Total Screen Time Research Articles

Associations of Contemporary Screen Time Modalities With Early Adolescent Nutrition

ObjectiveTo determine the associations between screen time across several contemporary screen modalities (eg, television, video games, text, video chat, social media) and adherence to the Mediterranean-DASH (dietary approaches to stop hypertension) intervention for neurodegenerative delay (MIND) diet in early adolescents. MethodsWe analyzed data from the Adolescent Brain Cognitive Development study of 9 to 12-year-old adolescents in the United States. Multiple linear regression analyses examined the relationship between self-reported screen time measures at baseline (year 0) and the 1-year follow-up (year 1) and caregiver-reported nutrition assessments at year 1, providing a prospective and cross-sectional analysis. Cross-sectional marginal predicted probabilities were calculated. ResultsIn a sample of 8267 adolescents (49.0% female, 56.9% white), mean age 10 years, total screen time increased from 3.80 h/d at year 0 to 4.61 h/d at year 1. Change in total screen time from year 0 and year 1 was associated with lower nutrition scores at year 1. Prospective: Screen time spent on television, video games, and videos at year 0 was associated with lower nutrition scores at year 1. Cross-sectional: Screen time spent on television, video games, videos, texting, and social media at year 1 was associated with lower MIND diet scores at year 1. ConclusionsBoth traditional (television) and several contemporary modalities of screen time are associated, prospectively and cross-sectionally, with lower overall diet quality, measured by the MIND diet nutrition score, in early adolescents. Future studies should further explore the effect of rising digital platforms and media on overall adolescent nutrition.

Association between screen time, including that for smartphones, and overweight/obesity among children in Japan: NICE EVIDENCE Study 4.

The association between screen time (ST), including that for smartphones, and overweight/obesity in children was examined separately for boys and girls, considering the influence of lifestyle factors. A cross-sectional study was conducted in 2,242 Japanese children (1,278 girls) aged 10-14 years. Overweight/obesity was defined by the International Obesity Task Force. Logistic regression analysis showed that only for girls, total ST (≥4 h), smartphone ST (≥3 h), and non-smartphone ST (≥2 h) were all independently and significantly associated with overweight/obesity compared to <2 h total ST, non-use of smartphones, and <1 h non-smartphone ST. Thus, smartphone ST ≥3 h and non-smartphone ST ≥2 h were additively associated with overweight/obesity in girls only. Girls having smartphone ST ≥3 h and non-smartphone ST ≥2 h were 6.79 times (95% CI: 3.11-14.81) more likely to have overweight/obesity than girls with less usage of both. In girls, when total ST was ≥4 < 5 h or smartphone ST was ≥2 h, the significant association with overweight/obesity disappeared when physical activity was ≥60 min/day and sleep time was ≥8.5 h. In addition, none of these associations was significant in boys. In Japanese girls, smartphone ST, non-smartphone ST, and total ST were all significantly associated with overweight/obesity. To avoid overweight/obesity, it is suggested to keep smartphone ST, non-smartphone ST, and total ST to <3 h, <2 h, and <4 h, respectively, and to engage in sufficient physical activity and sleep time.

Time trends and COVID-19 post-pandemic changes in physical activity and sedentary behavior prevalence among Brazilian adults between 2006 and 2021.

To analyze time trends and prevalence of physical activity and sedentary behavior among adults of Brazilian capitals between 2006 and 2021, including the pandemic period. This is a time-series of cross-sectional surveys based on the National Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey. Trends of sufficient leisure-time physical activity, sufficient physical activity while commuting, insufficient practice of physical activity, and total screen time were estimated by using Prais-Winsten regression. Annual prevalences and time trends were estimated for each indicator by sex, age group and education. For total population, significant time trends were found for leisure-time physical activity (β=0.614) and total screen time (β=1.319). As for prevalence, leisure-time physical activity increased from 29% in 2009 to 39% in 2019, followed by a reduction of 2.3% between 2020 and 2021. Total screen time prevalence increased considerably between 2019 and 2020 (4.7%). Though physical inactivity tended to reduce along the series, its prevalence increased by 3.4% between 2019 and 2021, as well as physical activity while commuting decreased by 3,7% in the same time period. Whereas leisure-time physical activity increased over the years, it is uncertain whether this trend will be the same in the years following COVID-19. Not only did people alter their leisure-time habits, but also there was an increasing dominance of screen time due to the change in work and social patterns. More strategies need to be addressed to tackle physical inactivity and sedentary behavior, and to review the post-pandemic national targets.

Screen time, social media use, and weight-related bullying victimization: Findings from an international sample of adolescents.

Screen time, social media, and weight-related bullying are ubiquitous among adolescents. However, little research has been conducted among international samples. Therefore, the aim of this study was to determine the association between screen time, social media use, and weight-related bullying victimization among an international sample of adolescents from six countries. Data from the 2020 International Food Policy Study Youth Survey were analyzed (N = 12,031). Multiple modified Poisson regression models were estimated to determine the associations between weekday hours of five forms of screen time, and total screen time, and use of six contemporary social media platforms and weight-related bullying victimization. Analyses were conducted among the overall sample, and stratified by country (Australia, Canada, Chile, Mexico, United Kingdom, United States). Greater hours of weekday screen time and use of each of the six social media platforms were associated with weight-related bullying victimization among the sample. Each additional hour of social media use was equivalent to a 13% (confidence interval [CI] 1.10-1.16) increase in the prevalence of weight-related bullying victimization. The use of Twitter was associated with a 69% (CI 1.53-1.84) increase in the prevalence of weight-related bullying victimization. Associations between hours of weekday screen time, use of six social media, and weight-related bullying victimization differed by country. Findings underscore the associations between screen time, social media, and weight-related bullying among a sample of adolescents from six medium- and high-income countries. Country-specific and global public health and technology efforts are needed to address this burgeoning social problem.

Effect of COVID-19 Pandemic on Physical Activity and Screen Time of School Children: A Cross-sectional Study from Chandigarh

Background The nationwide lockdown imposed due to the COVID-19 pandemic disrupted daily routines, especially for children. Being at home and attending virtual classes unintentionally precipitated an increase in both academic and nonacademic screen time and probably led to decreased physical activity in children. However, there is lack of evidence related to the physical activity and screen time of school-age children during the COVID-19 pandemic. So this study aimed to investigate the effect of the COVID-19 pandemic and lockdown on physical activity and screen time of children. Methods An online survey was used to recruit parents of school-age children through convenience sampling. Parents were asked to compare their child’s physical activity and screen time in the previous week with those in the pre-lockdown and lockdown periods. The global physical activity questionnaire was used to assess physical activity, and a screen time questionnaire was developed and validated. Data collection was done from September 2020 to December 2020. Results Data of 104 children were collected from parents’ reports. The average age of parents was 39.1 + 4.8 years for mothers and 40.8 + 6.9 years for fathers. Results revealed a decrease in physical activity from 564.95 min/week before the lockdown to 146.05 min/week during the lockdown, with the absolute decrease of 448.9 min/week. Total screen time increased from 2.42 h/day before the lockdown to 7.41 h/day during the lockdown. Conclusion Necessary steps to mitigate the effect of COVID-19 pandemic unintentionally affected children in terms of decreased physical activity and increased screen time.

Use of electronic media and its association with teenager’s behavior: an analytical cross-sectional study in community clinics of Karachi

OBJECTIVE: To estimate the proportion of electronic media usage among teenagers and identify the association between behavior and the use of electronic media. METHODOLOGY: An analytical cross-sectional study conducted from December 2021 to February 2022. A sample of teenagers (n=340) were selected from primary care clinics of Chanesar Goth and Hijrat Colony, Karachi. Participants were questioned regarding their daily usage of media. Strengths and Difficulties Questionnaire was administered to assess the behavior. Data was analyzed using SPSS 23. RESULTS: A total of 350 teenagers were enrolled in the study, and the distribution of gender was almost equal. Daily usage of media included Television(88.9%), videogames(47.4%), computer/laptop(79%), mobile phone(90.3%) and tablet(20.9%). The content viewed were movies (68.9%), Facebook (72%) and Chats/WhatsApp (76.6%). The mean of total difficulty score in our study population was 19.1 (SD: 4.8). On multivariate analysis, higher difficulty score was positively associated with increasing age (Beta: 0.428, 95% Cis: 0.070 -0.785, p-value:0.019) and total screen time (Beta: 0.003, 95% Cis: 0.001 -0.005, p-value: 0.036) while difficulty score was negatively associated with male gender (Beta: -1.223, 95% Cis: -2.441 -- -0.005, p-value: 0.049). CONCLUSION: Our population's media exposure and difficulty scores are higher than other populations. Media exposure needs to be reduced to control psychosocial problems. KEYWORDS: Electronic media, Behavior, Teenagers, Association, Adolescents, Media usage.

Types of On-Screen Content and Mental Health in Kindergarten Children

Excessive screen time has been associated with a higher risk for mental health problems, but whether the associations differ by screen content types is unclear. To examine the allocation of and longitudinal changes in screen exposure across different content types and to explore their associations with mental health in children aged 3 to 6 years. This cohort study used 3-wave, lagged generalized estimating equation models to analyze data from the Shanghai Children's Health, Education and Lifestyle Evaluation-Preschool (SCHEDULE-P) study in Shanghai, China. The cohort was a representative sample of kindergarten children. Data were collected between November 2016 and May 2019 when children were aged 3 to 4 years (wave 1), 4 to 5 years (wave 2), and 5 to 6 years (wave 3). Data analysis was performed between June 2022 and May 2023. Screen exposure (total daily time and time with each type of content, including educational programs, entertainment programs, non-child-directed programs, electronic games, and social media) was collected when children were aged 3, 5, and 6 years. Mental health of children at age 3, 5, and 6 years was reported by parents using the Strengths and Difficulties Questionnaire. Of the 15 965 children included in the representative sample, 8270 were males (51.7%) and the mean (SD) age at wave 1 was 3.73 (0.30) years. As children developed from ages 3 to 6 years, the proportion of screen exposure to educational programs (≤1 hour per day: 45.0% [95% CI, 43.5%-46.5%] to 26.8% [95% CI, 25.3%-28.3%]) and entertainment programs (≤1 hour per day: 44.4% [95% CI, 42.8%-45.9%] to 32.1% [95% CI, 30.4%-33.9%]) decreased, whereas exposure to social media increased (≤1 hour per day: 1.5% [95% CI, 1.2%-1.9%] to 27.1% [95% CI, 25.5%-28.7%]). The associations between on-screen content and mental health varied. For a given total screen time, a higher proportion of screen exposure to educational programs was associated with a lower risk for mental health problems (adjusted odds ratio [AOR], 0.73; 95% CI, 0.60-0.90), whereas non-child-directed programs were associated with a higher risk for such problems (AOR, 2.82; 95% CI, 1.91-4.18). Regardless of the content, total screen time was consistently associated with mental health problems. Results of this study indicated that both total screen time and different types of content were associated with mental health problems in children aged 3 to 6 years. Limiting children's screen time, prioritizing educational programs, and avoiding non-child-directed programs are recommended.

Changes in Refractive Error During Young Adulthood: The Effects of Longitudinal Screen Time, Ocular Sun Exposure, and Genetic Predisposition.

Changes in refractive error during young adulthood is common yet risk factors at this age are largely unexplored. This study explored risk factors for these changes, including gene-environmental interactions. Spherical equivalent refraction (SER) and axial length (AL) for 624 community-based adults were measured at 20 (baseline) and 28 years old. Participants were genotyped and their polygenic scores (PGS) for refractive error calculated. Self-reported screen time (computer, television, and mobile devices) from 20 to 28 years old were collected prospectively and longitudinal trajectories were generated. Past sun exposure was quantified using conjunctival ultraviolet autofluorescence (CUVAF) area. Median change in SER and AL were -0.023 diopters (D)/year (interquartile range [IQR] = -0.062 to -0.008) and +0.01 mm/year (IQR = 0.000 to 0.026), respectively. Sex, baseline myopia, parental myopia, screen time, CUVAF, and PGS were significantly associated with myopic shift. Collectively, these factors accounted for approximately 20% of the variance in refractive error change, with screen time, CUVAF, and PGS each explaining approximately 1% of the variance. Four trajectories for total screen time were found: "consistently low" (n = 148), "consistently high" (n = 250), "consistently very high" (n = 76), and "increasing" (n = 150). Myopic shift was faster in those with "consistently high" or "consistently very high" screen time compared to "consistently-low" (P ≤ 0.031). For each z-score increase in PGS, changes in SER and AL increased by -0.005 D/year and 0.002 mm/year (P ≤ 0.045). Of the three types of screen time, only computer time was associated with myopic shift (P ≤ 0.040). There was no two- or three-way interaction effect between PGS, CUVAF, or screen time (P ≥ 0.26). Higher total or computer screen time, less sun exposure, and genetic predisposition are each independently associated with greater myopic shifts during young adulthood. Given that these factors explained only a small amount of the variance, there are likely other factors driving refractive error change during young adulthood.

Internet-based Digital Simulation for Cleft Surgery Education: A 10-year Assessment of Demographics, Usage, and Future Directions.

In October 2012, an open-access, multimedia digital cleft simulator was released. Its purpose was to address global disparities in cleft surgery education, providing an easily accessible surgical atlas for trainees globally. The simulator platform includes a three-dimensional surgical simulation of cleft care procedures, intraoperative videos, and voiceover. This report aims to assess the simulator's demographics and usage in its tenth year since inception. Finally, we also aim to understand the traction of virtual reality in cleft surgical education. Usage data of the simulator over 10 years were retrospectively collected and analyzed. Data parameters included the number of users, sessions, countries reached, and content access. An electronic survey was emailed to registered users to assess the benefits of the simulator. The total number of new and active simulator users reached 7687 and 12,042. The simulator was accessed an average of 172.9.0 ± 197.5 times per month. Low- to middle-income regions accounted for 43% of these sessions. The mean session duration was 11.4 ± 6.3 minutes, yielding a total screen time of 3022 hours. A total of 331 individuals responded to the survey, of whom 80.8% found the simulator to be very useful or extremely useful. Of those involved in education, 45.0% implemented the simulator as a teaching tool. Global utilization of the simulator has been sustained after 10 years from inception with an increased presence in low- to middle-income nations. Future similar surgical simulators may provide sustainable training platforms to surgeons in low- and high-resource areas.

Nutrition literacy status and its association with adherence to the Mediterranean diet, anthropometric parameters and lifestyle behaviours among early adolescents.

To evaluate nutrition literacy status and its association with adherence to the Mediterranean diet (MD), anthropometric parameters and lifestyle behaviours among early adolescents. This is a cross-sectional study. Nutrition literacy was evaluated using the 'Adolescent Nutrition Literacy Scale'. Dietary intake was assessed by 24-h food recall. The 'Mediterranean Diet Quality Index' was used to evaluate adolescents' adherence to the MD. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). Body weight, height, waist, hip and neck circumference were measured. Four secondary schools in İzmir, Türkiye. The study included 1074 secondary school students. Adolescents' nutrition literacy was at a moderate level. Nutrition literacy scores were significantly lower in those who skip main meals. Adolescents with high nutrition literacy had higher intakes of fibre, protein, protein, Ca, K, Mg, P, vitamin C, folate and Fe intake than those with low and moderate nutrition literacy (P < 0·05). According to IPAQ, active adolescents had higher nutrition literacy scores than inactive adolescents. There was no significant difference in BMI and anthropometric measurements of the adolescents according to their nutrition literacy level. Linear regression analysis showed that each unit increase in nutrition literacy increased adherence to the MD by 0·286 points (β = 0·286) and decreased total screen time by 0·182 points (β = -0·182). These findings showed that nutrition literacy among early adolescents was not optimal, and a higher nutrition literacy score was significantly associated with higher MD adherence, and healthy eating habits and lifestyle behaviours.

Cross-sectional and prospective associations between screen time and childhood neurodevelopment in two Brazilian cohorts born 11 years apart.

The aim of this study was to investigate the associations between screen time from ages 2 to 4 years and child neurodevelopment at age 4. The participants were from the 2004 (N = 3787) and 2015 (N = 3604) Pelotas (Brazil) birth cohort studies. Childhood neurodevelopment was assessed at age 4 using the Battelle Development Inventory. The time children spent on screen devices was reported by their guardians at ages 2 and 4years. Linear regression models were used to investigate the association of: (i) time spent on television at ages 2 and 4years; (ii) time spent on other screens at age 4; and (iii) total screen time at age 4 (television + other screens) with childhood neurodevelopment at age 4. Average daily screen time among children born in 2004 and those born in 2005 aged 4years were 3.4 (SD: 2.4) and 4.4h (SD: 2.9), respectively. Overall, few associations of very small magnitude between screen time and child neurodevelopment were observed. Television time at 2 years of age was statistically associated with lower neurodevelopment at 4 years of age in the 2015 cohort (β = -0.30, 95%CI = -0.55; -0.05). Conversely, television time (β = 0.17, 95%CI = 0.07, 0.26) and total screen time (β = 0.22, 95%CI = 0.13, 0.31) at age 4 were associated with higher neurodevelopment at age 4 in the 2004 cohort. The findings of this study suggest that the amount of time spent on screen devices might not be associated with neurodevelopment of children under 5 years of age. The small magnitude and inconsistencies in the direction of associations did not find evidence to support the current guidelines for screen time at this age. Therefore, more studies, especially those with longitudinal data, are important to comprehend the true effect of screen time on neurodevelopment and other health outcomes.

Screen use while eating is associated with lower intuitive eating and higher disordered eating in Chinese adult men and women.

We aimed to explore the potential associations between screen use while eating and intuitive eating and disordered (thinness-oriented and muscularity-oriented) eating behaviors. Analyses included 600 Chinese adults (50% women; Mage = 30.67, SD = 8.08) recruited online. The use of four major screen devices was captured, including cell phones, tablets, computers, and TVs. Three types of eating behaviors were examined, namely intuitive eating, thinness-oriented disordered eating, and muscularity-oriented disordered eating. Pearson correlation and hierarchical regression analyses were conducted separately for men and women to examine the sex-specific associations between screen use while eating and intuitive eating, thinness-oriented disordered eating, and muscularity-oriented disordered eating. In both men and women, more screen use while eating was significantly associated with lower intuitive eating, higher thinness-oriented disordered eating, and higher muscularity-oriented disordered eating, above and beyond total screen time and social media use. We found preliminary evidence for the significant links between screen use while eating and intuitive eating and disordered eating. Given the global increases in screen use, continued research is warranted to further explore the role of screen use while eating in the development and maintenance of intuitive eating and disordered eating. Much remains unknown regarding screen use while eating and eating behaviors. We found that in both Chinese men and women, more screen use while eating was significantly and uniquely associated with lower intuitive eating, higher thinness-oriented disordered eating, and higher muscularity-oriented disordered eating. Findings highlight the importance of incorporating screen use while eating in future research on intuitive eating and disordered eating.

Sleep Quality and Screen Time as The Most Influential Factor of Computer Vision Syndrome

Background: Since the Covid-19 Pandemic hit Indonesia, college students have had many eye health complaints; one is Computer Vision Syndrome (CVS). Factors that can increase the risk of CVS are decreased sleep quality, high computer/laptop use duration, and a non-ergonomic position. This study aimed to prove the relationship between sleep quality, visibility, and screen time on the incidence of CVS in medical students of Diponegoro University.Method: This cross-sectional study, including 147 medical students was conducted using primary data from questionnaires of Wendy Strouse Watt, Thomas H Murphy, Hospitality Eye Care Center, and vsp.com to gain data on respondent identity, visibility, and screen time. Sleep quality data were taken from the PSQI and CVS data through the CVS-Q questionnaire. Chi-square, Mann-Whittney, and logistic regression of multivariate analysis were used to analyze the data.Results: From 147 subjects, 108 were CVS (73.5%), and 39 were Non-CVS (26.5%). Variables of sleep quality and screen time (total) showed a significant relationship with CVS, which had p-values of p=0.001 and p=0.009 (p&lt;0.05). As for the visibility to CVS, there was no relationship with p=0.863. In the multivariate test, sleep quality (p=0.000; ExpB=4.342) and total screen time (p=0.006; ExpB=3.913) were the most influential variables. The results showed that Computer Vision Syndrome is ubiquitous among Diponegoro University's final-year medical students. Sleep quality and total screen time can increase the risk of CVS by four times. This study also shows that CVS still appears in the post-pandemic era.

Sleep pattern and sleep disorders in school-going children aged 6-12 years and its association with screen time: a cross-sectional study from South Kerala during the COVID-19 pandemic

Background: Poor sleep quality in school children can negatively impact their neurocognitive abilities and academic achievement. Increased screen time was shown to interfere with children’s sleep habits and disrupts their sleep pattern. This study aimed to understand the sleep patterns and sleep disorders in school children and the influence of screen time on sleep in children during the COVID-19 pandemic. Methods: This cross-sectional observational school-based study was done on 443 children aged 6-12 years. Data was collected through parent filled online questionnaire having a proforma and child sleep habit questionnaire (CSHQ), a validated questionnaire to assess sleep disorders in children Results: Out of 443 children studied, the average sleep duration of the study population was 9:06 hours ±42:18 min and, 34.3% of the children slept less than 9 hours per day. The prevalence of sleep disorders was found to be 76.52%. Significant screen time after 8 PM was observed in 65.9% and 62.2 % of children had a total screen time of more than 2 hours. Increased screen time after 8 PM, delayed bedtime and wake-up time in children and also contributed to sleep disorders. Bedtime resistance and daytime sleepiness were more commonly observed in children with increased screen time. Conclusions: Sleep disorders in children are more predominant than sleep deprivation. Increased screen time before bed was found to alter sleep patterns in children and increases bedtime resistance, daytime sleepiness, and sleep disorders.

Связь темпа развития регуляторных функций за год с экранным временем детей 5—6 лет из трех регионов России

&lt;p&gt;The aim of this work was to investigate the relationship between the development rate of executive functions and the screen time in 5&amp;mdash;6 year old children within a year. The study involved 495 children from Kazan, Moscow and the Republic of Sakha (Yakutia), who were 5&amp;mdash;6 years old at the beginning of the study. The sample population was divided into three equal percentage groups based on the total screen time per week. This approach made it possible to analyze contrasting cases, that is, children with minimum (from 1 to 11 hours per week) and maximum (from 19.5 to 70 hours per week) screen time. It has been shown that the level of cognitive flexibility improved throughout the year in children with minimum screen time, and dropped in children with maximum screen time. In children with minimum screen time, the level of cognitive inhibitory control increased statistically more significantly over the year than in children with maximum screen time. For the development rate of working memory and behavioral inhibitory control, there were no statistically significant differences between the groups.&lt;/p&gt;

Asthenopia prevalence and vision impairment severity among students attending online classes in low-income areas of western China during the COVID-19 pandemic.

This study explored the impact of online learning during the coronavirus disease 2019 (COVID-19) pandemic on asthenopia and vision impairment in students, with the aim of establishing a theoretical basis for preventive approaches to vision health. This balanced panel study enrolled students from western rural China. Participant information was collected before and during the COVID-19 pandemic via questionnaires administered at local vision care centres, along with clinical assessments of visual acuity. Paired t tests and fixed-effects models were used to analyse pandemic-related differences in visual status. In total, 128 students were included (mean age before pandemic, 11.82 ± 1.46 years). The mean total screen time was 3.22 ± 2.90 hours per day during the pandemic, whereas it was 1.97 ± 1.90 hours per day in the pre-pandemic period (P<0.001). Asthenopia prevalence was 55% (71/128) during the pandemic, and the mean visual acuity was 0.81 ± 0.30 logarithm of the minimum angle of resolution; these findings indicated increasing vision impairment, compared with the pre-pandemic period (both P<0.001). Notably, asthenopia prevalence increased by two- to three-fold, compared with the pre-pandemic period. An increase in screen time while learning was associated with an increase in asthenopia prevalence (P=0.034). During the COVID-19 pandemic, students spent more time on online classes, leading to worse visual acuity and vision health. Students in this study reported a significant increase in screen time, which was associated with increasing asthenopia prevalence and worse vision impairment. Further research is needed regarding the link between online classes and vision problems.

Screen exposure and sleep: How the COVID-19 pandemic influenced children and adolescents – A questionnaire-based study

BackgroundCOVID-19 pandemic has drastically increased the exposure to electronic devices in children, influencing their lifestyle and their sleep. This study was conducted to explore the relationship between the augmented screen exposure and sleep habits in children during and after the pandemic. MethodsUsing the "Google Forms" tool, we created an online questionnaire addressed to parents of children and adolescents aged 2–18 years. We explored the use of screens before and during/after the lockdown and assessed the presence of sleep disturbances through the Sleep Disturbance Scale for Children (SDSC), referring to the period before and during/after COVID-19 pandemic. ResultsWe collected 1084 valid questionnaires (median age 8.5 ± 4.1 years). We observed a significant increase in screens exposure for school (72%) and for leisure (49.7%) during the pandemic. We reported an increased sleep disturbances prevalence from 22.1% before the pandemic to 33.9% during the outbreak (p < 0.001). Even before the pandemic, the highest risks for sleep disorders were related to daily screen time for school reasons (OR 1.65, p < 0.001) and total screen time after 6 p.m. (OR 1.59, p < 0.001). The augmented exposure to screens for any reasons during the pandemic was significantly related to an increase of sleep disorders, especially regarding the increased exposure after 6 p.m. (OR 1.67, p < 0.001). ConclusionsThe augmented use of electronic devices was recognized to be a significant predisposing factor in increasing the rate of sleep disorders during and after the pandemic, thus sleep hygiene recommendations should be highlighted to improve sleep habits.

Preschoolers’ screen time in China before and during COVID-19 lockdown: a parental survey

ObjectivesSince COVID-19 first appeared in Wuhan, China, in December 2019, the disease has spread rapidly across the country. To reduce the spread of infection, schools including kindergartens were closed. Prolonged...

Musculoskeletal complaints and associated factors in school children aged between 6 and 13 years in Istanbul during the COVID-19 pandemic: A cross-sectional study.

Following the first COVID-19 cases in Turkey, face-to-face education was ceased after March 16, 2020 until the end of the educational year (i.e. June 19, 2020) and education was substituted remotely due to confinement. This study aims to investigate the frequency of musculoskeletal complaints in school-age children and associated risk factors including reduced physical activity, increased screen time and poor ergonomics conditions in school-age children during the pandemic. This cross-sectional study included parents or guardians of 960 students aged between 6-13 years old with a non-randomized sampling. A survey was administered consisting of 65 items related with sociodemographic characteristics of the children and family, online education hours, technological device(s) used, screen time, type of physical activity, presence of musculoskeletal problems and poor ergonomics conditions such as incorrect sitting posture. Logistic regression results demonstrated that age, excess weight gain, total daily screen time, smartphone use, incorrect sitting posture were associated with musculoskeletal complaints. The long-term closure of schools due to the pandemic may have led to an increase in musculoskeletal complaints in 6-13 years old children, based on the factors identified in this study, which were excess weight gain, increased screen time and incorrect sitting posture. These findings might help education and health authorities to develop strategies to improve musculoskeletal health of children especially in emergencies such as the pandemic.

Prevalence of Myopia in Children Before, During, and After COVID-19 Restrictions in Hong Kong

Childhood myopia increased during the COVID-19 pandemic. Limited evidence exists about whether myopia development was reversed or worsened after the lockdown. To determine the prevalence of myopia and its associated factors before, during, and after COVID-19 restrictions. This population-based, repeated cross-sectional study evaluated children aged 6 to 8 years from the Hong Kong Children Eye Study between 2015 and 2021 in 3 cohorts: before COVID-19 (2015-2019), during COVID-19 restrictions (2020), and after COVID-19 restrictions were lifted (2021). All the children received ocular examinations, including cycloplegic autorefraction and axial length. Data about the children's lifestyle, including time spent outdoors, near-work time, and screen time, were collected from a standardized questionnaire. The main outcomes were the prevalence of myopia, mean spherical equivalent refraction, axial length, changes in lifestyle, and the associated factors over 7 years. Data were analyzed using descriptive statistics, logistic regression, and generalized estimating equations. Of 20 527 children (mean [SD] age, 7.33 [0.89] years; 52.8% boys and 47.2% girls), myopia prevalence was stable from 2015 to 2019 (23.5%-24.9%; P = .90) but increased to 28.8% (P < .001) in 2020 and 36.2% (P < .001) in 2021. The mean (SD) time spent outdoors was much lower in 2020 (0.85 [0.53] h/d; P < .001) and 2021 (1.26 [0.48] h/d; P < .001) compared with pre-COVID-19 levels (1.40 [0.47]-1.46 [0.65] h/d). The trend was reversed for total near-work time and screen time. High myopia prevalence was associated with the COVID-19 pandemic (odds ratio [OR], 1.40; 95% CI, 1.28-1.54; P < .001), younger age (OR, 1.84; 95% CI, 1.76-1.93; P < .001), male sex (OR, 1.11; 95% CI, 1.03-1.21; P = .007), lower family income (OR, 1.05; 95% CI, 1.00-1.09; P = .04), and parental myopia (OR, 1.61; 95% CI, 1.52-1.70; P < .001). During the pandemic, mean (SD) near-work and screen times in children from lower-income families were 5.16 (2.05) h/d and 3.44 (1.97) h/d, more than from higher-income families (4.83 [1.85] and 2.90 [1.61] h/d, respectively). The findings of this cross-sectional study revealed that after COVID-19 restrictions were lifted in Hong Kong, myopia prevalence among children was higher than before the pandemic, and lifestyle did not return to pre-COVID-19 levels. Younger children and those from low-income families were at a higher risk of myopia development during the pandemic, suggesting that collective efforts for myopia control should be advocated for these groups.