Computer usage and its relationship with adolescent lifestyle in Hong Kong

Influences of Smartphone and Computer Use on Health-Related Quality of Life of Early Adolescents

This study explored the daily amount of time that early adolescents spent using smartphones and computers, and their influences on health-related quality of life of early adolescents. A total of 650 early adolescents were recruited. The 36-Item Short Form Health Survey was used to measure their health-related quality of life. The early adolescents reported their average daily time spent using smartphones and computers over the course of the previous week; the majority of early adolescents (71%) spent approximately 1 h a day or less using computers on average or reported no computer use, and 98.8% indicated that they used smartphones for less than 1 h to more than 4 h per day on average. The results showed that the average daily time spent using smartphones was significantly negatively associated with two scales in the physical domain and four scales in the mental domain of health-related quality of life of early adolescents, whereas the average daily time spent using computers was significantly negatively associated with two scales in the mental domain (p < 0.05). Therefore, early adolescents who spent more time using smartphones and computers have significantly poorer outcomes in the physical and mental domains of their health-related quality of life.

Divergent secular trends in blood pressure and body mass index in children and adolescents in Hong Kong

Secular trends in blood pressure (BP) and body mass index (BMI) during childhood and adolescence are sentinels for the future population cardiovascular disease burden. We examined trends in BP z-score (ages 9-18 years from 1999 to 2014) and BMI z-score (ages 6-18 years from 1996 to 2014) in Hong Kong, China. Overall, BP z-score fell, systolic BP from 0.08 to -0.01 in girls and from 0.31 to 0.25 in boys. However, the trends were not consistent, for both sexes, systolic BP z-score was stable from 1999, decreased slightly from 2002 to 2005 and increased slightly to 2014, diastolic BP z-score decreased slightly from 1999 to 2004 and then remained stable to 2014. In contrast, BMI z-score rose from -0.15 to -0.01 in girls and from 0.14 to 0.34 in boys, mainly during 1997 to 2010. The upper tail of the systolic (except boys) and diastolic BP distribution shifted downwards, whereas the entire BMI distribution shifted upward. BP declined slightly whereas BMI rose in Hong Kong children and adolescents during the last 20 years, with systolic BP and BMI in boys above the reference. This warrants dual action in tackling rising BMI and identifying favorable determinants of BP, particularly targeting boys.

Musculoskeletal impact of the use of various types of electronic devices on university students in Hong Kong: An evaluation by means of self-reported questionnaire

INTRODUCTION

Despite the increasingly widespread popularity of electronic devices, there are limited comprehensive studies on the effects of usage and exposure to multiple electronic devices over extended periods of time. Therefore, this study explored the cumulative musculoskeletal implications of exposure to various electronic devices among university students.

METHODS

A self-reported questionnaire was administered in the university in Hong Kong and students provided information about the frequency and duration of electronic devices use, including computers, mobile phones and game consoles, and reported on any musculoskeletal pain or discomfort that may relate to electronic devices usage in the immediate 12 months prior to the survey date.

RESULTS

A total of 503 university students (59% males and 41% females) aged 18-25 years completed the questionnaire. The results showed that 251 (49.9%) respondents reported upper limb musculoskeletal symptoms, particularly in the neck and shoulder regions. Among these, 155 (61.8%) indicated that their discomfort was related to electronic device usage. Statistically significant differences in exposure to electronic devices and musculoskeletal outcomes between genders were found (p < 0.05).

CONCLUSION

The use of electronic devices and habitual postures were associated with musculoskeletal problems among university students in Hong Kong. This phenomenon highlights the urgent need for ergonomics education and recommendations to increase students' awareness of musculoskeletal wellbeing.

Impact of information and communication technology on child health

This article provides a general framework for understanding the use of information and communication technology in education and discusses the impact of computer usage on students' health and development. Potential beneficial and harmful effects of computer use by children are discussed. Early epidemiological and laboratory studies have indicated that children are at least of similar risk of developing musculoskeletal and vision problems as adults, and musculoskeletal and visual health problems developed in childhood are likely to persist into adulthood. This article, therefore, aims to provide a reflection on the deficits of existing policy and recommendations for child-specific guidelines in computer use.

A Six-Year Longitudinal Study of Consumption of Pornographic Materials in Chinese Adolescents in Hong Kong

STUDY OBJECTIVE

Using longitudinal data collected over 6 years, consumption of pornographic materials in adolescents in Hong Kong and the related demographic and psychosocial correlates were examined in this study. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A longitudinal research design with 6 waves of data was used to examine consumption of pornographic materials in high school students. A total of 3291 high school students from 28 schools responded to the questionnaire at wave 1.

RESULTS

Consumption of online pornography was higher than traditional pornography. There was an increase in consumption of pornographic materials in the high school years. Gender, family functioning, and positive youth development were related to the initial status of pornography consumption. Besides, gender, family intactness and positive youth development predicted rates of change in consumption of pornographic material over time.

CONCLUSION

The present findings showed that gender, family functioning, and positive youth development are significant predictors for pornography consumption in Chinese adolescents.

Association between screen viewing duration and sleep duration, sleep quality, and excessive daytime sleepiness among adolescents in Hong Kong

Screen viewing is considered to have adverse impacts on the sleep of adolescents. Although there has been a considerable amount of research on the association between screen viewing and sleep, most studies have focused on specific types of screen viewing devices such as televisions and computers. The present study investigated the duration with which currently prevalent screen viewing devices (including televisions, personal computers, mobile phones, and portable video devices) are viewed in relation to sleep duration, sleep quality, and daytime sleepiness among Hong Kong adolescents (N = 762). Television and computer viewing remain prevalent, but were not correlated with sleep variables. Mobile phone viewing was correlated with all sleep variables, while portable video device viewing was shown to be correlated only with daytime sleepiness. The results demonstrated a trend of increase in the prevalence and types of screen viewing and their effects on the sleep patterns of adolescents.

The deformation and longitudinal excursion of median nerve during digits movement and wrist extension

The use of electronic devices, such as mobile phones and computers, has increased drastically among the young generation, but the potential health effects of carpal tunnel syndrome (CTS) on university students has not been comprehensively examined. Thirty-one university students aged 18 to 25 y with no symptoms of CTS were successfully recruited in this study. By using noninvasive ultrasonography, the morphological characteristics of the median nerve of each volunteer, and the extent of its longitudinal excursion movement under experimental conditions, in which a real operating environment of electronic devices was simulated, were quantified. The results demonstrated that the median nerve at the carpal tunnel inlet was flattened during wrist extension: the flattening ratio increased from 3.40 ± 0.91 at the neutral position to 4.10 ± 1.11 at the angle of 30° and 4.09 ± 1.11 at the angle of 45°. In addition, the median nerve became swollen after the students performed rapid mobile-phone keying for 5 min, indicated by a significant increase in the cross-sectional area from 6.05 ± 0.97 mm(2) to 7.56 ± 1.39 mm(2). Passive longitudinal excursion was observed at the median nerve when the students performed mouse-clicking (2.4 ± 1.0 mm) and mobile-phone keying tasks (1.7 ± 0.6 mm), with the mouse-clicking task generating a greater extent of longitudinal excursion than the mobile-phone keying task did. In conclusion, the findings of the present study verify the potential harm caused by using electronic devices while maintaining an inappropriate wrist posture for a substantial period.

From 'What the F#@% is a Facebook?' to 'Who Doesn't Use Facebook?': The role of criminal lifestyles in the adoption and use of the Internet

Concerns about a digital divide persist and recent calls have been made for understanding how lifestyles influence Internet adoption and use. Online criminal behaviors have drawn attention from law enforcement, but diffusion of innovation theory suggests higher propensities for crime, particularly street crime, reduces the likelihood of Internet use. Drawing from this theory and research on the role of street criminal lifestyles on technology adoption, this study examined patterns of Internet use among a sample of 585 individuals at-risk for and involved in street crime. Results from our logistic and negative binomial regression analyses lead to two general conclusions: (1) compared to research on the general population, similar predictors and lower rates of Internet participation and usage are observed, and (2) mixed evidence suggests participation in criminal lifestyles contributes to digital inequality. The results support a theory of technological diffusion to marginalized populations. We conclude by discussing the expansion of technology, digital inequality, and crime.

Physical Activity Research in Hong Kong From 1987 to 2012

A comprehensive understanding of research on the physical activity (PA) of Hong Kong youth is necessary to develop specific and effective intervention strategies. This review summarizes existing evidence in studies on PA among the Hong Kong youth. An electronic literature search was conducted using MEDLINE, SPORTDiscus, ERIC, and HighWire database. Forty-five studies published from 1987 to 2012 were included in this review. The findings are presented in five categories, namely, health benefits of PA, participation in PA, assessment of PA, correlates of PA, and interventions to promote PA. The results indicate that PA among the youth in Hong Kong has attracted concern in the past decade. Specifically, extensive studies focused on the areas of health benefits of PA, participation in PA, and correlates of PA. Research into context-specific correlates of PA and tailored PA promotion programs for the Hong Kong youth is warranted in the future.

Correlates of physical activity and screen-based behaviors in Chinese children

OBJECTIVES

To investigate individual, behavioral, social and environmental correlates of physical activity (PA) and screen-based behaviors ([SBBs] TV viewing, electronic games playing and Internet use) in Chinese boys and girls in Hong Kong.

DESIGN

Cross-sectional study.

METHODS

PA and SBBs were self-reported among 303 children. Individual, behavioral, social and environmental correlates were reported by children and parents. Children's height and weight were measured and population density of residence districts was divided into tertiles. Hierarchical multivariable regression analyses were conducted to determine the contributions of correlates in explaining PA and SBBs.

RESULTS

Participation in school sport teams and self-efficacy was positively associated with PA in boys. Girls who reported participation in school sport teams, who perceived more peer support, had a more supportive home PA environment, and spent more time doing homework were more physically active. Family support for PA was negatively and homework was positively, associated with boys' SBBs. Body mass index and parent role modeling of TV was positively associated with TV viewing, whilst more sedentary opportunities in the home were associated with higher Internet use/e-games playing among girls.

CONCLUSIONS

Sex differences existed among the individual, behavioral, social and home environmental factors related to PA and SBBs. Interventions should consider multiple and sex-specific factors for promoting an active lifestyle and reducing sedentary time among Chinese children.

Motives for using Facebook, patterns of Facebook activities, and late adolescents' social adjustment to college

Previous studies have confirmed that Facebook, the leading social networking site among young people, facilitates social connections among college students, but the specific activities and motives that foster social adjustment remain unclear. This study examined associations between patterns of Facebook activity, motives for using Facebook, and late adolescents' social adjustment to the college environment. Anonymous self-report survey data from 193 mostly European American students (M age = 20.32; 54 % female) attending a major Midwestern university indicated that motives and activity patterns were associated directly with social adjustment, but the association between one activity, status updating, and social adjustment also was moderated by the motive of relationship maintenance. Findings provide a more comprehensive portrait of how Facebook use may foster or inhibit social adjustment in college.

The associations between self-reported sleep duration and adolescent health outcomes: what is the role of time spent on Internet use?

OBJECTIVE

This study aimed to examine the associations of self-reported sleep duration with adolescent health outcomes, taking into account time spent on Internet use.

METHODS

We used data from the 2008-2009 Korea Youth Behavioral Risk Factor Survey, a cross-sectional online survey of middle and high school students aged 13-18years in South Korea (N=136,589) to examine the associations of self-reported sleep duration with four mental and physical health measures, e.g. self-report of depressive symptoms, suicidal ideation, weight status, and self-rated health. The binary logit and generalized ordered logit models controlled for time spent on Internet use for non-study purposes and other factors.

RESULTS

Shorter self-reported sleep duration was associated with a higher likelihood of reporting depressive symptoms, suicidal ideation, and overweight or obese status, and a lower likelihood of reporting better self-rated health, even after accounting for time spent on Internet use. Excessive Internet use was found to be an independent risk factor for these outcomes.

CONCLUSIONS

Among in-school adolescents in South Korea, shorter sleep duration and excessive Internet use are independently and additively associated with multiple indicators of adverse health status. Excessive Internet use may have not only direct adverse health consequences, but also have indirect negative effects through sleep deprivation.

Brief report: Association between socio-demographic factors, screen media usage and physical activity by type of day in Spanish adolescents

This study examined the relationship between socio-demographic factors, screen media time usage, and light, moderate and vigorous activities on weekdays and weekends. Cross-sectional data was collected from 323 Spanish adolescents (mean age 13.59 years) who completed an interview administered recall questionnaire. Structural equation models indicated that male and younger adolescents spent more time on vigorous activities at the weekend, while females and older adolescents showed a greater involvement in light activities both on weekdays and weekends. State school students reported engaging in light and vigorous activities for longer periods than private school students on weekends. TV viewing was negatively linked to vigorous activities during weekdays and to light and moderate activities on weekends. The amount of mobile phone usage, however, was positively linked to light activities during weekdays, but negatively on weekends. The negative relationship between adolescents' use of screen media (TV and mobile phone) and physical activity and its possible displacement, depending on the type of day, added useful comparable knowledge for policies promoting an active lifestyle. Further research is required to provide evidence of the causality in the observed relationships.

Evidence-based guidelines for the wise use of computers by children: physical development guidelines

Computer use by children is common and there is concern over the potential impact of this exposure on child physical development. Recently principles for child-specific evidence-based guidelines for wise use of computers have been published and these included one concerning the facilitation of appropriate physical development. This paper reviews the evidence and presents detailed guidelines for this principle. The guidelines include encouraging a mix of sedentary and whole body movement tasks, encouraging reasonable postures during computing tasks through workstation, chair, desk, display and input device selection and adjustment and special issues regarding notebook computer use and carriage, computing skills and responding to discomfort. The evidence limitations highlight opportunities for future research. The guidelines themselves can inform parents and teachers, equipment designers and suppliers and form the basis of content for teaching children the wise use of computers. STATEMENT OF RELEVANCE: Many children use computers and computer-use habits formed in childhood may track into adulthood. Therefore child-computer interaction needs to be carefully managed. These guidelines inform those responsible for children to assist in the wise use of computers.

Electronic game play and school performance of adolescents in southern Thailand

Increasing exposure of children and adolescents to electronic media is a worldwide phenomenon, including in Thailand. To date, few studies examine electronic game play in Thai adolescents. Our research describes the prevalence of electronic game play and examines associations between the time spent engaged in electronic game play and school performance of adolescents in Hat-Yai municipality. A cross-sectional study was conducted among 1,492 adolescents from four secondary schools and one commercial college from January through March 2007, using questionnaires for collecting information about demographic data, school grades, and electronic game play behaviors. The prevalence of electronic game play was 75% in boys and 59% in girls. Twenty-two percent of boys and 8.7% of girls played electronic games every day with more than 2 hours per session. The two most common places of game play were at game shops (71%), followed by at their own home (70%). Using linear regression analysis, the "low user or less than 2 hours per session" game players and females were less likely to have school grades below 3.00 with adjusted odds ratios of 0.44 (95% CI 0.25-0.80, p = 0.004) and 0.49 (95% CI 0.30-0.76, p = 0.005) respectively. This study finds that excessive playing of electronic games is associated with school grades below 3.00.

Principles for the wise use of computers by children

Computer use by children at home and school is now common in many countries. Child computer exposure varies with the type of computer technology available and the child's age, gender and social group. This paper reviews the current exposure data and the evidence for positive and negative effects of computer use by children. Potential positive effects of computer use by children include enhanced cognitive development and school achievement, reduced barriers to social interaction, enhanced fine motor skills and visual processing and effective rehabilitation. Potential negative effects include threats to child safety, inappropriate content, exposure to violence, bullying, Internet 'addiction', displacement of moderate/vigorous physical activity, exposure to junk food advertising, sleep displacement, vision problems and musculoskeletal problems. The case for child specific evidence-based guidelines for wise use of computers is presented based on children using computers differently to adults, being physically, cognitively and socially different to adults, being in a state of change and development and the potential to impact on later adult risk. Progress towards child-specific guidelines is reported. Finally, a set of guideline principles is presented as the basis for more detailed guidelines on the physical, cognitive and social impact of computer use by children. The principles cover computer literacy, technology safety, child safety and privacy and appropriate social, cognitive and physical development. The majority of children in affluent communities now have substantial exposure to computers. This is likely to have significant effects on child physical, cognitive and social development. Ergonomics can provide and promote guidelines for wise use of computers by children and by doing so promote the positive effects and reduce the negative effects of computer-child, and subsequent computer-adult, interaction.

The associations between information and communication technology (ICT) and peer and parent relations in early adolescence

The study aims were, first, to examine the associations between the type and intensity of ICT (Information and Communication Technology) and peer and parent relationships. Second, the study explored gender- and age-specific ICT usage and their associations with peer and parent relationships. The participants were 478 Finnish 10- and 13-year-old girls and boys. They reported the frequencies of digital game playing, using a computer for information seeking, communication, and Internet surfing, and evaluated the qualities of peer relationships (popularity, loneliness, and friendship) and communication with mother and father (open and conflicting). As hypothesized, intensive usage of ICT for entertainment (digital playing and Internet surfing) was associated with poor relations with both peers and parents, while intensive usage of ICT for communication (email and chat rooms) was associated with good peer relations, and poor parent relations. The associations were, however, gender-specific. Among girls intensive digital game playing was associated with poor mother—daughter and among boys with poor father—son communication. ICT is discussed as provider of new tools for playing, exploring, and communicating in childhood and adolescence.

Electronic media use and adolescent health and well-being: cross-sectional community study

OBJECTIVE

To describe time adolescents spend using electronic media (television, computer, video games, and telephone); and to examine associations between self-reported health/well-being and daily time spent using electronic media overall and each type of electronic media.

METHODS

Design-Cross-sectional data from the third (2005) wave of the Health of Young Victorians Study, an Australian school-based population study. Outcome Measures-Global health, health-related quality of life (HRQoL; KIDSCREEN), health status (Pediatric Quality of Life Inventory 4.0; PedsQL), depression/anxiety (Kessler-10), and behavior problems (Strengths and Difficulties Questionnaire). Exposure Measures-Duration of electronic media use averaged over 1 to 4 days recalled with the Multimedia Activity Recall for Children and Adolescents (MARCA) computerized time-use diary. Analysis-Linear and logistic regression; adjusted for demographic variables and body mass index z score.

RESULTS

A total of 925 adolescents (mean +/- standard deviation age, 16.1+/-1.2 years) spent, on average, 3 hours 16 minutes per day using electronic media (television, 128 minutes per day; video games, 35; computers, 19; telephone, 13). High overall electronic media use was associated with poorer behavior, health status, and HRQoL. Associations with duration of specific media exposures were mixed; there was a favorable association between computer use (typing/Internet) and psychological distress, whereas high video game use was associated with poorer health status, HRQoL, global health, and depression/anxiety. Television and telephone durations were not associated with any outcome measure.

CONCLUSIONS

Despite television's associations with obesity, time spent in other forms of media use appear more strongly related to adolescent health and well-being. This study supports efforts to reduce high video game use and further exploration of the role of computers in health enhancement.

Family circumstance, sedentary behaviour and physical activity in adolescents living in England: Project STIL

BACKGROUND

Identification of non-modifiable correlates of physical activity and sedentary behaviour in youth contributes to the development of effective targeted intervention strategies. The purpose of this research was to examine the relationships between family circumstances (e.g. socio-economic status, single vs. dual parent household, presence/absence of siblings) and leisure-time physical activity and sedentary behaviours in adolescents.

METHODS

A total of 1171 adolescents (40% male; mean age 14.8 years) completed ecological momentary assessment diaries every 15 minutes for 3 weekdays outside of school hours and 1 weekend day. Analysed behaviours were sports/exercise, active travel, TV viewing, computer use, sedentary socialising (hanging-out, using the telephone, sitting and talking) and total sedentary behaviour. Linear regression was employed to estimate levels of association between individual family circumstance variables and each behaviour.

RESULTS

Compared to girls from higher socioeconomic status (SES) groups, girls from low SES groups reported higher weekend TV viewing and higher weekday total sedentary behaviour. For boys, single parent status was associated with greater total sedentary behaviour compared to those from dual parent households. Boys and girls from low socio-economic neighbourhoods reported lower participation in sports/exercise compared to those living in higher socio-economic neighbourhoods.

CONCLUSION

Associations were not consistent across behaviours or between genders. Overall, findings indicate that boys from single parent households and girls from low socio-economic families may be at increased risk of high sedentary behaviour. Those living in low socioeconomic neighbourhoods may be at increased risk of reduced participation in sports and exercise.

Computer use and habitual spinal posture in Australian adolescents

OBJECTIVE

Computer use is common in adolescents, and there is evidence that adolescent spinal posture alters during computer use. However, it is unknown if computer use and habitual postures are associated. The objective of this study was to evaluate associations between adolescent computer use and habitual postures.

METHODS

Eight hundred eighty-four adolescents (408 females, 476 males, mean age, 14.0 years, standard deviation, 0.2) completed a questionnaire assessing weekly computer use. Habitual spinal posture was assessed by photographic analysis while standing and sitting.

RESULTS

Computer use was associated with adolescent habitual postures. In males, increased computer use was associated with increased head flexion and neck flexion. In females, increased computer use was associated with increased lumbar lordosis.

CONCLUSIONS

The amount of weekly computer use was associated with changes in habitual spinal postures, and these depended on gender. These associations may result from temporary computer postures leading to adaptive neuromusculoskeletal changes, though further multivariate and longitudinal studies are needed to confirm causality. As some habitual posture changes may place a greater strain on the musculoskeletal system, computer use by adolescents should be viewed as a possible health concern.

Changes in sedentary behavior among adolescent girls: a 2.5-year prospective cohort study

PURPOSE

To describe longitudinal changes in leisure-time sedentary behavior among girls, during early to mid-adolescence.

METHODS

A 2.5-year prospective cohort study, comprising 5 data collections, 6 months apart, between 2000 and 2002. Girls aged 12-15 years (n = 200) from 8 high schools located in Sydney, Australia, self-reported the usual time spent each week in a comprehensive range of sedentary behaviors.

RESULTS

Retention rate for the study was 82%. Girls aged 12.8 years spent approximately 45% of their discretionary time in sedentary behavior, which increased to 63% at age 14.9 years. Watching TV, videos, and playing video games (small screen recreation; SSR) was the most popular sedentary pastime, accounting for 33% of time spent in sedentariness, followed by homework and reading (25%). Sedentary behavior increased 1.4 and 3.3 hours on week and weekend days, respectively. On weekdays, increased time was spent on hobbies (27 min/day) and on weekend days, increased time was spent sitting around talking with friends (60 min/day), computer use (37 min/day), and television viewing (34 min/day).

CONCLUSIONS

Among girls, the transition between early and mid-adolescence was accompanied by a significant increase in leisure-time sedentary behavior. Interventions to reduce sedentariness among adolescent girls are best to focus on weekend behaviors. Studies seeking to examine the association between inactivity and the development of chronic health problems need to examine a diverse range of activities that comprehensively measure sedentariness. This information will provide a better understanding of inactivity patterns among adolescent girls.

Descriptive epidemiology of small screen recreation among Australian adolescents

AIM

To describe the epidemiology of small screen recreation (SSR) that is: television, computer, video, and DVD use among school students aged 11-15 years in New South Wales, Australia.

METHODS

Cross-sectional representative population survey (n=2750) of 45 primary and 48 secondary schools in rural and urban areas. Self-reported time spent in SSR was categorised according to national guidelines into less than 2 h per day (low users) or 2 or more hours per day (high users).

RESULTS

Of primary and secondary school students, 53% and 72%, respectively, were high users of SSR. Boys spent significantly more time in SSR and were more likely to be high users of SSR compared with girls. For primary students, rural boys had a higher prevalence of high SSR use than urban boys (odds ratio (OR) 1.9, 95% confidence interval (CI) 1.0-3.5), while overweight girls had a higher prevalence than healthy-weight girls (OR 1.8, 95% CI 1.2-2.8). For secondary students, rural boys had a lower prevalence of high SSR use than urban boys (OR 0.5, 95% CI 0.3-0.6), and girls from high SES backgrounds had a lower prevalence than girls from low socio-economic status backgrounds (OR 0.6, 95% CI 0.3-1.0).

CONCLUSION

The majority of school students in New South Wales exceed the national guidelines for SSR. Reducing the time spent in SSR among young people is one potential approach to increasing energy expenditure and reducing adiposity or maintaining a healthy weight. First steps for intervention strategies among school-age children to reduce SSR could include teaching awareness skills and self-monitoring techniques.

The relationship between sedentary activities and physical inactivity among adolescents: results from the Canadian Community Health Survey

PURPOSE

To evaluate the relationships between the time spent on sedentary activities (computer usage, video game playing, television viewing, and reading) and physical inactivity in a sample of youth (aged 12-19 years) from the 2000-2001 Canadian Community Health Survey.

METHODS

The study sample included 7982 youth (4034 males, 3948 females) across Canada (mean age: 15.61 years, SD: 2.23 years). Weekly time spent on computers, video games, television, and reading during leisure-time was obtained through self-reported questionnaires. Physical inactivity was determined by respondents' daily energy expenditure assessed through a physical activity questionnaire. Multivariate logistic regression analysis was conducted to examine the relationship between sedentary activities and physical inactivity respectively by gender. Sociodemographic variables, health status, and overweight status were controlled in the analysis.

RESULTS

A substantial proportion of Canadian youth was inactive: 50.3% of males and 67.8% of females. Controlling for sociodemographic variables, health status, and body mass index, television viewing was significantly associated with physical inactivity for both males and females regardless of their overweight status. However, computer usage was associated with physical activity among males, and reading was associated with physical activity among females.

CONCLUSIONS

There is a complex inter-relationship between sedentary behaviors and physical inactivity, highlighting the need for targeted interventions addressing patterns of sedentary behavior engagement. Reducing time spent on television viewing may be one plausible strategy within such interventions in reducing physical inactivity among youth.

Use of information and communication technology (ICT) and perceived health in adolescence: the role of sleeping habits and waking-time tiredness

The first aim for this paper was to examine gender and age differences in the intensity of usage of information and communication technology (ICT: computer for digital playing, writing and e-mailing and communication, and Internet surfing, and mobile phone). Second, we modelled the possible mediating role of sleeping habits and waking-time tiredness in the association between ICT usage and perceived health (health complaints, musculoskeletal symptoms, health status). The participants were 7292 Finns aged 12, 14, 16 and 18 years responding to a postal enquiry (response rate 70%). The results showed that boys played digital games and used Internet more often than girls, whose mobile phone usage was more intensive. Structural equation model analyses substantiated the mediating hypothesis: intensive ICT-usage was associated with poor perceived health particularly or only when it negatively affected sleeping habits, which in turn was associated with increased waking-time tiredness. The associations were gender-specific especially among older adolescents (16- and 18-year olds). Intensive computer usage forms a risk for boys', and intensive mobile phone usage for girls' perceived health through the mediating links. Girls were vulnerable to the negative consequences of intensive mobile phone usage, as it associated with perceived health complaints and musculoskeletal symptoms both directly and through deteriorated sleep and increased waking-time tiredness. The results of gender-specific ICT usage and vulnerability are discussed as reflecting gendered psychophysiological, psychological and social developmental demands.

Pain and musculoskeletal pain syndromes related to computer and video game use in adolescents

The objective of the present study was to evaluate the presence of pain and musculoskeletal pain syndromes in adolescents and associate them to computer and video game use. A cross-sectional study was performed on the entire adolescent population (n=833) of a private situated in the city of São Paulo. The research included a questionnaire and physical examination of the musculoskeletal system. Statistical analysis was carried out with Fisher, chi-square, Mann Whitney tests and logistic regression. A total of 791 adolescent was evaluated. A computer was used by 99% and video games by 58%. Pain was reported by 312 (39.4%) students: 23% complained of back pain, 9% of upper limb pain, 4% of diffuse pain and 4% of pain in the trapezium muscle. A clinical examination was carried out in 359 students, and one or more musculoskeletal pain syndromes were present in 56 students (15.6%): benign joint hypermobility syndrome in 10%, myofascial syndrome in 5%, tendonitis in 2% and fibromyalgia in 1%. In the multivariate analysis, the logistical regression showed that the independent variables in the prediction of pain were sex [odds ratio (OR): 2.19, 95% confidence interval (95% CI): 1.33-3.61] and age (OR: 1.17, 95% CI: 1.07-1.28) and that the prediction of musculoskeletal pain syndromes were sex (OR: 3.17, 95% CI: 1.69-6.22) and number of days a week using the computer (OR: 1.22, 95% CI: 1.05-1.42). However, the variations in the dependent variables by the mathematical regression models were low. Despite the frequent use of computer and video games among adolescents, this was not associated with the presence of pain and musculoskeletal pain syndromes.

Use of information and communication technology and prevalence of overweight and obesity among adolescents

BACKGROUND

The prevalence of overweight and obesity has increased among children and adolescents, as well as among adults, and television viewing has been suggested as one cause. Playing digital games (video, computer and console games), or using computer may be other sedentary behaviors related to the development of overweight and obesity.

OBJECTIVE

To study the relationships of times spent on viewing television, playing digital games and using computer to overweight among Finnish adolescents.

DESIGN

Mailed cross-sectional survey.

SUBJECTS

Nationally representative samples of 14-, 16-, and 18-y-old (N=6515, response rate 70%) in 2001.

METHODS

Overweight and obesity were assessed by body mass index (BMI). The respondents reported times spent daily on viewing television, playing digital games (video, computer and console games) and using computer (for e-mail, writing and surfing). Data on timing of biological maturation, intensity of weekly physical activity and family's socio economic status were taken into account in the statistical analyses.

RESULTS

Increased times spent on viewing television and using computer were associated with increased prevalence of overweight (obesity inclusive) among girls: compared to girls viewing television <1 h daily, the adjusted odds ratio (OR) for being overweight was 1.4 when spending 1-3 h, and 2.0 when spending > or =4 h daily on viewing television. In girls using computer > or =1 h daily, the OR for being overweight was 1.5 compared to girls using computer <1 h daily. The results were similar in boys, although not statistically significant. Time spent on playing digital games was not associated with overweight.

CONCLUSION

Overweight was associated with using information and communication technology (ICT), but only with certain forms of ICT. Increased use of ICT may be one factor explaining the increased prevalence of overweight and obesity at the population level, at least in girls. Playing digital games was not related to overweight, perhaps by virtue of game playing being less sedentary or related to a different lifestyle than viewing television and using computer.

Gender, Internet Identification, and Internet Anxiety: Correlates of Internet Use

This paper reports a study that investigated the effects of gender, Internet anxiety, and Internet identification on use of the Internet. The study involved 608 undergraduate students (490 females and 118 males). We surveyed the students' experience with the Internet, as well as their levels of Internet anxiety and Internet identification. We found a number of gender differences in participants' use of the Internet. Males were proportionally more likely to have their own web page than were females. They used the Internet more than females; in particular, they were more likely to use game websites, to use other specialist websites, and to download material from the Internet. However, females did not use the Internet for communication more than males. There was a significant positive relationship between Internet identification and total use of the Internet, and a significant negative relationship between Internet anxiety and total use of the Internet. Controlling for Internet identification and Internet anxiety, we found a significant and negative correlation between gender and use of the Internet. In total, all three of our predictors accounted for 40% of the variance in general Internet use: with Internet identification accounting for 26%, Internet anxiety accounting for 11%, and gender accounting for 3%.

Optimizing the interaction of children with information and communication technologies

This paper outlines the major changes in the lives of children in industrially advanced countries associated with the increased interaction with information and communication technologies. The potential opportunities and threats to the cognitive, social, physical and visual development of children are reviewed to emphasize the importance of optimizing the interaction. The change in children's use of technology also poses opportunities and threats for ergonomics that should be noted if the profession is to continue being relevant and useful into this century. The paper ends with a pathway to the development and implementation of guidelines about child information and communication technology use for different groups of guideline users.

Relationships between media use, body fatness and physical activity in children and youth: a meta-analysis

OBJECTIVE

To review the empirical evidence of associations between television (TV) viewing, video/computer game use and (a) body fatness, and (b) physical activity.

DESIGN

Meta-analysis.

METHOD

Published English-language studies were located from computerized literature searches, bibliographies of primary studies and narrative reviews, and manual searches of personal archives. Included studies presented at least one empirical association between TV viewing, video/computer game use and body fatness or physical activity among samples of children and youth aged 3-18 y.

MAIN OUTCOME MEASURE

The mean sample-weighted corrected effect size (Pearson r).

RESULTS

Based on data from 52 independent samples, the mean sample-weighted effect size between TV viewing and body fatness was 0.066 (95% CI=0.056-0.078; total N=44,707). The sample-weighted fully corrected effect size was 0.084. Based on data from six independent samples, the mean sample-weighted effect size between video/computer game use and body fatness was 0.070 (95% CI=-0.048 to 0.188; total N=1,722). The sample-weighted fully corrected effect size was 0.128. Based on data from 39 independent samples, the mean sample-weighted effect size between TV viewing and physical activity was -0.096 (95% CI=-0.080 to -0.112; total N=141,505). The sample-weighted fully corrected effect size was -0.129. Based on data from 10 independent samples, the mean sample-weighted effect size between video/computer game use and physical activity was -0.104 (95% CI=-0.080 to -0.128; total N=119,942). The sample-weighted fully corrected effect size was -0.141.

CONCLUSION

A statistically significant relationship exists between TV viewing and body fatness among children and youth although it is likely to be too small to be of substantial clinical relevance. The relationship between TV viewing and physical activity is small but negative. The strength of these relationships remains virtually unchanged even after correcting for common sources of bias known to impact study outcomes. While the total amount of time per day engaged in sedentary behavior is inevitably prohibitive of physical activity, media-based inactivity may be unfairly implicated in recent epidemiologic trends of overweight and obesity among children and youth. Relationships between sedentary behavior and health are unlikely to be explained using single markers of inactivity, such as TV viewing or video/computer game use.

Visual Stimuli in Daily Life

People of all ages, but especially children and adolescents, are increasingly exposed to visual stimuli. Typical environmental stimuli that can trigger epileptic seizures in susceptible persons are televisions (TVs), computers, videogames (VGs), discothèque lights, venetian blinds, striped walls, rolling stairs (escalators), striped clothing, and sunlight reflected from snow or the sea or interrupted by trees during a ride in a car or train. Less common stimuli are rotating helicopter blades, disfunctioning fluorescent lighting, welding lights, etc. New potentially provocative devices turn up now and then unexpectedly. During the last decades especially, displays have become increasingly dominant in many of our daily-life activities. We therefore focus mainly on the characteristics of artificial light and on current and future developments in video displays and videogames. Because VG playing has been shown also to have positive effects, a rating system might be developed for provocativeness to inform consumers about the content. It is important that patients with epilepsy be informed adequately about their possible visual sensitivity.

How adolescents use technology for health information: implications for health professionals from focus group studies

BACKGROUND

Adolescents present many challenges in providing them effective preventive services and health care. Yet, they are typically the early adopters of new technology (eg, the Internet). This creates important opportunities for engaging youths via eHealth.

OBJECTIVE

To describe how adolescents use technology for their health-information needs, identify the challenges they face, and highlight some emerging roles of health professionals regarding eHealth services for adolescents.

METHODS

Using an inductive qualitative research design, 27 focus groups were conducted in Ontario, Canada. The 210 participants (55% female, 45% male; median age 16 years) were selected to reflect diversity in age, sex, geographic location, cultural identity, and risk. An 8-person team analyzed and coded the data according to major themes.

RESULTS

Study participants most-frequently sought or distributed information related to school (89%), interacting with friends (85%), social concerns (85%), specific medical conditions (67%), body image and nutrition (63%), violence and personal safety (59%), and sexual health (56%). Finding personally-relevant, high-quality information was a pivotal challenge that has ramifications on the depth and types of information that adolescents can find to answer their health questions. Privacy in accessing information technology was a second key challenge. Participants reported using technologies that clustered into 4 domains along a continuum from highly-interactive to fixed information sources: (1) personal communication: telephone, cell phone, and pager; (2) social communication: e-mail, instant messaging, chat, and bulletin boards; (3) interactive environments: Web sites, search engines, and computers; and (4) unidirectional sources: television, radio, and print. Three emerging roles for health professionals in eHealth include: (1) providing an interface for adolescents with technology and assisting them in finding pertinent information sources; (2) enhancing connection to youths by extending ways and times when practitioners are available; and (3) fostering critical appraisal skills among youths for evaluating the quality of health information.

CONCLUSIONS

This study helps illuminate adolescent health-information needs, their use of information technologies, and emerging roles for health professionals. The findings can inform the design and more-effective use of eHealth applications for adolescent populations.

Validation of a new scale for measuring problematic internet use: implications for pre-employment screening

The current study introduced a theory-driven, multidimensional measure of problematic Internet use: the Online Cognition Scale (OCS). Undergraduate students (n = 211) in an industrial/organizational psychology course completed the OCS, along with measures of procrastination, rejection sensitivity, loneliness, depression, and impulsivity. A confirmatory factor analysis indicated that problematic Internet use consists of four dimensions: diminished impulse control, loneliness/depression, social comfort, and distraction. As hypothesized, the OCS predicted all of the study variables in the expected directions. Representing a departure from previous research in this area, the current article focused on procrastination, impulsivity, and social rejection as key elements of problematic Internet use. Furthermore, interactive applications (e.g., chat) were most related to problematic Internet use, and scores on the OCS predicted being reprimanded at school or work for inappropriate Internet use. As a result, the utility of the OCS for both clinical assessment of Internet addiction and as an organizational preemployment screening measure to identify potential employees who are likely to abuse the Internet in the workplace (also known as "cyberslacking") were discussed.