with screen time guidelines, while the area under the receiver operating characteristic curve (AUC) was used to evaluate the model's discrimination ability. A total of 4,707 children participated in the survey. The rates of compliance with screen time guidelines were 56.8% for children under 1 year old, 18.8% for those between 1 and 2 years old, and 81.9% for those between 2 and 3 years old. The multivariable regression analysis identified negative attitudes towards screen exposure, co-viewing and engagement, as well as single child, as significant positive independent factors for compliance with the guidelines. The risk discrimination model demonstrated good performance, with an AUC of 0.845 and 0.812 in the two younger age groups, but showed medium discrimination with an AUC of 0.691 for children between 2 and 3 years old. Compliance with screen time guidelines among young children in Fujian Province, East China, is generally adequate, but notably low among children between 1 and 2 years old. Targeted interventions are needed to improve compliance, particularly for this age group.

Midpregnancy Placental Growth Factor Screening and Early Preterm Birth.

Early preterm birth (ie, at less than 34 weeks' gestation) confers a high risk for adverse health outcomes, yet no universal screening strategy exists, preventing targeted delivery of effective interventions. To evaluate the ability of midpregnancy placental growth factor (PlGF) screening to identify pregnancies at highest risk for early preterm birth. This prospective cohort study was conducted at an urban, tertiary care center from 2020 to 2023. Participants were unselected, pregnant people with singleton pregnancies, receiving universal-access prenatal care from obstetricians, family physicians, or midwives, who underwent a PlGF test at the time of routine gestational diabetes screening, typically at 24 to 28 weeks' gestation. Data were analyzed from January to May 2024. PlGF level less than 100 pg/mL at the time of gestational diabetes screen. The primary outcome was all early preterm birth, defined as less than 34 weeks' gestation. Secondary outcomes included iatrogenic preterm birth, spontaneous preterm birth, preeclampsia, stillbirth, and small-for-gestational-age birth weight. Among 9037 unique pregnant individuals, 156 (1.7%) experienced early preterm birth (52 spontaneous births; 104 iatrogenic births). The area under the curve (AUC) for PlGF and early preterm birth was 0.80 (95% CI, 0.75-0.85). Low PlGF level was associated with early preterm birth (positive likelihood ratio [LR], 79.400 [95% CI, 53.434-115.137]; negative LR, 0.606 [95% CI, 0.494-0.742]; specificity, 99.5% [95% CI, 99.3%-99.6%]; negative predictive value, 98.9% [95% CI, 98.8%-99.1%]). Time to birth from PlGF test was significantly reduced among patients with a PlGF level less than 100 pg/mL, among whom more than 50% delivered within 50 days of testing. Individuals with a low PlGF level made up more than 30% of subsequent stillbirths (aRR, 36.78 [95% CI, 18.63-72.60]) and more than half of patients requiring iatrogenic early preterm birth (aRR, 92.11 [95% CI, 64.83-130.87]). The AUC for iatrogenic early preterm birth was 0.90 (95% CI, 0.85-0.94). These findings suggest that low PlGF level (<100 pg/mL), identified at the time of routine gestational diabetes screening, may be a powerful clinical tool to identify pregnant people at risk of early preterm birth, especially in iatrogenic births. Strategic redirection of tertiary health care resources to this high-risk group could improve maternal and perinatal outcomes.

Enhancing systematic review efficiency in hand surgery using artificial intelligence (natural language processing) for abstract screening.

The aim of the present study was to train a natural language processing model to recognize key text elements from research abstracts related to hand surgery, enhancing the efficiency of systematic review screening. A sample of 1600 abstracts from a systematic review of distal radial fracture treatment outcomes was annotated to train the natural language processing model. To assess time-saving potential, 200 abstracts were processed by the trained models in two experiments, where reviewers accessed natural language processing predictions to include or exclude articles. The natural language processing model achieved an overall accuracy of 0.91 in recognizing key text elements, excelling in identifying study interventions. Use of the natural language processing reduced mean screening time by 31% without compromising accuracy. Precision varied, improving in the second experiment, indicating context-dependent performance. These findings suggest that natural language processing models can streamline abstract screening in systematic reviews by effectively identifying original research and extracting relevant text elements.Level of evidence: IV.

The impact of screen time and parental habits on children's sleep quality.

The impact of screen time and parental habits on children's sleep quality.

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.

Screen Exposure in 4-Year-Old Children: Association with Development, Daily Habits, and Ultra-Processed Food Consumption

This study aimed to investigate the association between child development, daily habits, and ultra-processed food consumption with screen exposure in 4-year-old children. A cross-sectional study was conducted using a questionnaire that included sociodemographic data, the child’s daily habits, and screenings for child development and eating habits. The daily screen exposure time (cell phone, computer, television, and/or tablet) was measured in minutes and classified as inadequate if &gt;60 min. We conducted bivariate analyses and a generalized linear model. Overall, 362 caregivers–children pairs were investigated. The average screen time per child was 120 min (IQR: 120), and most of the children (71%) showed inadequate screen time for the age group. The longest screen time was associated with the lowest score in child development (β = −0.03; p = 0.01), an increased habit of eating in front of screens (β = 0.34; p &lt; 0.001), and the highest score of ultra-processed foods (UPFs) (β = 0.05; p = 0.001). The sample showed a high prevalence of inadequate screen time, and this has been associated with the lowest score in child development, an increased habit of eating in front of screens, and the highest score of UPFs.

Factors Related to Sleep Quality in Final Semester Pharmacy Students of Mandala Waluya University

Introduction: Sleep is a recovery process for the body and brain and is very important for achieving optimal health. Lack of sleep can cause students to become tired or easily tired, emotional instability, lack of self-confidence, excessive impulsiveness and carelessness. A preliminary study with 32 final year pharmacy students revealed that 32 said they experienced symptoms of irregular sleep patterns, stress, decreased appetite, anxiety and restlessness. Objective: This study aims to determine the relationship between stress, screen time, eating patterns and anxiety with sleep quality in final semester pharmacy students at Mandala Waluya University in 2024. Method: The type of research used in this research is quantitative with a cross sectional study design. The population in this study was 158 final semester pharmacy students at Mandala Waluya University. A sample of 62 respondents was obtained using simple random sampling techniques. The analysis method uses Fisher's Exact Test. Result: The statistical test results show that Stress obtained a value of p=0.004 and ? 0.05, namely 0.004 &lt; 0.05, Screen Time obtained a value of p=0.004 and ? 0.05, namely 0.004 &lt; 0.05, Eating Pattern obtained a value of p=0.001 and ? 0.05, namely 0.001 &lt; 0.05, and Anxiety obtained a value of p = 0.000 and ? 0.05, namely 0.000 &lt; 0.05. Conclusion: Suggestions for students are that they hope to be able to improve sleep quality well so that it does not hinder the lecture process, then for further research, it is highly recommended to use online questionnaires such as Google Forms or similar and use other variables such as disease, caffeine consumption and the environment.

Screen time and obesity prevalence in adolescents: an isotemporal substitution analysis.

We examined the associations between screen time and adolescent obesity and the associations of reallocating screen time to other activities using isotemporal substitution models. Understanding the association between screen time and obesity may provide additional insights into effective obesity prevention strategies in adolescents. We conducted a cross-sectional analysis of 5,180 adolescents (4th and 7th grade students) from the Korean Children and Youth Panel Survey 2018. Participants reported their height, weight, and average time spent watching television, using computer, using smartphone, and other after-school activities. Obesity was defined as BMI-for-age and -sex ≥ 95th percentile based on the 2017 Korean National Growth Charts. We performed multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between screen time and obesity prevalence, adjusting for potential confounders. Prolonged smartphone use (≥ 180 vs. <60m/d: OR [95% CI] = 2.75 [2.06, 3.68]) was associated with a higher obesity prevalence. Television watching (≥ 120 vs. <60min/d) was positively associated with obesity prevalence among 4th grade students (2.09 [1.51, 2.89]) but the association was not observed among 7th grade students (0.97 [0.63, 1.49]). One-hour increments of any non-screen time activities, with a simultaneous 1-hour decrease in combined screen time, were associated with a lower obesity prevalence (physical activity: 0.75 [0.65, 0.85]; sleeping: 0.69 [0.62, 0.78]; hanging out with friends: 0.80 [0.71, 0.89]; reading: 0.82 [0.69, 0.97]; studying: 0.84 [0.78, 0.90]; chatting with parents: 0.89 [0.88, 0.98]). Our data suggest that public health strategies that reduce screen time and increase time for non-screen time activities, such as physical activity, may be effective in lowering adolescent obesity prevalence.

Abstract 4135333: Peripheral Perfusion Index: Normative Values From Electronically Reported Critical Congenital Heart Disease Screenin

Background: Critical Congenital Heart Disease (CCHD) screening is performed in an effort to reduce morbidity and mortality associated with CCHD by facilitating early detection. This screening consists of pulse oximetry and is most effective at identification of cyanotic cardiac lesions, with less sensitivity for left sided obstructive lesions. Research: Question Peripheral perfusion index (PPI) is obtained from the plethysmographic signal of a pulse oximeter and represents the ratio of pulsatile to non-pulsatile blood flow. As such, it is a surrogate for peripheral perfusion at the site of measurement. PPI has been postulated to be an adjunctive screening method for low perfusion states in neonates, including left sided obstructive lesions. To date, reference ranges of PPI values in neonates have not been published in the United States. This project utilized electronically reported CCHD screening results to establish normative PPI data in healthy neonates. Methods: In Minnesota, CCHD screening results are electronically sent to the Minnesota Department of Health (MDH) and are cross referenced against the Minnesota Birth Information System, which tracks infants who are identified to have a congenital birth defect within the first year of life. These data were provided by the MDH for infants born in Minnesota from Jan 2017 through Dec 2022. Infants were included in the analysis if they did not have a known critical congenital heart defect, were born between 35 and 42 weeks gestation, and were 24-48 hours of life at time of screening. Results: PPI data from 11,179 cases were included in the analysis. Overall, there is a trend towards increasing PPI with gestational age. Pre-ductal PPI trended higher than post-ductal PPI. There was no difference between PPI in males and females. Conclusions: These data reflect trends identified in international data. This is the largest dataset to date of PPI in healthy neonates and the first in the United States. Future studies will compare neonates with left sided obstructive lesions against these normative data. If PPI is found to predict left sided obstructive lesions in neonates, there may be utility in use of PPI in CCHD screening to facilitate earlier detection of these lesions.

IMPACT OF FOREIGN LANGUAGE ANIMATED CARTOONS ON PRESCHOOL CHILDREN: BENEFITS, CHALLENGES AND THE ROLE OF SPEECH THERAPISTS IN SERBIA AND BOSNIA AND HERZEGOVINA

This paper examines the impact of foreign language animated cartoons on preschool children in Serbia and Bosnia and Herzegovina, highlighting both benefits and challenges. While cartoons can enhance vocabulary, pronunciation, comprehension, cultural awareness and second language acquisition, some speech therapists in these countries express concerns. They argue that early exposure to foreign languages via screens may cause confusion, language mixing, and excessive screen time. Some of this scepticism contradicts current scientific findings. Interviews with speech therapists show how expert opinions shared through popular media can shape caregivers’ practices, often leading to misconceptions. As most caregivers rely on media for information rather than scientific literature, this emphasises the need for researchers to communicate their findings effectively to the public. The study reviews literature and empirical evidence, highlighting the gap between media narratives and scientific research and offers practical recommendations for educators, therapists, caregivers, and policymakers.

Ultra-processed food consumption is related to screen time among Brazilian adolescents, adults, and older adults.

The aim of this study was to investigate the association between screen time and ultra-processed food consumption (UPF) across the lifespan. Data from the 2019 Brazilian National Health Survey, a cross-sectional and population-based study, was used. UPF consumption was evaluated using a score, calculated by summing the positive answers to questions about the consumption of 10 UPF subgroups on previous day. Scores ≥5 represented high UPF consumption. Daily time spent engaging with television or other screens was self-reported. Crude and adjusted models were obtained through Poisson regression and results were expressed in prevalence ratios by age group. The sample included 2,315 adolescents, 65,803 adults, and 22,728 older adults. Prevalence of UPF scores ≥5 was higher according to increased screen time, with dose-response across all age groups and types of screen time. Adolescents, adults, and older adults watching TV for ≥6 hours/day presented prevalence of UPF scores ≥5 1.8 (95% CI 1.2-2.9), 1.9 (95% CI 1.6-2.3) and 2.2 (95% CI 1.4-3.6) times higher, respectively, compared to those who did not watch TV. For other screens, prevalence of UPF scores ≥5 was 2.4 (95% CI 1.3-4.1) and 1.6 (95% CI 1.4-1.9) times higher for adolescents and adults using screens for ≥6 hours/day, respectively, while for older adults only screen times of 2-<3 and 3-<6 hours were significantly associated with UPF scores ≥5. Screen time was associated with high consumption of UPF in all age groups. Considering these associations when planning and implementing interventions would be beneficial for public health across the lifespan.

Digital Screen Usage Amongst Doctors: Demographics, Patterns of Use and Effect of Health Parameters

Background: Advances in digital technology have led to widespread availability of digital devices and consequent increased usage amongst across the population including practising healthcare professionals. Increased ‘Digital Screen time’ and its effect on physical, psychological health, and sleep patterns has been predominantly evaluated in children, adolescents and adults from various walks of life. Purpose of the Study: The purpose of this survey was to evaluate the impact of Digital Screen usage (time and patterns) spent on portable and desktop digital devices amongst physicians, surgeons and radiologists. Material &amp; Methods: An online cross-sectional survey of an 11-part questionnaire (multiple choice questions and free text box) was circulated amongst orthopaedic surgeons, radiologists and physicians in India and the UK, to evaluate demographics, speciality and place of practice; Digital platform usage reasons and time; effect on mental health, physical health, sleep time amongst practising healthcare professionals. Results: There was an even spread amongst the various age groups. Smartphones were the commonest device utilised for digital screening in 90 (67.7%) doctors with 29 (38.5%) of doctors reporting more than five hours of daily screen time. Sixty-three (47%) of doctors used this for academic purposes, whereas 43 (32%) used it for entertainment more than for academic purposes. Thirty-nine doctors (29%) were unaware of whether screen usage affected mental health. Seventy-two (53%) were of the opinion that screen usage was having a negative effect on their physical health whilst 81 (60%) thought that it was having an adverse effect on their sleeping time respectively. Conclusion: A significant proportion of doctors appear to be using digital devices beyond the recommended ‘Digital Screen time’ by various national or international healthcare organisations. There is an emerging need to highlight the deleterious effect of excessive ‘Digital Screen time’ on various health parameters and be part of a global health narrative to mitigate ill-effects and a sustainable lifestyle.

Longitudinal changes in preschoolers' adiposity indicators according to compliance with 24-hour movement behavior guidelines: results from the ToyBox-study.

There is a lack of studies evaluating longitudinal changes in adiposity indicators and the association with 24-hour movement behavior guidelines in preschoolers. Therefore, this study aimed to investigate associations between changes in Body Mass Index (BMI) z-scores, waist circumference and waist-to-height ratio, and compliance with the 24-hour movement behavior guidelines in three- to six-year-old children from a European sample. In total, data from a European sample of 719 preschoolers (50.9% boys, 4.76 ± 0.45 years) were analyzed at baseline and one year later. Physical activity (steps/day) was objectively measured using Omron pedometers. Screen time and sleep duration were subjectively measured using a parental questionnaire. Height, weight and waist circumference were measured by well-trained researchers, using standardized procedures and equipment, and were used to calculate BMI z-score and waist-to-height ratio. Linear mixed-effects models were used to investigate associations between changes in adiposity indicators (BMI z-score, waist circumference and waist-to-height ratio) and compliance with 24-hour movement behavior guidelines. BMI z-scores changed differently from baseline to follow-up according to compliance with the integrated guidelines, both for weekdays (effect estimate = -0.15, p = 0.001) and weekend days (effect estimate = -0.12, p = 0.046). Preschoolers who did not comply with the integrated guidelines showed a small, significant increase in BMI z-scores compared to compliers having no significant change in BMI z-score. No significant difference between both groups over time was found for waist circumference and waist-to-height ratio neither for weekdays nor weekend days. The change in BMI z-scores after one year is less optimal for preschoolers who do not comply with the 24-hour movement behavior guidelines compared to preschoolers who comply with the integrated guidelines, although not clinically relevant. Future studies should incorporate longer follow-up periods to observe the effects of compliance to the integrated guidelines on adiposity indicators in preschool children.

A dyadic multimethod study of “partner phubbing”, smartphone conflict, and relationship quality in opposite-sex couples from Belgium

Abstract Existing research indicates that ‘partner phubbing’ is associated with heightened conflict and lower relationship satisfaction. However, previous studies have relied on cross-sectional designs involving subjective self-reports of only one partner. In this study, the main hypothesis entailed that the link between partner phubbing and relationship quality will be mediated by conflict over smartphone use. We utilized experience sampling (ESM) with objective smartphone logging measures collected over 14 days from 35 mixed-gender intimate dyads from Belgium (N = 70). An Actor-Partner Interdependence Model revealed that perceived relationship quality was negatively predicted by partner’s smartphone use in husbands only, but there were no indirect effects via smartphone conflict. We reported a low occurrence of smartphone frustration and conflict in couples. An outstanding dyad analysis revealed some incongruencies between partner’s smartphone use and its perception within couples. The design allowed us to distinguish between phone use frequency and screen time, which facilitated a nuanced understanding of smartphone use impact, and gender differences, to some extent refuting the previous literature. The findings prompt us to debate whether co-present smartphone use ought to be associated with negative outcomes exclusively, a rare notion to be explored in future research.

Global trends in importance of 24-hour movement behaviors to pediatric health: Implications for South Korea.

Cultivating a 24-hour movement behavioral profile conducive to health and well-being, marked by adequate levels of physical activity, limited screen time, and sufficient sleep, has emerged as an important avenue for promoting pediatric health. We aimed to provide evidence of this potential, this multiphase, multimethod, and integrative review comprehensively investigated the global trends in health promotion initiatives and status of the Korean pediatric population. This integrative review comprised three phases employing various review methods: an environmental scan of existing guidelines for 24-hour movement behaviors worldwide, a rapid review of physical activity-related indicators from Global Matrix data, and a systematic review of 24-hour movement behaviors among children and adolescents in South Korea. The growing recognition of a holistic approach to the 24-hour movement behavior paradigm in pediatric health promotion has led to the establishment and adoption of 24-hour movement guidelines in different countries and by the World Health Organization (WHO). Korean health authorities have also responded to this need by releasing a translated report of the WHO guidelines for physical activity and sedentary behavior as well as the 2024 update of the Physical Activity Guidelines for Koreans. Accordingly, actions must be followed in policy, research, and practice. This is critical considering that Korean children and adolescents exhibit an unfavorable profile of 24-hour movement behaviors compared to the global average. Among those aged 0-6 years, the weighted averages for guideline adherence were 18.2% for physical activity, 38.1% for sedentary behavior, and 76.2% for sleep. For those aged 12-18 years, the weighted averages for guideline adherence were 20.4% for physical activity, 55.9% for sedentary behavior, and 26.2% for sleep. Building on these current findings, this integrative review provides three priorities for pediatric health promotion policy and practice and three recommendations for future research.

Association between changes in adherence to the 24-hour movement guidelines with depression and anxiety symptoms among Chinese adolescents: a prospective population-based study

BackgroundThe 24-hour movement guidelines (24-HMG) include screen time (ST), sleep duration, and physical activity. Previous studies have explored the associations of adherence to the 24-HMG with depression and anxiety symptoms among adolescents, ignoring changes in behaviors. This study aimed to examine whether changes in adherence to the 24-HMG were associated with depression and anxiety symptoms among adolescents.MethodsWe recruited adolescents from Shenzhen, China in 2021 and followed them up 1 year later. Changes in adherence to the individual 24-HMG were categorized into four groups: persistent non-adherence, adherence to non-adherence, non-adherence to adherence, and persistent adherence. Changes in the numbers of adherence to the overall 24-HMG were obtained by subtracting the number of guidelines adhered to in wave 2 from that in wave 1.ResultsWe included 12,570 participants aged 9–18 years with 52.2% boys. Compared with persistent non-adherence for the ST/sleep duration guideline, non-adherence to adherence and persistent adherence were associated with lower depression and anxiety symptoms, but adherence to non-adherence was not. Changes in adherence to the physical activity guideline were not related to outcomes. The β coefficients (95% CIs) for each point increase in changes in the numbers of adherence to guidelines were − 0.58 (− 0.69, − 0.47) and − 0.43 (− 0.53, − 0.33) for depression and anxiety symptoms, respectively. The association of persistently adhering to sleep guideline with anxiety symptoms and the associations of changes in the numbers of adherence to the 24-HMG had sex differences.ConclusionsMaintaining and strengthening healthy movement behaviors to meet more guidelines of the 24-HMG, especially sleep and ST, may be beneficial for preventing depression and anxiety symptoms in adolescents.