Screen time

Background: Digital screen technology use by children has been traditionally used as a surrogate measure of sedentary behaviour exposure. However, poor health outcomes in children are more strongly associated with screen use than with device measured sedentary behaviour. This suggests other aspects of screen use may be important. Better evidence on which aspects of screen use are critical to child health requires measurement methods that can capture the complex interactions between children, technology, the tasks they perform and the context of the interactions, to compare contemporaneously with device measured sedentary behaviour. Such methods can provide clearer and more relevant evidence to guide families and those working with children. Purpose: The purpose of this study was to evaluate the range of screen use measurement methods available and support researcher selection of the most appropriate method(s). Methods: A narrative review was conducted, built on recent systematic reviews and literature searches of methods used with children, or with the potential to be used with children, to identify measurement challenges and methods along with aspects researchers should consider in method selection. Results: Evolution of technology has increased the complexity of child-technology interactions and thus increased the challenge of adequately capturing sufficiently important aspects of this interaction. Self-/proxy- reporting via questionnaire/diary/electronic sampling, direct observation, visual/audio recording devices, screen device onboard capture, network traffic and content capture, proximity sensors and specialised systems were identified as ways to capture particular aspects of children’s screen use, along with examples of use, and advantages and disadvantages. Conclusions: The complex child-technology interactions may require a combination of methods to provide stronger practical evidence on health implications. Practical implications: Researchers need to look beyond simple measures of screen time to provide evidence with practical detail of relevance for families. Funding: The Australian Research Council Centre of Excellence for the Digital Child.

Background: Screens are omnipresent and can have adverse effects on mental health. Outdoor physical activity (OPA) and group physical activity (GPA) have numerous benefits on mental health. Whether they could buffer the screen time- mental health negative associations remain unknown. Purpose: To estimate the association between occupational and recreational ST and positive mental health (PMH) in adults, and test whether GPA or OPA moderates this association. Methods: Data from the longitudinal NDIT Study are used (n = 623, mean (SD) age = 35.2 (0.6) yrs). The mean amount of hours/day of ST was measured for occupational and recreational contexts. PMH was measured six months later using the Mental Health Continuum-Short Form. The monthly frequency of GPA and OPA was measured using a 6-point Likert scale. Multivariable linear regressions were estimated adjusting for sex, age, education level, and PA volume; moderation was investigated by adding an interaction term (ST*GPA or ST*OPA). Stratified analyses were then conducted to compare frequent and infrequent OPA and GPA subgroups. Results: Adjusted models suggest a negative association for occupational ST (B[95%CI] = -0.3[-0.6, -0.0]) and recreational ST (-1.1[-1.6, -0.7]) and PMH. Adjusted stratified analyses show a lower negative association between occupational ST and PMH in the frequent OPA group (-0.1[-0.5; 0.2]) compared to the infrequent OPA group (-0.6[-1.2; -0.0]). In the context of occupational ST, similar findings were observed for GPA. A similar pattern of results also occurred for recreational ST. Conclusion: The results suggest a negative association between different contexts of ST and PMH in adults. Frequent OPA and GPA could moderate these associations. Practical implications: The moderating effect of GPA and OPA provides a promising avenue for intervention. Further investigations using longitudinal study designs with larger samples are needed.Funding : Réseau de recherche en santé des populations du Québec.

Background: Research shows that parenting practices are associated with physical activity (PA) and screen-time among children, but the differential effects between mothers and fathers remain unclear.Purpose: To synthesize the scientific literature comparing maternal and paternal parenting practices associated with PA and screen-time behaviors among 3-17-year-olds.Methods: We conducted a systematic review of quantitative cross-sectional, longitudinal, and experimental studies published in English from 2000-2021. The search encompassed 10 electronic databases, yielding 15 eligible articles. Study selection and extraction processes followed the PRISMA guidelines.Results: Fifteen papers examined associations between maternal and paternal parenting practices and child total PA (20%), light PA (7%), moderate and vigorous PA (40%), step count (13%), computer use (7%), TV watching (7%), and total screen-time (20%). The majority of studies focused on PA (87%) and a smaller proportion focused on screen-time (27%). The few consistent findings across PA studies highlighted that child PA is linked to greater parental support, modeling and co-participation in PA, whether implemented by both parents or solely by fathers. Conversely, in the screen-time context, significant associations were similarly observed between mothers and fathers, with restriction and monitoring predicting lower screen-time, and modeling unhealthy screen use predicting higher screen-time.Conclusions: These findings suggest distinct parental roles in influencing child PA, but similar influences with respect to screen-time. These results should be interpreted with caution as there is a relatively small number of studies that have compared mothers and fathers, and parenting practices are operationalized differently across studies.Practical implications: This review illustrates opportunities for further research and highlights the critical role of involving fathers in the development and implementation of familial interventions designed to encourage active behaviors in children.Funding: MSHRBC (ODJG); BCCHRI (LCM); USDA/ARS Children’s Nutrition Research Center, BCM (SOH, TMO).

Background: Exposure to screen time and its associations with health and development have been widely investigated in early childhood. However, little is known about how parental use of technology during parent-child interactions, referred to as parental technoference (PT), may influence children’s health and developmental outcomes.Purpose: To systematically review and synthesise current literature on associations between PT and 1) 24-hour movement behaviours (physical activity, sedentary behaviour/screen time and sleep), 2) motor skills, 3) cognitive development and 4) psychosocial health in children aged under five years.Methods: The protocol was registered in PROSPERO (CRD42023418164). Eight electronic databases were searched from inception to December 2023. Inclusion criteria were: 1) quantitative study published in a peer-reviewed journal; 2) PT during interactions with apparently healthy children aged from birth to <5 years; 3) examined an association with children’s 24-hour movement behaviours, cognitive, psychosocial, or motor development. Risk of bias was assessed using JBI’s critical appraisal tools.Results: Twenty-six studies (7102 participants from 12 countries) were eligible for inclusion. The majority of included studies reported associations of PT with psychosocial health outcomes (n=20) while a few reported associations with screen time (n=6) and cognitive skills (n=5). No study examined associations with motor skills. There was variability in the findings; however, a negative impact of PT on children’s cognitive outcomes, screen time, emotions and affectivity was observed.Conclusions: Most studies focused on PT’s impact on children’s psychosocial health, indicating a tendency for PT to trigger specific negative emotions in the early years. The findings underscore the need for further research with larger samples and encompassing additional health and developmental outcomes.Practical implications: Given the ubiquity of technological devices, it would be pertinent to highlight the importance of parental awareness regarding the potential impact of technoference on their children.Funding: Chilean National Scholarship Program for Graduate Studies.

Background: Rising screen time among children contributes to global physical inactivity and health issues.Purpose: this study aims to explore the associations between early-life screen time, executive function and mental health in middle childhood.Methods: This study included 1193 children (49.1% boys) from the Dutch GECKO Drenthe birth cohort. Parents reported TV and computer time at age 3-4 and 10-11. EF was assessed at age 10-11 using the BRIEF questionnaire, and mental health at age 5-6 and 10-11 using the SDQ questionnaire. Analysis included Spearman’s correlation and multiple linear regression, adjusting for BMI, outdoor playtime, and maternal education.Results: Increased TV time at age 3-4 correlated with increased TV time at age 10-11 (p<0.001), while greater computer time at age 3-4 was linked to increased computer time at age 10-11 (p=0.022). TV time was not related with EF. However, more daily computer time at age 10-11 was associated with higher scores in total EF (b=1.41, 0.54 to 2.3), behavioral regulation index (b=1.15, 0.30 to 1.99), and metacognition index (b=1.50, 0.62 to 2.4) in girls, not in boys, indicating worse EF. No such associations were found with computer time at age 3-4. For mental health, more computer time at age 10-11 was associated with poorer prosocial behaviors (r=-0.13, p=0.009) in boys, and more emotional problems (r=0.11, p=0.023) in girls.Conclusions: Children who spent more time in TV and computer tend to continue this pattern into middle childhood. While TV and computer time at age 3-4 were not associated with EF in school-aged children, girls with more computer time at age 10-11 showed poorer EF. Boys with more computer time at age 10-11 might display poorer prosocial behavior, while girls may have emotional problems.Practical implications: This study provides evidence for strategies to reduce screen time and promote physical activity.